Module 2: Historical and Socioeconomic Health Risks

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Goal of Module 2:
To examine the historical and sociological factors that put Native communities at increased risk for HIV infection.

Addressing HIV/AIDS is not an easy task in itself. Addressing HIV/AIDS among Native populations is even more difficult. It involves the health and psychosocial effects of many other issues: a traumatic history, homophobia and discrimination, poor communication, poverty, and substance abuse. In order to address HIV/AIDS among Native populations, it is essential to understand and respond to these historical and social barriers.
Contents Current Native American HIV/AIDS Issues and Needs

This module discusses the impact of HIV/AIDS on Native Americans and the health and psychological legacies of contact and colonization.

Topics include:

  1. History and Trauma


  2. Impacts of Contact and Colonization


  3. Discrimination and Homophobia


  4. Effective Communication


  5. Biological Factors


  6. Poverty


  7. Violence and Powerlessness


  8. Trust and Lack of Confidence


  9. Substance Abuse


  10. Healthcare Funding for Native Communities


  11. Structural Barriers to Intervention/Prevention

Introduction: Why should we be concerned?
Data shows that HIV/AIDS is a growing concern among Native peoples. American Indians, Alaska Natives, and Native Hawaiians (AI/AN/NH) have a high risk of HIV infection because of alcohol and substance abuse and other biological, economic, and social co-factors.

Between 1996 and 2001, AIDS cases declined for all races except AI/ANs.1 Likewise, between 1996 and 2001, the number of deaths among persons with AIDS declined for all races except AI/ANs.2 We need to concentrate on HIV/AIDS prevention in Native communities.

Currently HIV/AIDS plagues poor communities of color. For African Americans between ages 25 and 44, AIDS is now the number one killer. Causal factors include poverty, substance abuse, discrimination, and high rates of sexually transmitted diseases. Because many Native communities have these same high-risk factors, HIV/AIDS could have a similar impact on Native populations.

Addressing HIV/AIDS is not an easy task, especially when faced with health and psychosocial effects of contact and colonization, homophobia and discrimination, poor communication, biological vulnerabilities in women, poverty, and substance abuse. In addition, there is not enough funding for Indian Health Services, tribal, urban, or Native Hawaiian facilities to effectively address the HIV/AIDS threat. There is also wide cultural diversity among Native communities and a need for programs that appropriately address culture, gender, and age.

How Will This Module Help?
Module 2 asks you to delve into the historical and social issues that affect Native people in your community. It gives some information on how these issues relate to HIV/AIDS and then asks you to reflect, research, and communicate with others about each topic. You can use the questions as points of discussion in staff and community meetings and as starting points for your own research of written materials (online and in libraries). Remember: to get local feedback, you can talk to elders, community leaders, and community members. The goal is to create, improve, and carry out more culturally competent and effective HIV/AIDS prevention methods in your community. If you can understand the historical and social influences behind the behaviors and beliefs of your focus population, then you can carry out a stronger HIV/AIDS prevention program.

1Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, Year-End Edition. Atlanta: US Department of Health and Human Services, CDC. December 2001;13:5.

2Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, Year-End Edition. Atlanta: US Department of Health and Human Services, CDC. December 2001;13:6.