Large disparities in HIV incidence, prevalence and mortality exist for African-American women, especially in the southern region of the USA. Based on the culture-centric health promotion model, HIV-positive African American women can use their stories to support primary prevention. The purpose of this study was to document advice from HIV-positive African-American women (n = 25) to young African-American women, as described in their own cultural narratives collected through qualitative interviews. Content analysis of women's advice identified five common themes revolving broadly around: (1) advice for prevention, (2) support systems for prevention, (3) education, (4) empowerment/self-care and (5) potential barriers to prevention. Advice reflected recommendations based on personal experience and highlighted social determinants linked to HIV, such as stigma, access to education and healthcare, social support, and gender and power dynamics. Women also offered advice for coping with an HIV-positive diagnosis. Communication with parents, family and friends regarding education and social support emerged as an important interpersonal factor for participants, as were interactions with sexual/romantic partners. Stigma, at the community level, was consistently discussed as a hindrance to prevention. Narratives of HIV-positive women as community health agents of change can enhance the effectiveness of HIV prevention interventions for young US African-American women.

Little qualitative research has been conducted with cervical cancer survivors. We sought to understand the experiences of survivors in rural Eastern North Carolina and identify any barriers which may have kept women from receiving preventive Papanicolaou screenings or follow-up care. We conducted semi-structured in-depth interviews with 15 low-income and underserved cervical cancer survivors living in Eastern North Carolina. Participants included English-speaking women who attended a large cancer center for care between March 2012 and March 2013. Participants ranged from being recently diagnosed with cervical cancer to being 15 years post-diagnosis. Interviews lasted approximately 1 h and were audio-tape-recorded. On average, women were 55 years old (range 35-85) and were diagnosed with cervical cancer 3 years prior to the interview (range 0.2 to 180 months). A good proportion was uninsured or Medicaid-insured (60 %). Half reported an annual household income of less than $20,000, and 13 % reported having a college degree. The majority of survivors had limited understanding of cervical cancer, experienced persistent symptoms related to their cancer before seeking care, and were nonadherent to Papanicolaou screening recommendations. The main barriers to care reported by participants was lack of money and health insurance, followed by the perception of overall health (which equated to the belief that medical care was not needed), transportation issues, and discomfort with provider. Health professionals should focus educational efforts on the benefits of Papanicolaou screenings, the symptoms sometimes associated with cervical cancer, and the free or low-cost services available to low-income women.

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