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Introduction

The incidence of Human Immunodeficiency Virus (HIV) and Acquired

Immunodeficiency Syndrome (AIDS) in the 20th

century has become a critical matter

globally with dire implications if new infections continue at the current rate. Several

effective means of reaching populations at risk are currently in place, such as, mass

media, the Internet, and direct education. In addition to these methods of prevention and

education, the efficacy of using written documents, structured specifically for ethnic

groups in the form of flyers and brochures, needs to be tested, determined, and

implemented immediately. According to the Centers for Disease Control (CDC), “at the

end of 2006, an estimated 1.1 million persons in the United States were living with

diagnosed or undiagnosed HIV/AIDS, of which almost half (46%) were African

American” (CDC 2008), and although many programs are aimed at minorities, new

infections continue to rise at an accelerated rate.

As in many other healthcare issues, African Americans suffer disproportionately. The

probability of the current strategies producing better outcomes appears slim at best and

dismal at worst. While finding a cure in the near future is the hope in the dilemma,

securing intervention that is effective is the practical solution right now. The problem of

HIV/AIDS is a challenge for the healthcare profession in specific, and a moral imperative

for all in general. HIV/AIDS is the albatross around the neck of healthcare.

Unfortunately, the epidemic is not selective or exclusionary to adults; the youth are an

equally endangered species. “Young people in the United States are at persistent risk for

HIV infection. This risk is especially notable for youth of minority races and ethnicities”

(CDC 2008). The disparity among African American youth compared to their

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counterparts among other races is astounding. “African Americans between the ages of

13-24 represent 55% of all newly reported HIV infections” (CDC 2008). The prevalence

and increased rates of infection among minorities, particularly among African American

adolescents should be a compelling factor to unite healthcare workers, educators,

community activists, and religious organizations in the use of prevention strategies that

are effective among minorities. Yet, many of these once formidable organizations are

now a fractured bunch joint ventures, due to internal struggles, and jockeying for

funding. An Executive Summary released by the Joint United Nations Programme on

HIV/AIDS (UNAIDS) in 2006 stated, “HIV prevention programmes are failing to reach

those at greatest risk. Efforts to increase HIV knowledge among young people remain

inadequate” (UNAIDS, 2006). A most disturbing acknowledgement considering the

millions of dollars spent on HIV/AIDS education and prevention annually in the United

States. Much like the UNAIDS report, I too have observed programs developed for the

youth, not reaching the youth, particularly programs developed for African American

youth. The “failure to reach those at greatest risk” occurs because programs have not

incorporated the Fubu concept – which is, For Us By Us, a clothing line founded by

Daymond John where the designs have an urban appeal, thereby meeting the needs of

young African Americans. The International Directory of Company Histories (IDCH)

in1999 wrote concerning Fubu, “The burgeoning interest in urban wear not only offered

an increase in sales to already established designers such as Lauren, but created an

opportunity for small businesses to fill a growing niche market. What fueled and inspired

this market was rap music…”(IDCH, 1999). Like Fubu, program models for African

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American youth should reflect the rich heritage of the culture, the language derived from

urban quarters, and research based methodology.

The campaign against the spread of HIV intended to increase public awareness and

prevent new infections, has included T.V. commercials, documentaries, billboard

advertisements, health education courses and the dissemination of flyers and brochures.

The latter, (flyers and brochures) unlike visual and auditory methods, involves the

reading of information – effectively, reading comprehension. However, many adolescents

hit a literacy ceiling when they reach middle and high school. That is, they lack the

ability to independently access the knowledge and information embedded in the books

and printed materials that are a part of a curriculum (Schoenbach, Greenleaf, Cziko, &

Hurwitz, 2000). If the fastest growing number of HIV infections are among African

American adolescents, this group urgently needs printed materials that are both readable

and easy to comprehend. “Health information tailored to user sociodemographic

characteristic or health behavior models may be more effective than non-tailored health

information (Ito, Kalyanaraman, Ford, Brown & Miller (2008) citing Owen,

Fotheringham & Marcus, 2002). However, the readers’ capacity to comprehend

information must be factored in to the equation. According to Balfanz, Spiridakis, and

Neild (2002), “it is not unusual for 70% of eighth graders in high-poverty, high-minority

middle schools to comprehend at ["below basic"] levels,” thus document readability and

reading comprehension are critical components in the writing and development of

HIV/AIDS documents, which are intended to increase public awareness among the youth.

