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Chen WT, Sun W, Huang F, Shiu CS, Kim B, Candelario J, Toma L, Wu G, Ah-Yune J. Lost in Translation: Impact of Language Barriers and Facilitators on the Health Care of Asian Americans Living with HIV. J Racial Ethn Health Disparities 2024; 11:2064-2072. [PMID: 37306920 PMCID: PMC10713860 DOI: 10.1007/s40615-023-01674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023]
Abstract
Language barriers are major obstacles that Asian American immigrants face when accessing health care in the USA. This study was conducted to explore the impact of language barriers and facilitators on the health care of Asian Americans. Qualitative, in-depth interviews and quantitative surveys were conducted with 69 Asian Americans (Chinese, Filipino, Japanese, Malaysian, Indonesian, Vietnamese, and mixed Asian backgrounds) living with HIV (AALWH) in three urban areas (New York, San Francisco, and Los Angeles) in 2013 and from 2017 to 2020. The quantitative data indicate that language ability is negatively associated with stigma. Major themes emerged related to communication, including the impact of language barriers on HIV care and the positive impact of language facilitators-family members/friends, case managers, or interpreters-who can communicate with healthcare providers in the AALWH's native language. Language barriers negatively impact access to HIV-related services and thus result in decreased adherence to antiretroviral therapy, increased unmet healthcare needs, and increased HIV-related stigma. Language facilitators enhanced the connection between AALWH and the healthcare system by facilitating their engagement with health care providers. Language barriers experienced by AALWH not only impact their healthcare decisions and treatment choices but also increase levels of external stigma which may influence the process of acculturation to the host country. Language facilitators and barriers to health services for AALWH represent a target for future interventions in this population.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Cheng-Shi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
- National Taiwan University, Department of Social Work, Taipei, Taiwan
| | - Boram Kim
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Jury Candelario
- APAIT- A division of Special Service for Groups, Inc., Los Angeles, CA, USA
| | - Lance Toma
- San Francisco Community Health Center, San Francisco, CA, USA
| | - Gilbert Wu
- Chinese-American Planning Council, Inc., New York, NY, USA
| | - Judy Ah-Yune
- Chinese-American Planning Council, Inc., New York, NY, USA
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Huang F, Chen WT, Shiu CS, Lin SH, Tun MS, New TW, Thet Nu Y, Oo HN. Psychometric Evaluation of a Myanmar Version of the Perceived Stress Scale for People Living with HIV/AIDS. J Nurs Meas 2022; 30:603-626. [PMID: 36526419 PMCID: PMC10700027 DOI: 10.1891/jnm-d-21-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background and Purpose: Reliable instruments for the measurement of perceived stress in people living with HIV (PLHIV) are crucial. However, there is no Myanmar version of such an instrument. Methods: We adapted the 35-item Perceived Stress Scale for People Living with HIV/AIDS (PSSHIV) into a Myanmar version (PSSHIV-M), and 150 PLHIV completed the survey. Results: The 31-item PSSHIV-M with a five-factor structure has a Cronbach's alpha of .85 to .95. Construct validity was demonstrated for the instrument, and the findings of Rasch analysis also suggest evidence of reliability and validity. Conclusions: The psychometric properties of the 31-item PSSHIV-M with a five-factor structure support its efficacy in ascertaining how HIV perceived stress affects Myanmar PLHIV. It could also facilitate the development of stress management interventions for that population.
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Affiliation(s)
- Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Wei-Ti Chen
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
| | - Cheng-Shi Shiu
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Sai Htun Lin
- Human Right & Technical Services Department, Secretariat Office, Myanmar Positive Group (MPG)
| | - Min San Tun
- Human Right & Technical Services Department, Secretariat Office, Myanmar Positive Group (MPG)
| | - Thet Wai New
- National AIDS Program, Department of Public Health, Ministry of Health and Sports, Myanmar
| | - Yin Thet Nu
- Deputy Director, Health System Research Division, Department of Medical Research, Myanmar
| | - Htun Nyunt Oo
- National AIDS Program, Department of Public Health, Ministry of Health and Sports, Myanmar
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Huang F, Chen WT, Shiu CS, Sun W, Toma L, Luu BV, Ah-Yune J. Acculturation, HIV-Related Stigma, Stress, and Patient-Healthcare Provider Relationships Among HIV-Infected Asian Americans: A Path Analysis. J Immigr Minor Health 2021; 22:1217-1224. [PMID: 32789735 PMCID: PMC7424136 DOI: 10.1007/s10903-020-01068-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Acculturation may limit HIV-positive Asian Americans’ active interactions with patient-healthcare providers (HCP) and utilization of HIV healthcare services; however, the specific mediation effect of acculturation still unknown. A bias-corrected factor score path analysis was performed to examine the proposed model of relations among acculturation, stigma, stress, and patient-HCP relationships. A convenience sample of 69 HIV-positive Asian Americans in San Francisco, Los Angeles, and New York City were recruited and collect data were collected on demographics, HIV-related stigma, stress, and patient-HCP relationships. HIV stigma and stress had a direct, negative effect on patient-HCP relationships. Acculturation had a positive total effect on patient-HCP relationships, and was mediated by HIV stigma and stress. A acculturation also had a direct impact on stigma and stress. Acculturation, HIV-related stigma, and stress are key elements to achieving good patient-HCP relationships, and provide insights on the design of culturally sensitive interventions to improve patient-HCP relationships.
