Background: Census indicates 55,000 Native Americans in Indiana. Without Federally recognized tribes in state and nearest Tribal Health Facility 150 miles away, this impacts health care for Native Americans. Additionally, CDC 2014 STD data reveals higher rates for NAs: Chlamydia 3.7 times higher than whites and gonorrhea 4.2 times higher. Disparity of gonorrhea rates for NAs was greater in Midwest than in West, Northeast or South.
Methods: This mixed-method study surveyed 228, self-identified as NA from six Pow wows. Data collection was from 10/14 to 6/15. Descriptive statistics & frequencies were included for survey responses. Chi square goodness of fit tests were conducted assessing associations. Interviews were conducted with additional 25 participants. Inductive content analysis was used to identify themes. Interviews analyzed using content analysis to identify and interpret themes using NVivo qualitative software (Version 11) inter-coder reliability assessed.
Results: Affiliations:56 tribes with 56% female, 40% male, 4% Two-Spirit. Themes noted: Discretion and privacy is paramount for health testing; Non-coercive health services linked to trust in NA culture. Survey findings provided insight into perceived STI risk. Few participants felt “at risk” (3%); fewer felt “at risk” for specific diseases: [genital warts (2%); hepatitis B (4%); hepatitis C (4%); HIV (3%), gonorrhea (2%); chlamydia (2%)]. Regarding HIV: 53% tested, and 66% knew status. Over 70% heard about HPV, with those recognizing HPV being significantly younger than those who did not (t(207) = -3.765, p < .001). Over 62% thought “NA members” would participate in STI testing. Additionally, 37% indicated participation; 37% no participation, 26% unsure; 40% willing to accept STI testing & 70% accept hepatitis testing. Over 70% would accept hepatitis B and C screenings and 61% would consider HPV education.
Conclusions: Pow wow events are viewed by a majority as accepted venues for STI screening services. NA culture must be considered when planning services.