American Indians/Alaska Natives (AI/AN) are disproportionately affected by HIV. The CDC reported that HIV diagnoses increased in AI/AN from 2010-2014, while diagnoses most other race groups decreased (1). Despite this disparity, AI/AN communities are often left out of conversations on HIV prevention, which has directly resulted in a lack of patient education materials that are culturally appropriate for AI/AN people.

In particular, there are few AI/AN-specific patient education materials on pre-exposure prophylaxis (PrEP), the pill that can prevent HIV. To address the need for AI/AN-specific PrEP education materials, Urban Indian Health Institute (UIHI) established a partnership with Project Inform, a national HIV and hepatitis C education and advocacy group to culturally adapt pre-exposure prophylaxis (PrEP) education materials. These new materials were based off of information previously created by Project Inform.

 

To create these materials, UIHI conducted a survey on HIV knowledge, attitudes, and beliefs in self-identifying AI/ANs at local events. Results showed that 62% of respondents (195/317) had never heard of PrEP. In addition to the survey, UIHI worked on creating a brief educational postcard by adding appropriate AI/AN imagery, including an HIV awareness ribbon in the shape of a feather, and information regarding PrEP access at Indian health facilities.

 

Project Inform and other stakeholders (e.g. Urban Indian Health Program leaders, community members, etc.) reviewed the postcard and provided feedback on both the design and content. In addition, 10 AI/AN current or former PrEP users participated in key informant interviews to provide feedback on the postcard. The postcards will be distributed to all Urban Indian Health Programs and launched in 2018. In the future, UIHI will work with Project Inform to fulfill the need for materials targeted at AI/AN sub-populations, including Two Spirit people and heterosexual women.

1. CDC. (2015). HIV surveillance report: Diagnoses of HIV infections in the US and dependent areas, 2015.

View/Download Electronic PrEP Pamphlet (PDF 989KB)

For more information on the HIV, STI, and Hepatitis C work being done at UIHI visit our website.

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Starting to Quit By: Angela Snell
 

SUMMARY

Poarch Band of Creek Indians (PBCI) Tribal Nation was able to focus on their tobacco cessation program due to the CDC Good Health and Wellness in Indian Country (GHWIC) grant. PBCI utilized the funding from the GHWIC to conduct a community health assessment. Through this assessment, Tribal Council could hear from Tribal citizens their desire for smoke-free buildings and protection from secondhand smoke. Policies were approved and changes made to prohibit smoking within 100 feet of the Health Center.

CHALLENGE

Every year, about 3,000 adult nonsmokers die from lung cancer and 35,000 from coronary heart disease nationwide. People exposed to secondhand smoke (the smoke that comes from the burning end of tobacco and exhaled smoke from smokers) greatly increase their risk of developing lung cancer, heart disease, asthma, bronchitis, ear infections, pneumonia, croup, and sore throats. People can be protected from the harms of secondhand smoke by having smoke-free buildings and not allow smoking within 100 feet of the buildings.

RESULTS

Because Tribal Council knew they had the support of their Tribal citizens, Tribal Council passed a resolution to not allow smoking within 100 feet of the Health Center. The Health Center has designated smoking areas by the placement of picnic tables on each side of the building that are 100 feet away from the building. The picnic tables have been secured in place so that they cannot be moved. The GHWIC staff are now working to expand the smoke-free policies to the entire reservation.

The Health Department is also working on their Tobacco Cessation program. Approximately ten patients a month are being referred to the tobacco cessation program.

SOLUTION

Thanks to the CDC’s GHWIC funding, the PBCI health department conducted a community health assessment in 2016. A key component of the assessment was the development of surveys that asked if their Tribal citizens were in favor of having smoke-free buildings and not allowing smoking within 100 feet of those buildings. 82% of the respondents were in favor of smoke-free buildings and not allowing smoking around those buildings. This illustrated to the Tribal Council and Tribal leaders that their citizens did not want to be exposed to secondhand smoke and were in favor of policies that would protect them.

SUSTAINING SUCCESS

The PBCI health department’s goal is to continue the work in making more buildings with a 100 feet perimeter that is smoke-free. The success of policy change is encouraging and the dream is to one day have a smoke-free reservation. The PBCI health department will continue to educate the community about the harmful nature of commercial tobacco and assist smokers in quitting.

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Contact:
Toria Reaves, Epidemiologist
USET
711 Stewarts Ferry Pike
Suite 100
Nashville, TN 37214
615-467-1557
http://www.usetinc.org

 

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