1. Native Youth: An Invisible Population at Risk Harlan Pruden NorthEast Two Spirit Society and Pamela Jumper Thurman, Ph.D. Commitment to Action for 7thGeneration Awareness and Education Colorado State University XIX International AIDS Conference July 27 th, 2012

2. Many tribes, many cultures…

3. Remembering What We Were….

4. And What We Have Today…

6. 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.

7. 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)

8. 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

9. 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???

10. 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.

11. 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

12. 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

13. “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)

14. 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

15. 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

16. 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”

17. 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:

18. Contact Information Harlan Pruden harlan@ne2ss.org NorthEast Two Spirit Society www.ne2ss.org Pamela Jumper Thurman Pamela.Thurman@ColoState.Edu Commitment to Action for 7thGeneration Awareness and Education www.happ.colostate.edu