A Qualitative Study of Social Norms and their Impact on Native

Women's HIV Risk

Hannabah BlueCapacity Building Assistance Specialist

National Native American AIDS Prevention CenterAugust 2011

The views and opinions in this presentation only reflect those of the author

Learning ObjectivesBy the end of this presentation, attendees will be able to…• Discuss a community assessment model

for Native communities• Conceptualize behavioral determinants

(including social norms) and factors that impact HIV risk for Native women in select tribal communities

Native Women and HIV• Heterosexual Sex

– Highest Transmission Category • Highest percentage of contracting

HIV through IDU• Success

– Prenatal Screening and Parent to Child Transmission

Native Women and HIV• Risk Co-Factors

– Substance Use– Sexually Transmitted Diseases– Single Parent Homes

• Historical Trauma• Cultural Influences

– Strength– Challenges

Assessment with 3 Communities

• Tribal Communities in Northern New Mexico

• White Earth Nation• Denver Native Community

Note:– Results cannot be generalized for all Native

communities– But could point in the right direction of how to

craft programs for Native communities

Methods

• Assessment with 3 Communities:– Focus Groups– Phone Interviews

• Recruited self-identified Native women and key informants ages 18 and over

Community AssessmentCommunity Focus Groups Phone InterviewsTribalCommunity in New Mexico

1. 7 participants5 Native & 2 Hispanic women ages 18-65

15 interviews6 Native Females 25-643 Hispanic Females 25-542 Caucasian Females 25-442 Caucasian Males 45-641 Native Male 45-541 Hispanic Male 35-44

2. 7 participants7 Native women ages 16-34

White Earth Nation

1. 6 participantsNative women ages17-54

12 interviews8 Native Females 18-641 Native Transgender MTF 45-542 Native Male 18-441 Caucasian Male 45-54

2. 5 participants Native women ages 17-65

Denver Native Community

1. 6 participantsWomen ages 44-80 & one male age 20, all Native

12 interviews10 Native Females 25-642 Native Males 45-64

2. 8 participantsNative women ages 17-65

Analysis of Data• Community data was analyzed

using a grounded theory framework– Coded and categorized

• In order to map out the issues, understand linkages, and identify opportunities to create messaging

AnalysisTribal Community in New Mexico

Key Findings• The phenomena of stigma and lack of

awareness/personal connection to HIV• Leading to the actions/interactions of

fear of rejection & low perceived risk• Resulting in the consequences of

Native women in community not talking about HIV, taking it seriously or thinking they need to know about it

AnalysisWhite Earth Nation

Key Findings• The phenomena of stigma and

shame• Leads to the actions/interactions of

avoidance, non-disclosure and fear• Results in the consequence of

people not talking or teaching about it

AnalysisDenver Native Community

Key Findings• Phenomenon of low perceived risk• Lead to the action/interaction of

the belief that condoms are only for pregnancy prevention

• Resulting in the consequence that Native women were having unprotected sex

General Themes and Overall Findings

• Low perception of risk• Poor or unreliable resources• Lack of familiarity with HIV• Stigma around HIV and/or disease taboo• Leads to silence around HIV

– Teaching– Talking– Disclosure– Perpetuation of misinformation

Recommendations• Bring in a PLWHA that community

members can identify with• Promote community or population

specific rates or risks• Assess level of community readiness

and integrate programs to combat stigma associated with HIV

• Create materials and resources are that are Native- or community-specific

Questions?Ahe’hee!

Hannabah BlueNNAAPC

hblue@nnaapc.org(720) 382-2244, ext 301