186 infected black, non-Hispanic populations surpassed those of whites [1, 6]. Interventions focused on educating the general population on the modes of HIV/AIDS transmis- sion and attention was placed on barriers to accepting and using condoms and sexual decision-making that heighten HIV infection and transmission risks [7, 8]. Importantly, it became more apparent that in the absence of a biomedical cure for HIV, behavior change was and still is, the most effective strategy in decreasing HIV infection, re-infection, and transmission [9, 10]. This is especially significant given that sexual behaviors continue to be the most common mode of HIV transmission, and understanding the processes involved in sexual decision-making is necessary to ensure long-term behavior change. Going Beyond Condoms In 1996, the Prevention Research Branch, Division of HIV/ AIDS Prevention (DHAP) at the CDC initiated the HIV/ AIDS Prevention Research Synthesis (PRS) Project, whose purpose was to review and summarize the HIV behavioral prevention research literature, identifying efficacious inter- ventions. The PRS Project created a compendium whereby HIV/AIDS health care providers and community-based organizations (CBOs) could select and implement programs most appropriate for their target populations. While these programs have been evidenced-based, there continues to be barriers to implementing them in the real world, including their uptake by potential recipients who may not be motivated to participate without financial incentives. Financial incentives are commonly used in the testing of HIV interventions, but questions of successful programs arise when incentives are not part of community services. Further, the basic premise of these interventions was that knowledge influences behaviors and that by providing HIV education and access to condoms, HIV infection rates would decrease. Unfortunately, behavior change is complicated and multifaceted, and “cookie-cutter” models have not necessarily been proven to be translatable across diverse populations and attempts to do so have been fraught with challenges [11]. Identification of moderating and mediating variables that influence sexual behaviors and HIV transmission is critical to risk reduction if HIV interventions are to be successful in African American communities. One such variable is culture, which includes customs, lifestyle, activities, values, and beliefs, all of which are pertinent to individual sex roles. However, culture is only one contextual variable that must be included in HIV interventions [12 , 13–16]. The next generation of interventions targeting African Americans need to go beyond basic sex education and condom use and availability, acknowledging limitations of earlier interventions. Condom use must also be examined Curr HIV/AIDS Rep (2010) 7:185–193 within a broader sociocultural context. For example, the decision to use condoms is frequently decided upon at the couple’s level, which was evident with the Eban intervention for HIV serodiscordant African American couples [17]. Alternatively, population-level indicators of HIV risks such as partner availability and concurrency may also influence condom use [18, 19]. Finally, societal- level interventions, such as reducing HIV stigma, may influence HIV testing and possible condom use. Thus, HIV interventions must address the historical and institutional factors that can affect individual, as well as interpersonal decision-making, integrating the sociocultural context with critical core elements of community relationships and infrastructure. Without acknowledging the context and the strengths and challenges of African Americans within their communities, behavioral models of HIV risk reduction will only be plagued with limitations that do not provide the skills or problem solving strategies to maintain long-term behavioral change. This next generation of interventions must lend attention to core cultural and community elements, which will facilitate individual HIV risk reduction, but also support successful translation and implementation at the couple and community level. Addressing Culture After thoroughly reviewing evidenced-based interventions, Williams et al. [20 ] identified six core intervention elements: 1) gender specificity; 2) distinct target popula- tion; 3) theoretical foundation; 4) cultural and historical congruence; 5) skill-building components; and 6) well- defined goals. While most successful interventions address four of these core elements, two are commonly neglected. Applying appropriate theoretical models and focusing attention to cultural and historical factors tend to be commonly ignored or only minimally addressed. Conceptual Framework: Finding Appropriate Theoretical Models The first generation of HIV prevention research focused on mainly one prevention strategy, safer sex with condom use. They minimally addressed and included African American history and culture [21], or how these factors could impact individual experiences and sexual decision-making. Preva- lent was the notion that the elevated HIV/AIDS rates had to do solely with individual behavior and not the sociocultural context of health disparities, lack of health insurance and employment, and poverty that have long existed. Conse- quently, research promoted an individualistic approach to risk taking practices. Another limitation was that it assumed homogeneity across groups, which erroneously supported the notion that HIV risk factors were universally the same