Furthermore, continual HIV prevention outreach and education efforts, including

programs on abstinence and on delaying the initiation of sex, are required as new

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generations replace the generations that benefited from earlier prevention strategies

(CDC, 2007).

African American youth living in poverty and environments where education is de-

valued, are at an increased risk for sexually transmitted diseases and academic failure. As

a community activist/health educator in schools, urban communities, and juvenile

corrections facilities in the city of Memphis, I encountered many African American youth

who displayed disturbing patterns reading and/or understanding the information they

were required to read. However, when the required reading was written with

recognizable cultural indexes in the form of slang, colloquialisms, and hip-hop code

language, I observed the youth were (1) eager to read (2) displayed an improved pattern

of reading and (3) exercised greater dexterity in their comprehension of the materials

read. Researchers agree, “Language and identity are inseparable” (DeLeon, 2002). I

believe if HIV/AIDS information in flyers and brochures, incorporates culturally

appropriate wording, at-risk youth will experience greater comprehension of the

information that is being presented; as opposed to HIV/AIDS information presented in

flyers and brochures written in an inform only format, without culturally appropriate

wording. If culturally appropriate documents about HIV are a viable mode of

transmission, we have a moral obligation to explore and implement these strategies in

written form “by any means necessary” (Jean Paul Sartre, 1963) to promote HIV/AIDS

awareness among minorities in order to prevent new infections and the resulting, deaths.

However, the inclusion of culturally appropriate wording does not necessarily mean the

inclusion of Ebonics. The input of slang does not necessarily produce an output of

Ebonics. Neither does it mean the information should be inconsistent with Standard

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English, as some have suggested. Therefore, it is important to discuss why some African

American youth have an aversion toward Standard English, in order to determine how a

document can present information in a manner that is both culturally appropriate and

grammatically correct, since reading, and speaking are unquestionably connected.

Is Ebonics An Example of Black Resistance?

The process whereby opportunistic infections, such as pneumonia, present in the body

due to HIV infection and are unable to be subdued by antibiotics is called antibiotic

resistance. During my work with and observation of certain inner-city African American

youth, there was a resistance to Standard English. An analogous resistance occurs among

some African American youth toward Standard English for three major reasons, but

certainly not the only reasons.

Firstly, the prevalence of “broken English” and/or slang, colloquialisms, and hip-hop

code language in their respective communities – familiarity, may contribute to a singular

environmental complexity of language. Perhaps the resistance to Standard English occurs

in this case because Ebonics is repetitively, reinforced in everyday speech. It is the

language of the “hood” and the urban community may perceive speaking Standard

English as a betrayal of blackness, or they may feel Standard English belies “blackness.”

Secondly, in resistance to Standard English, there is an appreciation and promotion of

black language over white language – ownership, creativity, and disassociation, which

may contribute to a triple exclusion complexity of language. We own it, we created it, and

it belongs to us - like a soldier’s badge of honor and the scholar’s tome. There is an

intrinsic sense of pride and bolstered self-worth in the language of hip-hop. Similar to the

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Fubu motto, “…[it] is about Pride and Respect in what you wear and who you are”

(IDCH, 1999). Apparently, inner city African American youth, unwittingly, have a sense

of “black power” (at least in part) because their possessive and (sometimes defiant)

stance indicates an understanding of the radical side of the 60’s movement, which stated,

“Those who have the right to define are the masters of the situation” (Carmichael &

Hamilton, 1967).

