  We measure reddenings to HII regions in NGC 2903, NGC 1512, M51, NGC 4449 and
NGC 6946 from Hubble Space Telescope Pa alpha and H alpha images. Extinctions
range from A_V ~ 5 - 0 depending upon the galaxy. For the galaxies with HST
images in both lines, NGC 2903, NGC 1512 and M51, the Pa alpha and H alpha
emission are almost identical in morphology which implies that little emission
from bright HII regions is hidden from view by regions of comparatively high
extinction. The scatter in the measured extinctions is only +- 0.5 mag.
  We compare the reddenings we measure in five galaxies using the Pa alpha to H
alpha ratios to those measured previously from the Balmer decrement in the LMC
and as a function of radius in M101 and M51. We find that luminosity weighted
mean extinctions of these ensembles of HI regions are correlated with gas
surface density and metallicity. The correlation is consistent with the mean
extinction depending on dust density where the dust to gas mass ratio scales
with the metallicity. This trend is expected if HII regions tend to be located
near the mid-plane of a gas disk and emerge from their parent molecular clouds
soon after birth. In environments with gas densities below a few hundred
Msol/pc^2 star formation rates estimated from integrated line fluxes and mean
extinctions are likely to be fairly accurate.
