YVONNE DAVIS: Okay. Good morning. It is still morning, right? (Speaking non-English language). My name is Yvonne Davis, and I introduced myself traditionally because I want to acknowledge the people here from this land and also relatives out there in the audience who may be out there. And I want to talk to you a little bit about an issue, and I title my presentation "Female: The Primary Gender of Navajo Nation" because first of all, I want to acknowledge the clan on my mother's side because in the Navajo culture, everything in our lives revolved and is defaulted towards the feminine line of our people. So I want to give acknowledge to that. And the other thing I want to do is I want to thank the conference committee for putting together such a, you know, an elite scholarship panel that we have here. Let's give them a hand.

I want to start with a story that I want to talk to you, and it's a story from the relatives of the north. It resembles many stories that have been told before. After each day, after cutting wood, we would gather, sit, and talk near the mouth of the Porcupine River near where it flows into the Yukon. We would always end with Mom telling us a story. There we were, long past our youth, and our mother still telling us bedtime stories. One night, it was a different story. I heard for the first time a story about several women and their journey through hardship.

What I would like to do is to give you an example of what American Indian and Alaska Native women are going through in reference to fighting the HIV and AIDS disease, but also to associated risk factors that compound the issue of HIV and AIDS. I want to explore some of the HIV and AIDS prevention strategies that work, but only because to bring to your attention that there are only limited numbers of strategies that have been documented that are currently working in the American Indian, Alaska Native, and Native Hawaiian communities; then, to identify to process; and then, to dialog with indigenous leaders and how you can do this to address current HIV and AIDS health issues for indigenous women; and then, to perhaps recommend action-oriented strategies. Some may be foreign to you because you may not be aware of the concepts that are culturally tied to how these strategies can help increase positive health outcomes to American Indian, Alaska Native, and Native Hawaiian women, some strategies that we're not really familiar with or have been never been documented that need to be looked at.

One of the things that I want to share with you in my work with HIV and AIDS is that American Indian women and Alaska Native women and Native Hawaiian women represent a small portion of the total HIV/AIDS cases that are currently being reported. Data does not provide important information in terms of differences in rates by tribes. Several reasons is because data infection that is being reported may obscure confidentiality issues that are currently in place. Tribes with less than 300 in membership could be vulnerable to this. In addition, misclassification and misidentification of how data collection is made is another reason why we don't have current and effective numbers. Lastly, another area that I need to provide to you is the fact that geographically, representation of HIV infection data is not consistent. In other words, out of the 25 states that are currently reporting HIV infection rates, about maybe five of those are generally from states that have a predominantly high population. For example, California just recently started reporting HIV and AIDS rates.

We can't really start beginning to digest what those trends are going to be and how they are affecting American Indian women. Of the cumulative numbers of American Indians and Alaska Natives and Native Hawaiians reported with HIV, 21 percent of those are female compared to 10 percent of Whites, 29 percent among Blacks, 20 percent among Hispanics, and 15 percent among Asian Pacific Islanders. And then, again, of the total HIV and AIDS cases, 1.3 percent are younger than 13 years of age. And again, that number is starkly high because when you think about the average lifespan for American Indians and Alaska Natives and Native Hawaiians, 69 is for females; 68 is for males. I'm considered an elder, by the way. The most recent data includes that indicated in the year 2001 indicated that 172 cases of HIV were reported. Out of this, 21 percent were female. In 2001, the percentage—and this really blows my mind—the percentage of HIV exposure for heterosexuals at risk, because when we think about heterosexuals at risk with American Indians, we think of mainly heterosexual females. That rate was equivalent to the rate of injecting drug users, so there's definitely a notch of showing how this crisscross of how injecting drug users were somewhat higher in terms of risk of infections. But now, heterosexual females at risk have met that, and now it's climbing above that. Additional stressors related to HIV infection are not documented, but we also need to look at additional stressors that are associated to women, especially suicide rates of American Indian Alaska Native youth.

The children that the women are bearing are killing themselves, literally, when you translate this. These numbers that you see, 8.1, 2.1, and 3.3, are out of per thousand; and they are respective for the Navajo tribe, the Pueblo tribes—and the Pueblo tribes consist of 19 tribes—and the Apache tribes, respectively. The Fetal Alcohol Syndrome in Alaska Natives is 3.4 times higher than that for tribes in the lower 48 states. Of all cases reported for 15 and over, Alaska Native males represent 19 percent of the HIV cases and are only 14 percent of the population. Alaska Native females account for 40 percent of HIV/AIDS cases and only 16 percent of the population. So when we think about this, we are definitely missing the target when we're looking at American Indians, Alaska Natives, and Native Hawaiian females. What are we doing? Where are we missing? Why are the rates increasing? So when we think about this, Chlamydia rates and other associated infections that put Native American women at risk for HIV and AIDS are also needing to be addressed.

