HIV/AIDS is growing at a disproportional rate among African American adolescents. This trend has occurred despite the fact that 89% of schools have educational programs on HIV/AIDS. Barriers to effective HIV prevention may be related to a failure to develop educational programs based on the cultural competencies of vulnerable populations such as adolescents who are at risk for HIV. The purpose of this qualitative study was to explore African American adolescent perceptions of vulnerability and resilience to HIV/AIDS within a cultural competency paradigm. A group of 8 adolescents at an African American church participated in a focus group to discuss vulnerability and resilience to HIV. To facilitate discussion, the adolescents developed collages from pictures in African American magazines. Content analysis was used to identify themes. The themes revealed were confidence, safe social activities, innocence, image, music/drug culture, and peer pressure.
Bandura, A. (2001). Social cognitive theory: An agentic perspective . Annual Review of Psychology, 52, 1-26.
2.
Basen-Enquist, K., & Parcel, G.S. (1992). Attitudes, norms and self-efficacy: A model of adolescents' HIV-sexual risk behavior. Health Education Quarterly , 19(2), 253-267.
3.
Basen-Enquist, K., Tortolero, S., & Parcel, G. (1997). HIV risk behavior and theory based psychosocial determinants in Hispanic and Non-Hispanic White adolescents. Journal of Health Education, 28(6), 44-50.
4.
Blake, S.M., Simkin, L., Ledsky, R., Perkins, C., & Calabrese, J.M. (2001). Effects of a parent-child communication intervention on young adolescents' risk for early onset of sexual intercourse. Family Planning Perspectives, 33(2), 52-61.
5.
Blinn-Pike, L. (1999). Why abstinent adolescents report they have not had sex: Understanding sexually resilient youth. Family Relations , 48(3), 295-301.
6.
Blum, R.W., Beuhring, T., Shew, M.L., Bearinger, L.H., Sieving, R.E., & Resnick, M.D. (2000). The effects of race, ethnicity, income, and family structure on adolescent risk. American Journal of Public Health , 90(12), 1879-1884.
7.
Brown, E.J. & Waite, C.D. (2005). Perceptions of risk and resiliency factors associated with rural African American adolescents' substance abuse and HIV behaviors . Journal of the American Psychiatric Nurses Association, 11(2), 88-100.
8.
Brown, E.J. & Wells, S. (2005). A faith-based integrated substance abuse and HIV prevention program for rural AfricanAmerican adolescents. Journal of the American Psychiatric Nurses Association, 11(6), 344-350.
9.
Centers for Disease Control (2000). Mortality. Retrieved on January 6, 2003, from http:www.cdc.gov/hiv/graphics/images
10.
Centers for Disease Control (2002). HIV/AIDS surveillance in adolescents. Retrieved on January 6, 2003, from http://www.cdc.gov/hiv/graphics/images/1265/1265-7.htm
11.
Cochran, D.L. (1997). African American fathers: A decade review of the literature. Families in Society, 78(4), 340-351.
12.
Cole, P.M. (2004). Cultural competence now mainstream medicine. Postgraduate Medicine, 116(6), 1-4.
13.
Compas, B.E., Hinden, B.R., & Gerhardt, C.A. (1995). Adolescent development: Pathways and processes of risk and resilience. Annual Review of Psychology, 46, 265-293.
14.
Costa, F.M., Jessor, R., Donovan, J., & Fortenberry, J.D. (1995). Early initiation of sexual intercourse: The influence of psychosocial unconventionality. Journal of Research on Adolescence, 5(1), 93-121.
15.
Cross, T., Bazron, T., Dennis, K., & Isaacs, M. (1988). Toward a culturally competent system of care. Washington, DC: Georgetown University Center for Child and Human Development.
16.
DeCarlo, A., & Hockman, E. (2003). RAP therapy: A group work intervention method for urban adolescents. Social Work With Groups, 26(3), 45-60.
17.
