BACKGROUND:Black women in the United States continue to experience inequitable preventive health care shaped by racism, gender discrimination, and medical mistrust. While prior research has examined historical foundations of mistrust or individual attitudes, less attention has focused on how Black women interpret and navigate bias as it unfolds in everyday clinical encounters. OBJECTIVE:To examine how Black women understand their health care interactions, how they experience bias in preventive care, and the strategies they use to protect their well-being and sustain engagement in care. METHODS:Seventeen self-identified Black women, including both U.S. born and immigrant participants aged 21-65 years, completed in-depth semi structured interviews between February and April 2023. Interviews explored participants' interpretations of clinical interactions, perceptions of being unheard or dismissed, and the responses they enacted to preserve their dignity and health. A thematic analytic approach guided the interpretation of the data. RESULTS:Three major themes emerged: (1) participants described biased encounters ranging from subtle dismissive cues to overt discrimination connected to race, gender, class, immigration, and religion; (2) these experiences carried emotional and psychological demands, contributing to constant self-monitoring during care; and (3) women employed strategies such as modifying their behavior, selectively choosing providers, and self-advocacy, while acknowledging the personal limits and emotional toll of continually having to protect themselves in clinical spaces. These findings illustrate how mistrust is not only historically rooted but continually reinforced through routine interactions that communicate who is valued within health care systems. CONCLUSIONS:Black women's accounts demonstrate that mistrust emerges from lived experiences within health care, not only historical memory. Improving preventive care requires meaningful change in provider communication, institutional responsiveness to bias, and system level commitments that demonstrate trustworthiness. Strengthening trust will depend on whether health systems can consistently honor Black women's dignity, voice, and safety in care.

Background Racism across the life course has led to disproportionately high rates of maternal morbidity and mortality among Black women in the United States. Yet, few studies examine Black women's subjective interpretations of pregnancy-related risk, particularly within the context of their health care experiences. This qualitative study, informed by Social Amplification of Risk Framework and Black Feminist Theory, explores how Black women perceive pregnancy-related risk, how these perceptions influence health behaviors, and how gendered racism within health care settings constrains their agency. Methods Semistructured interviews were conducted with 28 self-identified Black women who were currently pregnant, recently pregnant, or planning to become pregnant. Transcripts were analyzed using reflexive thematic analysis to examine healthcare interactions and experiences within health care systems and their impacts on risk perceptions and decision making. Results Participants expressed concerns related to the impact of pregnancy on the health and well-being of self and fetus and a perception of health care as generally safe yet potentially harmful. Participants enacted agency to mitigate these risks by maintaining a healthy lifestyle, seeking information, engaging in self-advocacy, and making intentional decisions about their care provider and birth plan. However, participants reported that health care providers constrained enactment of their agency through disempowering responses to Black women's participation in their health care. Conclusions Findings underscore the need to rebuild the trustworthiness of health care systems and highlight the ways in which clinicians may foster Black women's agency to facilitate shared decision making and improve quality of care.

BACKGROUND:Black women in the United States face disproportionately high rates of cervical cancer incidence and mortality, driven in part by structural racism, medical mistrust, and barriers to culturally responsive care. Existing interventions often overlook the lived experiences of Black women and fail to address the systemic roots of healthcare inequities. OBJECTIVE:To explore how Black women conceptualize healthcare mistrust and identify multilevel changes needed to improve cervical cancer screening and equity-centered preventive care. METHODS:Seventeen in-depth, semi-structured interviews were conducted with self-identified Black women aged 21-65 years between February and April 2023. Guided by an integrated theoretical framework including Ecological Systems Theory, Ecosocial Theory of Embodiment, Intersectionality, and Black Feminist Thought. Interviews were thematically analyzed to surface key barriers and recommendations. Participants were recruited through purposive sampling, and thematic saturation was achieved. RESULTS:Four major themes emerged: (1) increasing access to affordable, community-centered healthcare; (2) expanding reproductive health knowledge and addressing informational gaps; (3) enhancing provider training in diversity, equity, and culturally responsive care; and (4) implementing systemic reforms to rebuild trust and deliver holistic, justice-driven healthcare. Participants underscored the importance of long-term community engagement, generational knowledge transfer, and trauma-informed care. Trust was framed as a central determinant, shaped by intersecting histories of discrimination and institutional exclusion. CONCLUSIONS:This study highlights the urgent need for systemic transformation in preventive care delivery. Improving cervical cancer outcomes among Black women requires multilevel strategies that prioritize trust, equity, and the leadership of communities most affected. These insights inform policy, provider training, and structural reforms aimed at advancing justice in healthcare.

