Module 2: Historical and Socioeconomic Health Risks

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

8 Trust and Lack of Confidence

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

Native people have a long and harmful history with the United States government. Because of this, some Native people do not trust Indian Health Services (IHS) or health providers. This makes HIV/AIDS prevention work difficult. In order to effectively prevent HIV among Native people in your community, you must get them to test early. Unfortunately, some Native people fear that their test results will not be kept private and, as a result, do not get tested for HIV. To gain the trust of the Native people in your community, try consulting prominent Native figures that already have the support of the community (such as elders, community leaders, or HIV+ community members, for example).

  • Identify issues of trust regarding healthcare in your Native community. Do people seem to trust doctors and the healthcare system? If not, why not?

  • Brainstorm ways to make Native people feel more welcome in your healthcare facilities. How can you show Native people that they can trust healthcare providers?

In Toward a Culturally Competent System of Care, Volume I, the authors identify positive attributes (listed below) that are necessary to achieve cultural competency. 8

Reflect on each of the characteristics below. How does each relate to trust? How could each of the following attributes help you to build trust among Native people in your community?

Genuineness
Non-possessive warmth
Accurate empathy
Open-mindedness
Flexibility
Commitment to cause
Ability to articulate one’s own biases
Acceptance of ethnic differences
Realistic professional self-image

For more information on cultural competency, click here.

8Cross T, Bazron B, Dennis K, Isaacs M. Towards a Culturally Competent System of Care: Volume I. Washington DC: CASSP Technical Assistance Center, Georgetown University Child Development Center; 1989.