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Objectives: To review the epidemiology, research, and prevention programs for sexually transmitted diseases in American Indians and Alaska Natives (AI/ANs). Study Design: We reviewed the current national and regional trends in sexually transmitted diseases (STDs) for AI/ANs from 1998-2004, peer-reviewed studies from January 1996, through May 2006, and reports, unpublished documents, and electronic resources addressing AI/AN STD prevention and control. Results: STD prevalence among AI/ANs remains high. For example, the case rate of C. trachomatis in the North Central Plains AI/AN populations is 6 times the overall US rate. Trends for C. trachomatis also show sustained increases. Little research exists on STDs for this population, and most is focused on HIV/AIDS. Fear of compromised confidentiality, cultural taboos, and complex financial and service relationships inhibit effective surveillance, prevention, and management. Conclusions: Recommendations for STD control in this population include improved local surveillance and incorporation of existing frameworks of health and healing into prevention and intervention efforts. Research defining the parameters of cultural context and social epidemiology of STDs is necessary.

ProblemThe persistent underrepresentation of American Indians and Alaska Natives (AIANs) in the health professions and the decline of AIAN matriculants into health-related programs suggest interventions are needed. The authors developed Healers, a text message mentoring service, to engage and support AIANs interested in the health professions.ApproachHealers, launched in 2018, seeks to reach urban and rural high school/college-aged AIANs and other AIANs. Individuals subscribe by texting “HEALER” to a numeric code using their mobile device. Two concurrent intervention strategies include: (1) a 17-week schedule of scripted texts and (2) live weekly office hours with 2 health pathway coaches. During the pilot year (June 2018–June 2019), participants were recruited via national conferences, health fairs, social media, and word of mouth. Intake and exit surveys were conducted. Content analysis of text messages received during office hours was conducted.OutcomesDuring the pilot, 304 subscribers opted into Healers and generated 2,933 text messages. Intake survey respondents included high school students (n = 18/77, 23.4%), college students (n = 29/77, 37.7%), and others (n = 29/77, 37.7%). They represented 60 Tribes from 28 U.S. states. Among exit survey respondents, 26/28 (92.9%) reported Healers was useful, 25/27 (92.6%) reported it exposed them to new health professions, 26/27 (96.3%) expressed stories from AIAN health professionals were valuable, and 25/26 (96.2%) reported pursuing a health professions career seemed possible. Five themes emerged from the analysis of the 346 participant texts received during office hours: cultural support, mentorship, opportunities, wellness, and community building.

The Project Red Talon Regional Partner Network, led by the Healthy Native Youth Project at the NPAIHB and Northwest Tribal Epidemiology Center, is a collaborative effort to address STI/HIV/HCV prevention and care for American Indian/Alaska Natives. The network includes partners who provide outreach, education, and technical assistance to disseminate best practices. Accomplishments in 2023 include the development of various resources such as webpages, campaigns, pocketbooks, and resource hubs focused on sexual health, syphilis, PrEP, HIV, HCV, and substance use disorder. More information can be found on the NPAIHB website. [Extracted from the article]