INTRODUCTION:Non-Hispanic Black (Black) colorectal cancer (CRC) patients have a higher risk of mortality than most other racial/ethnic groups. Limited studies examine the contribution of socioeconomic (SES), clinicopathologic, or treatment variations to mortality disparities. This retrospective cohort investigation examined the extent to which SES, clinicopathologic, and treatment factors explain racial/ethnic differences in CRC mortality. METHODS:We studied 146,515 individuals, 18+ years old, with a confirmed diagnosis of CRC within 2010-2017, identified from the Surveillance, Epidemiology, and End Results (SEER) database. We performed Cox regression analyses to examine the association of race and ethnicity, surgery type, and tumor site with all-cause mortality and CRC-specific mortality. We then performed mediation analysis to quantify the extent to which mortality differences were mediated by SES, clinicopathologic, and treatment factors. RESULTS:Black patients had a significantly higher hazard of all-cause mortality than non-Hispanic White (White) patients. The White versus Black patients' comparison demonstrated that variations in SES and clinicopathologic factors significantly explained 46.63% (indirect effect HR: 0.92, 95% CI 0.91-0.93) and 10.87% (indirect effect HR: 0.98, 95% CI 0.97-0.99) of the excess all-cause mortality among Black patients, respectively. The Hispanic versus Black comparisons identified SES as the most influential mediator, explaining 19.68% of the excess all-cause mortality. The proportions mediating for CRC-specific mortality showed comparable outcomes to all-cause mortality. CONCLUSION:Black patients had a greater risk for all-cause mortality and CRC-specific mortality attributed to SES and clinicopathologic variations compared to other racial/ethnic groups. Future studies should investigate equity in healthcare through interventions addressing SES-related disparities.

Structural failures and systemic racism increase the likelihood of Black women having adverse outcomes during pregnancy, but little is known about the role of communication with healthcare providers in amplifying or attenuating perceptions of pregnancy risk. Using a Black Feminist metatheoretical approach and the Social Amplification of Risk Framework, this study assesses the role of communication with healthcare providers on Black women's perceptions of risk and provides recommendations for empowering pregnancy-related communication between Black women and their healthcare providers. This study's metatheoretical underpinning in Black Feminist Theory informed the use of reflexivethematic analysis in the qualitative analysis of the in-depth interviews in order to center the narratives, perspectives and lived experiences of Black women. This study found that in a context in which Black women unjustly face heightened likelihood of poor outcomes, healthcare providers attenuated Black women's pregnancy risk perceptions when they communicated with clarity, fostered patient agency, and demonstrated empathy toward patients. In contrast, unclear communication and obstetric violence led to the amplification of concerns and worries about pregnancy as well as erosion of trust in healthcare. This study therefore underscores the importance of healthcare providers' clear communication, demonstration of empathy and fostering of patient agency as critical factors to empowering communication that attenuates Black women's pregnancy-related risk perceptions.

Background: Globally, over 15 million preterm births (PTB) occur annually, with sub-Saharan Africa bearing a disproportionate burden. In Kenya, studies conducted between 2017 and 2021 at the hospital level show a PTB prevalence ranging from 15.9% to 20.2%. However, current PTB prevalence and associated factors remain underexplored despite their significant public health implications. Understanding the prevalence and factors associated with PTB is critical for effective interventions. Objectives: This study aimed to determine the prevalence of PTB and also to identify individual- and community-level factors influencing PTB among women of reproductive age in Kenya. Design: The study utilised a cross-sectional design, analysing data from the 2022 Kenya Demographic and Health Survey. Methods: A sample of 7291 women aged 15–49 was analysed using weighted multilevel logistic regression in Stata 17.0. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) and a significance threshold of p < 0.05 were used to identify predictors of PTB. Results: The prevalence of PTB was 7.14%. Women aged 25–34 (aOR = 0.67; 95% CI: 0.49–0.94) and 35+ (aOR = 0.86; 95% CI: 0.59–1.24) were less likely to experience PTB compared to younger women (15–24 years). Attending four or more antenatal care visits reduced PTB likelihood (aOR = 0.68; 95% CI: 0.53–0.88). Women in the richest wealth index had higher odds of PTB (aOR = 2.28; 95% CI: 1.39–3.74), while medium community literacy levels increased PTB risk (aOR = 1.56; 95% CI: 1.21–2.03). Conclusion: This study highlights that individual- and community-level factors significantly influence PTB in Kenya. Addressing disparities in socio-demographic and obstetric factors through targeted, multipronged strategies is essential for reducing PTB rates and improving maternal and neonatal outcomes.

