Built on Tradition: Sexual Health Education for Indigenous Youth

lIn December 2021, health educator Barbara Harvey navigated icy and muddy roads through the rugged high desert of the Navajo Nation in their gray Ford Escape, getting lost several times before finally arriving at their destination: the home of several teenage boys.

To ease pandemic concerns, the 13, 14, and 16-year-olds had built a well-ventilated cabin in their side yard, complete with a tarpaulin roof and a crackling fire.

“They hung the plywood sheets themselves, and they even had a Christmas tree in them,” recalls Harvey. “We joked, ‘Do we have to wear a helmet during these classes?'”

The small group sheltered from the snow and watched intently as Harvey used a wooden model to demonstrate effective condom use. They asked where to find condoms and what to do if a condom breaks.

The visit was part of Respecting the Circle of Life, a program aimed at reducing sexual risk for Indigenous youth by educating them about pregnancy and STIs, building positive age groups and promoting condom use. For more than a decade, tribe members have worked with the Center for Indigenous Health on the course for Native American youth ages 10 to 19.

The programme, which emphasizes communication between young people and their parents and carers, also addresses striking health inequalities among Indigenous communities, where STIs such as chlamydia, gonorrhea and syphilis take a disproportionate toll. Findings from a randomized control trial of more than 500 Native American youth in 31 tribal communities, published in July in the journal Assessment of child and youth services, suggest it works. Participants reported better knowledge about sexual and reproductive health, as well as a greater intention to use a condom or practice abstinence.

The program is especially important in communities with a long history of exploitation and cultural oppression, notes Allison Barlow, PhD, MPH ’97, executive director of the Center for Indigenous Health. Decades of programs that removed Native American children from their families and placed them in federal boarding schools isolated youth from cultural teachings and traditions surrounding reproductive health.

RCL aligns with concepts that are important to Indigenous communities, such as respecting one’s body, making empowering choices and interacting as a positive member of the community, Barlow added.

“Facilitators come from the local communities and they themselves become agents of change,” said Barlow, a senior scientist at International Health. “Facilitators teach in a way that is engaging and not pedantic; there are supportive peer groups and open conversations with a lot of humour.”

Built on Tradition: Sexual Health Education for Indigenous Youth

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