KRC Articles

Cultural Competence: What Is Needed in Working With Native American With HIV/AIDS?

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Authors: Shelley Hamill, Michael Dickey

Publication Year: 2005

Last Updated:

Journal: Journal of the Association of Nurses in AIDS Care

Keywords: Awareness; Cultural Sensitivity and Appropriateness; Health Disparities; HIV/AIDS; Misclassification of AI/AN

 

Short Abstract: American Indian and Alaskan Native (AI/AN) people have a unique culture that is misunderstood by many health care professionals. There are nearly 2.5 million AI/ANs living in the United States in 300 different tribal or language groups and governed by 569 different tribal governments (U.S. Census Bureau, 2002).

 

Abstract: American Indian and Alaskan Native (AI/AN) people have a unique culture that is misunderstood by many health care professionals. There are nearly 2.5 million AI/ANs living in the United States in 300 different tribal or language groups and governed by 569 different tribal governments (U.S. Census Bureau, 2002). The myriad of ethnicities within the population labeled AI/AN or Native American makes it difficult to identify the scope of the HIV/AIDS problem under today’s system of classification. Throughout the evolution of the health care system, AI/AN populations have experienced, as have other minorities, less than adequate attention with regard to specific and culturally appropriate treatment and prevention programs (Dickey, Tafoya, & Wirth, 2003). Perhaps nowhere is this more evident than in the area of HIV/AIDS prevention and treatment. In 2000, then-U.S. Surgeon General David Satcher issued a call for action on the HIV/AIDS crisis in AI/AN communities. He stated an urgent need among Native communities as well as federal and state organizations and community health care providers to work together in an effort to fight the HIV/AIDS epidemic and to bring awareness to community members (Satcher, 2000). According to the Centers for Disease Control and Prevention (CDC, 2002), as of December 2002, there were 2,875 AIDS cases among AI/ANs. However, although the actual number of reported HIV/AIDS cases among Native Americans is relatively low, in this small population, the number is alarming. The number of AIDS cases has doubled among this population within the last 5 years (CDC). In the period from 1996 to 2002, AIDS incidence decreased markedly among Whites, Blacks, Hispanics, and Asian/Pacific Islanders but increased among AI/ANs (CDC). During that same time period, the number of deaths from AIDS also declined among all racial groups except AI/ANs (CDC). Many health professionals estimate the number of AIDS cases among AI/ANs to be much higher than what statistics are currently reporting and that the number of HIV cases could be as much as 10-times greater (Satcher, 2002). For example, a study of drug treatment patients conducted from 1991 to 1994 in New York City showed that the number of Native Americans testing positive for HIV was comparable to that of African Americans (Walters, Simoni, & Harris, 2000). This may indicate higher rates of HIV among AI/ANs within certain geographical populations. As with other minority populations, there is still a great stigma associated with HIV/AIDS within AI/AN communities. Among AI/ANs, concerns over confidentiality are evident because of the close-knit communities in which they live and the tremendous stigma of homosexuality. Many AI/ANs are not seeking testing for HIV because of this concern. As a result, underreporting of HIV among this community remains high. In addition, many Native Americans are misclassified by health care providers as Hispanic, Caucasian, African American, or Asian. During data reporting, this misclassification skews the statistics of the AI/AN population, resulting in underreporting of HIV/AIDS cases.

 

Source: Link to Original Article.

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Source: http://www.asph.sc.edu/news/cultural.pdf

Type of Resource: Peer-reviewed scientific article

Holistic system of care: a ten-year perspective.

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Authors: Ethan Nebelkopf and Serena Wright

Publication Year: 2011

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Journal: Journal of Psychoactive Drugs

Keywords: Cultural Sensitivity and Appropriateness; HIV/AIDS; Mental and Behavioral Health; Violence; Prevention; Intervention; Recovery

 

Short Abstract: The Holistic System of Care for Native Americans in an Urban Environment is a community-focused intervention that provides behavioral health care, promotes health, and prevents disease.

