1
|
Becker TD, Poku OB, Chen X, Wong J, Mandavia A, Huang M, Chen Y, Huang D, Ngo H, Yang LH. The impact of China-to-US immigration on structural and cultural determinants of HIV-related stigma: implications for HIV care of Chinese immigrants. ETHNICITY & HEALTH 2022; 27:509-528. [PMID: 32668975 PMCID: PMC7854980 DOI: 10.1080/13557858.2020.1791316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Objectives: Asian Americans have poor HIV-related outcomes, yet culturally salient barriers to care remain unclear, limiting development of targeted interventions for this group. We applied the 'what matters most' theory of stigma to identify structural and cultural factors that shape the nature of stigma before and after immigration from China to the US.Design: Semi-structured interviews were conducted with 16 immigrants to New York from China, recruited from an HIV clinic and community centers. Deductive followed by focal inductive qualitative analyses examined how Chinese cultural values (lian, guanxi, renqing) and structural factors influenced stigma before and after immigration.Results: In China, HIV stigma was felt through the loss of lian (moral status) and limited guanxi (social network) opportunities. A social structure characterized by limited HIV knowledge, discriminatory treatment from healthcare systems, and human rights violations impinged on the ability of people living with HIV to fulfill culturally valued goals. Upon moving to the US, positions of structural vulnerability shifted to enable maintenance of lian and formation of new guanxi, thus ameliorating aspects of stigma.Conclusions: HIV prevention and stigma reduction interventions among Chinese immigrants may be most effective by both addressing structural constraints and facilitating achievement of cultural values through clinical, peer, and group interventions.
Collapse
Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ohemaa B Poku
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Xinlin Chen
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Jeffrey Wong
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Amar Mandavia
- Teachers College, Columbia University, New York, NY, USA
| | - Minda Huang
- Department of Psychology, University of Hartford, West Hartford, CT, USA
| | - Yuqi Chen
- Department of Educational and Psychological Studies, University of Miami, Miami, FL, USA
| | - Debbie Huang
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hong Ngo
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Lawrence H Yang
- Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Social & Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
2
|
Dailey A, Johnson AS, Hu X, Gant Z, Lyons SJ, Adih W. Trends in HIV Care Outcomes Among Adults and Adolescents-33 Jurisdictions, United States, 2014-2018. J Acquir Immune Defic Syndr 2021; 88:333-339. [PMID: 34369909 PMCID: PMC8621807 DOI: 10.1097/qai.0000000000002778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND With significant improvements in the diagnosis and treatment of HIV, the number of people with HIV in the United States steadily increases. Monitoring trends in HIV-related care outcomes is needed to inform programs aimed at reducing new HIV infections in the United States. SETTING The setting is 33 United States jurisdictions that had mandatory and complete reporting of all levels of CD4 and viral load test results for each year during 2014-2018. METHODS Estimated annual percentage change and 95% confidence intervals were calculated to assess trends in stage of disease at time of diagnosis, linkage to HIV medical care within 1 month of HIV diagnosis, and viral suppression within 6 months after HIV diagnosis. Differences in percentages were analyzed by sex, age, race/ethnicity, and transmission category for persons with HIV diagnosed from 2014 to 2018. RESULTS Among 133,477 persons with HIV diagnosed during 2014-2018, the percentage of persons who received a diagnosis classified as stage 0 increased 13.7%, stages 1-2 (early infections) increased 2.9%, stage 3 (AIDS) declined 1.5%, linkage to HIV medical care within 1 month of HIV diagnosis increased 2.3%, and viral suppression within 6 months after HIV diagnosis increased 6.5% per year, on average. Subpopulations and areas that showed the least progress were persons aged 45-54 years, American Indian/Alaska Native persons, Asian persons, Native Hawaiian/other Pacific Islander persons, and rural areas with substantial HIV prevalence, respectively. CONCLUSIONS New infections will continue to occur unless improvements are made in implementing the Ending the HIV Epidemic: A Plan for America strategies of diagnosing, treating, and preventing HIV infection.
Collapse
Affiliation(s)
- André Dailey
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA
| | | | | | | | | | | |
Collapse
|
3
|
Pichetsurnthorn P, Pankow S, Sweet D, Kallail KJ. HIV Care in Asian and Pacific Islanders in Kansas. J Int Assoc Provid AIDS Care 2020; 18:2325958218821650. [PMID: 30798680 PMCID: PMC6748497 DOI: 10.1177/2325958218821650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A complex cultural dynamic within the Asian and Pacific Islander (APIs) population contributes to barriers in HIV care. This qualitative narrative study investigated how awareness, resource accessibility, and cultural taboo impact HIV care in APIs in Kansas. Eleven HIV-infected API patients were interviewed. Two evaluators independently completed a qualitative themes analysis. Important themes impacting HIV care included lack of awareness, sex as a taboo topic, and misconceptions about HIV infection. These factors create a closed community regarding HIV prevention and care. Clinicians must be aware of these barriers and provide specific culturally sensitive information and care to this population.
