American Indians and Alaska Natives (AIs/ANs) face health disparities across a variety of diseases and pathologies, a reality that some have argued can be linked to the multiple harms and injustices systematically perpetrated against the population (Jones, 2006). In 2006, it was estimated that over 4 million Americans identified their race as AI/AN, either alone or in combination with another race (U.S. Census Bureau, 2006b). Most AIs/ANs live outside of tribal areas (Ogunwole, 2006), and significant health disparities between AIs/ ANs and the general population have been documented in urban areas and throughout the country (Castor et al., 2006). Although the Indian Health Service (IHS) funds a number of urban programs, these programs represent a miniscule portion of the IHS budget (Castor et al., 2006; Forquera, 2001). HIV/AIDS is a problem of growing concern in AI/AN communities (Vernon J Vernon & Jumper-Thurman, 2005), sociocultural factors that stigmatize risk behaviors and perpetuate silence (Vernon & Jumper-Thurman, 2005), and socioeconomic disadvantage and poverty (Ogunwole, 2006; U.S. Census Bureau, 2007; Vernon & Jumper-Thurman, 2005). AIs/ANs are also disproportionately likely to engage in certain behaviors that place them at risk for HIV transmission. For example, they are significantly more likely to report past-year alcohol or drug use disorders compared with the other racial groups (Substance Abuse and Mental Health Services Administration [SAMHSA], 2007). Another issue is that HIV/AIDS surveillance may underestimate the burden of the disease on the AI/AN population due to racial misclassification (Bertolli, Lee, Sullivan, & the AI/AN Race/ Ethnicity DataValidationWorkgroup, 2007; Bertolli et al., 2004). In urban areas where they are a small minority, AIs/ANs may be especially susceptible to being misclassified as another race in HIV/AIDS statistics. Urban AIs/ANs may benefit from culturally tailored HIV/AIDS prevention services that have a firm grounding in local data. The Don't Forget Us program represents such an effort. The Don't Forget Us program began in 2006 with funding from the Center for Substance Abuse Prevention (CSAP) to deliver substance abuse, HIV/AIDS, and hepatitis prevention services to the urban-dwelling AI population in Baltimore, Maryland. AIs represent a very small minority in the city, constituting only 0.75 percent of Baltimore's total population (U.S. Census Bureau, 2006a). As such, comparatively little was known about the local population regarding characteristics and health risk behaviors. Anecdotal evidence from a local community program funded by the IHS suggested that AIs in the target area experienced numerous risks for substance abuse, HIV/AIDS, and hepatitis. The available local-level census and neighborhood data (Baltimore Neighborhood Indicators Alliance, 2006) indicated that AIs in the city were fragmented, although a few neighborhoods did have larger concentrations of the population. DEVELOPMENT OF THE DON'T FORGET US PROGRAM Strategic Prevention Framework In designing prevention services for the urban AI population, we used SAMHSA'S Strategic Prevention Framework (SPF) to focus our efforts. The SPF provides a road map for prevention program planning and consists of five broad steps: (1) Assess the needs of the target population; (2) build capacity to address needs; (3) develop a strategic plan; (4) implement effective programs, policies, and practices; and (5) evaluate (CSAP, 2007). …