Although HIV/AIDS prevention has presented challenges over the past 25 years, prevention does work! To be most effective, however, prevention must be specific to the culture and the nature of the community. Building the capacity of a community for prevention efforts is not an easy process. If capacity is to be sustained, it must be practical and utilize the resources that already exist in the community. Attitudes vary across communities; resources vary, political climates are constantly varied and changing. Communities are fluid-always changing, adapting, growing. They are "ready" for different things at different times. Readiness is a key issue! This article presents a model that has experienced a high level of success in building community capacity for effective prevention/intervention for HIV/AIDS and offers case studies for review. The Community Readiness Model provides both quantitative and qualitative information in a user-friendly structure that guides a community through the process of understanding the importance of the measure of readiness. The model identifies readiness- appropriate strategies, provides readiness scores for evaluation, and most important, involves community stakeholders in the process. The article will demonstrate the importance of developing strategies consistent with readiness levels for more cost-effective and successful prevention efforts.

Data are presented regarding the prevalence of HIV/AIDS among American Indian women. Health disparities found among American Indians are discussed and biological, economic, social, and behavioral risk factors associated with HIV are detailed. Recommendations are suggested to alleviate the spread of HIV among American Indian women and, in the process, to diminish a culture of treatment malpractice and a weakening of treatment ethics, racism, and genderism.

This study explored an underserved population, Native American youth, regarding health communication about sexually transmitted infections (STIs) and HIV/AIDS. Determining communication patterns of these youth, who markedly differ from the general population on access to health facilities and information, will inform public policy about lessening Native youth STI and HIV/AIDs morbidity, potentially leading to a reduction in health and human costs associated with these illnesses. Using information channel complementarity theory, this study examined sexual health information use by rural and urban Native American youth. Semistructured interviews in a community-participatory based research approach (CPBR) facilitated understanding these youth in their cultural contexts. Findings showed they preferred pamphlets as their sexual health information source. They trusted interpersonal more than mediated sources, yet noted a lack of confidentiality from health officials. Although knowledgeable about types of STIs and HIV/AIDS, participants did not demonstrate knowledge about symptoms and treatments and exhibited a false awareness of self-knowledge. They showed a strong sense of community, interested in helping younger 172 Communication About Sexual Health 173 people in health prevention. They engaged in sexual behaviors, frequently along with alcohol and drugs. Rural females associated alcohol with sex and violence more than rural males, although this was not found among urban females or males.

AIDS has steadily increased in recent years, becoming the ninth leading killer of Native people between the ages of 15 and 44. In 2003, the Centers for Disease Control and Prevention (CDC) reported that ethnic minorities account for more than 71% of all reported AIDS cases and that there are still increases in AIDS cases in the American Indian population. Despite the work that has been done related to HIV/AIDS, there remain some major challenges in the prevention of HIV/AIDS in Native communities. Yet, there are changes on the horizon and these changes bring hope to Native communities in the ongoing battle to decrease HIV and AIDS. This article details information about the biological, social, economic and behavioral cofactors related to the rise in HIV/AIDS in Native communities and follows with issues related to special populations and consideration of the unique needs of prevention in these subpopulations. The need for norming of HIV testing is discussed as is the need for Native-specific programs and interventions. Finally, changes in the recognition of the culturally specific needs of Native people are noted and new resources are presented.

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