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HONOR Project focuses on meeting needs of the two-spirit community

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SEATTLE – Karina Walters, Oklahoma Choctaw and professor of social work at the University of Washington, in conjunction with Native community members, national consultants and an all-Native staff, has begun the first community-based study of two-spirit American Indians. This research study is called the HONOR Project, the name for which does not reference an acronym.

Rather, the project will look at the relationships between trauma, coping and health of urban Natives and, in particular, those who are lesbian, gay, bisexual, transgendered or two-spirit (LGBTT-S). Through conducting surveys in Seattle and five partner sites across the United States, the project aims to build culturally relevant and timely interventions that address the urgent needs of two-spirits and other Native populations, nationally and internationally.

This project is a direct response to, and an attempt to counter, the very little research addressing the health and mental health concerns, as well as HIV risks and prevention needs, of urban LGBTT-S American Indians. Although great variety exists among the more than 560 federally recognized tribes in the United States, the Native population as a whole is one at potentially high and disproportionate risk for HIV. As of 2000, Native people were nearly twice as likely to have HIV as white people.

“But, Native Americans’ risk for HIV is actually misunderstood and misrepresented,” Walters reported. “This is primarily due to misclassification of Native peoples, high rates of sexually transmitted infections, and a host of adverse social conditions that exist for Native Americans, including historical oppression, low economic resources, and high rates of alcohol use and trauma.” As a result, these conditions contribute to substantial disparities in Native health, mental health and overall well-being.

When looking at LGBTT-S Natives specifically, even more stressors exist that impinge on their overall health, as well as risk for HIV. They endure increased rates of physical violence, trauma, discrimination and sexual assault.

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For these reasons, Walters and her collaborators are particularly interested in exploring how Native culture, spirituality and traditions decrease alcohol use, HIV risk behaviors and mental health problems of two-spirit people. This is being accomplished through a six-site national survey, the result of more than two years’ work assessing the needs of these communities through interviews and working groups of Native leaders. The results of this study have the potential to make profound impacts on the welfare of Native populations in the United States and beyond.

The project’s main office is located at the School of Social Work, University of Washington, Seattle, under the direction of the Native Wellness Center, led by Walters and Professor Tessa Evans-Campbell. The five collaborating sites, and where the largest urban Native populations live, are Los Angeles, San Francisco/Oakland, Minneapolis/St. Paul, New York and Oklahoma City/Tulsa. Through these collaborations, each site is enhancing its community’s capacities to intervene with marginalized Native communities and develop relevant evaluations of these interventions.

Along with the outreach efforts conducted in each site, the project has developed a central Web site (, containing the most current information about the study as well as links to researchers’ work, collaborating sites and related resources. Potential participants, community agencies, interested collaborators and other allied organizations and individuals can contact the project for more information via or calling toll-free (866) 685-0164.

The HONOR Project began in 2003 with a series of focus groups and interviews with Native leaders and allied community members from across the nation. This initial work helped to identify themes regarding stressors and coping strategies specific to two-spirit American Indians and was employed in the design of the second phase of the study.

Phase 2, which is currently underway in six U.S. cities, uses interviews to survey urban LGBTT-S Natives about issues of trauma, health and mental health, cultural and spiritual coping, risk behaviors related to HIV, and alcohol and other drugs. The project is funded through the National Institute of Mental Health. With continued success and funding, the project could expand to other pertinent needs in Native communities and provide timely responses to these issues.