Background:
American Indians and Alaska Natives (AI/AN) have disproportionately high rates of STDs. In 2004, among all race/ethnicities, AI/AN had the second highest reported rates of chlamydia, gonorrhea, and primary and secondary syphilis. Within Indian Country, STD screening practices and policies vary.

Objective:
To describe AI/AN-focused STD screening projects developed by Indian Health Service (IHS) and tribal health programs.

Method:
Through formal and informal communications, we identified and reviewed positivity data for 4 STD screening projects in settings with potentially high rates of STDs and common in many AI/AN communities: high schools, seasonal firefighter physical exams, community venues, and tribal jails.

Result:
Previously undetected STDs were identified in 3 of the 4 projects. In a high school on a North Dakota reservation, urine-based screening identified chlamydial infections in 14 of 269 students (5.2%); no gonococcal infections were found. During seasonal firefighter exams on two reservations in Montana, 11 of 82 (13.4%) asymptomatic males tested positive for chlamydia. On a southwestern reservation, screening at community venues and large public gatherings identified 2 cases of syphilis among 238 persons tested (0.8%). A six-month syphilis screening project in a southwestern tribal jail yielded no syphilis cases (of 114 persons tested).

Conclusion:
IHS and tribal health programs are conducting a variety of promising STD screening interventions. However, the yield of positive cases identified through these interventions is variable. Further studies are necessary to evaluate and improve STD screening activities in Indian Country.

Implications:
CDC and IHS must continue to support IHS and tribal health programs to develop, implement, and evaluate STD interventions for AI/AN.