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Sexual Health, STI and HIV Risk, and Risk Perceptions Among American Indian and Alaska Native Emerging Adults

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Abstract

Emerging adulthood (18–25) is a period of increased risk for adverse sexual health outcomes. While anyone in this age group is at elevated risk, American Indian and Alaska Native (AI/AN) youth and emerging adults face unique factors that influence their risk for sexually transmitted infections (STIs). To address this increased risk among AI/AN youth, culturally appropriate interventions are necessary. This study reports the results of a video-based sexual health intervention designed specifically for AI/AN youth and emerging adults (15–24 years old) on risk changing perceptions. This intervention was evaluated using a group-randomized design with three conditions: (1) fact sheet alone, (2) fact sheet and video, and (3) fact sheet, video, and facilitated discussion. Using data from 199 AI/AN emerging adults (18–24 years old) who participated in the Native VOICES evaluation, we used multiple multinomial logistic regressions to determine if changes in risk perceptions were significantly different between study arms from baseline to post-intervention, and from post-intervention to 6-month follow-up. Few differences in STI risk perceptions were found at baseline and observed differences in STI risk perceptions between study arms disappeared after including baseline risk perceptions in the model. Similarly, few differences in HIV risk perceptions between study arms were observed at baseline, and all differences in HIV risk perceptions between study arms disappeared after controlling for baseline risk perceptions, demographics, and baseline sexual risk factors. Overall, this study points to the need for interventions that specifically address the behaviors, social and sexual contexts, and risk perceptions of AI/AN emerging adults, an age group for whom few culturally relevant sexual health interventions exist.

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References

  • Albarracin, D., Johnson, B. T., Fishbein, M., & Muellerleile, A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127, 142–161.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55, 469–480.

    Article  CAS  PubMed  Google Scholar 

  • Basen-Engquist, K., & Parcel, G. S. (1992). Attitudes, norms, and self-efficacy: A model of adolescents’ HIV-related sexual risk behavior. Health Education Quarterly, 19, 263–277.

    Article  CAS  PubMed  Google Scholar 

  • Basen-Engquist, K., Massey, C., Coyle, K., Kirby, D., Parcel, G. S., Banspach, J. S., & Nodora, J. (1999). Validity of scales measuring the psychosocial determinants of HIV/STD-related risk behavior in adolescents. Health Education Research, 14, 25–37.

    Article  CAS  PubMed  Google Scholar 

  • Baumgartner, S. E., Valkenburg, P. M., & Peter, J. (2010). Assessing causality in the relationship between adolescents’ risky sexual online behavior and their perceptions of this behavior. Journal of Youth and Adolescence, 39, 1226–1239.

    Article  PubMed  PubMed Central  Google Scholar 

  • Centers for Disease Control and Prevention. (2016). VOICES/VOCES: Video opportunities for innovative condom education & safer sex. Accessed 10 June 2017 at https://effectiveinterventions.cdc.gov/en/HighImpactPrevention/Interventions/VOICES.aspx.

  • Center for Native American Youth. (2016). Drawing strength from our cultures: State of Native Youth 2016, in State of Native Youth Report 2016. Washington, D.C.: The Aspen Institute.

    Google Scholar 

  • Chambers, R., Tingey, L., Mullany, B., Parker, S., Lee, A., & Barlow, A. (2016). Exploring sexual risk taking among American Indian adolescents through protection motivation theory. AIDS Care, 28, 1089–1096.

    Article  PubMed  Google Scholar 

  • Champion, J. D., Harlin, B., & Collins, J. L. (2013). Sexual risk behavior and STI health literacy among ethnic minority adolescent women. Applied Nursing Research, 26, 204–209. https://doi.org/10.1016/j.apnr.2013.06.003.

  • Claxton, S. E., & van Nulmen, M. H. M. (2013). Casual sexual relationships and experiences in emerging adulthood. Emerging Adulthood, 1, 138–150.

    Article  Google Scholar 

  • Craig Rushing, S., & Gardner, W. (2016). Native VOICES: Adapting a video-based sexual health intervention for American Indian teens and young adults using the ADAPT-ITT Model. American Indian and Alaska Native Mental Health Research, 23, 24–46.

    Article  PubMed  Google Scholar 

  • Craig Rushing, S., Gaston, A., Kaufman, C. E., Markham, C., Jessen, C., Gorman, G., & Koogei Revels, T. (2015). Using technology to promote health and wellbeing among American Indian and Alaska Native teens and young adults. In L. E. Dyson, S. Grant, & M. Hendriks (Eds.), Indigenous people and mobile technologies (pp. 163–178). New York, NY: Routledge.

    Google Scholar 

  • de Ravello, L., Tulloch, S., & Taylor, M. (2012). We will be known forever by the tracks we leave: Rising up to meet the reproductive health needs of American Indian and Alaska Native youth. American Indian and Alaska Native Mental Health Research, 19, i–x.

    Article  PubMed  Google Scholar 

  • Fishbein, M. & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.

  • Haile, Z., Kingori, C., Darlington, K., Basta, T., & Chavan, B. (2017). HIV risk perceptions among college students a university in the Midwest. Sexuality & Culture, 21, 62–73.

    Article  Google Scholar 

  • Halpern-Felscher, B. L., Cornell, J. L., Kropp, R. Y., & Tschann, J. M. (2005). Oral versus vaginal sex among adolescents: Perceptions, attitudes, and behavior. Pediatrics, 115, 845–851.

    Article  Google Scholar 

  • Hellerstedt, W. (2004). Native teen voices. Minneapolis, MN: University of Minnesota Accessed 10 June 2017 at http://www.ntv.umn.edu/index.shtm.