Collapse
Affiliation(s)
- Pie Pichetsurnthorn
- 1 Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Stephanie Pankow
- 1 Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Donna Sweet
- 1 Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Ken James Kallail
- 1 Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| |
Collapse
|
4
|
Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review. AIDS Behav 2019; 23:21-36. [PMID: 30030740 DOI: 10.1007/s10461-018-2223-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A variety of interventions have been tested targeting people living with HIV (PLH) and their relationships with their children. The purpose of this study was to synthesize evidence on the goals, types, scope, and outcomes of such intergenerational interventions for PLH. Randomized trials targeting PLH alone or together with their children, published in English, with an intergenerational intervention component were included in this review. Thirteen studies met eligibility criteria. The types and goals of interventions varied greatly but often involved educational sessions with groups of PLH, skill-building sessions, or parental disclosure of HIV status among mothers living with HIV; six studies targeted problem behaviors, resilience, and self-esteem among their children. Two studies addressed general family coping with HIV. Seven studies reported positive outcomes as a result of an intergenerational intervention, with the greatest improvements being observed in those participants with the most stress. Most studies failed to report specific intervention methodology. Due to gaps in the literature noted, future intergenerational interventions targeting PLH should include more diverse groups of PLH. Studies should also explore the impact of intergenerational-based interventions on the mental health of PLH and their families.
Collapse
|
5
|
Hahm HC, Chang STH, Lee GY, Tagerman MD, Lee CS, Trentadue MP, Hien DA. Asian Women's Action for Resilience and Empowerment Intervention: Stage I Pilot Study. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2017; 48:1537-1553. [PMID: 29531405 PMCID: PMC5844475 DOI: 10.1177/0022022117730815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study describes the development and pilot test of Asian Women's Action for Resilience and Empowerment (AWARE), a culturally informed group psychotherapy intervention designed to reduce depressive symptoms, suicidality, substance use, and HIV and sexual risk behaviors among 1.5 and second generation Asian American (AA) women. To participate, AA women had to meet the criteria for posttraumatic stress disorder (PTSD) or have a history of exposure to interpersonal violence (IPV) as determined using the Clinician-Administered PTSD Scale (CAPS) and Traumatic Life Events Questionnaire (TLEQ). This article also presents the preliminary feasibility and acceptability of AWARE from its Stage I pilot study of nine Chinese, Korean, and Vietnamese American women. To foster holistic treatment, AWARE was developed based on original research findings from Stage 0 and integrated theoretical models including fractured identity theory, empowerment theory, cognitive behavioral therapy (CBT), mindfulness-based techniques, and the AIDS Risk Reduction Model (ARRM). The development of AWARE was an iterative process informed by participant feedback, which led to frequent intervention modifications for a future randomized controlled trial (RCT) in Stage II. A qualitative analysis of participant feedback informed the following modifications: further exploration of feelings, improvements in technology delivery, learning and practicing coping skills, more specific cultural tailoring related to sexual health, decreased number of sessions and increased time per session. Findings provide support for the acceptability and feasibility of AWARE as "culturally informed" for AA young women with IPV histories, high-risk behaviors, and mental health issues.
Collapse
|
6
|
Sen S, Nguyen HD, Kim SY, Aguilar J. HIV Knowledge, Risk Behavior, Stigma, and Their Impact on HIV Testing among Asian American and Pacific Islanders: A Review of Literature. SOCIAL WORK IN PUBLIC HEALTH 2017; 32:11-29. [PMID: 27410387 DOI: 10.1080/19371918.2016.1173612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Asian American and Pacific Islanders (AAPIs) are the fastest growing population in the United States with documented increases in HIV rates. AAPIs are as likely as other racial/ethnic groups to engage in HIV-related risk behaviors, while being concomitantly less likely to have been HIV tested. Testing is a critical step in HIV prevention. Research points to various barriers to HIV-related testing including HIV knowledge and attitude and stigma. However, these factors and their impact among AAPIs are poorly understood. Myths about this population's "model minority" status compound AAPIs' sociocultural factors including English language proficiency, access to healthcare, and a culture of "silence" that negatively influences HIV-related research. In this article, the authors review the scientific literature on knowledge, risk behavior, and stigma to document the current state of research. Based on the review the authors offer a set of research, policy, and practice recommendations for social workers and other service providers working with AAPIs.
