%0 Journal Article %J AIDS Educ Prev %D 2013 %T A cautionary tale: risk reduction strategies among urban American Indian/Alaska Native men who have sex with men. %A Pearson, Cynthia R %A Walters, Karina L %A Simoni, Jane M %A Beltran, Ramona %A Nelson, Kimberly M %K Adolescent %K Adult %K Alaska %K Condoms %K Cross-Sectional Studies %K Health Knowledge, Attitudes, Practice %K HIV Infections %K HIV Seronegativity %K Homosexuality, Male %K Humans %K Indians, North American %K Male %K Middle Aged %K Risk Factors %K Risk Reduction Behavior %K Risk-Taking %K Sexual Partners %K Socioeconomic Factors %K Surveys and Questionnaires %K Truth Disclosure %K Unsafe Sex %K Urban Population %K Young Adult %X

American Indian and Alaska Native (AIAN) men who have sex with men (MSM) are considered particularly high risk for HIV transmission and acquisition. In a multi-site cross-sectional survey, 174 AIAN men reported having sex with a man in the past 12 months. We describe harm reduction strategies and sexual behavior by HIV serostatus and seroconcordant partnerships. About half (51.3%) of the respondents reported no anal sex or 100% condom use and 8% were in seroconcordant monogamous partnership. Of the 65 men who reported any sero-adaptive strategy (e.g., 100% seroconcordant partnership, strategic positioning or engaging in any strategy half or most of the time), only 35 (54.7%) disclosed their serostatus to their partners and 27 (41.5%) tested for HIV in the past 3 months. Public health messages directed towards AIAN MSM should continue to encourage risk reduction practices, including condom use and sero-adaptive behaviors. However, messages should emphasize the importance of HIV testing and HIV serostatus disclosure when relying solely on sero-adaptive practices.

%B AIDS Educ Prev %V 25 %P 25-37 %8 2013 Feb %G eng %N 1 %R 10.1521/aeap.2013.25.1.25 %0 Journal Article %J J Prim Prev %D 2012 %T Community-responsive interventions to reduce cardiovascular risk in American Indians. %A Jobe, Jared B %A Adams, Alexandra K %A Henderson, Jeffrey A %A Karanja, Njeri %A Lee, Elisa T %A Walters, Karina L %K Adult %K Cardiovascular Diseases %K Child %K Child, Preschool %K Consumer Participation %K Diabetes Complications %K Diabetes Mellitus %K Female %K Health Behavior %K Health Promotion %K Humans %K Indians, North American %K Infant %K Male %K Obesity %K Randomized Controlled Trials as Topic %K Risk Factors %K Smoking %K United States %X

American Indian and Alaska Native (AI/AN) populations bear a heavy burden of cardiovascular disease (CVD), and they have the highest rates of risk factors for CVD, such as cigarette smoking, obesity, and diabetes, of any U.S. population group. Yet, few randomized controlled trials have been launched to test potential preventive interventions in Indian Country. Five randomized controlled trials were initiated recently in AI/AN communities to test the effectiveness of interventions targeting adults and/or children to promote healthy behaviors that are known to impact biological CVD risk factors. This article provides a context for and an overview of these five trials. The high burden of CVD among AI/AN populations will worsen unless behaviors and lifestyles affecting CVD risk can be modified. These five trials, if successful, represent a starting point in addressing these significant health disparities.

%B J Prim Prev %V 33 %P 153-9 %8 2012 Aug %G eng %N 4 %R 10.1007/s10935-012-0277-9 %0 Journal Article %J J Prim Prev %D 2012 %T Project həli?dx(w)/Healthy Hearts Across Generations: development and evaluation design of a tribally based cardiovascular disease prevention intervention for American Indian families. %A Walters, Karina L %A LaMarr, June %A Levy, Rona L %A Pearson, Cynthia %A Maresca, Teresa %A Mohammed, Selina A %A Simoni, Jane M %A Evans-Campbell, Teresa %A Fredriksen-Goldsen, Karen %A Fryberg, Sheryl %A Jobe, Jared B %K Adolescent %K Adult %K Body Mass Index %K Cardiovascular Diseases %K Community-Based Participatory Research %K Community-Institutional Relations %K Cultural Competency %K Family Relations %K Humans %K Indians, North American %K Inuits %K Life Style %K Male %K Motivational Interviewing %K Northwestern United States %K Parents %K Risk Factors %K Young Adult %X

