West Virginia has some of the highest risk areas in the country for HIV transmission. Opioid use, particularly through injection, has risen dramatically in the state which also has the nation’s highest drug overdose death rate. Objectives: This project would carry out pilot research in Charleston, WV to 1) seek greater understanding of how people who inject drugs perceive the risk of HIV acquisition and transmission 2) map cultural characteristics and assess beliefs about protective and risk factors for HIV 3) understand perceptions of local interventions eg needle and syringe programs, using the knowledge gained from the study to design low cost local interventions to reduce the HIV transmission risks and 4) design a wider ranging research project to develop methodologies capable of understanding cultural beliefs about HIV risk in other contexts and culturally appropriate responses to HIV prevention. Design: This one year study would use Douglasian Cultural Theory as a framework for mapping cultural characteristics to beliefs and values and hence behavior. Using ‘rapid assessment’, a highly focused form of ethnography, research participants aged 18 yrs and over (n=24) who currently inject heroin would be recruited in Charleston and surrounding towns. Local harm reduction workers would help make contact with potential participants and additional snowball sampling would be used. Each participant would be interviewed once. Although the interviews will be semi-structured, an interview guide would ensure that every participant is systematically asked core questions to determine Cultural Theory attributes and risk perception. Data Analysis: Interviews will be transcribed and analyzed thematically in accordance with the areas of inquiry and other themes arising organically from the data. A dual approach will be taken to the data analysis, considering both the participants’ own expressed terms and also interpreting their meaning in terms of Cultural Theory characteristics.