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Affiliation(s)
- Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China.,School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Cheng-Shi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.,Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Wenxiu Sun
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.,Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lance Toma
- San Francisco Community Health Center, San Francisco, CA, USA
| | - Binh Vinh Luu
- Chinese-American Planning Council, Inc, New York, NY, USA
| | - Judy Ah-Yune
- Chinese-American Planning Council, Inc, New York, NY, USA
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Experiences and needs of family support for HIV-infected Asian Americans: A qualitative dyadic analysis. Appl Nurs Res 2021; 58:151395. [PMID: 33745550 DOI: 10.1016/j.apnr.2021.151395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/21/2020] [Accepted: 12/31/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND When coping with HIV-related challenges, family support is the first line that Asian Americans living with HIV (AALHIV) lean on; however, few studies have explored the dyadic aspects of family support among AALHIV. We aimed to explore the dyadic aspects of family support among AALHIV and their family caregivers. METHODS From September 2017 to January 2020, we recruited 18 dyads among AALHIV and their caregivers in Los Angeles and New York City by the purposive sampling method. Using qualitative dyadic analysis of semi-structured, in-depth interviews, we explored dyadic aspects of family support among participants based on Fitch's Supportive Care Framework. RESULTS We found that AALHIV obtained support from family caregivers to cover the domains of their physical, psychological, spiritual, informational, social, and practical supportive care. This dyadic analysis indicated congruence in most supportive care; however, there were also dissimilar in the support perceptions. CONCLUSIONS Our findings exemplify the physical, psychological, spiritual, informational, social, and practical support from AALHIV and their family caregivers. When developing a culturally sensitive intervention for AALHIV, we need to consider the different aspects of the support. Especially, family support can enhance patients-providers' relationships as well as health engagement with HIV care.
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Nemoto T, Xie H, Iwamoto M, Sakata M. HIV Risk Behaviors in Relation to Psychosocial Factors and Internet Usage Among Asian and Pacific Islander (API) Men Who Had Sex With Men (MSM) in California. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:117-136. [PMID: 32539477 DOI: 10.1521/aeap.2020.32.2.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Very few studies have been conducted to investigate HIV risk and protective behaviors in relation to psychosocial factors among Asian and Pacific Islander (API) MSM whose HIV/AIDS prevalence is lower than those of other racial/ethnic groups. This study, based on an online survey targeting API MSM in California revealed that API MSM often met sex partners online and that psychosocial factors (e.g., homophobia and identity with API gay community) were correlated with condomless receptive anal sex (RAS) with casual partners. In particular, an Asian cultural construct, interdependency, was correlated with condom use for RAS; that is, those who consider sex partners' health and value harmony tend to engage in safe sex. This finding sheds light on re-thinking the current over-emphasis on assertiveness and self-responsibility to keep free from HIV/STIs during negotiation with partners. Future STI prevention programs for API MSM should incorporate Asian cultural constructs and target specific risk groups.
