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Gonorrhea Control in Region X Seattle, July 20, 2009
Jessica Leston, MPH
ANTHC STD Program
Clinical and Research Services
Overview
Alaska Overview
Alaska Tribal Health System
ANTHC STI/HIV Program
Overview of GC in the AN population of AK
ANTHC Programs
Alaska is Big
Alaska Native Peoples and Languages
Alaska Tribal Health System
Current Tribal Health Entities
12 “unaffiliated” tribes provide community-based health programs
Regional health organizations are non-profit, authorized by tribal government resolutions, with Native boards of directors
Some are small, representing 6-7 tribes, serving about 2,000 beneficiaries
Others are larger, representing as many as 50 tribes, serving about 25,000 beneficiaries; six of these manage regional hospitals
Chignik Lake Clinic
Alaska Tribal Health System
Levels of Care…
Village-based services: Community Health Aide/Practitioner working in a village clinic
Sub-regional services (some regions): Mid-level practitioner serving several villages
Regional services: Referral hospital or physician health center
Statewide services: Alaska Native Medical Center and Alaska Native Tribal Health Consortium
Contract Health Services: for private sector referrals
Alaska Native Tribal Health Consortium
The Alaska Native Tribal Health Consortium (ANTHC) was formed in late 1997 to manage statewide Native health programs based in Anchorage, including the Alaska Native Medical Center
ANTHC is the largest tribal self-governance entity in the United States with 1,700 employees
STI/HIV Services through ANTHC
Early Intervention Services Medical care and management
Prevention with Positives
HIV/STD Prevention Center Outreach and education
(Community PROMISE, Mpowerment)
Prevention Media Development and Distribution
Social Marketing/Youth Intervention
Research
Advocacy and Policy
International Partnership Building
Gonorrhea Rates 2008
Overall, GC rates decreased 1% in AK in 2008
Rates of GC increased by 53% in Alaska Native and American Indian males and increased 19% in Alaska Native and American Indian females.
The highest GC infection rates were among Alaska Native and American Indian people at 229 cases per 100,000 males and 347 cases per 100,000 females.
Unpublished IHS Surveillance Report 2007
Unpublished IHS Surveillance Report 2007
Unpublished IHS Surveillance Report 2007
Unpublished IHS Surveillance Report 2007
ANTHC STI Projects
Focus Group and Interview Project
Media/Technology
Marketing
Self-collected specimen project
International Collaborations
Alaska Native Focus Group and In-Depth Interview Project
Alaska Native adolescents (n=105) from five rural communities in Alaska, ages 15-24, participated in 21 focus groups.
In-depth interviews with 35+ community members
Alaska Native Focus Group and In-Depth Interview Project
Assessed themes related to knowledge and beliefs about STD, HIV/AIDS, and unplanned pregnancy, as well as perceptions of how adolescents prefer to learn about sexual health issues.
Results
STD/HIV and unplanned pregnancy messages are viewed within a framework of disease prevention and health protection activities
Sexual health messages should be delivered via the internet and school
Young adults want to hear messages promoting STD/HIV testing and condom use
Easier access to condoms is needed
Results
There is a basic understanding of sexual health, but adolescents have a lot of unanswered questions pertaining to STD/HIV
Alcohol and drug use affect sexual behavior and risk taking
Issues of confidentiality and embarrassment affect healthcare seeking behaviors for sexual health issues
Next Steps
Use the information gathered in the focus group and interview project to create an intervention:
Alaska Native Youth Social Marketing Campaign
Education/Health Promotion
Alaska Native Youth Website
STD Screening/Treatment
Education and Health Promotion
www.iknowmine.org
Self-Collected Specimen Project
Quayana
Jessica Leston
STD Program Manager, ANTHC
Clinical and Research Services
+ 1 907 274 8104
