Sponsor:

National Institute on Minority Health and Health Disparities

Built on an 8-year community-based participatory partnership, in full collaboration with the Tribal Nation, this study is a 5-year two-arm randomized comparative effectiveness trial to evaluate prevention of HIV/STI sexual risk behavior by directly addressing PTSD or substance use. We will evaluate Narrative Exposure Therapy (NET) versus Motivational Interviewing with Skills Training (MIST) in HIV/STI prevention. AI elder and community leaders have insisted that “we can keep providing substance use or sexual risk programs but until we get to the underlying cause – trauma – then we’ll keep replacing one means of avoidance for another”. This study will help address this community-generated clinical and empirical question. The overall

goal is to compare two evidence based treatments, each addressing a different HIV sexual-risk behavior (HSB) causal pathway. NET addresses PTSD preventing substance use disorder (SUD) and HSB. MIST addresses substance misuse preventing SUD and HSB.