(P188-LB) Developing the Indigenous HIV/AIDS Syndemic Strategy: Weaving together the National HIV, STI, and Viral Hepatitis Plans

Project description: The Indigenous HIV/AIDS Syndemic Strategy is unique in addressing the syndemic of HIV, STIs, and viral hepatitis within the context of a holistic approach to improving the health and well-being of Indigenous communities. The Strategy centers the strengths of Indigenous people, including relational worldviews that understand the deep interconnectedness of all people with each other and the land.

Issue: Inequities in HIV, STI, and viral hepatitis outcomes among Indigenous people are rooted in colonial practices that disconnected Indigenous peoples from each other, their cultures, and the land and resulted in structural issues such as housing instability and incarceration, stigma, mental health conditions such as depression, and other stressors. National strategies are often focused on health conditions individually instead of holistically and exclude, in conceptualization, development, and implementation, communities the Strategies are intended to support. To truly address inequities in health conditions and care among Indigenous people, policymakers must center the needs of Indigenous communities and honor the principle of Indigenous sovereignty.

Results: This work convened a group of Indigenous community partners to guide the development of the Indigenous Syndemic Strategy. The group co-created a vision; core values; main messages; and related goals, objectives, strategies, and measures of progress, including use of the Medicine Wheel as a framework for improving the well-being of Indigenous people and incorporation of traditional medicines to acknowledge the fundamental role of Indigenous culture and ways of knowing in supporting Indigenous health and well-being. The Strategy emphasizes the importance of Indigenous sovereignty, cultural responsiveness of services, partnerships, awareness and stigma, availability of services and capacity, and data systems in addressing the syndemic of HIV, STIs, and viral hepatitis.

Lessons learned: Centering the strengths and perspectives of Indigenous people supports the emergence of integrative, culturally- and life-affirming public health responses that are uniquely well positioned to address syndemics. The partners hope that sharing the approach and Syndemic Strategy promotes deeper community engagement, leadership, and ownership in developing public health strategies that truly address community needs.