Sexual Health, STI and HIV Risk, and Risk Perceptions Among American Indian and Alaska Native Emerging Adults
- 120 Downloads
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.
KeywordsEmerging adulthood American Indian/Alaska Native Sexual health Technology-based intervention
The Native VOICES adaptation and evaluation study was funded by the Native American Research Centers for Health program (PI: Thomas Becker).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
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 . 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 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.
- 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
- 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.
- 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
- Fishbein, M. & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.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.CrossRefPubMedPubMedCentralGoogle 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
- 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
- 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.CrossRefPubMedGoogle 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