Unprotected sex, sexual activity in Alaska Natives are reported as being the more social norm and acceptance of how sexual intercourse and how, I guess, in terms of how it's practiced. In the public communities, I have been told that condoms are not to be talked about because it's a form of genocide. We can understand that, a form of genocide that is preventing our population from increasing. You know, we have to work around these cultural issues, these post-traumatic stress syndrome factors that we have to look at. So there's a lot of other areas that are compounding American Indians and Alaska Natives when we're talking about HIV and AIDS. Risk identified, a term that I want to use that anthropologists who work with American Indians, Alaska Natives, and Native Hawaiians use—adopt to suggest that the cultural trauma was involved have created a condition that has been passed down from generation to generation. The sold wound, as we so call it, is passed down, and it results in a kind of pathology or vulnerability with a direct loss of land, lives, and vital aspects of traditional cultural that is not being inclusive into the interventions that we are developing. We need to be cognizant of that. This vulnerability also is manifesting depression, anxiety, post-traumatic stress disorders, feelings of alienation, depression, and anxiety among women, especially when you connect that with the suicide rates when we're seeing suicide rates of their young dying. When you think about that, you've got to think about, you know, other factors that are affecting. So these domains that I'm mentioning to you that we somewhat overlook when we're just dealing with HIV infection, we have to consider how we're going to be looking at that on a cultural perspective.

Empowering American Indian and Alaska Native women. From a Navajo traditional perspective, a traditionalist is a woman who basically stays on the reservation who basically provides traditional roles, performing herbal ceremonies, talks in the Navajo language, and also works in the community. We don't have interventions directed towards this woman who plays in this traditionalist role. The transitionalist woman in the Navajo culture is a woman who lives and performs very much jobs on and off the reservation who migrates frequently. Her transition may be because maybe one of her father might have been a bureaucratic employee, like for BIA or HIS; and therefore, movement had to be, you know, pushed, had to place in her different areas. So she's not directly involved on the reservation. Again, migrating back and forth and on the reservations or in the villages or in the rural frontier areas are not being addressed in interventions. The contemporary woman on the Navajo reservation has some little knowledge or some understanding of cultural issues with reservation life and usually returns to the reservation on very short visits. Again, interventions are not being developed for this woman.

The acculturated and assimilated woman has to live away from the reservation only because maybe she's married to another race, maybe an intertribal race; and therefore, she has to migrate to her husband's home or her partner's home. So when we think about these areas in terms of how we develop and empower American Indian Alaska Natives, we have to consider all of these areas of solutions that we need to look at. Finally, what I want to do is explore effective interventions for American Indian and Alaska Natives. Unfortunately, studies reporting the sexual practices are yet to be documented. These are some of the areas that I've looked at in terms of women who have asked me questions. For example, Pueblo women responded immediately by asking the first question in our village: who are women trying to impress? Literally, she was not making a derogatory statement, but rather answering an important question. That question was why are women not enjoying their interdependence, as we had mentioned before? So that's something that we need to think about in terms of how we are directly translating.

Education, I have heard, needs to be done in American Indian communities. Action-oriented strategies need to be done. We need to decrease the paradox of community-based participation research that includes social factors as well as identification of tribal social protective factors. Tribal protective factors include spirituality, include traditionalism, include language, include culture and practice because these are some of the areas that we look at in terms of how we are addressing. We've been here. We have survived. We will continue to survive. To address the high rates of suicide among youth, I think we need to cross interventions over from suicide prevention because when you look at Jerkum's theory of prevention for suicide, applying Jerkum's theory to American Indians and Alaska Native communities looks at the low social integration component. Band-like areas, band-like cultures that the Apache and Navajo both exhibit, as you recall back to the stats of suicide, those rates were higher than for cultures that practice on clanship, which had a higher level of social integration. We need to practice and start applying some of these other theories and interventions that are somewhat identified successful in other areas of risk factors into American Indian and Alaska Native women.

Finally, what I want to do is conclude with the funding of education, which must increase not only for reservations but for frontiers and for villages. Funding should not only just target youth; it should target both men and women. Education is not a one-stop workshop, and specifically to that, further research is needed to clarify and justify another gender category because I didn't have time to go into this, but we do have six genders that are identified in our culture. And so we need to identify interventions to address specifically one of those six genders. I am woman. (Speaking foreign language). When you think about it (inaudible) an elder woman. So it depends on how you look at me. And the other thing that I want to do and look at is to share with you is that I started this presentation with a story because now, I want you to finish that story. Like you, I am impressed with the beginning because I want to educate myself as well as with the health and well-being of American Indians and Alaska Natives. I also know that the story not only teaches me and you a lesson, but it's also a way for us to work together. Thank you very much.