This analytical essay examines the history of reproductive coercion and medical mistrust among Black women in the United States. Using historical and interdisciplinary literature, the essay presents evidence of racialized and gendered violence, colonial medicine, and structural inequities that have shaped the medical experiences of Black women. It contextualizes medical mistrust as a rational and protective response to generations of medical exploitation, including forced breeding, involuntary sterilization, and unethical experimentation. The essay also highlights how controlling images have normalized systemic injustices and perpetuated barriers to equitable care. Contemporary disparities in pain management, reproductive autonomy, and maternal mortality are also situated within this legacy of racialized medical abuse. The paper concludes by emphasizing the need to address health inequities and to foster trustworthy healthcare systems for marginalized populations.

Cervical cancer remains a preventable disease, yet Black women in the United States continue to face disproportionately high rates of incidence and mortality. These persistent disparities highlight that Black women’s trust in preventive services is shaped not only by historical injustices but also by current experiences of systemic complexity, inequitable access, and provider behaviors. This qualitative study explored how Black women perceive and navigate the U.S. healthcare system in the context of cervical cancer prevention. Seventeen African American and Black immigrant women between the ages of 21 and 65 participated in semi-structured interviews. Thematic analysis was guided by an integrated framework combining Ecological Systems Theory, the Ecosocial Theory of Embodiment, Intersectionality, and Black Feminist Thought. Three main themes emerged from the analysis: (1)systemic fragmentation that makes the healthcare system difficult to navigate and limits provider capacity; (2) inequitable access shaped by high costs, inadequate insurance coverage, and structural discrimination; and (3) the central role of healthcare providers in fostering trust, safety, and engagement. Participants emphasized that medical mistrust among Black women is rooted not only in historical injustices but also in ongoing experiences of marginalization and invisibility within clinical care. To improve engagement with cervical cancer prevention services, healthcare systems must address both structural and interpersonal barriers. Culturally responsive care, institutional accountability, and acknowledgment of historical harm are essential to rebuilding trust and advancing health equity for Black women in the United States.

BACKGROUND:The COVID-19 pandemic has had a profound impact on societies and economies around the globe, and experts warn about the potential for similar crises in the future. Risk communication theories underscore that while the potential for harm is objective, risk perception is a subjective, socially derived interpretation. While there is broad literature on the social construction of risk, fewer studies examine the role of communities-online or offline-in developing and reinforcing distinct interpretations of the same risk event. During COVID-19, online communities emerged as individuals sought to make sense of the ongoing crisis. These communities offer an opportunity to gain important insights into how concerned public collectively interprets risk and create group identities, informing public health strategies. OBJECTIVE:This study aims to, first, explore how online communities with distinct ideologies create and reinforce divergent conceptualizations of risk and, second, identify the role of group identity in shaping the development and communication of risk interpretations in these communities. METHODS:We used computational grounded theory, a multistep approach that includes pattern detection, hypothesis testing, and pattern confirmation to explore interpretations of risk and group identity in about 500,000 comments from the subreddits r/LockdownSkepticism and r/Masks4All. In the pattern detection step of this study, we grouped comments by the post they were made on and then used latent Dirichlet allocation topic modeling to identify 10 topics based on the frequency of term co-occurrence. In the hypothesis refinement step, we conducted a qualitative thematic analysis of 30 posts under each topic using Braun and Clarke's approach. Finally, in the pattern confirmation step, we trained a Word2Vec word embedding model to validate emerging themes from the second step. RESULTS:This study found that Masks4All and LockdownSkepticism both centered risk in their conversations, but with divergent concerns related to the threat of COVID-19. While Masks4All emphasized the threat to health, LockdownSkepticism questioned the necessity of preventive measures and focused on other risks: the threat to the economy, educational disruptions, and social isolation. Group identity was also found to shape collective meanings around risk, as community members in both subreddits affirmed group positions and condemned the outgroup. CONCLUSIONS:This study demonstrated that while both communities were concerned about COVID-19, their perceptions of risk focused on different aspects of the same risk event. This underscores the need for targeted interventions that engage with divergent ideologies and value systems across groups of people.

