Native Youth: An Invisible Population at Risk

Harlan PrudenNorthEast Two Spirit Society

andPamela Jumper Thurman, Ph.D.

Commitment to Action for 7thGeneration Awareness and Education

Colorado State University

XIX International AIDS ConferenceJuly 27th, 2012

Many tribes, many cultures…

Remembering What We Were….

And What We Have Today…

Defining Characteristics of Native Peoples

• Historical trauma;• Intergenerational trauma; • Band/Tribal membership; • Half-truths, misconceptions, stereotypes

pervade all aspects our Indian life and history; and

• We are small population - however it is precisely because our number are so small that our community should be declared a top priority – once we are gone – we are gone.

What is historical trauma?

A combination of immense losses and traumatic events that are perpetrated upon an entire culture. For Native Peoples, these losses include:

• Culture• Language• Land• People (deaths due to diseases and

war)• Way of life• Religion• Family structure (forced into

boarding schools)

Are These the Realities We Want For Our Youth? …

• …that we have a dialysis machine in most every Native community

• …that we will die younger than others (in South Dakota, median age of death in 2009 for general

population was 81 and for American Indians, it was 58)• …that violence and substance use are a way of

life? That youth suicide rates are higher than the white population

• …that we have no risk for HIV; therefore, we need no funding for education, testing,

prevention or treatment

Estimates of New HIV Infections, by Race/Ethnicity, Risk Group, and Gender for the Most Affected US Populations,

2009

Who is Missing From This Chart???

Natives and HIV/AIDS• Natives represent less than 1% of the

reported AIDS cases and represent less than 1% of US population– Are at high risk for contracting HIV/AIDS as

evidenced by related data – STIs, pregnancy, substance use…

– Data on Natives are NOT accurate– HIV/AIDS has a significant impact upon Native

women and adolescents whose HIV rates are increasing

• We have very little to no data available on Native Youth in the U.S.

What DO We Know About Youth and HIV Risk?

• Relative to other ethnic groups, AI/AN youth have received minimal attention due to low “rates” of infection (or problematic data)

• Recently, rates of infection among AI/AN have increased, especially among youth, who are a large portion of our population

• Our youth population, like other groups, is sexually active, have multiple sex partners, engage in substance use, and sex is unprotected

We Also Know That Our STI rates reflect….

• That the gonorrhea rate among American Indian/Alaska Natives was 110.2 per 100,000 which was 3.6 times higher than the rate among whites

• The chlamydia rate among American Indian/Alaska Natives was 808.8 cases per 100,000 population, an increase of 11.5% from the 2007 rates

“Some researchers have described HIV as the new smallpox, an epidemic which could wipe out entire American Indian communities in a way reminiscent of the epidemics caused by early European colonization”

- Marsiglia, Nieri, and Stiffman (2011)

Native Urban Youth, Violence & Sexual Risks

• Native urban youth…– 2x more likely to have forced sexual intercourse– If they experienced forced sex, it was more than likely

to have been initiated before 15 yrs of age– Are more likely having more unprotected sex on first

experience– More likely to have an unintended pregnancy and are

pregnant at 3 times the rate of white youth– Also more likely to continue to use substances during

pregnancy both as part of the youth culture and to self medicate emotional pain of abuse

What Is The Impact of Inaccurate and Incomplete Data for Native

People?• More health disparity• MORE increases in new infections• Decreased access to care • Health outcomes aren’t positive• Increase in HIV related health disparities• Challenge in planning interventions when

we don’t know the true scope, nature or face of the population

Summary and Recommendations• Native youth are born, live, and grow in very complex

environment• Solutions must be developed both in the context of

urban, rural and reservation youth – the legal, cultural, and resiliency factors will vary within each group!!

• Native youth risks are a web of interconnected factors that include historical underpinnings, inequality, power relations, violence, and intergenerational trauma– Historical trauma must be addressed– Though data is important, we ARE indigenous and

we MUST be considered. Even though our numbers appear small, this infection COULD decimate our people if it reaches the proportion sufficient to be on the “funding agenda”

• Collaboration MUST occur within our own ranks as well as within the ranks of our allies

• Recognition that for Native Nations, Health Care AND Capacity Building Assistance have legal implications, that go beyond Cultural Competency!

• Need for additional infrastructure for testing • Culturally Relevant Mental Health and Substance

Abuse Services targeting youth • Social media interventions

Our Recommendations:

Contact InformationHarlan Pruden

harlan@ne2ss.orgNorthEast Two Spirit Society

www.ne2ss.org

Pamela Jumper ThurmanPamela.Thurman@ColoState.Edu

Commitment to Action for 7thGeneration Awareness and Educationwww.happ.colostate.edu