American Indian and Alaska Native (AIAN) populations are disproportionately at risk for cardiovascular disease (CVD), diabetes, and obesity, compared with the general US population. This article describes the həli?dx(w)/Healthy Hearts Across Generations project, an AIAN-run, tribally based randomized controlled trial (January 2010-June 2012) designed to evaluate a culturally appropriate CVD risk prevention program for AI parents residing in the Pacific Northwest of the United States. At-risk AIAN adults (n = 135) were randomly assigned to either a CVD prevention intervention arm or a comparison arm focusing on increasing family cohesiveness, communication, and connectedness. Both year-long conditions included 1 month of motivational interviewing counseling followed by personal coach contacts and family life-skills classes. Blood chemistry, blood pressure, body mass index, food intake, and physical activity were measured at baseline and at 4- and 12-month follow-up times.

%B J Prim Prev %V 33 %P 197-207 %8 2012 Aug %G eng %N 4 %R 10.1007/s10935-012-0274-z %0 Journal Article %J Ann Behav Med %D 2011 %T 'I've had unsafe sex so many times why bother being safe now?': the role of cognitions in sexual risk among American Indian/Alaska Native men who have sex with men. %A Nelson, Kimberly M %A Simoni, Jane M %A Pearson, Cynthia R %A Walters, Karina L %K Adult %K Alaska %K Attitude to Health %K Cognition %K Condoms %K Cross-Sectional Studies %K HIV Infections %K Homosexuality, Male %K Humans %K Indians, North American %K Male %K Middle Aged %K Multivariate Analysis %K Risk Factors %K Risk-Taking %K Sexual Partners %K Socioeconomic Factors %K Stress Disorders, Post-Traumatic %K Surveys and Questionnaires %K Unsafe Sex %K Young Adult %X

BACKGROUND: American Indian/Alaska Native (AI/AN) men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV) acquisition and transmission.

PURPOSE: This study aimed to investigate a potential area of focus for HIV prevention interventions by assessing the impact of sexual risk cognitions on sexual risk-taking among AI/AN MSM.

METHODS: AI/AN MSM (N = 173) from a national cross-sectional survey were analyzed.

RESULTS: Reporting more frequent sexual risk cognitions overall (high sexual risk cognitions) was associated with multiple HIV risk factors including unprotected anal intercourse and serodiscordant unprotected anal intercourse. Participants with high sexual risk cognitions had a 2.3 (95% Confidence Interval: 1.1, 4.7) times greater odds of engaging in unprotected anal intercourse regardless of childhood sexual abuse, depression, and alcohol dependence. Most individual sexual risk cognitions were associated with unprotected anal intercourse, serodiscordant unprotected anal intercourse, or both.

CONCLUSIONS: Results suggest that sexual risk cognitions may be a productive area for further work on HIV prevention among AI/AN MSM.

%B Ann Behav Med %V 42 %P 370-80 %8 2011 Dec %G eng %N 3 %R 10.1007/s12160-011-9302-0 %0 Journal Article %J Womens Health Issues %D 2011 %T Keeping our hearts from touching the ground: HIV/AIDS in American Indian and Alaska Native women. %A Walters, Karina L %A Beltran, Ramona %A Evans-Campbell, Tessa %A Simoni, Jane M %K Acquired Immunodeficiency Syndrome %K Adaptation, Psychological %K Culture %K Epidemics %K Female %K HIV Infections %K Humans %K Indians, North American %K Inuits %K Male %K Rape %K Residence Characteristics %K Spouse Abuse %K Stress, Psychological %K Substance-Related Disorders %K United States %K Women's Health %X

HIV/AIDS is a critical and growing challenge to American Indian and Alaska Native (AIAN) women's health. Conceptually guided by the Indigenist Stress-Coping Model, this paper explores the historical and contemporary factors implicated in the HIV epidemic among AIAN women and the co-occurring epidemics of sexual violence and substance abuse. The authors also outline multiple indicators of resiliency in AIAN communities and stress the need for HIV prevention interventions for AIAN women to capitalize on cultural and community strengths.

%B Womens Health Issues %V 21 %P S261-5 %8 2011 Nov %G eng %N 6 Suppl %R 10.1016/j.whi.2011.08.005