IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i7p3566-d526558.html
   My bibliography  Save this article

“There Is a Lot of Practice in Not Thinking about That”: Structural, Interpersonal, and Individual-Level Barriers to HIV/STI Prevention among Reservation Based American Indians

Author

Listed:
  • Richard F Armenta

    (Department of Kinesiology, California State University, San Marcos, CA 92078, USA)

  • Daniel Kellogg

    (School of Public Health, San Diego State University, San Diego, CA 92182, USA)

  • Jessica L Montoya

    (Department of Psychiatry, University of California, La Jolla, San Diego, CA 92093, USA)

  • Rick Romero

    (Southern California Tribal Health Center, San Diego, CA 92539, USA)

  • Shandiin Armao

    (Southern California Tribal Health Center, San Diego, CA 92539, USA)

  • Daniel Calac

    (Southern California Tribal Health Center, San Diego, CA 92539, USA)

  • Tommi L Gaines

    (Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, La Jolla, CA 92093, USA)

Abstract

American Indians (AI) face significant disparities in HIV/STI morbidity and mortality, and historical, structural, interpersonal, and individual level barriers stymie prevention efforts. The objective of this paper is to examine barriers to HIV/STI prevention among reservation-based AI. We conducted face-to-face qualitative interviews with 17 reservation-based AI community leaders and community members in Southern California on HIV/STI knowledge and attitudes and barriers to prevention. The disruption of traditional coping mechanisms and healing processes were compromised by historical trauma, and this allowed stigmas to exist where they did not exist before. This impacted access to healthcare services and trust in medicine, and is linked to individuals adopting negative coping behaviors that confer risk for HIV/STI transmission (e.g., substance use and sexual behaviors). Most of the participants reported that HIV/STIs were not discussed in their reservation-based communities, and many participants had a misperception of transmission risk. Stigma was also linked to a lack of knowledge and awareness of HIV/STI’s. Limited available services, remoteness of communities, perceived lack of privacy, and low cultural competency among providers further hindered the access and use of HIV/STI prevention services. These findings highlight the need to address the historical, structural, and interpersonal factors impacting individual-level behaviors that can increase HIV/STI transmission among reservation-based AIs. Prevention work should build on community strengths to increase HIV/STI knowledge, reduce stigma, and increase access to preventative care while using culturally grounded methodologies.

Suggested Citation

  • Richard F Armenta & Daniel Kellogg & Jessica L Montoya & Rick Romero & Shandiin Armao & Daniel Calac & Tommi L Gaines, 2021. "“There Is a Lot of Practice in Not Thinking about That”: Structural, Interpersonal, and Individual-Level Barriers to HIV/STI Prevention among Reservation Based American Indians," IJERPH, MDPI, vol. 18(7), pages 1-12, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:7:p:3566-:d:526558
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/7/3566/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/7/3566/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Reilley, B. & Bloss, E. & Byrd, K.K. & Iralu, J. & Neel, L. & Cheek, J., 2014. "Death rates from human immunodeficiency virus and tuberculosis among American Indians/Alaska natives in the United States, 1990û2009," American Journal of Public Health, American Public Health Association, vol. 104(S3), pages 453-459.
    2. Walters, K.L. & Simoni, J.M., 2002. "Reconceptualizing native women's health: An "indigenist" stress-coping model," American Journal of Public Health, American Public Health Association, vol. 92(4), pages 520-524.
    3. Kaufman, C.E. & Whitesell, N.R. & Keane, E.M. & Desserich, J.A. & Giago, C. & Sam, A. & Mitchell, C.M., 2014. "Effectiveness of circle of life, an HIV-preventive intervention for American Indian middle school youths: A group randomized trial in a northern plains tribe," American Journal of Public Health, American Public Health Association, vol. 104(6), pages 106-112.
    4. Hellerstedt, W.L. & Peterson-Hickey, M. & Rhodes, K.L. & Garwick, A., 2006. "Environmental, social, and personal correlates of having ever had sexual intercourse among American Indian youths," American Journal of Public Health, American Public Health Association, vol. 96(12), pages 2228-2234.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lea Sacca & Stephanie Craig Rushing & Christine Markham & Ross Shegog & Melissa Peskin & Belinda Hernandez & Amanda Gaston & Michelle Singer & Nicole Trevino & Chrystial C. Correa & Cornelia Jessen & , 2021. "Assessment of the Reach, Usability, and Perceived Impact of “ Talking Is Power ”: A Parental Sexual Health Text-Messaging Service and Web-Based Resource to Empower Sensitive Conversations with America," IJERPH, MDPI, vol. 18(17), pages 1-15, August.
    2. Devries, Karen & Watts, Charlotte & Yoshihama, Mieko & Kiss, Ligia & Schraiber, Lilia Blima & Deyessa, Negussie & Heise, Lori & Durand, Julia & Mbwambo, Jessie & Jansen, Henrica & Berhane, Yemane & El, 2011. "Violence against women is strongly associated with suicide attempts: Evidence from the WHO multi-country study on women's health and domestic violence against women," Social Science & Medicine, Elsevier, vol. 73(1), pages 79-86, July.
    3. R. Brian Woodbury & Scott Ketchum & Vanessa Y. Hiratsuka & Paul Spicer, 2019. "Health-Related Participatory Research in American Indian and Alaska Native Communities: A Scoping Review," IJERPH, MDPI, vol. 16(16), pages 1-26, August.
    4. Davis Dilla & Jones Ian & Johnson Martin & Howarth Michelle & Astin Felicity, 2020. "“I don’t do it for myself, I do it for them”: A grounded theory study of South Asians’ experiences of making lifestyle change after myocardial infarction," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(19-20), pages 3687-3700, October.
    5. Umit Shrestha & Jessica Hanson & Tess Weber & Karen Ingersoll, 2019. "Community Perceptions of Alcohol Exposed Pregnancy Prevention Program for American Indian and Alaska Native Teens," IJERPH, MDPI, vol. 16(10), pages 1-12, May.
    6. Ramona Beltrán & Stephanie Begun, 2014. "‘It is Medicine’," Psychology and Developing Societies, , vol. 26(2), pages 155-179, September.
    7. T. Wing Lo & John W. L. Tse & Christopher H. K. Cheng & Gloria H. Y. Chan, 2019. "The Association between Substance Abuse and Sexual Misconduct among Macau Youths," IJERPH, MDPI, vol. 16(9), pages 1-17, May.
    8. Tingey, Lauren & Chambers, Rachel & Littlepage, Shea & Lee, Angelita & Pinal, Laura & Slimp, Anna & Rosenstock, Summer, 2022. "The respecting the circle of life teen pregnancy prevention intervention: Its impact among different subgroups of Native American youth," Children and Youth Services Review, Elsevier, vol. 138(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:7:p:3566-:d:526558. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.