1. TWO-SPIRIT
LGBT
Client Care,
Messaging ,and Media
Points to Consider
Tommy Chesbro
John Hawk Cocke’
Mattee Jim

2. What type of community do you
live in?

3. What is your role in your community?

4. What is your Age?

5. What is your gender?

6. How do you identify?

7. Who should HIV prevention messages
primarily be targeted to within the Native
American Two-Spirit, LGBT community?

8. Who else should be targeted?
• Tribal Council/Decision Makers 39.6%
• Family members of Two-Spirit/LGBT 33.3%
• Health providers of Two-Spirit/LGBT 20.8%
• Teachers and School Administrators 6.3%

9. What would be useful awareness or
educational tools for the Native American
Two Spirit, GLBT community?
Twitter:
Facebook: 76% YES RATE
90% YES RATE
TXT MSG:
71% YES
RATE

10. Please rank the following educational materials
1st (most important) to 5th (least important)
Print Materials: fliers, posters, brochures, fact sheets
Multimedia Materials: website, facebook, text messaging
Promotional Items: t-shirts, magnets, key chains or other give away items

11. Messages for TWO-SPIRIT/LGBT
Youth and Adults
• Improve Identity Attitudes/Use cultural examp
• Importance of HIV Testing
• Hope, Inclusiveness, connection, heritage
• Responsibility to yourself, loved ones, and
community.
• Specific messages for Transgender
• Info on STIs
• Condom use

12. Messages for Other Audiences
• Native specific statistics
• Support for Two-Spirit/LGBT family and
friends
• Testing
• Use culture in messages
• Acceptance, stigma reduction
• condoms

13. Discrimination and Health Outcomes
• Discrimination has been related to depressive
symptoms; global measures of distress; anxiety
symptoms; and poor general health
• Everyday discrimination is much more stressful
than time-limited discrimination, and, as a result,
daily hassles have a greater impact on health
outcomes
• Among Natives, one study found that perceived
discrimination was related to AOD use and
depression (Whitbeck & Morris, 2001)
• Evidence suggests that oppressed statuses
associated with multiple forms of discrimination
may lead to more cumulative physical and mental
health symptoms (Diaz & Ayala, 2001)

14. Triangle of Risk
Trauma/Violence Alcohol/Drug Use
& Mental Health
Health Risk Behaviors and Outcomes

15. Preliminary Correlations: Historical
Trauma Events, Drug Use, and
Risk y Sex events were associated with drug use
Historical trauma
Lifetime crack/coke use (.19*)
Crank (.18*), inhalants (.21*), opiates (.20*); and XTC (.20*)
Historical trauma events were associated with alcohol use
Needing a drink in the morning (.28**)
Injury as a result of drinking (.23*)
Quantity and frequency binge drinking (.20-.22**)
Drinking to manage moods (HT parents, .16* -.24***)
Historical trauma events were associated with risky sexual
behaviors
Inconsistent condom use for vaginal sex in last year (.24-33***)
Inconsistent condom use for anal sex in last year (.48**-.54)
Inconsistent condom use for anal sex among MSMs 2-spirits (.61**)
Ability to use condoms affected by AOD (.35**)
*p = <.05; **p<.01; ***p<.001