About 75 miles south of New Orleans lies Dulac County, where the United Houma Nation and other tribes live on fishing and shrimping in the bayou or laboring in the oil fields. Dulac County is an improbable place to hold an AIDS conference. But for two sweltering days in June, some 65 health-care providers and social workers serving Native American communities in the South converged on remote Houma for the Native American HIV Training Workshop. Rebecca Guidry, of the Dulac Community Center, called in the South Carolina-based Catawba Indian Nation HIV Training Initiative to help give providers a lesson in how poverty, illiteracy and lack of quality health care make fertile ground for HIV transmission.

The event came on the heels of new Centers for Disease Control and Prevention data showing that AIDS cases among American Indians and Alaska Natives have almost doubled over the last five years. The real number could be much higher, Guidry said, since caregivers often misreport Native American patients as Latino or Asian. And countless others may avoid testing and care. "Clinics are usually based on tribal reservations," Guidry said. "Many people won't be tested for HIV in a place where they may run into their parents."

More than half of Native Americans are from tribes that are not officially recognized by the feds -- and thus can't access the Indian Health Service. The Catawba Indian Nation has taken matters into its own hands, according to HIV project director Michael Dickey. "As a result of our training efforts, we expect health-care professionals to provide better care to their American Indian patients," said Dickey.