In the coming months, teenagers from a Native American tribe in the Southwest will be learning how to properly put on a condom, how to assertively communicate with their partner about sexual activity and how to talk to a trusted adult about sex and reproductive health.
It’s part of Respecting the Circle of Life, a research program from the Johns Hopkins University Center for American Indian Health. The program teaches comprehensive sex education for teenagers ages 13 to 19 in the tribal community. Tribal officials asked that the name of the tribe not be identified due to the sensitive nature of the topic.
The program teaches about comprehensive sexual education and reproductive health topics, including STD and HIV prevention, abstinence, teen pregnancy prevention, proper condom usage, community resources and where to obtain condoms, and where to get tested, said Angie Lee, the local coordinator for the program.
“They’re also taught about how to talk to a trusted adult, being able to communicate with someone and they learn a lot about goal-setting, their values in their upbringing,” she said. “A lot of this has to play into when it comes times to make a decision to be sexually active, we want your values and upbringing to play a big role in that.”
The program, which was developed in 2010, is offered over eight days in eight sessions, said Lauren Tingey, associate director for the Center for American Indian Health. Community health workers deliver the information in small groups organized by age and gender.
“We also ask that kids come to camp with people they know,” she said. “The idea being that if you get in these small groups with people they know and people they’re spending time with outside of camp, some of the messaging and attitudes and norms around sexual reproductive health would be reinforced after camp and also might start changing over the long-term.”
The program has been rolled out through different research grants. The goal in the long run is to secure funding not as part of research, just as a service, Tingey said.
Lee said the program started because there was a lack of sexual reproductive health information in schools in the community, particularly around STDs.
A lot of people in the community were shy about talking about reproductive health at the start, she noted. “I think that was an eye-opener for a lot of parents to know that sexual reproductive health of their children is really important,” she said.
Over time, both the adults and youth have changed their perspective. For example, in one exercise, the youth were asked to estimate how many of their peers engage in drinking alcohol and sexual activity. The youth estimated the numbers were higher than they actually were, Lee said.
“That exercise itself was an eye-opener for a lot of the youth who participated,” she said. It showed they aren’t as active in the risky behaviors as they may talk about or share with others. “Just because someone is talking about it doesn’t mean they are actually doing it,” she said. They discussed why someone might do that, which included wanting to be popular or liked.
The youth were given a neutral space to learn about and discuss the issues without being judged, Lee said.
One youth, she noted, put it this way: “If I asked my mom, she thinks just because I’m curious I’m actually doing it or planning on doing it. But I just want to know so I will be prepared in the future.”
The program takes place during a basketball camp, and additional activities inspired by Native culture are being added, including painting, traditional foods, arts and crafts and bow-and-arrow making, Lee said.
A few elders will also speak to the youth about what is expected of them in terms of being a member of the tribe and the role of male and female and what role respect plays into being a Native American living in the community, she added.
“We didn’t want a program that was sort of tied to school,” Tingey said, adding that it was important to have a venue available for kids who are both in and out of school in order to participate.
Evaluations of the program show improved condom use and greater knowledge regarding prevention and transmission of HIV/AIDS. The Center hopes to replicate the program elsewhere in the future.
For Lee, she has watched as the program has affected not only the youth but the parents and grandparents of the youth as well.
“I feel like it’s really beneficial for the parents and especially those Native youth being raised by grandparents. The older generation are not so receptive or open to talking about sexual health, reproductive health, STDs, or teen pregnancy prevention,” she said, later adding: “Having this program basically and the people in the community becoming aware of it…kind of sets that pace where it is now OK to have that conversation.”