OBJECTIVES/GOALS: There is a scarcity of research examining the views of Black and Latine HIV care consumers on healthcare experiences that influence medical mistrust. The present qualitative study aims to bridge the existing gaps in the literature pertaining to the experiences of Black and Latine HIV care consumers. METHODS/STUDY POPULATION: We conducted 21 semi-structured interviews with Black and Latine HIV care consumers from November to December 2021 to explore perceptions of provider behaviors that increase or decrease HIV care consumers’ trust and mistrust, experiences of stigma, and behaviors and responses when experiencing medical mistrust. Conventional content analysis was conducted to derive meaning from the narratives shared by participants. RESULTS/ANTICIPATED RESULTS: Provider behaviors that increase HIV care consumers’ mistrust include lack of person-centered care, lack of partnership in health decision making, perceived provider incompetence, lack of adequate follow-up to care, and lack of trustworthiness of providers and organizations. Perceived experiences of intersectional stigma in healthcare included feeling judged and discriminated against by healthcare providers regarding HIV status and observing differential care outcomes and delayed care delivery by race and ethnicity. DISCUSSION/SIGNIFICANCE: Findings can inform the development of provider-level interventions to address medical mistrust.

BACKGROUND:Thyroid cancer remains a significant public health concern, with disparities in mortality rates observed across racial/ethnic groups. We quantified the extent to which socioeconomic, clinicopathologic, and treatment variations explain racial/ethnic disparities in thyroid cancer mortality. METHODS:We studied a cohort of 109,981 thyroid cancer patients diagnosed from 2006 to 2018 using the United States Surveillance, Epidemiology, and End Results database. We used multivariable logistic regression to assess the association of race/ethnicity with treatment status. We also performed mediation analyses to estimate how much the racial/ethnic differences in thyroid cancer-specific mortality were explained by variations in treatment and clinicopathologic and socioeconomic factors. RESULTS:Non-hispanic (NH) Black patients were more likely to not receive the recommended surgical resection than NH White patients (adjusted odds ratio [aOR] 1.10, 95% confidence interval [CI] 1.02-1.20). NH Black patients had a significantly higher risk of all-cause mortality compared with NH White patients (adjusted hazards ratio [aHR] 1.19, 95% CI 1.07-1.31). Mediation analysis showed that socioeconomic status significantly explained 48.7% (indirect effect HR 1.07, 95% CI 1.01-1.14) of the difference in thyroid cancer-specific mortality between NH Black and NH White patients. CONCLUSIONS:This study found that race/ethnicity was associated with treatment status and the risk of mortality among patients diagnosed with thyroid cancer. Moreover, clinicopathologic and socioeconomic factors were identified as the most crucial mediators that explained the excess mortality among minority groups. These findings provide insight into the pathways through which disparities in thyroid cancer mortality in NH Black and Hispanic thyroid patients could operate.

Purpose: The post-pandemic management of COVID-19 infections and any emergent outbreaks is because this endemic disease remains a public health concern. Vaccine hesitancy may continue to hamper efforts to respond to any new disease outbreaks and future epidemics. This qualitative study aimed to explore the factors influencing COVID-19 vaccine acceptance and hesitancy in Kenya to gain deeper insights into this issue. Methods: This study was implemented in western Kenya using key informant interviews. Fourteen (14) key informants were purposively selected for this study. All interviews were transcribed and analyzed using thematic analysis. The interpretation of findings was conducted within the framework of the Health Belief Model. Key findings: Knowledge was a critical factor in combatting misinformation and fostering vaccine acceptance among participants in this study. Misinformation included rumors that the vaccine lowers immunity and was intended for population control. Cues to action included influence from political and opinion leaders and observing the loss of life among unvaccinated individuals. Perceived barriers to vaccine uptake included fear of vaccine safety, side effects, long waiting times at the time of our study, fear of contracting COVID-19 at vaccination sites, family/spousal influence on vaccine uptake and fear of the unknown with the vaccine. Conclusions: The findings from this study provide insight into areas for targeted strategies for managing COVID-19 vaccinations and future pandemics. Within the framework of the Health Belief Model, this study identified salient barriers and facilitators of COVID-19 vaccine hesitancy that may be helpful to inform future pandemic responses.

