PHOENIX (AP) – Frank Igluguq Gooden grew up near the end of the Earth.

His Alaskan village of Kiana, home to 400 Inupiat natives, lies north of the Arctic Circle.

No roads go there. To visit, you must fly 550 miles north from Anchorage to the hub town of Kotzebue, then catch a puddle-jumper east across 150 miles of water and open tundra, populated by moose and bears, to the edge of the Kobuk River.

In this region of breathtaking beauty, AIDS seemed far away, a distant danger haunting big cities.

No one in Kiana had ever admitted having it. Until Frank.

With AIDS cases increasing in the most remote Native American outposts, the isolated, insular nature of some of those communities may be their downfall.

Those who thought the isolation would protect them, that the disease was only found in urban areas, now see it cropping up in the smallest villages, far from the nearest clinic.

And late diagnoses mean more transmission and quicker deaths.

“Because some Native villages, reservation rancherias and pueblos are small and isolated, HIV/AIDS could wipe out entire communities if not aggressively addressed,” said Irene Vernon, who has written a book on Native Americans and HIV/AIDS titled Killing Us Quietly.

Epidemics have wiped out Native populations before.

After European contact, diseases like smallpox, typhus and measles cut their numbers to 250,000 from more than 5 million.

“AIDS could become the next smallpox,” Vernon said. “It’s grim.”

More than a million Americans are living with HIV/AIDS. About 1,900 of them are Native American.

AIDS infection rates for Native American adults and adolescents, which surpassed Anglos’ rate in 1995, are more than 40 percent higher than the Anglo rate. The 2003 rate was 11.5 per 100,000, compared with 8.1 for Anglos.

More than half of the Native American cases occur in five states in the West: California, Oklahoma, Arizona, Washington and Alaska. Many fear the numbers could increase dramatically.

The first cases of what would later be called AIDS appeared in the United States in 1981 among gay men in California. Now, more than 500,000 people have died.

The introduction of new drug regimens in 1995 greatly reduced the death rate and the number of new cases, but both are rising again. And heterosexual transmission, which was 3 percent in 1985, increased to 31 percent in 2003.

Some believe the number of Native American cases are already higher than reported because some people are misclassified as another race.

In the depth of her grief over Frank’s diagnosis, Selina Moose, Frank’s sister, realized the threat to the village.

“He had relations with women here in the village,” she said. “His contacts are all here.”

Meaning he had contracted the virus from someone else in the village. And maybe passed it on.

Frank’s family members decided to do the unthinkable. They decided to talk.

Earlier, there had been a case in another village that had caused such hysteria that planes bringing mail, food and supplies wouldn’t land, and the village had to change its name.

“I worried the village wouldn’t want us around, that they wouldn’t want Frank around, that the whole family would be shunned,” Selina said. “But we couldn’t have blood on our hands.”

A meeting was planned that brought in the regional mayor, a public health nurse, the state epidemiologist, a spiritual leader and a lab technician to take blood samples.

More than 45 people lined up at the clinic after the meeting to be tested, many concerned they could have been exposed, some in a show of support for the family.

There were several positives.

“One mother called me and thanked me for saving her son’s life,” Selina said. “He was positive, and he got medications that can help him live a long time.”

By October, Frank had gone through months of treatment and blood transfusions in Anchorage. He wanted to go home.

“His doctor told him, ‘You know, Frank, if you go home, you’re going home to die,’” Selina said. “He said, ‘I know.’”

Frank died on Dec. 1, 2002, World AIDS Day.