C R Pearson1, D Kaysen2, D Huh3, M Bedard-Gillgan4, D Walker5, R Marin3, K Saluskin6. 1. Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, WA, USA. Electronic address: pearsonc@uw.edu. 2. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. 3. Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, WA, USA. 4. Department of Psychiatry, University of Washington, Seattle, WA, USA. 5. Innovative Programs Research Group, School of Social Work, University of Washington, Seattle, WA, USA. 6. Yakama Nation Behavioral Health Services, Toppenish, WA, USA.
Abstract
Native Americans (NA) experience interrelated risks of trauma exposure, substance use, and HIV risk behaviors that put them at increased risk for HIV infection. Despite these known risk factors, there are very few published randomized trials testing interventions to reduce trauma-related symptoms and substance misuse among NA. METHODS: The Healing Seasons study is a randomized comparsion trial of two counseling strategies, Narrative Exposure Therapy (NET) addressing PTSD or Motivational interviewing with cognitive behavioral therapy skills training (MIST) addressing substance misuse as a means to prevent HIV among NA. Using a community-based participatory research approach, we adapted both evidence-based interventions to be specific to the risk contexts and realities of NA and to include psychoeducational and skill-building components that include cultural-specific stories, virtues, and traditional treatment strategies. Participants, 16 years and older, were recruited from a Pacific Northwest tribal community, screened over the phone, enrolled in person, and randomized in equal numbers to NET or MIST. We stratified by age (16-29 years and 30 or older) and gender (male or female identified) to ensure balance between treatment arms. The primary outcomes were number of sex partners and frequency of sexual acts (with and without condoms), sex under the influence of substances, frequency of substance use, and PTSD severity. DISCUSSION: Behavioral interventions for NA are needed to prevent HIV risk behaviors when faced with trauma symptoms and substance misuse. This study will provide evidence to determine feasibility and efficacy of addressing related risk factors as part of counseling-based HIV prevention intervention to reduce sexual risk among this population. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT03112369, registered April 12, 2017.
Native Americans (NA) experience interrelated risks of trauma exposure, substance use, and HIV risk behaviors that put them at increased risk for HIV infection. Despite these known risk factors, there are very few published randomized trials testing interventions to reduce trauma-related symptoms and substance misuse among NA. METHODS: The Healing Seasons study is a randomized comparsion trial of two counseling strategies, Narrative Exposure Therapy (NET) addressing PTSD or Motivational interviewing with cognitive behavioral therapy skills training (MIST) addressing substance misuse as a means to prevent HIV among NA. Using a community-based participatory research approach, we adapted both evidence-based interventions to be specific to the risk contexts and realities of NA and to include psychoeducational and skill-building components that include cultural-specific stories, virtues, and traditional treatment strategies. Participants, 16 years and older, were recruited from a Pacific Northwest tribal community, screened over the phone, enrolled in person, and randomized in equal numbers to NET or MIST. We stratified by age (16-29 years and 30 or older) and gender (male or female identified) to ensure balance between treatment arms. The primary outcomes were number of sex partners and frequency of sexual acts (with and without condoms), sex under the influence of substances, frequency of substance use, and PTSD severity. DISCUSSION: Behavioral interventions for NA are needed to prevent HIV risk behaviors when faced with trauma symptoms and substance misuse. This study will provide evidence to determine feasibility and efficacy of addressing related risk factors as part of counseling-based HIV prevention intervention to reduce sexual risk among this population. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT03112369, registered April 12, 2017.
Authors: Allison J Applebaum; C Andres Bedoya; Ellen S Hendriksen; Jesse L Wilkinson; Steven A Safren; Conall O'Cleirigh Journal: J Assoc Nurses AIDS Care Date: 2014-11-10 Impact factor: 1.354
Authors: Cynthia R Pearson; Debra Kaysen; Annie Belcourt; Cynthia A Stappenbeck; Chuan Zhou; Lucy Smartlowit-Briggs; Patricia Whitefoot Journal: Am Indian Alsk Native Ment Health Res Date: 2015