摘要：Many HIV/AIDS and substance abuse prevention studies in American Indian and Alaska Native communities have been directed by academic researchers with little community input. We examined the challenges in conducting HIV/AIDS-related research in American Indian and Alaska Native communities and the benefits of changing the research paradigm to a community-based participatory model. The lessons we learned illustrate that the research process should be a cyclical one with continual involvement by community members. Steps in the process include (1) building and sustaining collaborative relationships, (2) planning the program together, (3) implementing and evaluating the program in culturally acceptable ways, and (4) disseminating research findings from a tribal perspective. These steps can enhance the long-term capacity of the community to conduct HIV/AIDS and substance abuse prevention research. The North American Indians of the 21st century are a diverse and complex group whose demographic patterns and cultural multiplicity result from 5 centuries of conflict between the indigenous population of North America and the Europeans who colonized the continent. When Europeans first arrived in North America, there were many culturally, politically, and geographically dispersed groups of indigenous people. Estimates of the indigenous population at the beginning of the European invasion of North America vary between 7 and 18 million. 1 Today, only 4.1 million Americans (1.5% of the US population) report their race as American Indian or Alaska Native (AIAN). 2 This number includes 2.5 million persons who report being American Indian or Alaska Native alone and 1.6 million persons who report being American Indian or Alaska Native in combination with another race. Although the AIAN population is a diverse group of more than 560 federally recognized tribes (as well as tribes recognized at the state level and other tribes seeking recognition), the AIAN population as a whole has experienced a long history of oppression and alienation. For some tribes and individuals, this history is believed to have led to unresolved grief and negative health outcomes. 3 – 6 Among the people of one tribe, evidence has been found of a “historical trauma response,” including depression, survivor guilt, excesses in cardiovascular disease and mortality, and violent deaths. 7 Furthermore, the general health of American Indians and Alaska Natives continues to lag behind that of the general US population; American Indians and Alaska Natives experience high rates of illness and early death from injuries and disease. 8 , 9 In addition, HIV/AIDS is a growing concern in AIAN communities. Thus, our focus is to present the challenges of conducting HIV/AIDS-related research in AIAN communities and the benefits of using a community-based participatory model.
