The number of new HIV/AIDS infections recorded in the Navajo Nation today is three times the number recorded a decade ago, the Los Angeles Times reported Thursday. Experts say poor education is partly to blame, with some tribal members learning about HIV and AIDS only upon diagnosis.

The Los Angeles Times’ Stephen Ceasar wrote about the rise of HIV infections on the Navajo reservation on Thursday, below is an excerpt from “Navajo Nation confronts HIV and AIDS:”

Most of the infections are occurring in the Navajo Nation, a vast expanse in the Four Corners region where poverty, poor education, alcohol abuse and the hardships of reservation life cultivate an environment in which the virus can spread.

Like Smith, some Navajo learn of HIV and AIDS upon diagnosis. Others believe it’s a white man’s disease. Doctors, meanwhile, must explain the virus and disease in round-about ways because, in traditional Navajo culture, to speak of death is to bring it about.

Larry Foster, the Navajo Nation’s sexually transmitted disease coordinator, said health professionals had encountered resistance when giving presentations on the disease.

“They didn’t want to listen because they thought we were bringing a curse, bringing death into their communities,” Foster said. “Nobody cares until they have seen an AIDS death in their family.”

Beyond the Navajo Nation, the overall rate of HIV and AIDS diagnosis for American Indians and Alaska Natives has been higher than the rate for whites, but generally lower than that of blacks or Latinos, according to the Centers for Disease Control and Prevention.