The overall goal of the NICHD K99/R00 award is to facilitate Dr. Sabri's transition from a post-doctoral researcher to an independent, extramurally funded researcher within an academic research institution. Her short-term training objectives are (1) to gain substantial knowledge of the intersections of cumulative interpersonal violence, reproductive-sexual health, and HIV risk behaviors, (2) gain proficiency in multilevel analytical techniques and integration of physiological data in mixed methods research, and 3) acquire intervention development skills for a culturally tailored intervention for Black African immigrant women with cumulative violence experiences. The training plan includes formal coursework and didactics (e.g., seminars, workshops), advanced methods training, use of physiological data, individual mentorship, training in the ethical conduct of research, manuscript development, presentations at national and international conferences, and experience with grantsmanship activities. Long term career goal is to develop culturally tailored interventions to promote safety and health among minority and immigrant women. The K99 training phase will occur under the primary mentorship of Dr. Jacquelyn C. Campbell at Johns Hopkins University. Johns Hopkins University has a long history of scientific excellence and will provide an outstanding environment for Dr. Sabri's guidance by an invaluable group of experts and senior investigators. The proposed K99 concurrent mixed methods formative research, tailored with the training goals in mind, will examine differences between native-born and immigrant Black women via a) analysis of quantitative data collected by the ongoing ESSENCE Project (1R01HD077891:PI: Stockman) from 140 women with childhood and/or adulthood violence experiences; and b) additional qualitative data collection from a purposive sample of Black African immigrant women from 6 East and West African countries using in-depth interviews (n=25) and 6 focus groups (7-10 women per group). The K99 phase research will a) investigate roles of environmental, cultural, and individual (i.e., physiological and psychological) factors in the intersections between cumulative violence exposure, reproductive-sexual health, and HIV risk, b) explore how environmental and cultural factors affect perceptions and responses to violence, reproductive-sexual health, and HIV risk, among Black African immigrant women, and c) identify strategies Black African immigrant women use to enhance protective factors and reduce risk factors, perceptions of potential intervention components, and barriers/ facilitators i delivery of the intervention. The findings will inform the development of a trauma-informed culturally tailored intervention for Black African immigrant women with cumulative violence experiences. The R00 phase will utilize the K99 research findings to focus on standardization of the intervention, development of fidelity measures, and pilot test for large scale implementation of the intervention in community-based clinics and programs serving Black immigrant women.