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Gonorrhea Control in Region X Seattle, July 20, 2009 Jessica Leston, MPH ANTHC STD Program Clinical and Research Services

Gonorrhea Control in Region X Seattle, July 20, 2009 Jessica Leston, MPH ANTHC STD Program Clinical and Research Services

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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

[email protected]