Background:
A 2004 Epidemiological Report by CDC revealed evidence of syphilis infection occurring among persons who had been incarcerated or received treatment for substance abuse on the Navajo Nation. In response to the report, the Navajo Nation Division of Health (NNDOH) developed and implemented the Dine Unity Project with funding from the CDC.

Objective:
STD screening, and prevention education, are provided, targeting incarcerated individuals and persons accessing behavioral health services. Through this integrated venue based approach, the NNDOH is addressing the increasing number of sexually transmitted diseases on and around the Navajo Nation.

Method:
STD prevention education and rapid reagin plasma (RPR) testing for syphilis are provided to detainees and clients through weekly group screening sessions at two correctional facilities (Window Rock and Shiprock), at four Behavioral Health sites (Fort Defiance, Sanders, Tohatchi, and Gallup) and Chinle Juvenile Detention Center. Tests at Chinle include Chlamydia, Gonorrhea, Syphilis, HIV/AIDS, and Hepatitis Panel. Education is presented in both English and Navajo to ensure culturally appropriate service delivery. The Dine Unity Project collaborates with community based organizations and NMDOH who are involved in the STD Taskforce that focuses on community outreach, prevention education, and screening.


Result:
There have been no positive syphilis tests to date in any of the screening sites. At the Detention Centers, 688 detainees received education and 432 tested. The Behavioral Health Sites 64 clients received education and 44 tested. Chinle Detention Center, 18 received education and 16 tested. An evaluation processes will determine the effectiveness of STD education.

Conclusion:
The Dine Unity Project presents the Navajo Nation with a unique opportunity to conduct STD prevention education, and screening to individuals in detention and behavioral health centers across the Navajo reservation.

Implications:
Ultimately, the goal of Dine Unity Project is to empower incarcerated individuals to refrain from high-risk sexual behaviors and increase knowledge about STD's.