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

4 Effective Communication

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

Open communication is vital to effective HIV/AIDS prevention and care. Unfortunately, many Native people do not openly discuss sexual activity, pregnancy, contraception, sexually transmitted diseases, and other important health topics.16 Studies show that Native American children know less about HIV and AIDS than white children, partly because of poor family communication.17 This is an area that you can focus on in your community. Although there are many factors that contribute to poor family communication, you can address cultural taboos about sex and the body and work to improve communication between adults and youth.

Native organizations can use community assessments to get specific feedback from Native community members. They can survey Native community attitudes about HIV/AIDS and beliefs about what makes an appropriate and inappropriate intervention.18,19,20 With this information on hand, you can improve communication with Native members of your community.

  • Research Native community attitudes about diseases and treatment. How do Native people in your community feel about HIV/AIDS? What are some general assumptions about the disease?

  • Identify words and settings that are acceptable for the discussion of sex, STDs, and HIV/AIDS.

  • Using this research, brainstorm ways to present educational material to Native people in your community. How can you encourage parents to speak more openly to their children? How can you reach out directly to youth?
16Rolf JE, Nansel TR, Baldwin JA, Johnson JL, Benally CC. HIV/AIDS and alcohol and other drug abuse prevention in American Indian communities: Behavioral and community effects. In: Mail PD, Heurtin-Roberts S, Martin SE, Howard J, eds. Alcohol Use Among American Indians and Alaska Natives: Multiple Perspectives on a Complex Problem. Bethesda: NIH Publication; 2002:295-319.

17Ramirez JR, Crano WD, Quist R, Burgoon M, Alvaro EM, Grandpre J. Effects of fatalism and family communication on HIV/AIDS awareness variations in Native American and Anglo parents and children. AIDS Education and Prevention. 2002;14:29-40.

18Vernon I, Jumper-Thurman P. Prevention of HIV/AIDS in Native American communities: Promising interventions. Public Health Report. 2002;117:96S-103S.

19Minkler M, Wallerstein N, eds. Community Based Participatory Research for Health. Jossey-Bass; 2000.

20Vernon I. Killing Us Quietly: Native Americans and HIV/AIDS. Lincoln: University of Nebraska Press; 2001:81-99.