Background:

The Navajo Nation in Arizona and New Mexico is experiencing an increase of syphilis and HIV since January 2001. In 2003, the infection rate of syphilis was at the highest ever reported. Report from the increase investigations indicated a lack of safe sex practices and STD/HIV education. While primary and secondary syphilis rates declined in general U.S. cities, syphilis cases on the Navajo Nation tripled from the year 2002 to 2003.

Objective:
We will examine the recent syphilis, HIV progression and discuss the increase of syphilis, HIV and co-infections; in addition it will involve sexual risk behaviors and discussing implementation for future prevention and partner notification efforts.

Method:
Behavioral data were obtained during the syphilis original, re-interviews and cluster interviews. Coordination and networking among the Community Health Nursing, the HIV Prevention Programs, the local Indian Health Service Unit STD Task Forces. Media campaign and radio public service announcements were the expansion efforts to the community, along with the pamphlets distribution to deliver prevention messages on syphilis/HIV.


Result:
Barriers to syphilis/HIV prevention include alcohol addiction, Border town bars, minimal traditional and western STD knowledge, and a public health focus on the syphilis/HIV and STD infection with emphasis on partner notification.

Conclusion:
Knowledge of partner infection (notification) status is critical in syphilis/HIV control efforts. Expansion of prevention and outreach, developing long range plans to reduce syphilis with the local Health Departments, community based organization, local bars, syphilis (STD) screening at the Navajo Tribal jails, Behavioral Health and treatment facilities.

Implications:
Development of protocols to improve syphilis/HIV screening at the Health Care facilities, to ensure the syphilis case management. And promote awareness through the first ever Social Marketing campaign targeting syphilis, HIV testing and awareness.