 

Abstract: The Holistic System of Care for Native Americans in an Urban Environment is a community-focused intervention that provides behavioral health care, promotes health, and prevents disease. This approach is based on a community strategic planning process that honored Native American culture and relationships. Substance abuse, mental illness, homelessness, poverty, crime, physical illness, and violence are symptoms of historical trauma, family dysfunction, and spiritual imbalance. The holistic model links treatment, prevention, and recovery. The link between prevention and treatment is early intervention. Peer support is the link between treatment and recovery. Recovering individuals serve as role models linking recovery to prevention. Culture and spirituality build a strong and resilient foundation for recovery. This article documents the effectiveness of the holistic model over a ten-year period that it has been implemented at the Family & Child Guidance Clinic of the Native American Health Center in the San Francisco Bay Area. The holistic model has produced statistically significant reductions in substance abuse among adult Native American women, men, reentry, and homeless populations; reductions in substance abuse among Native American adolescents; reductions in HIV/AIDS high-risk behavior among Native American men, women, and adolescents; and decreases in acting out behavior among Native American severely emotionally disturbed children.

 

Source: Link to Original Article.

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Source: https://www.thefreelibrary.com/Holistic+system+of+care%3A+a+ten-year+perspective-a0278880917

Type of Resource: Peer-reviewed scientific article

Discriminatory Distress, HIV Risk Behavior, and Community Participation among American Indian / Alaska Native Men Who Have Sex with Men

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Authors: Matthew A. Town, Karina L. Walters, E. Roberto Orellana

Publication Year: 2021

Last Updated:

Journal: Ethnicity and Health

Keywords: Health Disparities; HIV/AIDS; LGBTQ/2S; Mental and Behavioral Health; Minority Groups; Race; Sexuality; Men Having Sex With Men (MSM); Discriminatory Distress; Risk Behavior

 

Short Abstract: Research regarding men who have sex with men (MSM) indicates that exposure to discrimination based on race and sexuality are positively associated with increased incidence of unprotected anal intercourse (UAI).

 

Abstract: Research regarding men who have sex with men (MSM) indicates that exposure to discrimination based on race and sexuality are positively associated with increased incidence of unprotected anal intercourse (UAI). In an effort to better understand this association, we assessed the associations of discriminatory distress with UAI among a sample of 183 American Indian and Alaska Native (AI/AN) MSM using survey data drawn from the HONOR Project. The HONOR Project examined the relationship between trauma, coping, and health behaviors among Two-Spirits (a contemporary name for gender and sexual minorities among American Indian and Alaska Native people). Using multivariable logistic regression techniques, our analysis showed participants reporting higher mean levels of distress from two-spirit discrimination had higher odds of reporting UAI (OR = 1.99, 95% CI, 1.19–3.32) compared to those reporting lower levels of distress. This analysis also showed lower odds of engaging in UAI among participants reporting higher levels of participation in LGBT specific online forums (OR = 0.86, CI = 0.75, 0.99; p < .05) and attending Two-Spirit events (OR = 0.82, CI = 0.71, 0.94; p < .01). Future prevention research and program designs should address the differential impact of discrimination and community participation on sexual behavior specifically among AI/AN MSM.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581640/

Type of Resource: Peer-reviewed scientific article

Feasibility and Acceptability of Virtual Implementation of a Sexual Reproductive Health Teen Pregnancy Prevention Program for Native Youth

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Authors: Hima Patel et al.

Publication Year: 2022

Last Updated:

Journal: American Indian and Alaska Native Mental Health Research

Keywords: Communication Technologies; Covid-19; HIV/AIDS; Pregnancy; Women's Health; Substance Use; Youth; Virtual; Telehealth

 

Short Abstract: American Indian/Alaska Native (Native) youth face high rates of substance use, teen pregnancy and sexually transmitted infections. In response to the COVID-19 pandemic, Respecting the Circle of Life (RCL), a sexual reproductive health and teen pregnancy prevention program for Native youth and their trusted adult, was adapted and delivered in a virtual format with Native youth in a rural, reservation-based Native community.

