title: A One-Size-Fits-All HIV Prevention and Education Approach?: Interpreting Divergent HIV Risk Perceptions Between African American and East African Immigrant Women in Washington, DC Using the Proximate-Determinants Conceptual Framework.
abstract: BACKGROUND
  To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women's perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the United States.
  
  
  METHODS
  Forty in-depth, semistructured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semistructured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board.
  
  
  RESULTS
  Adopting Boerma and Weir's Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. Although African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival.
  
  
  CONCLUSIONS
  Study findings suggest that addressing HIV prevention and education among black women in DC will require distinct and targeted strategies that are culturally and community-centered to resonate with these different audiences.
authors.affiliation: From the *School of International Service and Center on Health, Risk, and Society, American University, Washington, DC; †School of International Service, American University, Washington, DC; and ‡The Women's Collective, Washington, DC.
authors.forename: Maria
authors.initials: M
authors.lastname: De Jesus
authors.forename: Juanita
authors.initials: J
authors.lastname: Taylor
authors.forename: Cathleen
authors.initials: C
authors.lastname: Maine
authors.forename: Patricia
authors.initials: P
authors.lastname: Nalls
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D044383:Black People / Q000523:psychology*; D004219:District of Columbia / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011203:Poverty; D036301:Qualitative Research; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology; D055815:Young Adult