Office of Minority Health

Grantee Information

Grantee:  The National Indian Women’s Health Resource Center
Tahlequah, OK 74464
Project: Minority Community HIV/AIDS Partnership
Amount: $771,270
Grant Period: 2010-2013

Project Description
The National Indian Women’s Health Resource Center (NIWHRC) envisions American Indian and Alaska Native women living in balance within the sacred circle of life. To do this, the NIWHRC assists American Indian and Alaska Native women in achieving optimal health and well-being for themselves, their families and their communities. The purpose of the Minority Community HIV/AIDS Partnership project was to reduce HIV/AIDS-related health disparities and increase access to and availability of HIV/AIDS preventive services for American Indian/Alaska Native (AI/AN) populations. The project addressed the lack of culturally appropriate intervention materials, social and cultural barriers to treatment and preventive services and the lack of awareness of health status of AI/AN students at Fort Totten Northeastern State University (NSU) and Candeska Cikana Community College (CCCC).

NIWHRC supported many HIV-related campus events and held numerous two-day sexual health classes. The HIV prevention/sexual health class was implemented at all NSU campuses and included a speaker who addressed the dangers of alcohol and drugs and their influence over sexual health, risky behaviors, and negative consequences, and increased students’ sexual violence awareness. Special HIV testing days were often offered during these campus events and have been held at all NSU campuses and at CCCC. The intended outcomes of the intervention activities were: 1) improved access to HIV/AIDS services? among American Indians and Alaska Natives, 2) reduced high-risk behaviors and promotion of healthy behaviors among the student body and in the surrounding community, and 3) increased access to and availability of HIV counseling and testing services for AI/AN students.

The education pilot program was evaluated through knowledge-based pre- and post-tests and a three-month follow-up assessment. The surveys asked about physical anatomy, sexually transmitted infections, HIV basics, HIV testing and resources, birth control, relationships and power dynamics, condom negotiation, alcohol and drugs and their influence on decision making, historical trauma and how it influences individuals and communities, self-efficacy for condom negotiations and self-assessed intentions to change and perceived level of risk. Baseline HIV awareness surveys were also administered at the beginning of each school year to measure general awareness of HIV, resources available, and knowledge about HIV testing on the campuses.

Key Program Findings Reported throughout the Grant Period

• Increased access to HIV and STI testing. During the course of the grant, across all campuses, 903 students were tested and made aware of their HIV status. The school year prior to the grant, only eight students were tested.
• Increased knowledge.The mean score on questions (maximum was 13 points) about HIV increased from 9.76 at pretest to 10.98 and then 11.13 at post-test and follow-up, respectively (N=60). Average scores on the five questions measuring knowledge of the effects of alcohol consumption went from 3.16 at pretest to 3.91 and then 3.59 at post-test and follow-up, respectively (N=60).   
• Increased HIV awareness. 1,131 students from NSU and CCCC campuses were surveyed over a five-year period. Perceived risk of HIV/AIDS went from 53 percent during the 2008–2009 school year to 28 percent during 2012–2013. Overall, students receiving HIV/AIDS information in the classroom increased from 22 percent to 52 percent over the five years.
• Increased campus HIV capacity. Free HIV testing was made available at all NSU campuses. The campus program director at CCCC was trained on HIV testing and counseling and continues to offer free rapid HIV testing on campus. Testing at Little Hoop (located on a small reservation) was made available by having the campus director become certified as an HIV tester.
• Institutionalized HIV prevention strategies. The Student Health Services Center at NSU has included a question regarding HIV testing on the admissions questionnaires to help normalize HIV testing. A required health class for incoming freshmen at the Tahlequah campus incorporated the sexual health curriculum into the course. NSU has renewed the campus director’s contract and will provide a stipend for student ambassadors to coordinate educational events.

Identified Best Practice

• Formed relationships with key personnel. One of NIWHRC’s first activities at NSU was developing a good working relationship with student health services. NIWHRC was able to financially support HIV testing at NSU and within the first year increased the number of students tested from 8 to 165. The relationship with student health services in conjunction with a visible impact of NIWHRC’s efforts empowered staff to become champions for the program. One staff member eventually became assistant dean of the school and helped create opportunities to get HIV/STI education into the classrooms and redistribute funds to continue providing free HIV testing to students. This relationship played a large role in carrying out systems change at NSU. 

Related Goals

National Partnership for Action to End Health Disparities

• Awareness: Increase awareness of the significance of health disparities, their impact on the nation, and the actions necessary to improve health outcomes for racial, ethnic and underserved populations

Healthy People 2020 Objectives and Sub-objectives

• HIV-3: Reduce the rate of HIV transmission among adolescents and adults