A Youth Leader's Guide to Building Cultural Competence 

Chapter Four 

Cultural Background for HIV/AIDS Prevention 

If you turned to this section without reading the previous sections, STOP! Acquaint yourself with the 

steps to building cultural competence outlined in the previous pages. Understand that reading the 

information offered in this section is no substitute for gaining understanding of your own culture, the 

individual young people in your program and their cultural backgrounds.  

This section offers some important information that can help you place HIV/AIDS prevention efforts in a 

cultural context and perhaps understand some of the beliefs and attitudes of your program participants and 

their families. Due to the alarming rates of HIV infection among African American, Latino/Latina and 

gay male youth, this section will outline some of the reasons that HIV/AIDS prevention messages might 

be resisted by African Americans, Latinos/Latinas and young gay men.  

Economic Issues  

As the HIV/AIDS epidemic moves into its second decade, it is hitting particularly hard in communities in 

poor, urban communities of color.  

African Americans and Latinos/Latinas experience higher rates of unemployment, poor housing, poor 

health, early death and inadequate medical insurance than others. Many would argue that the greatest 

problems facing many African American and Latino/Latina communities are economic. In the words of a 

Latino man in a poor neighborhood in New York:  Look around our neighborhood. What do you see? All 

you see is extreme poverty. We get sick mostly because we are poor. Our children get worse education 

because we are poor. In order to fight the AIDS epidemic, we have to fight the evils of poverty. 

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For the many African Americans and Latinos/Latinas whose daily lives are a series of struggles rooted in 

poverty, worries about HIV/AIDS fall way down on the list of concerns. When finding the next meal, 

paying the rent or taking a sick child to the emergency room are common problems, concern about a 

disease that might be fatal in 10 years is unlikely to be a priority.  

Childbearing has tremendous meaning for everyone. Various researchers have commented on the fact that 

for African Americans and Latinos/Latinas  who live in poverty, having children is often the only way 

they have to prove that they are socially productive and to demonstrate their manhood or womanhood.

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HIV/AIDS prevention messages that focus on condom use are in direct conflict with this cultural value as 

condoms prevent pregnancy.  

Distrust of Public Health Officials  

Society intrudes upon the lives of poor African Americans and Latinos/Latinas in many ways. Social 

workers, case managers, law enforcement officials and child protective service workers are constantly 

telling them what to do. In many ways, the private realm of sexuality is the last area in which they feel a 

sense of control and power. When public health officials start telling people to change those private 

sexual behaviors to prevent HIV/AIDS it is understandable why the safer sex messages might be resisted.  

There are several reasons that African Americans in particular tend to distrust public health messages 

about HIV/AIDS prevention. First, that sense of distrust has roots in the legacy of the Tuskegee Syphilis 

Study. In that Public Health Service study, black men with syphilis were intentionally given inadequate or