MULTICULTURAL OUTREACH FOR HIV/AIDS/DRUG RISKS

HIV infection is rapidly moving from urban areas to smaller towns and rural
areas where the epidemic can quickly have devastating effects on the
viability of small local populations. At particularly high risk are Native
Americans and other minority groups whose HIV-risking substance abuse and
sexual norms and culturally shaped health belief systems have left them
relatively inaccessible to both AIDS prevention broadcast media and urban
styles of street outreach preventive interventions. Our proposed project addresses several rural high risk cultural groups that
have been neglected by HIV outreach prevention research. Its overall
purpose is the development, implementation and evaluation of an innovative
method of culturally shaped outreach intervention which as compared to
conventional outreach would be demonstrably superior in reducing HIV-
risking behaviors while increasing preventive intentions. The project's
four ethnic target groups are Navajo and Hopi Native Americans, Hispanics
and Anglos. The targeted subjects for intervention are IVDU's, non-IV
substance abusers, their sexual partners, and other individuals whose
lifestyles place them at higher risk for HIV infection. The project would
be conducted by an interdisciplinary collaborative team of investigators
and consultants experienced in ethnography. HIV/AIDS prevention and
epidemiologic research, and evaluation of community based intervention
studies. Project Phase 1 involves preparatory mapping of risk environments and
ethnographic investigations to define effective, culturally appropriate
elements of the experimental outreach interventions plus the
monitoring/surveillance strategies. Phase 2 (beginning 01 year 4th
quarter) implements a quasi-experimental study testing the relative
effectiveness of the intervention strategies. Using pre and post-
intervention plus follow-up assessments of process and outcome variables.
Both outreach interventions include the use of natural discourse and
culturally appropriate metaphors, but one is conventionally didactic in its
risk-reduction information transmission while the other uses an enhanced
story-based approach which is traditionally used by many rural minorities
and in Native American cultures in particular.