Thirdly, slang, colloquialism, and hip-hop language shifted the paradigm of

communication toward urban communities instead of away from them because hip-hop

as a culture is a phenomenon – multi-ethnic complexity of language. On some levels,

African American youth and youth of other ethnicities are defining themselves through

the language of hip-hop culture. The language of the masses - not attuned to their struggle

- while the clarion tones of hip-hop resonate with the intricacies of their lives. Slang,

colloquialisms, and hip-hop in the urban youths vocabulary, is more than language, it is

an expression of who, what, why, where, when and how, in coded language. For

example, “what’s up” as opposed to “hello, how are you,” asks more than how a person is

faring. What’s up asks, what’s going on, as in what’s happening in your life. This is an

everyday greeting in the urban community among youth, created in the African American

community that predates this generation. The term, “what’s going down” has very little to

do with gravity or a downward direction of a thing, but rather, “what’s going down,” is

synonymous with “what’s up,” and/or “what’s happening,” again, these terms were

created by African Americans, but before hip-hop. Hip-hop identifies very closely with

the political and social revolution of the 60’s with language and rap music used as tools

for empowerment instead of sit-ins, marches, and the pulpit. Having a personalized

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language is empowering for African American youth. It is as empowering as the name

Daimler Benz inscribed on a Mercedes and because African Americans have traditionally

felt an absence of power – liberation through language is liberating.

Historical Factors Influencing African Americans and Language

Historical accounts of African Americans in the United States and their misuse of

Standard English ranges from creatively interesting to categorically pathetic. Some

scholars assert that the amalgamation of broken English with Standard English, (Ebonics)

is a cultural, sociolinguistic factor. Others challenge the language specialists from a

defiant perspective, citing Ebonics as an aberrant index of adolescent behavior or a

negative component of the infectious hip-hop subculture, as rapper Keith Murray (1994)

put it, “I get in you.” I am inclined to believe all of the above is true with the inclusion of

an underlying aversion for “all things white” with roots as far back as slavery and as

recent as the current time on the wall.

The meaning of “all things white,” refers to an attitude of some inner city African

American youth (and others) who, appropriate correct grammar usage derisively, with

whiteness as opposed to correctness. In particular, this attitude of resistance toward

speaking Standardized English - fosters an unwillingness to conform and perform

academically; which subsequently affects the learning process, and increases the

occurrence of lower test scores, resulting in overall underachievement.

For the sake of theoretical balance, it should be clarified, inner city, African American

children are not “Lone Rangers” in their use of Ebonics, slang, and colloquialisms, which

we will collectively term hip-hop language throughout the remainder of this discourse

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because hip-hop is widely accepted as more than language (although that is substantially

our focus). Hip-hop has spawned a clothing industry, hip-hop is music, hip-hop is a group

of persons – called “hip-hoppers,” and hip-hop is an attitude. Hip-hop code language is

an amalgamation of African American energy, culture, vernacular, and music. Hip-hop

has taken on a life and indeed a genre of its own that is pervasive in every race, ethnicity,

background, and at all socioeconomic levels. From the hood to the neighborhood, hip-

hop is a forceful, compelling, component in lifestyles and in language.

Oftentimes hip-hop code language is spoken in the home (by the parents) and in the

community by the neighbors. Even the media, and occasionally prime time news

reporting is infected with hip-hop such as, “the bomb,” meaning awesome; or “off the

charts,” meaning extreme; and “for real,” meaning that’s true and I agree with you or

sometimes it may mean are you for real as if questioning the veracity of a statement.

These “sayings,” would have been referred to as slang, in the past, but the more

acceptable term since losing its “ghetto,” gun-toting, gang banging stereotype, is hip-hop,

and everybody’s using it knowingly and unknowingly. Therefore, the home, the

community, popular music, and the media, all serve as an incubator of sorts - a

reinforcement of the resistance, because while hip-hop may be a stylistic, colorful,

occasional switch for some, for many African American youth it is the norm, with

baggage. In fact, the use of euphemisms to disguise the true intention of messages is a

commonly used style in hip-hop. Hip-hop for African American youth delivers a message

with an undertone of exclusion of “others” (by using subversive, more cunning language)

with an understood digression away from Standard English – because Standard English is

generally considered, “white.”

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Why “White” Is Not Right In Hip-Hop Language

The appropriation of Standard English as a component of whiteness as opposed to

correctness in addition to the discussion heretofore, is also highly suggestive of aversion,

hostility, and unresolved issues with racial implications between African Americans and

European Americans. Especially since English is as much a universal language in global

affairs as it is the primary language spoken in the United States, one might expect a

similar if not the same degree of resistance from blacks in other countries. However, the

attitude of blacks (both adults and children) in other countries is not consistent with the

resistance manifested by blacks (mostly inner city school age children from elementary to

high school) in America toward the usage of Standard English.

