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World AIDS Day: American Indians Join the Fight ‘Getting to Zero’ New HIV Infections

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Niki Graham

December 1 marks World AIDS Day, a global health day first held in 1988 to unite people in the fight against HIV/AIDS, show support for people living with HIV/AIDS and commemorate those who have died from the disease. This year’s theme is “Getting to Zero," calling for zero new HIV infections, zero discrimination and zero AIDS-related deaths.

In a World AIDS Day event at George Washington University today, President Barack Obama declared his commitment to combating the spread of the disease. “...[M]ake no mistake, we are going to win this fight," Obama said, reported ABC News. “This fight isn’t over. Not for the 1.2 million Americans who are living with HIV right now. Not for the Americans who are infected every day. This fight isn’t over for them. It isn’t over for their families. It isn’t over for anyone in this room. And it certainly isn’t over for your President."

Obama also announced a reorganization of existing funds to put an additional $50 million toward HIV and AIDS prevention efforts and care. Then he shared a new goal: to help 6 million people receive treatment by the end of 2013—an additional 2 million above the original target.

Native American organizations and Tribal health programs across the country are also joining the effort to combat HIV/AIDS. To commemorate World AIDS Day, the Center for Prevention and Wellness at Salish Kootenai College on the Flathead Indian Reservation in Pablo, Montana will host free HIV testing and offer information for the community. The Center focuses on HIV/AIDS education, awareness and treatment. The program launched in 2004 and now stands as an example of best practices for culturally relevant education, diagnosis and treatment.

The National Native American AIDS Prevention Center (NNAAPC) recently named Niki Webster Graham, the Center's prevention programs director and a member of the Confederated Salish & Kootenai Tribes, as the 2011 recipient of its Honoring the Red Ribbon Award. Graham also works with seven reservations in Montana, three reservations in Idaho and various other Tribal health centers to help them develop local HIV/AIDS prevention and treatment programs.

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The Honoring the Red Ribbon Award recognizes the efforts of a Native person each year to increase education, prevention and treatment of HIV/AIDS. The award was created and is given in honor of Marty Lynn Prairie (1958-2001), an Oglala Lakota Sioux who demonstrated fearless leadership in his commitment to HIV/AIDS education and prevention in Indian Country and throughout the United States.

From a nomination pool of 18 Natives across the country, NNAAPC selected Graham for the prestigious award. “She works at Salish Kootenai College and she has really set the standard, a very high standard, of what an HIV prevention program should like and can do at a reservation and at a tribal college,” says Robert Foley, president of the NNAAPC. “She has shown the way and how to garner support from tribal college administration, how to work with local and Tribal health clinics, and how to raise awareness, whether among youth or adults.”

The need to raise awareness of HIV testing throughout Indian Country is pivotal, Graham stresses, since many American Indians do not get tested until signs of illness begin to appear. "The kicker that gets me about Natives is that they are often dually diagnosed," Graham says in an interview on View Point, a production of the nonprofit the DE LA LUNA Foundation. "Dual diagnosis means that when they come in, they tend to come in really sick. ...[W]hen they get the blood work done and find out they’re HIV-positive, then they do a CD4 count, and find out that they’re diagnosed with AIDS. Seventy percent of our Native Americans are diagnosed that way. [Seventy percent] is overwhelmingly large."

"We’re not getting tested soon enough," Graham says. "It’s not that it’s too late when they find out they have AIDS. AIDS is not necessarily a death sentence anymore. It’s manageable, and they survive it. I have a friend who’s survived with an AIDS diagnosis for 25 years."

Native Americans diagnosed with HIV or AIDS also have high mortality rates. Of Native Americans who are diagnosed HIV-positive, American Indians and Alaska Natives had the shortest overall survival time, according to the Centers for Disease Control and Prevention’s 2009 HIV Surveillance Report. “Of persons who were diagnosed with HIV, more than 1/3 progressed to an AIDS diagnoses in less than 12 months. Only Asian and Hispanic/Latino populations had higher percentages,” the CDC report states.

Graham hopes to change that. Her program hosts events throughout the Tribal college and community to encourage people to learn their risks, get tested and prevent the spread of the disease. She credits the success of her program to confidentiality and its long-term ability to operate due to grant funding. "We offer anonymous testing," she says. The Center also seeks to provide information, dispel myths about the disease, and does not pressure anyone to take a test if they are not ready. "If you have concerns, worries, or you just want some information, please come in," she told The View. "If anything, we want to make you feel comfortable, so that you do come back."