In Their Own Voices: Rural African American Youth Speak Out About Community-Based HIV Prevention Interventions

Abstract

Background The HIV epidemic is a major public health problem in the United States, particularly among rural African American adolescents and young adults. Objectives We sought to explore young, rural African American’s perspectives about key programmatic components to consider when designing youth-targeted, community-based HIV prevention interventions. Methods We report data from four focus groups with adolescents and young adults aged 16 to 24 (n = 38) conducted as part of a community-based participatory research (CBPR) project designed to develop multilevel HIV risk reduction interventions in two rural North Carolina communities with high HIV rates. Analysis was performed by academic and community partners using a modified grounded theory approach to content analysis. Results Interventions should target preadolescents and early adolescents rather than older adolescents and young adults in an effort to “catch them while they’re young.” Intervention developers should obtain input from local young people regarding critical programmatic components, such as whom to employ as study recruiters and intervention leaders; intervention format and delivery options, acceptable recruitment and intervention locations, and incentive structures. Participants believe selecting community collaborators representing varied community sectors is critical. Important barriers to address included limited transportation, discomfort communicating about sexual issues, lack of community interest in HIV prevention, and unwillingness to acknowledge and address sexual activity among adolescents. Conclusion When designing HIV/AIDS prevention interventions, targeting young people, it is important to form academic–community partnerships that ensure young people’s perspectives are integral to the intervention development process.

‘I make sure I am safe and I make sure I have myself in every way possible’: African-American youth perspectives on sexuality education

“…Prior youth focused studies also indicate the need for a range of sources of sexuality education and the development of audience-specific programmes (Coker-Appiah et al 2009; Flores, Blake, and Sowell 2011). Young people have previously identified non-school based sources such as parents and other family members as primary sources of sexuality education (DiIorio, Pluhar, and Belcher 2003; Somers and Surmann 2004).…”

Exploring the Everyday Lived Experience of African American People Living with HIV/AIDS (PLWH) in the Rural South

“…This finding is consistent with recent studies of rural southern areas in the United States (US) that report inadequacies in the delivery of HIV health care services to PLWH in rural southern areas as an issue. 14,26,[38][39][40] Table 1 details the responses from study participants. This continues to be a problem on a national level.…”

“…Cumulative traumas, which are the effect of trauma accumulated across the life course, can cause high levels of subjective stress. 15,26,32…”

“…15,[23][24][25] Many of these barriers are unique to PLWH in rural areas and can prohibit them from seeking HIV testing, counseling, and care, as well as related services such as drug and alcohol treatment and mental health counseling. 6,7,26,27…”

Connecting PLWHA in Rural Virginia to Health and Mental Health Care-Perspectives from the Life Worlds of Frontline Health Workers and PLWHA

“…Many of these barriers are unique to PLWHA in rural areas and can prohibit them from seeking HIV testing, counselling, and care, as well as related services such as drug and alcohol treatment and mental health counseling. [14][15][16]3 In rural Virginia, African American MSM accounted for nearly half of all HIV infections and AIDS cases. Many MSM, especially African Americans, do not self-identify as gay, have sexual intercourse with both men and women without disclosing their sexual behavior partners, and are inconsistent in their use of condoms.…”