During my travels abroad, I observed, for example, in the country of Zambia in

eastern Africa, that English is the primary language (national) and the various indigenous,

tribal languages are spoken as secondary languages. Both the adults and the youth spoke

impeccable English (also called the King English). The usage of tribal language as a

secondary language could be attributed to the widespread mixture of different tribes

throughout the continent, therefore English serves as the common denominator for

language just as English is the common denominator for language in America.

During my travels to Africa I also observed, that whenever Zambians were clustered

together they deliberately used their tribal language, but effectively switched back to

English whenever Americans were around. Similarly, when our group of American

visitors were clustered together, we integrated hip-hop terms in our dialogue.

Interestingly, but not surprisingly, the Zambians did not understand the language of hip-

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hop. Both groups, (the Americans and the Zambians) was excluded from conversing with

the other when a secondary form of language was engaged. Nevertheless, the Zambians

spoke Standard English fluently, and appeared comfortable with the language that was

introduced via the language of the conqueror in terms of English colonization, and did

not associate Standard English negatively with whiteness. This may be due in part to

what Tikly calls, “the continued hegemony of western books, materials, and

resources…[therefore] it is likely that education will continue to serve as a basis for a

Eurocentric kind of education for most of the world’s children” (Tikly, 2004).

These observations may have major implications related to the attitudes of inner city

African American children in their use of hip-hop code language, such as:

1) Language may be a cohesive factor - a point of communication used to bring

groups of people together.

2) Language may be a divisive factor – a point of communication used to separate

groups of people.

3) Language may be a dividing factor (not necessarily divisive)

4) Language is a personal index that denotes origin (of the language) and identity.

5) The usage of English in the United States may (or may not be) be a cohesive

factor that unifies Americans in academics, business, recreation, communities,

etc.

6) The usage of Ebonics may be a dividing factor separating races or people with

different socio-economic backgrounds.

7) The usage of Ebonics among African Americans may fulfill a need in language

for ownership, creativity and disassociation.

8) The original languages of many African tribes remain intact since they

experienced minimal displacement, (intercontinental/Diaspora) therefore the need

for ownership via language is fulfilled.

9) Hostility and aversion against other races is minimized when ethnic identifiers

(language, foods, music) remain intact.

In the preceding paragraph, I used the term “language of the conqueror" with no

offense intended. There have always been conquerors and subsequently, the conquered.

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In the narrative of Daniel in the Bible, the story is told of King Nebuchadnezzar’s (the

Chaldean king) siege of Jerusalem.

“And the king told Ashpenaz, the master of his eunuchs to bring in some of the

children of Israel, both of the royal family and of the nobility. Youths without

blemish, well-favored, in appearance and skillful in all wisdom, discernment, and

understanding, apt in learning knowledge, competent to stand and serve in the

king’s palace – and to teach them the literature and language of the Chaldeans.”

(Amplified Bible Daniel 1:3, 4)

In most cases, the language of the conqueror becomes the language of the conquered.

Resistance to the language of the conqueror is hardly an indication of a lack of skills of

mastery, (proven by former slaves who learned to read during slavery and post-

Reconstruction) but rather rebellion against anything remotely related to the conqueror or

the dominant culture, often perceived to be the oppressor. Dinnerstein and Reimers

(1975) effectively paint the picture of immigrants and their historical experience in

America by stating, “The Mexican communities in the southwest, for example, were so

well developed that the newcomer did not have to change his faith, alter his language, or

relinquish other cultural ties in order to be accepted…to a considerable extent, [this]

retarded assimilation (Dinnerstein & Reimers, 1975). African Americans on the other

hand, experienced a peculiar migration described by Carmichael and Hamilton (1967) as

a “forced introduction to this country” (Carmichael & Hamilton, 1967). Perhaps the

resistance to Standard English by African American youth is actually resistance to

“whiteness” perceived as oppression. A group of conscientious counselors wrote in the

Negro Journal of Education, about the intrinsic social dynamics of Ebonics v. Standard

English in an interesting perspective. “For the descendants of the Africans brought to the

Western hemisphere as slaves, Standard English is the imposed language of racial

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oppression. Therefore, in the present day, care must be [exercised] to not teach the

terminology, phraseology, and symbolism of this form of English in ways that encourage

further oppression or depreciation” (Harper, Braithwaite & LaGrange, 1998). This quote

confirms inferences that African American students, who use Hip-hop in the home and in

their community, may be inclined to harbor feelings of aversion toward the use of

Standard English. This aversion may be an extension of the historical hostility stemming

from slavery and racial discrimination. In essence, contempt for “all things white,” - to

the detriment of academic achievement - may actually be projected on to Standard

English for lack of another scapegoat.

