North Dakota Native American HIV/AIDS Needs Assessment

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Anastasia Sharp
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1 2003 Dakota Conference on Rural and Public Health Successful Strategies for Healthy Communities February 18, 2003 Best Western Ramkota Hotel 800 South 3 rd Street Bismarck, North Dakota North Dakota Native American HIV/AIDS Needs Assessment Leander R. McDonald, MA Center for Rural Health University of North Dakota School of Medicine and Health Sciences PO Box 9037 Grand Forks, ND

2 Purpose The purpose of this study was to examine HIV/AIDS knowledge, attitudes, behavior, and beliefs of Native American populations in the state of North Dakota. Population Native Americans between the ages of 18 and 44. All ND tribes were asked to participate Residing within the boundaries of the Fort Berthold, Spirit Lake, and Trenton Indian Service Area. 100 Respondents from each of the three areas. 2

3 Methodology Simple random sampling Oversampled at a rate of 2, so our data collector had a list of 125 households when going into the field. Main method of data collection was a survey instrument Data collectors Native Americans students at UND were employed as data collectors. Training was provided on confidentiality, cultural appropriateness, data collection procedures, and privacy issues. Data collectors stated, most people were very willing to participate in the project. 3

4 Data collection procedures Most respondents elected to fill out the survey immediately or have the data collector stop back within the hour for pickup. Respondents placed the completed survey into a sealed envelope and dropped in a lock box. Upon receipt of the envelope, the data collector presented the respondent with a coupon for $9.99 to be redeemed at a local eating establishment, gas station, or grocer. Institutional Review Board (IRB) The University of North Dakota Institutional Review Board and the Center for Rural Health research protocols require the principal investigator to contact the tribal councils for permission to conduct research within reservation boundaries prior to collecting data. 4

5 Demographics Gender Men Women 6 5

6 Average age Mean (average) age of respondent was years Marital status % 3 9% 7% 4% Single Married Divorced Part/opp Common law 2% 1% Separated Widowed Part/same 6

7 Educational Status % 2 13% 7% 2% 8th grade or less less than H.S. GED H.S. Grad T.S./Tech Some college College Grad 2% Graduate Degree Income 2 18% 1 14% 12% 8% 4% 2% 2 Under $5,000 11% 11% $5,000- $6,000 $7,000- $9,999 12% $10,000- $14,999 $15,000- $19,999 9% $20,000- $24,999 13% $25,000- $34,999 7% 7% $35,000- $49,999 $50,000 or more 7

8 Sexual Activity Age of First Sex % 21% 13% 1 4% 3% 12 and younger 13 years 14 years 15 years 16 years 17 years 18 years 19 years 20 years 21 and older (Mean = 16.2 years) 8

9 Condom Use % 14% 1% 1% 1% 1% 1% 1% 1% 1% (Mean=.1644) Sex w/different People 10 91% % 0 or 1 sexual partner 2 or more sexual partners 9

10 Condom Use None 5 Less than 1 partner 2 or more sexual partners Drug Use X Multiple Partners % 53% 33% 33% 14% 14% 4% 1% 1% 0 or 1 partner 2 or more partners 0 drug use 1 drug 2 drugs 3 drugs 4 drugs 5 or more 10

11 Drug Use 7 63% % 2% 2% 1% 1% 1% Alcohol Marj/hash Amphetamines Opiates Cocaine Crack Nonpresciption Heroine by itself Methadone Heroine & Cocaine together Sexually Transmitted Diseases 7% 4% 3% 2% 1% 2% 2% 2% 1% Chlamydia Genital Warts Trichomonas Gonorrhea Hepatitis B Syphilis Genital Herpes 11

12 HIV Testing 54% answered yes to receiving an HIV blood test. HIV Test Results Received % % 12% 9% 2% 2% 0 times 1 time 2 times 3 times 4 times 5 times 6 times 12

13 Year of Last HIV Test % 4% 3% 2% and before HIV Status One person reported being infected with HIV Infection occurred in 1999 D/K if they had been infected in or our of state 13

14 AIDS Status One person reported being infected with AIDS Infection occurred in 1992 No answer was given for where infection occurred Hemophilia Status 3.3% reported having transfusions 1 person reported being advised they were hemophiliacs 14

15 Knowledge/Attitude/Prevention Chance of Getting AIDS 8 74% No chance 2 Some chance 3% Half chance High chance 1% 1% Sure chance 15

16 Information/Risk Reduction Supplies Last 30 Days 4 37% % 7% 7% AIDS Info Condoms/latex Drug Treatment Referral HIV Antibody Testing Referral Clean Needle by Prev Worker Bleach Other Needle Exchange Referral Source of Information/Supplies % 24% 18% I.H.S. Tribal Health Other Source Chemical Dependecy HIV/AIDS Prev. 4% CHRs 16

17 Personal Sexual Experiences Experience Always Often Sometimes Seldom Never Use of condoms 28% 8% 13% 22% 28% Same partner 74% 12% 8% 4% 2% Talk about safety 37% 17% 1 21% You in control 5 18% 18% 4% Alcohol present 9% 24% 34% 24% 2 Use of drugs 11% 69% Shared needles 2% 3% 9 Fear of STDs 18% 8% 8% 1 52% Fear of pregnancy 1 19% 11% 44% Know partner s HIV status 51% 32% Effectiveness in Preventing AIDS Prevention Very High High Medium Low Very Low Abstain from Sex 69% 7% 8% 8% 8% Non Penetrative Sex 27% 17% 18% 18% 2 Always Use Condoms 5 17% 11% 7% Limit Sexual Partners 52% 12% 1 11% One sex partner 68% 13% 7% 7% Avoid Sex workers 6 14% Sex w/virgin % 12% 19% Sterilized needles 4 1 9% 2 Require Partner to take blood test 59% 12% 9% 7% 14% 17

18 Conclusions 74% believe they have no chance of getting AIDS with an additional 2 reporting minimal chance. 88% of the population is sexually active by the end of high school. Older respondents were less likely to participate in risky behavior. Older respondents had a higher understanding or prevention. Respondents in monogamous relationships were less likely to use condoms. Conclusions cont Respondents in monogamous relationships were less likely to use multiple drugs The higher the number of drugs used, the less income reported. Respondents using alcohol were less likely to use a condom. Respondents using 1 or more drugs were more likely to be tested for HIV with the rates of testing increasing with the increased number of drugs used. Respondents using one drug were more likely to participate in medium and high risk behavior. 18

Populations to Target Reach the young as they have the greatest need for information. Reach the users for they appear resistant to recognizing the risk and receiving materials.

19 Populations to Target Reach the young as they have the greatest need for information. Reach the users for they appear resistant to recognizing the risk and receiving materials. Reach those with multiple partners for each new partner exposes them to the risks associated with every sexual partner the new person has had. The young, the users, and those with multiple partners are most at risk, and should be targeted to receive information on the risk associated with HIV/AIDS. For more information contact: Leander R. McDonald PO Box 9037 Grand Forks, ND Tel:

LET S TALK about How do you let your partners know they have been exposed to HIV?

LET S TALK about How do you let your partners know they have been exposed to HIV? LET US HELP YOU. Partner Services will help you inform your partners about their exposure What is Partner Services? Partner