Losing all the pieces: a qualitative study of HIV risk perception and risk reduction among rural African American women who use cocaine

The purpose of this study was to examine HIV-related beliefs of rural African American women who use stimulant drugs and their perceived risk for acquiring HIV. Qualitative interviews were conducted with 15 African American women living in the Mississippi Delta region of rural Arkansas. All women in the study were active users of crack and/or powder cocaine. We used the qualitative methods of content analysis and constant comparison to analyze the transcribed interviews. Four major themes emerged from the analysis: 1) Knowledge and Beliefs, 2) Don't Ask, Don't Tell, 3) Staying Safe, and 4) Surviving in the Community. Based on participants' responses, we discuss implications for framing new risk-reduction interventions tailored to the specific needs of this high-risk population at both the individual and community levels.