Psychological Ramifications

The trail of African Americans in the United States is a story of dislocation initiated

by a protracted, oppressive, slave trade, which morphed into Jim Crow, and eventually

evolved into racial discrimination. Basic inequalities such as denial of bathroom and

water fountain privileges were major issues in the United States less than 40 years ago.

However, black people are often ridiculed and mocked when we attempt to apply

theories of post-traumatic stress to our lives. When black people discuss this

issue, they often refer to slavery, which seems too many people, including black

folks, like something that happened so long ago that it should not really impinge

much on the present. It impinges on the present because many of the

psychological difficulties black people faced during slavery and at its end were

simply not addressed and because so much of the brutal trauma experienced then

as a result of white supremacist assault continues to happen in different forms

today. Whether it is the bombing of a church where black children are murdered,

police stopping all black men in a northern city because a white woman claimed

that a black man took her children, the freeing of a black man after years of

imprisonment for a rape he did not commit, the dying Klansman confessing to the

torture of a black man he and others threw from a bridge to his death, or the state-

sanctioned bombing of a home where black folks, including infants and small

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children, reside, dreadful crimes motivated by racism continue to happen and go

unpunished; justice does not prevail (Hooks, 2003).

While inner city African American children hardly remember nor experienced

segregation or slavery, the history of blacks in America is noted primarily by these

painful memories. For all African Americans the past is pin cushioned with pain, but for

them, the past and the present converge in a twisted paradigm. Unfortunately, when they

think on the past atrocities while living in midst of present inequalities, blighted

neighborhoods infested with drugs, high in crime, and low in resources, a new painful

reality emerges. As a result, the community is isolated by reason of the environment and

therefore has a life and language of its own. Much of what surrounds the child at home

and in the community reinforces negative stereotypes. One such stereotype is that the

system alone, (system representing all whites) is responsible for the plight of all black

Americans. Stereotypes of this nature, implanted into the minds of impressionable

schoolchildren, has the power to truncate many efforts in the educational process –

especially if speaking Standard English is “whiteness.” Why then should not Standard

English be the devil himself? What young blacks know presently and historically of race

relations in America is quite negative. Even in 1963, there was a generalized feeling of

indignation seething among blacks regarding the state of the union. Louis Lomax writes,

The Negro masses were more than just resentful and angry; they were also

informed. For decades, Negro newspapers have devoted their column to glaring

accounts of racial injustices. These reports were stepped up beginning with the

Emmitt Till case and became a floodtide with the outbreak of violence at Little

Rock. On the surface, the school integration cases involved the right of children

of taxpayers to attend public schools. However, the real issue was deeper than

that; it involved the entire status of the black man, as an individual, in American

society (Lomax, 1962).

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Even today, outwardly it appears that resistance to speaking Standard English by

African American inner city youth is a result of everything from the media and peer

pressure to drugs and a lack of focus. No one wants to look deeper because going deeper

means opening that proverbial can of worms that we have been avoiding - the deeply

psychological repercussions of slavery, racism and discrimination on black children in

the United States. The problems related to Ebonics are less Language Arts and more

Social Studies. The root of the problem is the broken psyche of a broken people.

Sometimes, the heart of the matter is the matter of the heart. The one man who ultimately

represented the heart of the dream for all black people, at the most pivotal moment of the

Civil Rights’ movement was Dr. Martin Luther King Jr.

The brutal assassination of Martin Luther King, Jr. and Malcolm X silenced public

discourse about the souls of black folks. Psychologists wrote no books about the

collective depression and despair generated by the hopelessness of theses deaths or the

collective grief earned by the loss of the belief that love would conquer hate, that

democracy and freedom would rule the day. While the world witnessed the collective

public grief of this nation when liberal and progressive leaders were slaughtered one after

the other, no one attended to the private despair of African Americans who felt the dream

of beloved community, of ending racism was never to be realized (Hooks, 2003).

