Where should African American youth learn about HIV/AIDS?: A community's perspective of how to prevent HIV/AIDS among youth in rural North Carolina

Background: HIV/AIDS rates among African American youth continue to rise, especially in the rural South. These increased infection rates have been associated with stigma and a lack in HIV/AIDS-related knowledge. Although some adults agree that youth should be educated about HIV/AIDS, the settings where this information should be discussed remains controversial. As part of a broader community-based participatory research project to reduce HIV/AIDS risk among rural African American youth, we explored a community's current state of HIV/AIDS related knowledge, attitudes, behaviors and next steps for preventing HIV/AIDS among their youth. Methods: We conducted 31 interviews with adult community leaders and service providers in two rural North Carolina counties over a two-month period in 2009. Data were managed using Atlas.ti 6.1 and analyzed using constant comparison techniques and visual displays. Results: Community members associated the increase in youth's HIV/AIDS-related risk behaviors with non-communication about HIV/AIDS in settings where youth spend most of their time: “the home”, “the school”, and, “the church.” When discussing the use of these settings for HIV/AIDS education, community members consistently identified accessibility and the presence of trusted opinion leaders, such as parents, educators and pastors, as facilitating factors and the HIV/AIDS related stigma perpetrated by these trusted opinion leaders as a major barrier. Conclusion: Although community members believed that these three settings should be places where youth are educated about HIV/AIDS, they also acknowledged their challenges. These results will inform the future direction of an HIV/AIDS prevention intervention for African American youth in these rural South communities.