Four Corners Project: A collaborative effort between the Nanizhoozhi Center, the Navajo Nation and the University of New Mexico. The program has improved HIV screening among Navajo Area clinics. It helped to put into place rapid testing (15-minute response) at the clinics.
Minority AIDS Initiative Grant: A $250,000 grant that goes toward improving patient care at the Gallup HIV clinic and increase testing rates. It helped to put into place rapid testing at the clinics. Also helped fund Gallup movie theater advertisements that encouraged HIV testing.
Navajo Area Indian Health Services: Clinics are working to prevent the spread of HIV by providing free condoms to one of the major bars in Gallup. Also regularly screening patients and working with local governments to educate Navajo communities.
Forty-seven new cases of HIV, or the virus that causes AIDS, were reported to Navajo Area Indian Health Service in 2012, according to a recent report from the service.
The number of new cases on the Navajo Nation has risen steadily since 1999, when there were 10 cases.
From 2011 — when 39 new cases were reported — to last year, the number of new cases reported increased by 20 percent.
The annual report, released in mid-April, marked 25 years since the service began treating the human immunodeficiency virus, or HIV.
Since 1987, 436 cases of HIV and AIDS have been treated. About 82 percent of the cases were men and about 18 percent were women.
Men having sex with other men accounted for about 40 percent of the cases. Men having sex with women accounted for 26 percent.
Only about 200 of those cases are currently being handled by the service, as some patients have sought other care or passed away.
Of the current cases, the average age of patients is 43.3 years old.
"They're catching it on the reservation and in the border towns," said Dr. Jonathan Iralu, the chief clinical consultant for infectious diseases at Gallup Indian Medical Center.
Since 1995, Iralu has overseen the bulk of the cases reported on the Navajo Nation.
The increase in new cases reported, he said, is because the Navajo Nation medical centers are boosting efforts to detect HIV.
The Gallup Indian Medical Center, for instance, offers free HIV tests to all patients.
"We want people to think of an HIV test as a cholesterol test or a blood test, so there's not that stigma," Iralu said.
In 2012 alone, Gallup Indian Medical Center diagnosed 25 new cases.
Other medical centers reported a half dozen cases or fewer.
In the past, most of the new cases of HIV were diagnosed years after the patient acquired the virus.
Last year, patients were diagnosed soon after acquiring the virus, the report said.
Fortunately, diagnosing HIV early reduces complications for patients and improves their ability to live with the virus.
But, unfortunately, that also means that HIV still is being spread. Its spread is largely attributed to alcohol abuse, since about half of HIV and AIDS patients abuse alcohol, either by admission or by a physician's opinion. Many patients admit that they likely were under the influence of alcohol when they acquired the virus because alcohol made them make poor decisions.
"There are many, many more out there who are positive, and they don't know it," said Faith Baldwin, prevention program coordinator for the Navajo AIDS Network in Chinle.
The network educates the Navajo Nation about HIV and AIDS by visiting schools, chapter houses and other community gathering locations.
Baldwin said that many communities know little about the disease, and they do not know how to treat people with HIV or AIDS. Oftentimes, patients are alienated by their communities, she said.
Because many of the communities are rural, patients often have a difficult time making appointments consistently, the report said.
In part, this is because treatment has not been as effective in past years as it is now, Iralu said. Additionally, he said that many patients worsen their condition by not adhering to a strict treatment plan, sometimes to the point of death.
"If you miss more than one pill every two weeks, eventually it can lead to infection, cancer and death," Iralu said. "They have to take more than 95 percent of their medication."
The report said that patients are improving their adherence to appointments, though it still is an issue.
Of the Navajo Area clinics' current HIV and AIDS patients, about half are seen regularly, or keep about 50 percent or more of their appointments.
Still, nearly a quarter of the HIV and AIDS patients reported since 1987 have passed away, a rate that now is slowing. In 1996, about 30 percent of patients at the time died. in 2012, 2.4 percent died, the report said.
"The hardest part is the deaths," Iralu said.
The report noted that various efforts are ongoing to help prevent and treat HIV and AIDS patients on the Navajo Nation. The programs encourage people to get tested at their area hospital, whether they live on or off the Navajo Nation.
Many of the programs are putting into place rapid testing programs, that only take about 15 minutes for results, and they are especially trying to test alcohol and drug abusers. They also are trying to encourage HIV positive patients to enroll in alcohol rehabilitation if they struggle with alcoholism. Either way, they encourage patients to treat themselves for HIV, at the very least.
"It's really easy to treat," Iralu said, noting that while the spread of HIV continues, the treatments are improving. "People who are HIV positive are living as long as if they were HIV negative. This is not a fatal disease anymore."