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GALLUP, N.M. — A surge in HIV infections on the Navajo Reservation has doctors and public-health workers increasingly alarmed that the virus that causes AIDS has resurfaced with renewed intensity in this impoverished region.

A report released last month by the federal Indian Health Service found there were 47 new diagnoses of HIV on the reservation in 2012, up 20 percent from 2011. Since 1999, HIV cases among Navajo are up nearly fivefold, the report found.

“I’m scared to death,” said Dr. Jonathan Iralu, an infectious-disease specialist who runs an HIV clinic. “The time to act is now.”

Over the past few years, the HIV numbers on Navajo land have crept up.
Though the numbers are still comparatively low the challenges of prevention are amplified in a place where sex is still rarely discussed publicly and infection is often hidden from loved ones.

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The intimacy of reservation life, where a hospital receptionist might be a relative or close friend, can be a barrier to swift treatment and prevention. Mindful of those challenges, the Indian Health Service allocated $5 million over the past three years for communities to create HIV prevention, treatment and education programs.

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