The document summarizes a three-year HIV/AIDS prevention project that adapted an evidence-based intervention called Sisters Informing Sisters on Topics About AIDS (SISTA) for American Indian women in Arizona. Key points: - The project was a collaboration between the Inter Tribal Council of Arizona and local tribes to provide culturally-appropriate HIV education. - The SISTA curriculum was adapted into a new curriculum called Native American Sister Informing Sister by adding new sessions and tailoring activities to local tribes. - Preliminary evaluations found increased condom use intentions, self-efficacy around condoms, and STI screening rates among the women who participated. - Next steps include sharing outcomes, providing more

1. NA SISTER: Sharing Outcomes of a
three-year HIV/AIDS Prevention
Project
By Beatrice Norton (Hopi Tribe), Frances Cupis (Pascua Yaqui Tribe), and
Gwenda Gorman (ITCA)

2. Overview
• Background – Statistics/SISTA
• Partnerships
• Adaptation Process/Tailoring to Tribes
• Results
• Next Steps

3. Background
• America Indians/Alaska Natives (AI/AN) in AZ
have the second highest Chlamydia and
Gonorrhea rates in Arizona among 10-19 years old
and adults
• AI/AN in AZ have the third highest HIV/AIDS rates
• The ITCA received a three-year grant from the
Office of Women’s Health to adapt the evidence-
based intervention, Sisters Informing Sisters on
Topics About AIDS (SISTA) for American Indian
women in Arizona

4. SISTA
Incorporates
• Discussions and activities to empower women
to praise their strengths and identify role
models in their communities.
• Risk reduction skills building.
• Take home assignments that includes their
partners participation.

5. SISTA
• Original curriculum targeted African-American
heterosexual women
• A group-based evidenced-based intervention
• Includes 5, two-hour sessions, with two optional
booster sessions
Session 1: Ethnic and Gender Pride
Session 2: HIV/AIDS Education
Session 3: Assertiveness Skills Training
Session 4: Behavioral Self-Management
Session 5: Coping Skills

6. SISTA
Women who completed the SISTA
intervention reported:
• Increased consistent condom use.
• Greater sexual self control.
• Greater sexual communication.
• Greater sexual assertiveness.
• Increased partners’ adoption of norms
supporting consistent condom use.

7. Project Goal
To provide culturally appropriate HIV/AIDS
prevention education to AI/AN women in Arizona,
through adapting, tailoring, and implementing the
Sisters Informing Sisters on Topics about AIDS
(SISTA) Project.

8. Collaboration

9. Adaptation Process
• Two women were identified from each tribal
site to participate in a four-day SISTA Facilitator
Training by CDC in May of 2010.
• Face to face meetings were held with the tribes
on further discussion of adaptation steps.
• Each tribe conducted feedback sessions and key
informant interviews on how to implement the
project in their respective communities.

10. Adaptation Process
• Recruited at least 40 women American Indian
women to receive sessions from original
curriculum.
• Women received gifts cards for participating in
the sessions and were offered an additional gift
card for voluntarily getting an HIV/STD test.
• Feedback from participants were recorded to
make changes to new curriculum, Native
American Sister Informing Sister: Educating,
Talking, and Reducing Risk.

11. Adaptation Process
• Capacity building activities were provided to
facilitators (i.e. Program Evaluation, Effective
Facilitation Skills)
• Facilitator Training on the new NA SISTER
curriculum held in Phoenix, AZ
• Facilitator observations were conducted to ensure
fidelity of curriculum

12. NA SISTER
• Targets American Indian women
• Group based intervention with six sessions:
Historical Trauma and Cultural Resilience
session added (based on literature review
conducted and feedback)
• American Indian poems added and activities and
role play scenarios were changed
• Modified “SISTAS Assertiveness Model” acronym to
“SISTER Proactive Communication Model”
• New design cover for curriculum

13. Tailoring to Tribes - Hopi
NATIVE AMERICAN SISTER PROJECT
Na'na tupkom na'nami tunat yaw yungwa
(Sisters helping to protect one another….)
ADAPTATIONS:
 Motto: Women’s Journey
 Opening Poem: Written by Hopi woman
 Values worksheet: Corn Plant Values Sheet
 At the Parking Lot: At the PIKI HOUSE
 Props : Cultural items defining Hopi women’s significance in the Hopi Cultural

14. Tailoring to Tribes - Hopi

15. Tailoring to Tribes – Pascua
Yaqui Tribe
Sewa Hamut Program – RESPECT FOR MY COMMUNITY, MY TRIBE,
MY LIFE.
• Collaborated with the Language and Culture Department and
Elders from tribal communities to assist in curriculum
development of traditional learning techniques.
• Utilized the Language and Culture Department regarding
ceremonial direction in spirituality, historical trauma and
cultural resiliency.
• Utilized our Hiaki language to adapt the Sewa Hamut Program
from NA SISTERS to provide connection with community.
• Integration of symbolism of Sewa Hamut or flower women has
a connection to nature, culture and health.

16. Tailoring to Tribes – Pascua
Yaqui Tribe

17. Results
NA-SISTER Preliminary
Evaluation Select Findings

18. NA-SISTER Preliminary Evaluation
Select Findings
Age Group of Participants Health & STI Screenings
(in years) – 91% reported Pap Test
– 41% reported Chlamydia
– 26% reported Gonorrhea
– 53% reported HIV test
Note: These are self-reported
from the pre-tests

19. Confidence or Self-efficacy
(Condoms)
Highest Pre-test Highest Post-test

20. Increased Intention to Use
Condoms (Next Time)

21. Increased Intention to Use
Condoms (Next 3 Months)
Almost 12%
increase

22. Next Steps
• Share findings of project outcomes with tribes
• Provide Facilitators Training on NA SISTER
curriculum (dependent on additional funding)
• Share curriculum with other tribes
• Identify other funding sources to continue
project

23. Questions?