Safer Sexual Practices and HIV Screening Behavior among Rural California American Indians.

This paper reports on safer sexual practices and HIV screening behavior among rural California American Indians. Thirteen Indian health clinic registries formed the random household survey sampling frame (N=457). Measures included socio-demographics, safer sexual practices, HIV testing, high-risk behaviors, perception of wellness, general health status, neglect, physical and sexual abuse history. Statistical tests included chi-square and Fisher's exact tests, as well as multiple logistic regression analysis. Respondents who practiced safer sex were younger, not married, reported lower annual income, changed sexual behavior in the last 12 months, were not in a monogamous relationship, and had a higher perception of wellness. Those who were tested for HIV were younger, had at least a high school education, consumed alcohol, had significantly higher suicide ideation and attempts, changed their sexual behavior in the last 12 months, and reported a history of sexual abuse as a child and adult. Very little is known about HIV prevention and screening behaviors in rural American Indian populations. Identifying predictors of unsafe sexual practices and non-HIV testing tendencies help to plan for measures to protect the population from this devastating disease. We make recommendations for implementing HIV prevention education and screenings at American Indian clinics.