Which reminds us of another failure in HIV/AIDS education and intervention…the

minimal involvement of the church, whose methods some find controversial, however,

lest we forget, the civil rights movement was largely a movement of faith from the pulpit;

initiated firstly for African American minorities suffering under Jim Crow and

discrimination, but later benefitting other minorities - most recently immigrants and gay

constituents. Utilizing the church for structural support and mobilization and the creation

of documents for African American youth with culturally appropriate wording, was the

core of my presentation and interview with Dr. Kevin Fenton, Director of the National

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Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers

for Disease Control & Prevention (2009). The black church, I emphasized to him is the

heart of the African American community and has traditionally been effective working

with social causes. The HIV/AIDS epidemic in the African American community is

largely a result of the social ills that have either never been addressed or have been

addressed with failure. For example, the drug problem increases HIV infection due to

shared needles. The problem of disproportionate African American males’ prison

confinement, results in an absent parent in the home, which opens the door to a myriad of

problems among African American youth such as early introduction to law enforcement,

early onset of sexual activity, drug and alcohol use, abuse and drug trafficking. We both

agreed that the church is sometimes a controversial figure in the fight against HIV/AIDS

because they traditionally promote abstinence from a religious perspective, which

alienates a large body of people affected by the virus - gays. However, in our zeal to

protect some members of society who have been marginalized such as gay men and men

who have sex with men, (who are quite frankly, under a cloud of double discrimination if

they are black and gay), we have failed to address the specific interventions needed for

women, children and the elderly. In a state of war, no society, ethnic group, tribe, or clan

leaves their young or their women exposed to danger, yet the perception that we are in an

aggressive battle for human life seems muted. Where is the trumpeted warning for

African American youth of the impending crisis upon us? If the best education is given in

our schools and students are motivated by the changing times, such as the election of the

first African American President, but the HIV/AIDS issue is not more aggressively

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addressed, what will happen to the next generation of African Americans? What is

present education without a future generation?

Is Multicultural Education the Solution?

In light of harbored resentment, politically structured bulwarks, overcrowded

classrooms, low salaries and high expectations – how does the health educator reach

youth at risk for infection? One solution that has been discussed is the implementation of

multicultural education in public school curriculums. Multicultural education has not yet

become a central part of the curriculum regularly offered to all students; instead,

educators have relegated it primarily to social studies, language arts, and the fine arts…

(Gay, 2004). Multicultural education involves more than black history month and a

choice of Spanish as a class. It is the intertwining of education with practical,

environmental features that are familiar to the student.

For example, teachers could demonstrate mathematical concepts such as less than/greater

than, percentages and ratios, and probabilities using ethnic demographics. Younger

students could consider the ethnic and racial distribution in their own classrooms,

discussing which group’s representation is greater than, less than or equal to

another’s…students should not simply memorize facts about major events involving

ethnic groups, such as civil rights movements, social justice efforts, and cultural

accomplishments. Instead, educators should teach students how to think critically and

analytically about these events, propose alternative solutions to social problems, and

demonstrate understanding through such forms of communication as poetry, personal

correspondence, debate, editorials, and photo essays (Gay, 2004).

Hassell and Rodge agree (2007) “respect students’ culture and heritage. Teachers can

do this by providing multicultural resources that are relevant to the students’ lives as well

as resources in their first language” (Hassell & Rodge, 2007). Although the concept of

multicultural education appears complicated and somewhat overbearing, the possibility of

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reaching children who feel marginalized by on their race, social and economic status is

increased. A pilot study for female adolescents at the Wake Teen Medical Services

supports the idea of multicultural integration by using an “interactive CD-Rom with

culturally appropriate prevention information, for modeling negotiations for abstinence

and consistent condom use, the teaching of media literacy and allowing the reader to

choose a culturally appropriate host to guide them through the CD-ROM” (Ito et al,

2008).

