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.


5 Biological Factors

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

Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs)—now used as a more inclusive term—put both men and women at increased risk for HIV infection. First, the presence of STIs signifies high-risk behavior, such as unprotected sex. Second, STIs increase risk by allowing entry for HIV through open sores and microscopic breaks in affected tissue. Third, 70-80 percent of STIs have no symptoms and go unnoticed, making persons infected more vulnerable to HIV. Native communities with high STI incidence rates have a greater likelihood of high HIV/AIDS incidence rates. Health professionals must pay close attention to high STI rates in Native communities, especially gonorrhea, chlamydia, and syphilis.

HIV is increasing steadily among women, especially among women of color. Women and adolescents make up 19 percent of Native American AIDS cases and 27 percent of reported HIV infections.21 Women have some gender-specific HIV risk factors. First, they can receive the HIV virus from men, who make up the majority of AIDS cases. Second, the HIV virus can easily enter the bloodstream through the lining of the vagina and cervix. Third, in older women vaginal dryness can cause tearing, which provides a prime pathway for HIV. Hormone replacement treatments among older women also increase susceptibility to HIV.

  • What STI prevention methods or programs are already in place in your community?

  • Find a piece of health education literature targeting STI prevention (a brochure, flyer, etc.). Identify its target audience (who was it written for?). How is the brochure being distributed to this audience? What language or images does the brochure use to better relate to its audience? Do you think the design and text can be improved in any way?

  • Brainstorm ways to target the female population of your Native community. Where can you distribute information so that women will see it? What concepts, words, and images can you use so that women will relate to it?

21Westberg J. Native Americans and HIV/AIDS. Winds of Change. Autumn 2003;18:59.