Journal of Black Psychology

This article provides an overview of the history of AIDS in the United States. In 1985, a formal analysis of AIDS among Blacks was initiated. The Centers for Disease Control sponsored the first national conference on AIDS in minority communities in August 1987, an official acknowledgment that the HIVepidemic disproportionately affected Blacks. This article provides surveillance data for several groups of Blacks including women and men who have sex with men. Projections on AIDS cumulative incidence among Blacks within the next several years are also provided in the article.

There is a widening gap between the growing numbers ofAfrican Americans with HIVand AIDS and culturally specific programs that address education, prevention, and psychological services within the African American community. This article describes an Africentric model for training psychologists who deliver AIDS education, prevention, and services within the African American community. The principles of NTU and Nguzo Saba were used in the training of 75 African American psychologists with the expectation that they would use these principles when doing education, prevention, and intervention activities within their communities. The article provides a historical context and conceptual framework for the program along with a summary of the impact of the program and implications for future programming and research.

Existing models of attitude-behavior relationships, including the Health Belief Model4 the Theory of ReasonedAction, and the Se4f-Efficacy Theory, are increasingly being used by psychologists to predict human immunodeficiency virus (HIV)-related riskbehaviors. The authorsbrieflyhighlightsome of the dfficulties that might anse in applying these models to predicting the risk behaviors of African Americans. These social psychological models tend to emphasize the importance of individualistic, direct control of behavioral choices and deemphasizefactors, such as racism and poverty, particularly relevant to that segment of the Afncan American population most at riskfor HIV infection. Applications of these models without taking into account the unique issues associated with behavioral choices within the African American community may fail to capture the relevant determinants of risk behaviors.

Young incarcerated African American males are at high riskfor contracting the human immunodeficiency virus (HIV). The purposes of this study were to (a) describe the levels ofHIlVknowledge, norms regarding condom use, self-efficacy, and intentions to engage in HlV-preventive behaviors in a sample of young incarcerated African American males; and (b) assess the relationships between knowledge, norms, self-efficacy, and behavioral intent. Data were collected during an AIDS educational session from 52 African American males 17 to 22 years of age. The results indicated that this sample had a moderate level ofAIDS knowledge overalL However, knowledge regarding transmission myths was relatively low. This sample evidencedfairly high self-efficacy regarding HIVprevention and showed moderate intentions to engage in HIV-preventive behaviors. The data also indicated that both peer and subjective norms support condom use.

Effectively educating African American adolescents about the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has recently become a crucial issue for many health educators. As a result, the American National Red Cross developed a culturally specific HIV/AIDS education course designed to reach African American urban adolescents. An evaluation of this course was conducted with 339 youths who participated in course presentations in their schools in Los Angeles, California. The purpose of the evaluation was to measure the effectiveness of the culturally specific curriculum and the environment in which it was presented. The course was presented in schools, and both African American and non-African American students participated. Classroom groups were generally of two types: ethnically homogeneous (predominantly one ethnic group, only) and ethnically heterogeneous (ethnically mixed groups). Results showed that although all students increased their knowledge and behavioral intent after the course, students performed significantly better in ethnically homogeneous classrooms as compared to ethnically heterogeneous classrooms. The study pointed out some difficulties in the evaluation of culturally specific courses, such as confounding variables, unreliable instruments, and the lack of long-term follow-up testing.

Recent epidemiological studies indicate that African American female adolescents are at a markedly higher riskfor diagnoses with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) than their White female counterparts. Although epidemiologic data are informatve with respect to monitoring the course of the epidemic and quantifying the differential riskfor AIDSIHIV infection among young Afican American women in relation to other populations, they provide less insight into the influence of the diverse cultural, gender, andpsychosocial determinants ofHIV-associated risk behaviors. Afactor ofparticular importance is communication between sexual partners about condom use. Focus groups were conducted with African American women aged 18 to 25, to explore the process ofsexual communication and barriers toward sexual negotiation of condom use. HlVprevention programs tailored to African American women should emphasize training in sexual negotiation, conflict resolution, and refusal skills.

The ways in which selected factors limit human immunodeficiency virus (HIV) prevention efforts in African American communities are discussed. Specifically, this discussion focuses on barriers to expanding the HIVprevention knowledge base such as (a) the stigma associated with the HIV/AIDS pandemic, (b) the overreliance on traditional models of health such as those used with adolescent pregnancy and substance abuse, and (c) the lack offunding for needed service delivery and research programs. Several dimensions of the African worldview are presented and these are used to illustrate ways to overcome the barriers just mentioned so that HIV prevention efforts might be more effective in African American communities.

The major obstacles to sustaining mobilization efforts are objective conditions, attitudes toward sexuality, perceptions of substance abuse and HIV/AIDS, and conflicting policy views. Organizational responses to the epidemic occur within circumstances ofperceived oppression, neglect, competing and conflicting agendas, and religious conservatism. Suspicion, often dismissed by public health officials and community-based outreach workers, neutralizes programmatic activities. Popular reactionsfocus on debates about conspiracy theories, fear of racist stigmatization, anda pervasive sense that only marginal groups are affected. Ambivalence hampers prevention and treatment. Public health education is still not sufficiently penetrating African American neighborhoods. Efforts have not been systematic or continous. Many are top-down actions organized by professional elites aimed at their constituencies rather than neighborhoods. Addicts and their sex partners have not been sufficiently empowered or persuaded in large numbers to change their vulnerable actions. Unfortunately the crisis has not waned.