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P179 Regional STD Rates & Trends Among American Indians and Alaska Natives—1998-2009

Tuesday, March 13, 2012
Hyatt Exhibit Hall
Scott Tulloch, BS, NCHHSTP, DSTDP, OD, Centers for Disease Contorl and Prevention, Albuquerque, NM, Jimmy Braxton, AS, Division of STD Prevention, CDC, Atlatna, GA, MELANIE Taylor, MD, MPH, DIVISION OF STD PREVENTION, CENTERS FOR DISEASE CONTROL, Phoenix, AZ and Lori de Ravello, MPH, Assigned to the Indian Health Service National STD Program, Centers for Disease Control and Prevention, Albuquerque, NM

Background:  National STD rates among American Indians and Alaska Natives (AI/AN) are up to 4.5 times higher than rates for whites, with differences even more pronounced at some regional levels.

Objectives: Describe STD rates and trends among AI/AN by region.

Methods: During 1998-2009, we calculated crude annualized rates for chlamydia (CT), gonorrhea (GC), and primary and secondary syphilis (P&S) for AI/AN living in counties on or near reservations in the 12 Indian Health Service (IHS) Areas. Numerators were based on county-level STD cases reported to CDC, and denominators were based on census population estimates. We compared rates with those in the general US population (US). Rates are expressed as per 100,000 population.

Results: In 2009, the overall AI/AN CT rate (776.5) was nearly twice as high as the US rate (409.2). This disparity resulted primarily from high CT rates in four IHS Areas, Aberdeen, Alaska, Billings, and Navajo that had rates 2.1 to 5.8 times higher than the U.S. rate. For GC, rates among AI/AN were slightly higher compared to overall US rates (113.3 and 99.1, respectively). GC rates were highest in Alaska Area (593.4), followed by Aberdeen and Oklahoma City Areas (239.9 and 125.9, respectively). For P&S, overall rates among AI/AN were significantly lower as compared to US rates (2.4 and 4.6, respectively). Several IHS Areas—Tucson, Albuquerque, Navajo—had higher than US rates (12.4, 6.2, and 4.8, respectively); five Areas (Aberdeen, Alaska, Billings, California, Nashville) reported no P&S cases in 2009. Since 1998, overall AI/AN rates have remained stable (GC) or increased modestly (CT and P&S), although significant variability exists in regional rates.

Conclusions: AI/AN STD rates vary considerably by region. Further studies are necessary to identify determinants for these differences.

Implications for Programs, Policy, and Research: Regional data should be used to guide local STD prevention and control efforts in Indian Country.

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