 

Abstract: American Indian/Alaska Native (Native) youth face high rates of substance use, teen pregnancy and sexually transmitted infections. In response to the COVID-19 pandemic, Respecting the Circle of Life (RCL), a sexual reproductive health and teen pregnancy prevention program for Native youth and their trusted adult, was adapted and delivered in a virtual format with Native youth in a rural, reservation-based Native community. This manuscript describes the adaptation process, feasibility, and acceptability of virtual program implementation. The manuscript describes the process of rapidly shifting the RCL program into a virtual format. In addition, a mixed-methods process evaluation of implementation forms, program feedback forms, in-depth interviews with participants, and staff debriefing sessions was completed. Results show virtual implementation of RCL is both feasible and acceptable for Native youth and their trusted adults. A key benefit of virtual implementation is the flexibility in scheduling and ability to have smaller groups of youth, which offers greater privacy for youth participants compared to in-person implementation with larger groups. However, internet connectivity did present a challenge for virtual implementation. Ultimately, sexual and reproductive health programs seeking to reach Native youth and families should consider virtual implementation methods, both during and outside of pandemic situations. NOTE: This project was conducted to better understand how the virtual implementation of the program was received by participants and not to draw any conclusions about its utility or impact.

 

Source: Link to Original Article.

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Source: https://coloradosph.cuanschutz.edu/docs/librariesprovider205/journal_files/vol29/29_2_2022_63_patel.pdf

Type of Resource: Peer-reviewed scientific article

Acceptability of an Adapted HIV Prevention Intervention for Native American Adolescents

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Authors: Crystal Lee, Melva Thompson-Robinson, Carolee Dodge-Francis

Publication Year: 2018

Last Updated:

Journal: AIDS Education and Prevention

Keywords: Cultural Sensitivity and Appropriateness; Data Collection; HIV/AIDS; Minority Groups

 

Short Abstract: Relatively few HIV evidence-based interventions (EBIs) among Native Americans have been developed, adapted, evaluated, and/or published in the scientific literature. An adolescent HIV EBI was adapted in three phases: (1) securing input from a Native American Advisory Board; (2) modifying the EBI to be more consistent with Native American culture; and (3) conducing a pilot with 14 Native American adolescents to examine acceptability and cultural congruence between the adapted intervention and the youth’s culture based on Likert-scale ratings and a focus group.

 

Abstract: Relatively few HIV evidence-based interventions (EBIs) among Native Americans have been developed, adapted, evaluated, and/or published in the scientific literature. An adolescent HIV EBI was adapted in three phases: (1) securing input from a Native American Advisory Board; (2) modifying the EBI to be more consistent with Native American culture; and (3) conducing a pilot with 14 Native American adolescents to examine acceptability and cultural congruence between the adapted intervention and the youth’s culture based on Likert-scale ratings and a focus group. The adaptations included diverse Native American social and cultural stories that assisted with responsible decision-making skills. The adolescents consistently rated each intervention session as highly acceptable. A difference in knowledge from pre-survey (M = 13.93, SD = 3.08) to post-survey (M = 17.14, SD = 2.25) was statistically significant; t(13) = 4.166, p < .0005. The adapted curriculum did appear culturally responsive based on the pilot test results.

 

Source: Link to Original Article.

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Source: https://guilfordjournals.com/doi/10.1521/aeap.2018.30.1.72

Type of Resource: Peer-reviewed scientific article

Traditional Healing, Biomedicine and the Treatment of HIV/AIDS: Contrasting South African and Native American Experiences

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Authors: Adrian Flint

Publication Year: 2015

Last Updated: April 20th, 2015

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Keywords: Cultural Sensitivity and Appropriateness; Ethnicity; HIV/AIDS; Minority Groups

 

Short Abstract: Traditional healing remains an important aspect of many people’s engagement with healthcare and, in this, responses to the treatment of HIV/AIDS are no different.

 

Abstract: Traditional healing remains an important aspect of many people’s engagement with healthcare and, in this, responses to the treatment of HIV/AIDS are no different. However, given the gravity of the global HIV/AIDS pandemic, there has been much debate as to the value of traditional healing in this respect. Accordingly, this paper explores the extent to which meaningful accommodation between the biomedical and traditional sectors is possible (and/or even desirable). It does this through a consideration of Native American and South African experiences, looking at how the respective groups, in which medical pluralism is common, have addressed the issue of HIV/AIDS. The paper points to the importance of developing “culturally appropriate” forms of treatment that emphasize complementary rather than adversarial engagement between the traditional and biomedical systems and how policymakers can best facilitate this.

 

Source: Link to Original Article.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410250/

Type of Resource: Best Practices Newsletter