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Cultural Neuropsychology Considerations in the Diagnosis of HIV-Associated Neurocognitive Disorders. Curr Top Behav Neurosci 2020; 50:193-223. [PMID: 32157665 DOI: 10.1007/7854_2019_121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Human Immunodeficiency Virus Type-I (HIV) is a health disparities issue that affects culturally and linguistically diverse (CALD) and underrepresented minority populations to a greater degree than non-Hispanic white populations. Neurologically speaking, CALD populations experience worse HIV-related health outcomes, which are exacerbated by inadequate neurocognitive measures, poor normative samples, and the complex interplay of sociocultural factors that may affect test interpretation. Although cross-cultural neuropsychologists are working diligently to correct this gap in the literature, currently, studies examining neurocognitive outcomes among CALD populations are sparse. The most well-studied CALD groups are of African American/Black and Latinx adults in the US, and the chapter therefore focuses on these studies. There is more limited work among other populations in the US, such as Asians, Native Hawaiians, Pacific Islanders, and American Indians/Alaskan Natives, and even fewer studies for many CALD populations outside of the US. For example, HIV neuropsychology data is rare or nonexistent in the First Peoples of Australia and Indigenous People of Canada. It is often not adequately reported in Europe for the migrant populations within those countries or other world regions that have historically large multicultural populations (e.g., South America, Caribbean countries, Asia, and Africa). Therefore, this chapter reviews HIV-related health disparities faced by CALD populations with focus on North American research where it has been specifically studied, with particular attention given to disparities in HIV-Associated Neurocognitive Disorders (HAND). International data was also included for research with focus on First Peoples of Australia and Indigenous People of Canada. The chapter also examines other sociocultural and health factors, including global and regional (e.g., rural versus urban) considerations, migration, and gender. Further, guidelines for incorporating sociocultural consideration into assessment and interpretation of neurocognitive data and HAND diagnosis when working with HIV-positive CALD populations that would be relevant internationally are provided.
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Examining the Associations Between Immigration Status and Perceived Stress Among HIV-Infected and Uninfected Women. J Community Health 2019; 43:1172-1181. [PMID: 29926272 DOI: 10.1007/s10900-018-0537-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Stress is associated with poor mental and physical health outcomes. In the United States (U.S.), little is known about perceived stress and associated factors among HIV-infected and immigrant women. Here, we examine these associations within a sample of 305 HIV-infected and uninfected, U.S.-born and non-U.S.-born women who were part of the Women's Interagency HIV Study (WIHS) at three sites (New York, Chicago, and Los Angeles). Perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10); HIV infection was serologically confirmed, and nativity status was self-reported. Bivariate and multivariable logistic regression were used to identify associations with perceived stress. The majority of participants were U.S.-born (232, 76.1%) and were HIV-infected (212, 68.5%). Mutlivariable analyses found the odds of perceived stress to be lower for those employed [adjusted odds ratio (AOR) = 0.31, 95% confidence interval (CI) = (0.15-0.63)], with high levels of social support (AOR = 0.45, 95% CI 0.26-0.79), and HIV-infected (AOR = 0.44, 95% CI 0.24-0.79). Perceived stress was positively associated with living in unstable housing (AOR = 2.54, 95% CI 1.17-5.51). Here, immigration status was not associated with perceived stress. We identified stress to be higher among women who were unemployed, unstably housed, or who had low social support. Community-based programs should tailor interventions to include stress reduction strategies for participants with identified risk factors to improve mental and physical health outcomes.
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Wheeler KM, Antoniou T, Gardner S, Light L, Grewal R, Globerman J, Husbands W, Burchell AN. Sociodemographic and Health Profile of Heterosexual Men Living With HIV in Ontario, Canada. Am J Mens Health 2017. [PMID: 28625119 PMCID: PMC5675339 DOI: 10.1177/1557988317696639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In Ontario, Canada, the number of heterosexual men living with HIV has increased over time, yet they remain an understudied population. The study objective was to describe the sociodemographic and clinical characteristics of this population, using data from a multisite clinical cohort of patients receiving HIV care. Sociodemographic and clinical characteristics of men interviewed between 2010 and 2012 were compared according to their self-identified sexual orientation, followed by multivariable linear and logistic regression to assess the association of sexual orientation with CD4 cell count, viral load, hepatitis C co-infection, self-rated health, and mental health concerns after adjustment for covariates. A total of 552 men identified as heterosexual, 2,023 as gay, and 171 as bisexual. Compared to gay and bisexual men, heterosexual men were more likely to have been born outside of Canada (34.8%); more likely to report African, Caribbean, or Black ethnicity (26.4%) or Indigenous ethnicity (13.6%); and more likely to have low socioeconomic status (59.5% earning less than $20,000 per year), and/or a history of injection drug use (31.7%). Relative to gay men, heterosexual men had 5.19 times the odds of co-infection with hepatitis C virus regardless of injection drug use history (95% confidence interval = 3.87-6.96), and 40% lower odds of rating their health as excellent or good (95% confidence interval = 0.50-0.84). HIV-positive heterosexual men in Ontario constituted a socially marginalized group characterized by a high prevalence of injection drug use history and hepatitis C co-infection.
