Giles, M., Schiff, R., & Valcour , J. May 2014

1. Impact of an HIV/AIDS Sexual Health Education Program for Youth in Southern Inuit Communities Giles, M., Schiff, R., & Valcour, J. May 2014

2. West St. Modeste, Labrador 2013

3. Research Team • Primary Investigator: Madison Giles • Supervisory Committee: Dr. Rebecca Schiff, Dr. James Valcour, and Dr. Carolyn Sturge-Sparkes • Community Partner:Scosha Diamond of the Labrador Friendship Centre (LFC) • Indigenous Governing Authority: NunatuKavut Community Council

4. Our Story • Community-based & collaborative research project • Need indicated by an Indigenous organization, the LFC, to evaluate their HIV/AIDS Project • Funding Agencies: Canadian Institutes of Health Research, Atlantic Aboriginal Health Research Project, and the Northern Scientific Training Program. • No conflicts of interest to declare.

5. Background • Indigenous peoples are 3.5x more likely to be infected with HIV • Young Indigenous females who have a history of sexual abuse or IDU are most at risk • Increase of HIV infections among Indigenous youth • Paucity of age-, culture-, and community-appropriate programs for Indigenous youth

6. So What? To determine if a culturally-appropriate HIV prevention strategy is effective for youth in Southern Inuit communities • School-based one-off sexual health presentation with a central HIV/AIDS component • Presented and developed by a young two-spirited Southern Inuit woman • Includes games, demonstrations and discussions

7. Research Objectives • Identify the current knowledge levels and attitudes surrounding HIV/AIDS among youth in Southern Inuit communities. • Evaluate whether the LFC’s sexual health presentation, specifically the HIV/AIDS component, is effective for youth in Southern Inuit communities.

8. Theory & Ethics • Theoretical Stance • Decolonizing Methodologies • Indigenist Stress-Coping Model • Information, Motivation, and Behavioural Skills Model • Ethical Requirements • Ethics informed by TCPS2, NunatuKavut Community Council, and principles of OCAP • Participation of community partners throughout all stages of the research

9. Research Setting • South coast of Labrador • NunatuKavut communities: • Cartwright • Port Hope Simpson • St. Lewis/Fox Harbour • L’Anse Au Loup Labrador Coast Drive Regional Map, 2005.

10. Data Collection • Self-administered pre- and post-questionnaires • Assessed knowledge and attitudes surrounding HIV/AIDS, and evaluated the LFC’s presentation • Amalgamation of two validated tools used frequently in the literature

11. Data Analysis • Statistical program R Project • Conduct ANOVA, Tukey’s HSD tests, and linear regressions to determine if relationships existed between demographic identifiers and questionnaire categories • Thematic coding to analyze two open-ended questions that asked students their programming preferences

12. Sample • 97 participants (60% response rate) • 51% identified as female • 2% identified as an LGBTQ category • Participants ranged from 11 – 17 years • 54% identified as Southern Inuit/Inuit-Métis • All participants attended the all grade public school in their region

13. Results • Knowledge and attitudes increased • Common misconceptions: HIV transmission, vectors, testing, vaccination and interaction with PLWHA. • Females gained more positive attitudes compared to males • Older students had more positive attitudes compared to younger students • Older students evaluated the LFC’s sexual health presentation higher than younger students

14. Results Continued … • A small sample of First Nations and Inuit students demonstrated lower knowledge scores at post-questionnaire • A small sample of LGBTQ students scored the highest in knowledge, attitudes, and evaluation • The most memorable aspect of the LFC’s presentation was condoms • Students would have enjoyed the presentation better if it included more games, activities, or demonstrations

15. Proposed Recommendations • Follow-up education sessions • Sexual health education tailored to specific age groups • Sustained reciprocal communication between sexual health educators and school authorities • Training and support for sexual health educators

16. Limitations • Not generalizable to all Indigenous youth in Canada, nor all high school students in Labrador • Social desirability bias given that the questionnaire addressed a sensitive topic and was self-administered • Volunteer bias given that non-probability sampling was employed

17. Implications • This project has the potential to: • Inform future program design or the tailoring of the LFC’s HIV/AIDS project; • Assist community organizations and decision-makers to better understand what methods of prevention are preferred; • Highlight specific subgroups that may benefit from additional education or support, and a • Sustainable evaluation process.

18. Dissemination • Aim to provide understandable and accessible reports to: • participants who have requested a copy of research results; • participating high schools; • community partners (LFC & NunatuKavut); • school board; • funding agencies; • broader Indigenous community through brief summary reports, and • publication in peer-reviewed journals.

19. Thank-you!