    Google Scholar 

  • Kaufman, C. E., Beals, J., Mitchell, C. M., Lemaster, P., Fickensher, A., & The Pathways of Choice and Healthy Ways Project Teams. (2004). Stress, trauma, and risky sexual behavior among American Indians in young adulthood. Culture, Health & Sexuality, 6, 301–318.

    Article  Google Scholar 

  • Kaufman, C. E., Desserich, J., Big Crow, C. K., Holy Rock, B., Keane, E., & Mitchell, C. M. (2007). Culture, context, and sexual risk among Northern Plains American Indian youth. Social Science & Medicine, 64, 2152–2164.

    Article  Google Scholar 

  • Kaufman, C. E., Mitchell, C. M., Beals, J., Desserich, J. A., Wheeler, C., Keane, E. M., Whitesell, N. R., Sam, A., & Sedey, C. (2010). Circle of Life: Rationale, design, and baseline results of an HIV prevention intervention among young American Indian adolescents of the Northern Plains. Prevention Science, 11, 101–112.

    Article  PubMed  PubMed Central  Google Scholar 

  • Markham, C. M., Craig Rushing, S., Jessen, C., Lane, T. L., Gorman, G., Gaston, A., Revels, T. K., et al. (2015). Ractors associated with early sexual experience among American Indian and Alaska Native youth. Journal of Adolescent Health, 57, 334–341.

    Article  Google Scholar 

  • Millstein, S. G., & Halpern-Felsher, B. L. (2001). Perceptions of risk and vulnerability. In B. Fischoff, E. O. Nightingale, & J. G. Iannotta (Eds.), Adolescent risk and vulnerability: Concepts and measurement (pp. 15–50). Washington, DC: National Academy Press.

    Google Scholar 

  • Myint-U, A., Bull, S., Greenwood, G. L., Patterson, J., Rietmeijer, C. A., Vrungos, S., Warner, L., et al. (2010). Safe in the City: Developing an effective video-based intervention for STD clinic waiting rooms. Health Promotion Practice, 11, 408–417.

    Article  PubMed  Google Scholar 

  • Rogers, R. W. (1975). A protectio motivation theory of fear appeals and attitude change. The Journal of Psychology, 91, 93–114.

    Article  PubMed  Google Scholar 

  • Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2, 328–335.

    Article  Google Scholar 

  • Rushing, S. C., Gaston, A., Kaufman, C., Markham, C., Jessen, C. M., Gorman, G., Torres, J., & Williamson, J. (2016). Using technology to promote health and wellbeing among American Indian and Alaska Native teens and young adults. In L. E. Dyson, S. Grant, & M. Hendriks (Eds.), Indigenous people and mobile technologies (pp. 163–179). New York, NY: Routledge.

    Google Scholar 

  • Slater, H. (2013). LGBT-inclusive sex education means healthier youth and safer schools. Washington, DC: Center for American Progress Accessed 2 February 2018 at: https://www.americanprogress.org/issues/lgbt/news/2013/06/21/67411/lgbt-inclusive-sex-education-means-healthier-youth-and-safer-schools/.

    Google Scholar 

  • Suellentrop, K., & Hunter, G. (2009). American Indian/Alaska Native youth and teen pregnancy prevention, In Putting What Works to Work. Washington, DC: The National Campaign to Prevent Teen Pregnancy.

    Google Scholar 

  • Sychareun, V., Thomsen, S., Chaleunvong, K., & Faxelid, E. (2013). Risk perceptions of STIs/HIV and sexual risk behaviours among sexually experienced adolescents in the Northern part of Lao PDR. BMC Public Health, 13, 1126–1139.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tingey, L., Mullany, B., Chmbers, R., Hastings, R., Lee, A., Parker, A., Barlow, A., & Rompalo, A. (2015). Respecting the circle of life: One year outcomes from a randomized controlled comparison of an HIV risk reduction intervention for American Indian adolescents. AIDS Care, 27, 1087–1097.

    Article  PubMed  Google Scholar 

  • U.S. Census Bureau. (2016). American Indian and Alaska Native alone or in combination with one or more other races 2015. Washington, DC: U.S. Department of Commerce, U.S. Census Bureau Accessed 2016 Dec 13 at : http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_10_1YR_S0201&prodType=table.

    Google Scholar 

  • Wingood, G. M., & DiClemente, R. J. (2008). The ADAPT-ITT model, a novel method of adapting evidence-based HIV interventions. Journal of Aquired Immunodeficiency Syndrome, 47, S40–S46.

    Article  Google Scholar 

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Funding

The Native VOICES adaptation and evaluation study was funded by the Native American Research Centers for Health program (PI: Thomas Becker).

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Authors and Affiliations

  1. Department of Social and Behavioral Sciences, TH Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, USA

    Steven Paul Hafner

  2. NW Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, Portland, USA

    Stephanie Craig Rushing

Authors
  1. Steven Paul Hafner
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  2. Stephanie Craig Rushing
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Correspondence to Steven Paul Hafner.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. The Native VOICES intervention was reviewed and approved by the Portland Area Indian Health Service Institutional Review Board at the Northwest Portland Area Indian Health Board in Portland, OR [333712]. This analysis was exempted by the Institutional Review Board in the Office of Human Research Administration at the Harvard TH Chan School of Public Health in Boston, MA.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Consent was also obtained from parents/guardians of minors.

Statement of Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Hafner, S.P., Craig Rushing, S. Sexual Health, STI and HIV Risk, and Risk Perceptions Among American Indian and Alaska Native Emerging Adults. Prev Sci 20, 331–341 (2019). https://doi.org/10.1007/s11121-018-0920-7

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  • DOI: https://doi.org/10.1007/s11121-018-0920-7

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