HIV prevention in a rural community: Project grace—a multigenerational approach to community engagement

The burden of HIV and sexually transmitted infections (STIs) is disproportionate for the African-American community. The Project GRACE (Growing, Reaching, Advocating for Change and Empowerment) Consortium is an ongoing community–academic partnership based in eastern North Carolina that was established to address the disproportionately high rates of HIV among the African-American/black population in two eastern North Carolina counties. In this chapter, we explore the impact that the HIV and STI epidemics have had on African-American communities in the southeastern USA in general and within rural communities in North Carolina specifically. We highlight the unique ways in which community members were engaged in the formation of the Project GRACE Consortium; the development, implementation, and evaluation of the multigenerational HIV-prevention intervention known as Teach One Reach One (TORO) that was born out of this community–academic partnership; the lessons learned throughout the community engagement process; and recommendations for future research. We also describe research needs and priorities in terms of prevention and community engagement.