We will study and assess potential associations between two cultural constructs particular to Asian cultures, "harmonious control" and "fatalism" and HIV risk and prevention. This research will be conducted in a highly affected and marginalized population of young at-risk women working in the sex and entertainment industry in Phnom Penh, Cambodia. This research aims to: (1) assess the association between "harmonious control" and "fatalism" with HIV infection and other biological markers of HIV risk; (2) determine the association between "harmonious control" and "fatalism" and preventive and risk behaviors including (a) condom use (preventive sexual behavior) (b) use of amphetamine-type substances (drug use), and (c) adherence to a preventive vaccine schedule (HPV vaccine will be offered and studied as a proxy for HIV vaccine in susceptible participants); and (3) generate knowledge regarding the integration of socio-cultural beliefs ("harmonious control" and "fatalism") in the design and implementation of HIV prevention programs and HIV prevention research. These aims will inform future HIV prevention programs and clinical trials in Cambodian women through the process of integrating across socio-cultural and bio-behavioral domains. The research will be conducted by a multi-disciplinary collaborative prevention research group that includes researchers from: the U.S. at the University of California San Francisco; Australia at the University of New South Wales; the Cambodia National Center for HIV/AIDS, Dermatology, and STDs, and a community-based organization, the Cambodian Women's Development Association. It will be implemented in two phases: 1st, a formative phase during which qualitative and ethnographic data will be collected examining the views of young high-risk women regarding the apriori socio-cultural constructs of harmonious control and fatalism, HIV, risk and protective behaviors, and attitudes toward biomedical prevention technologies. This will be followed by prospective observational study (Phase 2), with clinical and serological assessments for HIV and STI, sexual and drug risk behaviors and measurement of adherence to a preventive vaccine regimen. The research will generate scientific knowledge in a culturally sensitive and appropriate way. Knowledge gained about cultural influences on risk and resilience will be highly relevant to the development of appropriate interventions aimed at reducing HIV among young women in Cambodia.

 This research will assess two cultural measures particular to Asian cultures, "harmonious control" and "fatalism" and their association with HIV infection and HIV related risks (sex and drug use behavior) and preventive behavior, including adherence to a multidose preventive HPV vaccine series, in a highly affected and highly marginalized population of young high-risk women working in the sex and entertainment industry in Phnom Penh, Cambodia. The study will have two phases: 1st, a formative, qualitative ethnographic phase to assess the priori socio-cultural constructs of harmonious control and fatalism, HIV, risk behaviors, and attitudes toward biomedical prevention technologies, followed by a by prospective observational phase (2) with clinical and serological assessments for HIV and STI, sexual and drug risk behaviors and measurement of adherence to a preventive vaccine regimen. The research will be conducted by a multi-disciplinary collaborative research group that includes academic, governmental and community partners.