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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.
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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
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
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.
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
Quayana Jessica Leston STD Program Manager, ANTHC Clinical and Research Services + 1 907 274 8104 jdleston@anthc.org