HIVAIDS ISSUES: The American IndianAlaska Native SPNS Initiative

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HIV/AIDS ISSUESThe American Indian/Alaska
Native SPNS Initiative

• The University of Oklahoma
• May 2003
• Betty E. S. Duran, MSW, MPH

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U.S. P.H.S. HRSA SPNS American Indian/Alaska
Native Initiative

• Funded by US Public Health Service
• Health Resources and Services Administration
• HIV/AIDS Bureau
• Special Projects of National Significance
• SPNS Research and demonstration branch for all
  titles of the Ryan White CARE Act

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Health Resources and Services Administration

• SPNS Branch Chief
• Lois Eldred, PhD.
• AI/AN SPNS Project Officers
• Kathleen Handley, PhD.
• Sandra Duggan
• Sarah Hargrove

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Research and Evaluation Center
www.ou.edu/hiv

• School of Social Work
• University of Oklahoma, Norman

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Research and Evaluation Center

• Primary Principal Investigator
• David D. Barney, MSW, MPH, PhD
• Assistant Professor, School of Social Work,
  University of Oklahoma Norman
• Teaches advanced group work program evaluation
  (MSW program)
• M.S.W., San Diego State University
• M.P.H., University of California, Berkeley
• Ph.D., University of Kansas

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Research and Evaluation Center

• Project Director
• Betty E.S. Duran, MSW, MPH
• From Pojoaque Pueblo, New Mexico
• Second HRSA multi-site evaluation center (former
  Director of Client Services, NNAAPC)
• M.S.W., University of Kansas
• M.P.H., University of Oklahoma

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Research and Evaluation Center STAFFING

• Marguerite Keesee,
• MA
• Evaluation and Research Specialist

• Tim Brittingham,
• MSW
• Information Technology Analyst

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Research and Evaluation Center STAFFING

• Gregg Fryday, MSW
• Program Specialist

• Paul Rowe, BA
• Administrative/Data Specialist

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American Indian/Alaska Native HIV/AIDS Focal
Points for Action

• Lack of AI/AN individuals who are trained in the
  areas HIV/AIDS primary care medical, social,
  and mental health.
• HIV/AIDS medical care being identified as low
  priority due limited tribal/village resources.
• Existing projects are generally aimed at
  providing services that do not generally include
  program evaluation.

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HIV/AIDS Focal Points for Action (cont)

• Limited publicly funded HIV testing in rural
  and/or tribal areas.
• Higher rate of co-morbidities to HIV such as
  STIs, mental illness and chemical dependency.
• Social and geographic isolation.
• Historic fear and/or mistrust of governmental
  agencies among tribes and villages.

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Goals of the AI/AN SPNS Initiative

• Increase the number of substance/alcohol abusers
  at risk for HIV who know their HIV status.
• Increase the number of multiply diagnosed who are
  receiving appropriate and consistent health care.
• Increase the number of multiply diagnosed who are
  actively working to prevent the spread of HIV.
• Increase adherence of multiply diagnosed to
  medical therapies for HIV, STI, substance/alcohol
  use, and/or mental health issues.

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Six Demonstration Sites

• Location of Service Projects
• Native American Health Center Friendship House,
  Oakland, CA
• Four Corners American Indian Circle of Services
  Collaborative (4CC), Gallup, NM
• Robeson Health Care Corporation, Fairmount, NC
• Alaska Native Tribal Health Consortium,
  Anchorage, AK
• Yukon-Kuskokwim Health Corporation, Bethel, AK
• South Puget Intertribal Planning Agency, Shelton,
  WA

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Partner Evaluators

• University of New Mexico, Albuquerque, NM
• Native American Health Center, Oakland, CA
• University of North Carolina, Pembroke, NC
• University of Washington, Seattle, WA
• Yukon-Kuskokwim Health Corporation, Bethel, AK
• University of Alaska, Anchorage, AK

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NATIVE AMERICAN HEALTH CENTERSan Francisco

• Parousha Zand R.N.
• Director of HIV Services
• Karen Saylors PhD.
• Project Evaluator

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Key Components

• Nurse Case Management
• HIV Primary Care
• Substance Abuse Treatment
• Mental Health Treatment
• Dental Care
• Friendship House
• Cultural Activities

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Main Characteristics of Target Population

• Majority MSM
• Hx or Current IDU
• Triple Diagnosed HIV/Mental/Substance
• Urban/Rural Migration
• Multi-tribal, multi-racial, multi-cultural
• Identity issues

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