Black and Latine Americans face the highest HIV burden among U.S. racial and ethnic groups, exacerbated by intersectional stigma and medical mistrust. We conducted 21 interviews with Black and Latine HIV care consumers between November- December 2021, investigating their views on medical mistrust and experiences of stigma. Key drivers of mistrust included perceptions of providers not prioritizing patient interests, perceived dishonesty, and doubts about their competence. In addition, participants highlighted a lack of individualized care, no partnership in decision making, insufficient follow-up, and overall institutional mistrust. Participants felt judged based on their HIV status and observed race and ethnicity- based disparities in care outcomes. In response to mistrust, they either switched providers or self- advocated. These insights may guide the creation of interventions to tackle medical mistrust among providers.

585 Background: Breast cancer is the most common malignancy affecting women of all racial and ethnic backgrounds in the United States (US). Although Socioeconomic status (SES), race/ethnicity, and surgical type/delays are associated with breast cancer mortality outcomes, studies on these associations have been contrasting. This study examined the racial/ethnic and SES differences in surgical treatment types and delays. Also, we quantified the extent to which these differences explained the racial/ethnic disparities in breast cancer mortality. Methods: We studied 290,066 women 40+ years old diagnosed with breast cancer between 2010 and 2017 identified from the Surveillance, Epidemiology, and End Results database. We performed logistic regression models to examine the association of SES and race/ethnicity with surgical treatment type and delays. We performed mediation analysis models to quantify the extent to which mortality differences were mediated by treatment, sociodemographic, and clinicopathologic factors. The study subjects were de-identified, and there was no patient contact; thus, the study was exempted from an Institutional Review Board's (IRB) approval. A p-value less than 0.05 indicated significant associations for the descriptive statistics, logistic and Cox proportional hazard regressions, and mediation analysis. We used Stata 17 to perform the analyses. Results: Non-Hispanic (NH) Black [Odds ratio (OR) = 1.16, 95% CI: 1.13-1.19] and Hispanic women [OR = 1.27, 95% CI: 1.24-1.31] were significantly more likely to undergo mastectomy compared to NH White women. Similarly, NH Black and Hispanic women had higher odds of delayed surgical treatment than NH Whites. Patients in the highest SES quintile, compared to those in lowest the lowest, were less likely to experience breast cancer-specific mortality (BCSM). Variations in treatment, SES, and clinicopathological factors significantly explained 70% of the excess BCSM among NH Blacks compared to their NH White counterparts. Conclusions: In conclusion, health disparity continues to be a major societal concern in the US. It affects people of all ages, socioeconomic classes, and ethnic/racial backgrounds. The findings of this study showed that racial and ethnic minorities, the majority of whom have a lower socioeconomic position, are significantly disadvantaged regarding the evaluation, quality, cost, and duration of medical care. Future studies can assess the multifactorial effects of sociodemographic factors like SES, access to health care assessment, and educational background amidst other variables as a multidimensional predictor of treatment delay and overall survival of breast cancer and other health issues among minoritized populations.

Background: This study examined the associations of socioeconomic status (SES), race/ethnicity, surgery type, and treatment delays with mortality among colon cancer patients. In addition, the study also quantifies the extent to which clinical and SES factors' variations explain the racial/ethnic differences in overall survival.Patients and methods: We studied 111,789 adult patients & GE;45 years old who were diagnosed with colon cancer between 2010 and 2017, identified from the Surveillance, Epidemiology, and End Results (SEER) database. We performed logistic regression models to examine the association of SES and race/ethnicity with surgery type and first course of treatment delays. We also performed mediation analysis to quantify the extent to which treatment, sociodemographic and clinicopathologic factors mediated racial/ethnic differences in survival.Results: Non-Hispanic (NH) Blacks [adjusted Odds Ratio (aOR) = 1.19, 95% CI:1.13-1.25] were significantly more likely to undergo subtotal colectomy and to experience treatment delays [aOR = 1.39, 95% CI: 1.31-1.48] compared to NH Whites. Hispanics [aOR = 1.59, 95% CI: 1.49-1.69] were more likely to experience treatment delays than NH Whites. Delayed first course of treatment explained 23.56% and 56.73% of the lower survival among NH Blacks and Hispanics, respectively, compared to their NH White counterparts.Conclusions: Race/ethnicity is significantly associated with the surgery type performed and the first course of treatment delays. Variations in treatment, SES, and clinicopathological factors significantly explained racial disparities in overall mortality. These disparities highlight the need for multidisciplinary interventions to address the treatment and social factors perpetuating racial disparities in colon cancer mortality.