Multicultural education embodies the pattern of what is needed in flyers and brochures

aimed at African American youth who are disproportionately affected by the HIV/AIDS

virus. If disproportionate numbers of African American youth continue to be infected at

the current rates, the economical, social, and educational balance and progress within

certain communities will be irreparably damaged. Knoblach and Brannon, citing Gelbs

(1993) says, as language distinguishes man from barbarian...an illiterate person cannot

expect to participate successfully in human progress (Knoblach & Brannon, 1993). That

the ability to read and write and thus to communicate was a high water mark for

civilization is an understatement. Therefore, the inability to read may exclude one from

the dominant discourse. In my work as a community activist people suffering with

HIV/AIDS often, report feeling dismissed by society. The next generation of African

American youth can ill afford to be marginalized due to illiteracy and infection –

especially if one (education) can be used help to prevent the other.

Methodology

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This small, true experiment was an attempt to reject the null hypothesis and occurred

in two different parts: the writing of the experiment document and the actual experiment

testing the documents. The researcher theorized that African American teen-age subjects

would overwhelmingly dislike a healthcare document aimed at the prevention of

HIV/AIDS, which excluded slang, colloquialisms, and hip-hop code language and would

overwhelmingly prefer a document aimed at the prevention of HIV/AIDS inclusive of

slang, colloquialisms, and hip-hop code language.

The experiment took place in the southeastern region of the United States at a local high

school. There were two experiments performed at different times divided by class

periods, in two separate classes, none of whom had access to the other. A test of

comprehension using two different healthcare documents with 40 high school student

subjects was conducted. Two documents with information based on sexually transmitted

diseases (STD’s) and HIV/AIDS was administered to determine the effectiveness of a

healthcare document written in Standard English (Teen Talk) by the U.S. Department of

Health & Human Services, a government agency, compared to a healthcare document

written using slang, colloquialisms, and hip-hop code language (What’s Up With STD’s

and HIV). The control document is used by health departments and health educators and

the experiment was written exclusively by the researcher using slang, colloquialisms, and

hip-hop code language familiar to her through interaction with inner city youth and

listening to hip-hop music.

Substantial data (age, grade, zip code, and race) from the subjects was asked for but

not mandatory, although all of the subjects complied. This data may be useful for later

studies in determining the levels and type of intervention needed based on the

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demographics in the area compared with health department data detailing increased

infections.

Half of the subjects read a document written by the government agency (control/Teen

Talk), and the other half of the subjects, read the other document written by the

researcher (experiment/ What’s Up With STD’s and HIV). The documents were

randomly administered alternately to every other student. After the reading session, the

subjects answered approximately 10 questions to assess comprehension of the document.

The subjects also answered one perception-based question to assess the readability from

the student’s perspective. No questions were asked relative to past, present, or future

sexual activity or sexual preferences.

The experiment was reviewed and approved by the Institutional Review Board

University of Memphis, (see appendix) and parental consent was obtained through the

teachers, while the principal of the high school officially granted the researcher

permission to perform the study.

Healthcare officials including the Centers for Disease Control (CDC) and the World

Health Organization (WHO) have indicated that HIV/AIDS has reached disproportionate

rates among youth and minorities. In my evaluation of the statistics, this study is justified

based on educational and health merits, which will inform writers of how effective slang,

colloquialisms, and hip-hop code language may be, when used to reach marginalized

groups. I believe the benefits far outweigh the risks, especially since there were no

violations of privacy.

19

Materials

The two documents, Teen Talk (control) and What’s Up With STD’s And HIV

(experimental) were used to assess the reading ease of the document for comprehension

levels and preference of one document over the other, as expressed by the reader in

writing, for question two of the questionnaire.

In terms of graphics, the Teen Talk document is two-sided, while the What’s Up With

STD’s And HIV document is one-sided. Both documents were printed in black and white

to avoid bias based on graphics. At least 2 students remarked that the document should

have been in color.

Both document titles addressed the teens directly, Teen Talk, by designating a specific

peer group and What’s Up With STD’s And HIV by incorporating hip-hop language.

There were no human graphics on the What’s Up With STD’s And HIV document,

however the Teen talk document had two “smiling” photos which 1 of the 40 subjects

thought was peculiar since the topic is HIV/AIDS.

Apparently 2 of the subjects thought the researcher was “trying too hard” in jis/her use

of hip-hop language, and 1 of the 40 subjects was rather “bummed out” that abstinence is

the only 100% protection against STD’s and HIV.

