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Last modified: Thursday, October 21, 2004

Guidelines target HIV/STD prevention in Native American communities

Successful prevention programs for HIV and sexually transmitted diseases in Native American communities often look different from programs in non-native communities -- and this is how it should be, according to first-ever guidelines developed by Indiana University's Rural Center for AIDS/STD Prevention in collaboration with the National Native American AIDS Prevention Center.

Possible venues for program initiatives, for example, include sweats, dances, casinos, community dinners and tax centers. Some communities rely on help from spiritual elders. What works in one native community, however, may not work in others, according to the new guidelines, which offer prevention strategies and tips for reaching people, as one would expect, but also describe the complexities involved in addressing this insidious health need.

With people in these communities experiencing a disproportionate rate of HIV infection, the need for the guidelines and effective treatment is great. A history of colonization and poverty, unique cultures, and a distrust and misunderstanding of the American health care system are just some of the challenges that require programs that are well planned, culturally sensitive and inclusive.

William Yarber, senior director of RCAP, noted that the term "Native American communities" encompasses American Indians, Alaska Indians and Native Hawaiians, hundreds of tribes with their own unique cultures and traditions, all of which influence behavior and effective treatment.

"If we fail to look at that, the prevention strategies won't be effective," said Yarber, who described the guidelines as one of the most important projects in the center's 10-year history.

The guidelines are the product of the views of more than 20 HIV/STD native prevention specialists from throughout the United States who participated in an expert consultation meeting at IU.

Yarber said it was crucial to bring together these health experts. Michael E. Bird, executive director of the NNAAPC, said it can take five to 10 years for people working in native communities to become effective at addressing the health care needs of their patients. The new guidelines, he said, will give these health care providers useful information that could speed up this lag time.

The guidelines also address funding issues. A lack of resources, notably federal funding, calls for more creativity and efforts to develop links with state health programs.

"Clearly, issues concerning American Indians, Alaska Indians and Native Hawaiians are not even on the table when people are talking about HIV and AIDS, whether it's the federal agencies or other organizations," Bird said.

The free guidelines are being mailed to health care providers across the country. They can also be obtained from RCAP.

Yarber can be reached at 812-855-7974 and