Equifinality and multifinality as guides for preventive interventions: HIV risk/protection among American Indian young adults

Using a person-centered developmental approach, we explored how 319 American Indian youth moved to various aspects of HIV risk/protection from adolescence to young adulthood. With two waves of data spanning seven years, we examined multifinality (looking prospectively) and equifinality (looking retrospectively) to identify both normative and less common combinations of risk/protective configurations. These analyses highlighted that a preventive intervention that does not take into account the diversity of risk/protection may be ineffective in addressing the needs of a significant number of young people. Editors' Strategic Implications: This paper provides examples of several strategies that show promise. The authors applied a developmental, person-centered approach - informed by systems theory - to a longitudinal study of HIV risk in a large sample of Northern Plains American Indian youth/young adults. The introduction of these systems concepts should prove useful to many preventionists. The authors' "one size does not fit all" message is relevant to all practitioners working with minority populations. Details about how traditional cultural and developmental expectations vary across American Indian tribes, and often conflict with everyday experiences and functioning in reservation communities, may be of interest to practitioners working with such populations. © 2004 Springer Science+Business Media, Inc.