Although much emphasis has been placed on the impact of ambiguity on cognitive processes, the impact of mental health disorder symptoms and racial/ethnic disparities in cancer perception of fatalism and ambiguity remains less explored. This study explored the association between mental health disorder symptoms and negative cancer perceptions. Also, we assessed differences in these outcomes within mental health disorder symptoms and racial/ethnic subgroups to investigate the association between cancer perceptions and the other covariates within the aforementioned subgroups. We used the 2019–2020 Health Information National Trends Survey data (N = 9,303) to assess the perception of cancer fatalism and cancer communication ambiguity and employed weighted multivariable logistic regression to determine the effects of mental health disorder symptoms using the Patient Health Questionnaire-4 (PHQ-4) scale on these negative cancer perceptions among United States adults. People with moderate [Adjusted Odds Ratio (AOR) = 1.58, 95

In Nigeria, the predictors of quality of life among children exposed to sexual abuse are unknown. Addressing this gap may strengthen the capacity of the health system to care for this population. Thus, this cross-sectional study selected 545 (mean age = 14.4 ± 1.4 years) Nigerian children exposed to sexual abuse. Results show that self-compassion, resilience, and meaning in life jointly predicted quality of life and explained 39% variance. The independent prediction of each predictor variable shows that self-compassion, resilience, and meaning in life have significant independent predictions, with self-compassion showing the greatest independent prediction, followed by resilience and meaning in life. Sex, age, and how long ago respondents were exposed to sexual abuse jointly predicted quality of life and explained 6% variance. However, how long ago respondents were exposed to sexual abuse shows a significant independent prediction. Results offer clinical implications that may strengthen the capacity of the health system to care for this population.

To achieve the lowest risk level for various cancers, individuals would engage in several healthy lifestyle behaviors and age-eligible cancer screenings as recommended. Nonetheless, research has largely omitted exploration of concurrent primary and secondary prevention behaviors. This study was designed to explore influences of cervical cancer screening among physically active women who reported participation in recreational sports. U.S. based women between the ages of 21-49, who had never been diagnosed with cancer, were eligible to complete a web-based survey. Logistic regression analyses were conducted using SAS 9.4. On average, women were 31 years of age (N = 394) and self-identified as Black (51.3 %). Although low overall (30.7 %), higher odds of cervical cancer screening were associated with age (OR = 1.06, 95 % CI = 1.03-1.10), employment (OR = 2.43, 95 % CI = 1.14-5.18), knowledge of cancer-related risk behaviors (OR = 4.04, 95 % CI = 1.33-12.28), routine doctor's visit (OR = 4.25, 95 % CI = 1.56-11.54), and team-based vs individual-based sport participation (OR = 1.95, 95 % CI = 1.13-3.34). Our study provides insight into the health profile of physically active women, ages 21-49, as it relates to risks for cervical cancer. Screening uptake among this diverse sample was much lower than the general population and national goals set by Healthy People 2030. Interventions should be tailored to increase knowledge of cancer-related risk behaviors, access to healthcare, and recommended cervical cancer screenings among even assumed-to-be healthy populations.

Objective: This study aimed at assessing cervical cancer awareness and prevention among 21-65 year-old African immigrant women (AIW) in Iowa City, Iowa. Specifically, we queried about barriers and facilitators to the uptake of Papanicolaou screening, women’s knowledge of the Human Papilloma Virus (HPV), and acceptance of the HPV vaccine for their children. Study design: This was a qualitative study that included a total of 39 AIW. Twelve women were interviewed and 27 women participated in two FGDs. The FGDs included Sudanese women, and were conducted in Arabic. The interviews included women from Togo, Nigeria, Congo, Ghana, Tanzania, Botswana, and Kenya and were all conducted in English. Interviews and FGDs were recorded and transcribed/ translated. We used thematic analysis and the Socio-ecological Model as a framework to highlight main themes. Results: Low levels of knowledge on cervical cancer, pap smears, HPV, and HPV vaccination were found among study participants. Women described many barriers to the uptake of pap smear tests at the intrapersonal, interpersonal, organizational and community levels of the socio-ecologic model including: Language, lack of time, hardship in navigating the US health care system, cost of screening, fear of results, and lack of education regarding cervical cancer. Women were more inclined to accept the HPV vaccine for their children only after further explanation from the study facilitators. Conclusions: Findings from this study indicate the need to increase knowledge of AIW on cervical cancer, Pap tests, HPV, and HPV vaccination; and to implement interventions to remove social and structural barriers to obtaining pap tests.