Dias, S.F., Matos, M.G. & Goncalves, A.C. (2005). Preventing HIV transmission in adolescents: An analysis of the Portuguese data from the Health Behavior School-Aged Children study and focus groups. European Journal of Public Health, 15(3), 300-304.
18.
Dias, S.F., Matos, M.G., & Goncalves, A.C. (2006). AIDS-related stigma and attitudes toward AIDS-infected people among adolescents. AIDS Care, 18(3), 208-214.
19.
DiClemente, R.J., Wingood, G.M., Crosby, R., Sionean, C., Cobb, B.K., Harrington, K., et al. (2001). Parental monitoring: Association with adolescents' risk behaviors. Pediatrics, 107(6), 1363-1368.
20.
DiIorio, C., Dudley, W.N., Lehr, S., & Soet, J.E. (2000). Correlates of safer sex communication among college students. Journal of Advanced Nursing, 32(3), 658-665.
21.
DiIorio, C., Kelley, M., & Hockenberry-Eaton, M. (1999). Communication about sexual issues: Mothers, fathers, and friends. Journal of Adolescent Health, 24, 181-189.
22.
DiIorio, C., Kelly, M., & Mbwara, J. (2001). Social cognitive correlates of sexual experience and condom use among 13- through 15-year-old adolescents. Journal of Adolescent Health, 29, 208-216.
23.
Dittus, P.J., Jaccard, J., & Gordon, V.V. (1997). The impact of African American fathers on adolescent sexual behavior. Journal of Youth and Adolescence, 26(4), 445-465.
24.
Felton, G.M., & Bartoces, M. (2002). Predictors of initiation of early sex in Black and White adolescent females. Public Health Nursing, 19(1), 59-67.
25.
Freedman, D., Salazar, L.F., Crosby, R.A. & DiClemente, R.J. (2005). Environmental barriers to HIV prevention among incarcerated adolescents: A qualitative assessment . Adolescence, 40(158), 333-343.
26.
Furstenberg, F.F., Morgan, S.P., Moore, K.A., & Peterson, J.L. (1987). Race difference in the timing of adolescent intercourse. American Sociological Review , 52(4), 511-518.
27.
Goh, D.S., & Primavera, C. (1996). Risk behaviors, self-efficacy and AIDS prevention among adolescents. Journal of Psychology, 130(5), 537-547.
28.
Goh, M. (2005). Cultural competence and master therapists: An inextricable relationship. Journal of Mental Health Counseling , 27(1), 1-10.
29.
Jemmott, J.B., & Jemmott, L.S. (2000). HIV risk reduction behavioral interventions with heterosexual adolescents. AIDS, 14, 40-52.
30.
Johnson, T.P., Cho, Y., Fendrich, M., Kelly-Wilson, L., & Pickup, L. (2004). Treatment need and utilization among youth entering the juvenile corrections system. Journal of Substance Abuse Treatment, 26(2), 117-129.
31.
Kaopua, L.S., & Mueller, C.W. (2004). Treatment adherence among native Hawaiians living with HIV. Social Work, 49(1), 1-11.
32.
Kerr, A.E., & Patton, M.J. (1994). Interpersonal correlates of narcissism. Journal of Counseling and Development, 73(2), 204-210.
33.
Krueger, R. (1998). Developing questions for focus groups. Thousand Oaks, CA: Sage.
34.
Lammers, C., Ireland, M., Resnick, M., & Blum, R. (2000). Influences on adolescents' decision to postpone onset of sexual intercourse: A survival analysis of virginity among youths aged 13 to 18 years. Journal of Adolescent Health, 26(1), 42-48.
Leone, P., Hightow, L., Foust, E., Owen-O'Dowd, J., Phillip, S., Gray, P., et al. (2005). HIV transmission among Black college student and non-student men who have sex with men-North Carolina, 2003. Morbidity and Mortality Weekly Report53(32), 731-734.
37.
Libermann-Smith, J. (2001). Teenage relationship with an older partner may lead to early first sex. Family Planning Perspectives, 33(3), 1-2.
38.
