Hispanics are the fastest growing minority group in North Carolina with increasing incidence of HIV infection. Gender roles, cultural expectations, and acculturation of women may explain some of Hispanic women’s risks. The perspectives of Hispanic female immigrants and community-based providers were sought to identify services they offer, understand HIV risk factors, and support the adaptation of a best-evidence HIV behavioural intervention for Hispanic women. Two sets of focus groups were conducted to explicate risks and the opportunities to reach women or couples and the feasibility to conduct HIV prevention in an acceptable manner. Salient findings were that Hispanic female immigrants lacked accurate HIV/AIDS and STI knowledge and that traditional gender roles shaped issues surrounding sexual behaviour and HIV risks, as well as condom use, partner communication, and multiple sexual partnerships. Intervention implications are discussed such as developing and adapting culturally appropriate HIV prevention interventions for Hispanics that address gender roles and partner communication. 1. Introduction Hispanics are the fastest growing minority group in the United States and in the state of North Carolina [1–3]. As the Hispanic population has grown in North Carolina, so have the HIV cases among them. Eight percent of newly diagnosed HIV cases in North Carolina in 2008 were among Hispanics [4]. HIV prevalence among Hispanics in North Carolina was 3.7 times higher than among non-Hispanic whites, and among Hispanic women it was 4 times higher than among non-Hispanic white women [4]. While Hispanic women are disproportionately affected by HIV and sexually transmitted infections in the USA, paradoxically they tend to report lower levels of HIV risk behaviours than African-American and non-Hispanic white women [5, 6]. This raises questions regarding why these rates are higher. One possible factor might be related to Hispanic cultural norms surrounding gender roles. Several of these norms may influence behaviour in ways that affect HIV risk and limit Hispanics’ understanding of risk and the manner in which they communicate about it. The cultural norm for men known as “machismo” describes the role of the Hispanic man in his family and in society [7, 8]. While there are positive aspects to machismo, other elements of it such as the belief in male dominance and an emphasis on male sexual prowess are used by some men to justify sexual encounters outside of their primary relationship [9, 10]. The cultural norm for Hispanic women, “Marianismo,” strongly encourages
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