Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs)—now used as a more inclusive term—put both men and women at increased risk for HIV infection. First, the presence of STIs signifies high-risk behavior, such as unprotected sex. Second, STIs increase risk by allowing entry for HIV through open sores and microscopic breaks in affected tissue. Third, 70-80 percent of STIs have no symptoms and go unnoticed, making persons infected more vulnerable to HIV. Native communities with high STI incidence rates have a greater likelihood of high HIV/AIDS incidence rates. Health professionals must pay close attention to high STI rates in Native communities, especially gonorrhea, chlamydia, and syphilis.

HIV is increasing steadily among women, especially among women of color. Women and adolescents make up 19 percent of Native American AIDS cases and 27 percent of reported HIV infections.²¹ Women have some gender-specific HIV risk factors. First, they can receive the HIV virus from men, who make up the majority of AIDS cases. Second, the HIV virus can easily enter the bloodstream through the lining of the vagina and cervix. Third, in older women vaginal dryness can cause tearing, which provides a prime pathway for HIV. Hormone replacement treatments among older women also increase susceptibility to HIV.

• What STI prevention methods or programs are already in place in your community?


• Find a piece of health education literature targeting STI prevention (a brochure, flyer, etc.). Identify its target audience (who was it written for?). How is the brochure being distributed to this audience? What language or images does the brochure use to better relate to its audience? Do you think the design and text can be improved in any way?


• Brainstorm ways to target the female population of your Native community. Where can you distribute information so that women will see it? What concepts, words, and images can you use so that women will relate to it?