Results/Statistical

Of the 20 subjects in the control group, 18 answered affirmatively that they

understood the Teen Talk document. Of the 20 subjects in the experimental group, 20

answered affirmatively that they understood the What’s Up With STD’s And HIV

document.

20

p value and statistical significance: The two-tailed p value equals 0.1544

By conventional criteria, this difference is considered to be not statistically significant.

Confidence interval: The mean of Group One minus Group Two equals -0.20

95% confidence interval of this difference: From -0.48 to 0.08

Intermediate values used in calculations: t = 1.4530

df = 38

standard error of difference = 0.138

Group Group One Group Two

Mean 4.80 5.00

SD 0.62 0.00

N 20 20

My hypothesis was that the What’s Up With STD’s And HIV document would be

easier to read and comprehend. However, results of the t-test show a negligible difference

between the control and the experiment groups. Based on the t-test, the small true

experiment did not prove the Teen Talk document would be substantially more difficult

to read than the What’s Up With STD’s And HIV document. Therefore, I was unable to

reject the null hypothesis based on the t-test for this particular population. It follows that

it was not possible to accept the intended alternate hypothesis: That there was a

difference between the two documents. the actual results is that we do not know what to

conclude and that further study of these aspects of the experiences are to be

recommended in addition to the following content analysis.

Results/Content Analysis

In my opinion, the experiment/What’s Up With STD’s And HIV document is easier to

read and comprehend based on the answers to question number three of the questionnaire

21

which asks, “What didn’t you like about the STD reading?” This question was designed

to receive a written response from the subjects in order to perform content analysis.

Of the 20 control subjects who read the Teen Talk document, the results are as

follows: On the written response: 8 of the 20 subjects stated the document was too long;

1of the 20 subjects stated there was no one to contact for more information; 1 subject

replied with n/a; 6 of the 20 subjects liked the document; 1 of the 20 felt the document

was accusatory of teens; 1 of the 20 subjects answered “I don’t know”; 1 of the 20

subjects did not enjoy reading information about STD’s; and 1 of the 20 subjects felt

there was a lack of information.

Of the 20 experimental subjects who read the What’s Up With STD’s And HIV

document the results are as follows on the written response: 11 of the 20 subjects liked

the document; 3 of the 20 subjects disliked the statistical data; I of the 20 subjects stated

the document was boring; 1 of the 20 subjects; 1 of the 20 subjects did not enjoy the

content in general; 1 of the 20 subjects felt the writer was ‘trying too hard to be

relatable”; 1 of the 20 subjects appreciated the focus on “African American teens for a

change”; 1 of the 20 subjects did not enjoy reading information about STD’s; and 1 of the

20 subjects did not like the fact that abstinence is the only 100% protection against STD’s

and HIV.

In comparison of the responses to the control document vs. the experimental

document, certain variables stand out. Firstly, more of the subjects who read the What’s

Up With STD’s And HIV, 11 out of 20 preferred the document overall compared to the

control at only 6 out of 20. In lieu of the lack of statistical significance in the t-test, this

may provide more detail about how the subjects truly felt about the documents.

22

Additionally students will typically answer in the affirmative when the results are

recorded - in other words, they understood the results had implications – especially since

the topic was HIV/AIDS among teenagers. At the onset of the experiment, I made every

possible effort to explain the purpose of the reading and questionnaire without pathos,

however, the critical nature of HIV/AIDS makes it difficult not to express something.

Nevertheless, it is apparent that I did not show bias toward my document, or the results

may have been more favorable in proving my theory. In addition, one of the students

remarked that the What’s Up With STD’s And HIV document was “trying too hard to be

relatable.” This may be something to consider in the future. Perhaps the intentions of the

writer were transparent and the subjects perceived it to be bait, or perhaps African

American teens perceived the use of hip-hop usage as disingenuous.

It might be useful, as the study at Wake Teen Medical Services discovered, to allow

students a hand in writing the documents or performing a readability test in a pilot study

before final production (Ito et al, 2008). Although I failed to prove my theory, I believe

the 1 of the 40 total subjects who appreciated the focus on “African American teens for a

change” is enough to further explore developing hip-hop healthcare documents.

23

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