This study used Q methodology to examine perspectives regarding participatory action research (PAR) among participants in a UNICEF initiative aimed at enhancing HIV/AIDS prevention among youth in the Caribbean. We interviewed 20 youth PAR researchers and 12 project managers from youth organizations about their attitudes and experiences. Statements from the interviews were used in a structured ranking task. Q factor analysis of the rankings identified three clusters of respondents with differing viewpoints on PAR. The clusters respectively saw PAR as an effective peer education tool, an empowering process for youth, and a tool for gathering information on the gap between knowledge and behavior. We identified divergent perspectives on the purpose and utility of PAR among participants who received the same orientation, training, and support and who worked in the context of a single initiative. These multiple perspectives present both challenges and resources for health projects.