Sexual assault surveillance instrument development and improved service delivery: Strengthening Tribal systems

Background. According to the state and CDC, rates for violence against women is high and increasing, with 40% being sexual assault. Racial minorities experience a higher rate. Research also demonstrates a connection between sexual violence and HIV/STDs. No precise and reliable rates for Native Americans exist nationally or locally. Objective. Using mini-grant funding, a project was developed to determine the prevalence of sexual violence in a Native American Tribal community. Additional objectives were to educate on connections between sexual violence and STDs/HIV, and to increase inter-agency collaboration. Methods. An inter-disciplinary workgroup developed a surveillance tool to collect sexual assault prevalence data. Training regarding the use of this tool was provided to local agencies. Agency staff was educated regarding the connection between sexual assault and STDs/HIV, and were informed about counseling and HIV testing referral processes. Results. The inter-disciplinary workgroup went through several iterations of a surveillance tool. Twelve Tribal agencies adopted the tool. Though tool utilization has been limited to date, increased communication has improved understanding of the burden of sexual assault in the community. More precise rates may be determined as surveillance improves, with possible limitations due to the biases specific to the "high risk" clients accessing these Tribal agencies. Inter-agency collaboration has increased, referral processes are better understood, and Tribal staff is better informed about risks associated with sexual assault. Conclusion. Implementation of a sexual assault surveillance tool improved the understanding of prevalence and service delivery in a Native American Tribal community.