Abstract
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.