Vaginal microbiota of American Indian women and associations with measures of psychosocial stress

Molecular-bacterial vaginosis (BV) is characterized by low levels of vaginal Lactobacillus species and is associated with higher risk of sexually transmitted infections (STI). Perceived psychosocial stress is associated with increased severity and persistence of infections, including STIs. American Indians have the highest rates of stress and high rates of STIs. The prevalence of molecular-BV among American Indian women is unknown. We sought to evaluate measures of psychosocial stress, such as historic loss (a multigenerational factor involving slavery, forced removal from one’s land, legally ratified race-based segregation, and contemporary discrimination) and their association with the vaginal microbiota and specific metabolites associated with BV, in 70 Northwestern Plains American Indian women. Demographics, perceived psychosocial stressors, sexual practices, and known BV risk factors were assessed using a modified version of the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project survey. Self-collected mid-vaginal swabs were profiled for bacterial composition by 16S rRNA gene amplicon sequencing and metabolites quantified by targeted liquid-chromatography mass spectrometry. Sixty-six percent of the participants were classified as having molecular-BV, with the rest being either dominated by L. crispatus (10%) or L. iners (24%). High levels of lifetime trauma were associated with higher odds of having molecular-BV (adjusted Odds Ratio (aOR): 2.5, 95% Credible Interval (CrI): 1.1–5.3). Measures of psychosocial stress, including historic loss and historic loss associated symptoms, were significantly associated with lifestyle and behavioral practices. Higher scores of lifetime trauma were associated with increased concentrations of spermine (aFC: 3.3, 95% CrI: 1.2–9.2). Historic loss associated symptoms and biogenic amines were the major correlates of molecular-BV. Historical loss associated symptoms and lifetime trauma are potentially important underlying factors associated with BV.

Alcohol Consumption during COVID among Women with an Existing Alcohol-Use Disorder

Prior to the pandemic, our research team implemented a randomized controlled trial of an intervention to reduce risk for alcohol-exposed pregnancy (AEP) in American Indian women. When active recruitment for the in-person trial was paused due to COVID, the research team moved to conducting follow-up surveys with participants who had completed the intervention to better understand changes to their alcohol use during the pandemic. We collected surveys from 62 American Indian women who had completed the Native CHOICES intervention. Baseline data collected pre-COVID included demographics and scores on the Alcohol Use Disorders Identification Test (AUDIT). Follow-up surveys conducted during the active pandemic period included a self-reported questionnaire about changes in drinking patterns. At pre-COVID baseline, all participants were engaged in heavy or binge drinking. At follow-up during COVID, 24.2% reported drinking more, and over half had at least one binge drinking episode. Approximately half reported reduced drinking. We found that risky drinking remained an issue during the pandemic for many American Indian women who had engaged in this behavior pre-COVID, while others reported reducing their alcohol consumption. As the pandemic abates, concerted efforts must be made to reach those with identified alcohol use disorders to offer resources and intervention as needed.

Predictors of Breast Cancer Screening Behaviors Among American Indian Women in the Northern Plains

Purpose: This study examined predictive models of the utilization of mammograms among American Indian women adapting Andersen’s behavioral model. Using a sample of 143 American Indian women residing in the Northern Plains. Methods: Data were collected using a self-administered survey completed by 143American Indian women over the age of 45 in the Midwest. Logistic regression analyses were conducted to assess predisposing (age and marital status), need (personal and family cancer history), and enabling factors (education, monthly household income, mammogram screening awareness, breast cancer knowledge, self-rated health, and cultural practice to breast cancer screening). Results: Nested logistic regression analyses indicated that only 55.5% of participants reported having had a breast cancer screening within the past 2 years, whereas 21.0% never had a mammogram test. After controlling for predisposing and need factors, higher education, greater awareness of mammogram, and higher utilization of traditional Native American approaches were significant predictors of mammogram uptake. Conclusions: The findings highlight important implications for intervention strategies aimed at improving breast cancer screening and service use among American Indian women. Educating health professionals and American Indian community members about the importance of breast cancer screening is highly needed. It is critical to assess a woman’s level of traditional beliefs and practices and its possible influence on screening participation and future screening intention. Given the findings, prevention and intervention strategies, including public awareness and education about breast cancer screening are promising avenues to reduce screening disparities among American Indian women.

Dialectics of Time and Space in American Indian Women’s Writings

<p>This study new-historically explores the dialectics of time and space in American Indian women’s writings to explain American Indians’ awareness of and attachment to their surrounding nature and its expression in the contemporary American Indian tribal life. With delimited focus on Louise Erdrich’s <i>Tracks</i> (1988) and Leslie Marmon Silko’s <i>Ceremony </i>(1977), this article analyzes American Indian approach to time and space reflecting Natives’ awareness of their surrounding place. Mythical stories of oral tradition inscribed in <i>Tracks</i> and <i>Ceremony </i>recreate American Indian timeless and macrocosmic realities. American Indian women writers have been selected owing to the matriarchal nature of American Indian social order wherein women have been the conscious carriers of their timeless oral tradition. The two selected novels of different settings express the cultural range of American Indian tribal belt from Canadian border (<i>Tracks’ </i>setting) to Mexican border (<i>Ceremony’s </i>setting). This range is evidence of the synchronic and diachronic integrations and distinctions of American Indian past, present and future.</p>

Dialectics of Time and Space in American Indian Women’s Writings

<p>This study new-historically explores the dialectics of time and space in American Indian women’s writings to explain American Indians’ awareness of and attachment to their surrounding nature and its expression in the contemporary American Indian tribal life. With delimited focus on Louise Erdrich’s <i>Tracks</i> (1988) and Leslie Marmon Silko’s <i>Ceremony </i>(1977), this article analyzes American Indian approach to time and space reflecting Natives’ awareness of their surrounding place. Mythical stories of oral tradition inscribed in <i>Tracks</i> and <i>Ceremony </i>recreate American Indian timeless and macrocosmic realities. American Indian women writers have been selected owing to the matriarchal nature of American Indian social order wherein women have been the conscious carriers of their timeless oral tradition. The two selected novels of different settings express the cultural range of American Indian tribal belt from Canadian border (<i>Tracks’ </i>setting) to Mexican border (<i>Ceremony’s </i>setting). This range is evidence of the synchronic and diachronic integrations and distinctions of American Indian past, present and future.</p>