The HIV/AIDS epidemic is becoming increasingly concentrated among African Americans who live in the rural South. HIV denial, stigma, and misconceptions have been identified as helping spread the virus among adults. However, little is known about these psychosocial factors among African American rural adolescents. This article presents findings from a study aimed at exploring the role HIV denial, stigma, and misconceptions play in the disproportionate impact of HIV/AIDS on African American adolescents in the rural South. A mixed-method study, which included questionnaires and focus group discussions, was used. Results indicated that the majority of participants had average HIV knowledge levels and that HIV denial, stigma, and misconceptions played a role in the current HIV/AIDS epidemic among rural African American adolescents. Nurses and health care professionals can play a key role in understanding and addressing HIV stigma, denial, and misconceptions among African American adolescents in the rural South to reduce HIV/AIDS health disparities among this population. © SLACK Incorporated.