Madiz, E. (2000). Focus groups in feminist research. In Y. S. Lincoln (Ed.), Handbook of Qualitative Research (pp. 835-850). Thousand Oaks, CA: Sage.
39.
Magura, S., & Shaprio, J.L. (1994). Condom use among criminally involved adolescents . AIDS Care, 65(5), 595-603.
40.
Marcus, M.T., Walker, T., Swint, J.M., Smith B. P., Brown, C., Busen, N., et al. (2004). Community-based participatory research to prevent substance abuse and HIV/AIDS in African-American adolescents. Journal of Interprofessional Care, 18(4), 347-359.
41.
Marin, B.V., Coyle, K.K., Gomez, C.A., Carvajal, S.C., & Kirby, D.B. (2000). Older boyfriends and girlfriends increase risk of sexual initiation in young adolescents. Journal of Adolescent Health, 27(6), 409-418.
42.
Nahom, D., Wells, E., Gilmore, M.R., Hoppe, M., Morrison, D.M., Archibald, M., et al. (2001). Differences by gender and sexual experience in adolescent sexual behavior: Implications for education and HIV prevention . Journal of School Health, 71(4), 153-158.
43.
Napoles-Springer, A.M., Santoyo, J., Houston, K., Perez-Stable, E., & Stewart, A. (2005). Patients' perceptions of cultural factors affecting the quality of their medical encounters. Health Expectations , 8(1), 4-18.
44.
National Center for Cultural Competence. ( 1999-2004a). Definition and conceptual framework of cultural competence. Washington, DC: Georgetown University Center for Child and Human Development.
45.
National Center for Cultural Competence. ( 1999-2004b). Rationale for self-assessment, 1-7 . Washington, DC: Georgetown University Center for Child and Human Development.
46.
Reimann, J., Talavera, G., Salmon, M., Nunez, J., & Velasquez, R.J. (2004). Cultural competence among physicians treating Mexican Americans who have diabetes: A structural model . Social Science & Medicine, 59(11), 2195-2206.
47.
Robenstine, C. (1995). AIDS education for black high schoolers. Education Digest, 61(1), 53-56.
48.
Sidelinger, D.E., Meyer, D., Blaschke, G.S., Hametz, P., Batista, M., Salguero, R., et al. (2005). Communities as teachers: Learning to deliver culturally effective care in pediatrics. Pediatrics, 115(4), 1160-1164.
49.
Sirin, S.R., Diemer, M.A., Jackson, L.R., Gonsalves, L., & Howell, A. (2004). Future aspirations of urban adolescents: A person-in-context model. International Journal of Qualitative Studies in Education , 17(3), 437-456.
50.
Speziale, H.J. and Carpenter, D.R. (2007). Qualitative Research in Nursing (4th ed.). Philadelphia: Lippincott.
51.
Stanton, B., Romer, D., Ricardo, I., Black, M., Feigelman, S., & Galbraith, J. (1993). Early initiation of sex and its lack of association with risk behaviors among adolescent African-Americans. Pediatrics , 92(1), 13-19.
52.
Stevenson, H.C. & Davis, G. (1994). Impact of culturally sensitive AIDS video education on the AIDS risk knowledge of AfricanAmerican adolescents. AIDS Education & Prevention, 6(1), 40-52.
53.
Takata, Y. (2002). Supporting by a nurse teacher in a school infirmary using collage therapy. Psychiatry and Clinical Neuroscience , 56(4), 371-379.
54.
U.S. Department of Health and Human Services ( 2000). Healthy people 2010 (special edition CD-Rom). Washington, DC: Author.
55.
Villarruel, A.M., Jemmott, L.S., Howard, M., Taylor, L., & Bush, E. (1998). Practice what we preach? HIV knowledge, beliefs, and behaviors of adolescents, and adolescent peer educators. Journal of the Association of Nurses in AIDS Care, 9(5), 61-72.
56.
Wade, J.C. (1994). African American fathers and sons: Social, historical, and psychological. Families in Society, 75(9), 1-11.
