Views of Young, Rural African Americans of the Role of Community Social Institutions in HIV Prevention

Background. We explored rural African American youths' perceptions about the role of community social institutions in addressing HIV. Methods. We conducted four focus groups with African Americans aged 16 to 24 years in two rural counties in North Carolina. Groups were stratified by gender and risk status. We used a grounded theory approach to content analysis. Results. Participants identified four social institutions as primary providers of HIV-related health promotion efforts: faith organizations, schools, politicians, and health agencies. They reported perceiving a lack of involvement in HIV prevention by faith-based organizations, constraints of abstinence-based sex education policies, politicians' lack of interest in addressing broader HIV determinants, and inadequacies in health agency services, and viewed all of these as being counter-productive to HIV prevention efforts. Conclusions. Youth have important insights about local social institutions that should be considered when designing HIV prevention interventions that partner with local organizations.