Doctors on the Navajo Nation fear the human immunodeficiency virus (HIV) may become an epidemic on the reservation if education and prevention outreach efforts do not increase and prove effective.
Since 1999, new HIV cases on Navajo land have risen fivefold, and 47 Navajo residents were diagnosed with HIV in 2012, up 20 percent from 2011.
In the 1980s, AIDS took the remote Four Corners reservation by surprise. Men would walk in to clinics with a cough and die days later.
Early detection has increased. But the stigma still remains.
“They are afraid of rejection,” said Melvin Harrison, the executive director of the Navajo AIDS Network. Of the 65 people his group treats, the great majority keep their diagnosis a secret from family and friends, Harris said.
As a result, the disease continues to spread.
It was previously thought that Navajo residents were contracting HIV in outside towns, but now doctors suspect a worrisome trend: Navajo members are passing the infectious disease to one another.
“H.I.V. in Indian country is very different than the rest of the world,” Dr. Susan V. Karol, a member of the Tuscarora Indian Nation and Indian Health Service’s chief medical officer, told the Times. “Our communities are very small, and that can lead to people avoiding stigma, rather than getting the care they need.”
To reverse this trend and foster acceptance and open dialogue about HIV and AIDS, the tribe’s health department, the Navajo AIDS Network and Dr. Iralu’s clinic are all leading outreach efforts, running public service campaigns in Navajo, promoting awareness through social media, and distributing condoms.
“I’m afraid that if we wait too long,” Dr. Iralu said, “it could turn into a true epidemic.”