By Beatrice Norton (Hopi Tribe), Frances Cupis (Pascua Yaqui Tribe), and Gwenda Gorman (ITCA)

NA SISTER: Sharing Outcomes of a three-year

HIV/AIDS Prevention Project

Overview

• Background – Statistics/SISTA

• Partnerships

• Adaptation Process/Tailoring to Tribes

• Results

• Next Steps

Background

• America Indians/Alaska Natives (AI/AN) in AZ have the second highest Chlamydia and Gonorrhea rates in Arizona among 10-19 years old and adults

• AI/AN in AZ have the third highest HIV/AIDS rates

• The ITCA received a three-year grant from the Office of Women’s Health to adapt the evidence-based intervention, Sisters Informing Sisters on Topics About AIDS (SISTA) for American Indian women in Arizona

SISTA

Incorporates

• Discussions and activities to empower women to praise their strengths and identify role models in their communities.

• Risk reduction skills building.

• Take home assignments that includes their partners participation.

SISTA

• Original curriculum targeted African-American heterosexual women

• A group-based evidenced-based intervention

• Includes 5, two-hour sessions, with two optional booster sessionsSession 1: Ethnic and Gender PrideSession 2: HIV/AIDS EducationSession 3: Assertiveness Skills TrainingSession 4: Behavioral Self-Management Session 5: Coping Skills

SISTA

Women who completed the SISTA intervention reported:• Increased consistent condom use.• Greater sexual self control.• Greater sexual communication.• Greater sexual assertiveness.• Increased partners’ adoption of norms supporting consistent condom use.

Project Goal

To provide culturally appropriate HIV/AIDS prevention education to AI/AN women in Arizona, through adapting, tailoring, and implementing the Sisters Informing Sisters on Topics about AIDS (SISTA) Project.

Collaboration

Adaptation Process

• Two women were identified from each tribal site to participate in a four-day SISTA Facilitator Training by CDC in May of 2010.

• Face to face meetings were held with the tribes on further discussion of adaptation steps.

• Each tribe conducted feedback sessions and key informant interviews on how to implement the project in their respective communities.

Adaptation Process

• Recruited at least 40 women American Indian women to receive sessions from original curriculum.

• Women received gifts cards for participating in the sessions and were offered an additional gift card for voluntarily getting an HIV/STD test.

• Feedback from participants were recorded to make changes to new curriculum, Native American Sister Informing Sister: Educating, Talking, and Reducing Risk.

Adaptation Process

• Capacity building activities were provided to facilitators (i.e. Program Evaluation, Effective Facilitation Skills)

• Facilitator Training on the new NA SISTER curriculum held in Phoenix, AZ

• Facilitator observations were conducted to ensure fidelity of curriculum

NA SISTER

• Targets American Indian women

• Group based intervention with six sessions:Historical Trauma and Cultural Resilience session added (based on literature review conducted and feedback)

• American Indian poems added and activities and role play scenarios were changed

• Modified “SISTAS Assertiveness Model” acronym to “SISTER Proactive Communication Model”

• New design cover for curriculum

Tailoring to Tribes - Hopi

NATIVE AMERICAN SISTER PROJECT

Na'na tupkom na'nami tunat yaw yungwa(Sisters helping to protect one another….)

ADAPTATIONS: Motto: Women’s Journey Opening Poem: Written by Hopi woman Values worksheet: Corn Plant Values Sheet At the Parking Lot: At the PIKI HOUSE Props : Cultural items defining Hopi women’s significance in the Hopi Cultural

Tailoring to Tribes - Hopi

Tailoring to Tribes – Pascua Yaqui Tribe

• Collaborated with the Language and Culture Department and Elders from tribal communities to assist in curriculum development of traditional learning techniques.

• Utilized the Language and Culture Department regarding ceremonial direction in spirituality, historical trauma and cultural resiliency.

• Utilized our Hiaki language to adapt the Sewa Hamut Program from NA SISTERS to provide connection with community.

• Integration of symbolism of Sewa Hamut or flower women has a connection to nature, culture and health.

Sewa Hamut Program – RESPECT FOR MY COMMUNITY, MY TRIBE, MY LIFE.

Tailoring to Tribes – Pascua Yaqui Tribe

ResultsNA-SISTER Preliminary Evaluation Select Findings

NA-SISTER Preliminary Evaluation Select Findings

Age Group of Participants (in years)Health & STI Screenings

– 91% reported Pap Test– 41% reported Chlamydia– 26% reported Gonorrhea– 53% reported HIV test

Note: These are self-reported from the pre-tests

Confidence or Self-efficacy (Condoms)

Highest Post-testHighest Pre-test

Increased Intention to Use Condoms (Next Time)

Increased Intention to Use Condoms (Next 3 Months)

Almost 12% increase

Next Steps

• Share findings of project outcomes with tribes

• Provide Facilitators Training on NA SISTER curriculum (dependent on additional funding)

• Share curriculum with other tribes

• Identify other funding sources to continue project

Questions?