Center for Health Promotion and Prevention Research

Project Overview

The goal of Project Red Talon is to provide outreach, education, and technical assistance to disseminate Native It’s Your Game 2.0, a web-based HIV, STI, and pregnancy prevention curriculum for American Indian and Alaska Native youth ages 12-14 with both an online and jump drive delivery. Additionally, this project plans to develop an enhanced version of this program (NIYG 3.0) designed for increased cultural relevance and sensitivity specific to trauma-informed approaches.

In the U.S., racial and ethnic disparities in teen births and sexually transmitted infections (STIs) persist. American Indian and Alaska Native (AI/AN) females (15-19 yrs) have the highest teen birth rate and the highest prevalence of repeat teen births compared to other racial/ethnic groups. AI/AN youth are also disproportionately affected by STIs, including HIV, gonorrhea, and chlamydia. In 2014, AI/ANs had the second highest chlamydia and gonorrhea rates in the U.S. and AI/AN females (15-19 yrs and 20-24 yrs) had the highest chlamydia rates compared to other ethnic groups. Between 2007 and 2011, 69% and 59% of all chlamydia and gonorrhea cases, respectively, were reported among AI/AN youth (13-24 yrs). Moreover, AI/AN individuals have had the poorest survival rates at 12, 24, and 36 mos. post-HIV diagnosis. The sole increase in HIV diagnosis rates between 2008-2012 was among AI/AN females, while having the lowest proportion of access to needed care within 3 mos. of an HIV diagnosis (0.1%), the lowest retention in care, and the lowest viral suppression.

A need for effective and culturally salient middle school HIV/STI and pregnancy prevention curricula for AI/AN youth is indicated yet there is a lack of sexual health curricula that take advantage of the motivational appeal, reach, and fidelity of communication technology for this population, who are sophisticated technology users. Native It’s Your Game (NIYG) is a standalone 13-lesson Internet-based sexual health life-skills curriculum.12 A RCT of 371 AI/AN youth (53.4% female, 12-14 yrs.) in 24 sites across 3 regions demonstrated a significant positive change at 12-months on intention to pursue education after high school, condom knowledge, and self-efficacy to obtain and to use condoms.

An enhanced NPAIHB-funded version of NIYG (NIYG 2.0) is nearing completion that provides options for Internet streamed or downloadable (Internet or jump drive) delivery. Over 1,000 AI/AN youth have accessed NIYG across the PNW and AZ. NIYG is available via the HNY website with broad reach to 50 U.S. states and 77 countries and a Community of Practice linking educators to culturally relevant curricula and resources.

The goal of the proposed project is to provide outreach, education, and technical assistance to disseminate Native It’s Your Game 2.0 (Internet and downloadable versions) and to plan for development of an enhanced version of this program (NIYG 3.0). NIYG 3.0 will be designed for increased cultural relevance and sensitivity specific to trauma-informed approaches and Two Spirit/LGBTQ inclusivity to improve HIV prevention among American Indian and Alaska Native (AI/AN) (including MSM, young adults, IDUs and transgender individuals). This work builds on a successful partnership between UTHealth, North Portland Area Indian Health Board (NPAIHB), Alaskan Native Tribal Health Consortium (ANTHC), and Intertribal Council of Arizona (ITCA). The project comprises 3 Aims: (1) Disseminate NIYG 2.0, (2) develop the design document for NIYG 3.0, and (3) participate in the dissemination of Healthy Native Youth (HNY) activities and findings in the professional abstracts and publications. This project is significant, addressing the need for efficacious and culturally relevant HIV/STI prevention for underserved AI/AN youth and is innovative in providing next-generation Internet-based sexual health education that represents a cost-effective, high-fidelity, readily accessible curriculum for widely dispersed AI/AN youth.

Partners include the Inter Tribal Council of Arizona Inc, Alaska Native Tribal Health Consortium, and the Northwest Portland Area Indian Health Board.