San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - EDITION: FINAL; SECTION: MN; PAGE: A15, 9 Jan 1996.
George Snyder, Chronicle Staff Writer

Currently, an estimated 1,202 AIDS cases have been diagnosed out of a population of about 2 million people claiming Native American ancestry.

"There are 340 AIDS cases in California out of a population of about 250,000 Indians in the state," said Ron Rowell, a Choctaw and director of the National Native American AIDS Prevention Center in Oakland.

"Although the numbers might seem small, these numbers are significant if you consider that many Indian communities are rather small and tight-knit. And if you realize that the history between Indians and non-Indians is a sad and long one of death from infectious disease in which entire tribes and cultures were wiped out . . . it drives a lot of the urgency in our trying to control the spread of HIV among native populations."

Of particular concern are HIV infection rates among Native American women.

According to Rowell, HIV tests at rural Indian clinics produced alarming results. The tests, conducted by the federal Indian Health Service and the Centers for Disease Control, focused on the first and third trimesters of pregnancy.

"What they found (were) rates of HIV infection among Indian women that ranged from four to eight times higher" than rural women in general, Rowell said. "That is alarming. Some of these small Indian communities could collapse demographically."

In addition, California Indian women compose 11 percent of the state's total Native American AIDS cases, a figure considered relatively high by state health officials.

Nationwide, studies show that women make up about 15 percent of Native American AIDS cases. White women, on the other hand, represent about 6 percent of the nation's AIDS cases.

Those figures disturb 43-year- old Cathy Campbell, a Chiricahua Apache/Yaquai case manager for the San Francisco-based Native American AIDS Project.

"Getting women to disclose their status and take care of themselves is a big push for us," she said amid the bustle of NAAP's small offices on Market Street. "Most of them have kids or take care of elders or their partners. The last thing they think of is caring for themselves . . . and that includes how to keep from getting AIDS."

Traditionally, Chapman said, "it has been difficult to preach prevention in a society that has always considered sexuality as sacred, the ultimate communication between one human being and another. To require that process, once considered very natural and innocent, to be stigmatized as life-threatening, is a major problem."

In the meantime, said Rowell, the rate of new AIDS cases continues to climb not only in urban areas but on the rural reservations. <p> According to the California Department of Health Services, Native Americans had a 32 percent increase in diagnosed AIDS cases between 1990 and 1992. During the same period, Latinos had a 9 percent increase, and African Americans a 7 percent increase.

Nationwide in 1995, the number of AIDS cases reported was 476,899, out of an estimated population of 263,434,000.

According to Rowell, the statistics for Native Americans do not include those patients of mixed ancestry who do not declare themselves Indians.

"An ongoing problem is misclassification," he said. "That's because a majority of Indians are of mixed racial descent, confusing even well-meaning people. Studies have been published by the Centers for Disease Control regarding studies in Los Angeles and in King's County, Wash., and found that in both places from three-of- four to four-of-four respondents reported as either white or Hispanic. We have always had a hard time getting a handle on the numbers. You just can't look at a person and use color or depend on what they look like to determine whether or not they are Indian."

Rowell's organization -- with a budget this year of $2 million -- acts as a national umbrella group for various HIV-related programs for Native Americans. It was funded in 1988 by the Centers for Disease Control as a prevention-oriented organization.

It also helps local communities set up AIDS prevention programs, as well as operate a national hotline, publish journal, "Seasons," and provide AIDS-related news packets to more than 200 tribally- run or Indian-owned newspapers, magazines and radio stations.

Rowell said his agency also helped create and finance the Oklahoma-based Ahalaya Project, which provides care to AIDS patients in Indian communities using regional tribal spiritual and cultural traditions, as well as mainstream health care.

"Unlike the stereotype," he said, "Indian people are all different, with different tribes having different customs. I can't as a Choctaw step into Navajo ways. We work with people who know the language and culture and the proper way to approach people. I would say that in virtually every case, a link is made between local programs and the elders, as well as the traditional medicine people."

Similar projects have been set up in New York City, Anchorage, Phoenix, Milwaukee, Minneapolis, Chinle, Ariz., Honolulu, Seattle, Pembroke, N.C., and Pauma Valley in San Diego County.

Although Rowell's organization operates mainly as an AIDS clearinghouse for Native Americans, Chapman's agency works hands-on with its Bay Area AIDS clients.

Headed by Lumbee-Cheraw Executive Director Clisby Locklear, the NAAP helps secure housing, mental health services, medical treatment and legal services, as well as provide emotional, cultural and traditional spiritual support for its caseload of about 75 clients.

"I do a lot of my work right here," said Locklear, as he stood on Market Street recently chatting with several young Indian men over the roar of passing traffic. "It's probably more effective than pushing paper up in the office."

Such contact is vital for native people, who often inhabit a border world whose cultural and spiritual underpinnings are either misunderstood or ignored by contemporary, non-Indian society.

"Many of our clients are right off the res," said Chapman. "But we also work with people who are third- and fourth-generation urban Indian. We are one of the few agencies addressing the traditional needs of our clients and emphasizing the traditional aspect of life in the healing process."

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