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Affiliation(s)
| | - Tony Antoniou
- 2 St. Michael's Hospital, Toronto, Ontario, Canada.,3 University of Toronto, Toronto, Ontario, Canada
| | - Sandra Gardner
- 3 University of Toronto, Toronto, Ontario, Canada.,4 Baycrest Health Science, Toronto, Ontario, Canada
| | - Lucia Light
- 1 Ontario HIV Treatment Network, Toronto, Ontario, Canada
| | | | | | | | - Ann N Burchell
- 2 St. Michael's Hospital, Toronto, Ontario, Canada.,3 University of Toronto, Toronto, Ontario, Canada
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Mohammadnezhad M, Fetuu FP, Mangum T, Alakalia JQ, Lucas JJ. A Systematic Review Study on Prevalence, Determinants, and Risk Factors of HIV/AIDS among Pacific Countries. WORLD JOURNAL OF AIDS 2016. [DOI: 10.4236/wja.2016.64024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Kim SY, Shen Y, Hou Y, Tilton KE, Juang L, Wang Y. Annual Review of Asian American Psychology, 2014. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2015; 6:291-332. [PMID: 26925199 PMCID: PMC4765738 DOI: 10.1037/aap0000031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This 2014 review of Asian American psychology is the sixth review in the series. It includes 316 articles that met the inclusion criteria established by the past five annual reviews. Featured articles were derived from three sources: 137 were generated via the search term "Asian American" in PyscINFO, 111 were generated via a search for specific Asian American ethnic groups, and 32 were generated via author searches of articles that met the inclusion criteria. The top primary topic was health and health-related behaviors, the most frequently employed study design was cross-sectional, and the most studied Asian American ethnic group was Chinese. This year's review includes information on the target population of the primary topic, the age range and developmental period of participants, and whether the study design was cross-sectional or longitudinal. It also identifies top authors and journals contributing to the 2014 annual review. These new features reveal that the most common target population of the primary topic was youths; studies most commonly included emerging adults ages 18-25; cross-sectional study design was employed more often than longitudinal design; the top contributor to the 2014 review was Stephen Chen, who authored the highest number of papers included; and the Asian American Journal of Psychology generated the highest number of publications for this review.
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Affiliation(s)
- Su Yeong Kim
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 471-5524
| | - Yishan Shen
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 983-7551
| | - Yang Hou
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 660-2236
| | - Kelsey E Tilton
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 956-459-4212
| | - Linda Juang
- University of Potsdam, College of Human Sciences, Education, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany, +49 (0)172 1882255,
| | - Yijie Wang
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 289-8136
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Chen WT, Guthrie B, Shiu CS, Wang L, Weng Z, Li CS, Lee TSH, Kamitani E, Fukuda Y, Luu BV. Revising the American dream: how Asian immigrants adjust after an HIV diagnosis. J Adv Nurs 2015; 71:1914-25. [PMID: 25740206 DOI: 10.1111/jan.12645] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 12/13/2022]
Abstract
AIM We explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population. BACKGROUND Asians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate. DESIGN A mixed-methods study was conducted. METHODS Thirty in-depth interviews were conducted with HIV-positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross-sectional audio computer-assisted self-interviews were conducted with a sample of 50 HIV-positive Asians and Pacific Islanders. Content analysis was used to analyse the in-depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self-actualization. The study took place from January-June 2013. DISCUSSION Major themes were extracted from the interview data, including self-actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self-actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self-actualization and those who believed they could still achieve their 'American dreams'. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self-actualize and those who still believed they could 'make their dreams come true.' CONCLUSION Acculturation levels influence depression and self-actualization in the HIV-positive Asians and Pacific Islanders population. Lower acculturated Asian Americans achieved a lower degree of self-actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self-actualization.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, Yale University, Orange, Connecticut, USA
| | - Barbara Guthrie
- School of Nursing, Northeastern University, Boston, Massachusetts, USA
| | - Cheng-Shi Shiu
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Lixuan Wang
- School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Zhongqi Weng
- School of Nursing, Yale University, Orange, Connecticut, USA
| | - Chiang-Shan Li
- Department of Psychiatry and Neurobiology, Yale University, New Haven, Connecticut, USA
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Education, National Taiwan Normal University, Taipei, Taiwan
| | - Emiko Kamitani
- School of Nursing, University of California, San Francisco, California, USA
| | - Yumiko Fukuda
- APICHA Community Health Center, New York, New York, USA
| | - Binh Vinh Luu
- HIV/AIDS Service, Chinese-American Planning Council Inc, New York, New York, USA
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