Collapse
Affiliation(s)
- Soma Sen
- a School of Social Work, San Jose State University , San Jose , California , USA
| | - Hoang Dung Nguyen
- a School of Social Work, San Jose State University , San Jose , California , USA
| | - So Yung Kim
- a School of Social Work, San Jose State University , San Jose , California , USA
| | - Jemel Aguilar
- b School of Social Work, University of Saint Joseph , West Hartford , Connecticut , USA
| |
Collapse
|
7
|
Altschuler J. Midlife and older women's experiences and advice about sex with men, risk behaviors, and HIV prevention education. J Women Aging 2016; 29:63-74. [PMID: 27410764 DOI: 10.1080/08952841.2015.1063955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This article reports on older women's experiences and advice on condom use, male-female relationships, HIV risk, and prevention education. It reports on findings from five written, open-ended questions with 110 ethnically and economically diverse women, 40-80 years old. Analysis revealed four themes: (a) Gap between condom use advice and condom use behavior; (b) invisibility with age; (c) negative expectations of men; and (d) desire for education that breaks the silence on sex. The article discusses the meaning of the findings as they relate to current knowledge about HIV prevention education and midlife and older women and offers recommendations for research and education.
Collapse
Affiliation(s)
- Joanne Altschuler
- a School of Social Work , California State University Los Angeles , Los Angeles , California , USA
| |
Collapse
|
8
|
Leung MR, Chin JJ, Petrescu-Prahova M. Involving immigrant religious organizations in HIV/AIDS prevention: The role of bonding and bridging social capital. Soc Sci Med 2016; 162:201-9. [PMID: 27372709 DOI: 10.1016/j.socscimed.2016.06.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 10/21/2022]
Abstract
Immigrant religious organizations in the United States are uniquely positioned to address critical issues beyond religion because of their moral, social and cultural prominence in community life. Increasingly, religious organizations have taken on a leadership role around health issues such as decreasing HIV/AIDS stigma and misinformation. However, there are barriers for some religious leaders and organizations in adopting new health programs, especially if the issue is seen as controversial. Our study examines how social network structures among religious members influence organizational acceptance of new information or controversial ideas, like HIV/AIDS. Using social network analysis methods on data from 2841 contacts in 20 immigrant Chinese Buddhist temples and Christian churches in New York City, we tested whether an immigrant religious organization's likelihood of being involved in HIV/AIDS activities was associated with the presence of bonding or bridging social capital. These two forms of social capital have been found to mediate the levels of exposure and openness to new ideas. We found HIV/AIDS-involved religious organizations were more likely to have lower levels of bonding social capital as indicated by members having fewer ties and fewer demographic attributes in common. We also found HIV/AIDS-involved religious organizations were more likely to have higher levels of bridging social capital as indicated by members having significantly more ties to people outside of their organization. Our study highlights the importance of looking beyond religion type and leadership attributes to social network structures among members in order to better explain organization-level receptiveness to HIV/AIDS involvement.
Collapse
Affiliation(s)
- ManChui R Leung
- Sociology, School of Public Health, University of Washington, 211 Savery Hall, Box 353340, Seattle, WA 98195, United States.
| | - John J Chin
- Urban Affairs and Planning, Hunter College, City University of New York, 695 Park Avenue, W1611, New York, NY 10065, United States.
| | - Miruna Petrescu-Prahova
- School of Public Health, Health Promotion Research Center, University of Washington, 1107 NE 45th St., Suite 200, Seattle, WA 98105, United States.
| |
Collapse
|
9
|
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]
|
10
|
Chin JJ, Neilands TB. Chinese Immigrant Religious Institutions' Variability in Views on Preventing Sexual Transmission of HIV. Am J Public Health 2015; 106:110-8. [PMID: 26562121 DOI: 10.2105/ajph.2015.302924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined Chinese immigrant religious institutions' views on teaching about preventing sexual transmission of HIV and the consistency of their views with public health best practices in HIV prevention. METHODS We used 2009 to 2011 survey data from 712 members of 20 New York City-based Chinese immigrant religious institutions to analyze their views on (1) teaching adolescents about condoms, (2) discussing homosexuality nonjudgmentally, and (3) promoting abstinence until marriage. RESULTS Religion type was a significant predictor of views in the 3 domains, with Evangelical Protestants in least agreement with public health best practices, Buddhists in most agreement, and mainline Protestants between them. Greater HIV knowledge was significantly associated with agreement with best practices in all 3 domains. The frequency of prayer, meditation, or chanting and the level of acculturation were significant predictors of views on teaching adolescents about condoms and promoting abstinence until marriage. CONCLUSIONS The best practice messages about HIV prevention that Chinese immigrant religious institutions find acceptable vary according to religion type and several other key factors, including HIV knowledge; frequency of prayer, meditation, or chanting; and level of acculturation.
Collapse
Affiliation(s)
- John J Chin
- John J. Chin is with the Department of Urban Policy and Planning, Hunter College, City University of New York, New York, NY. Torsten B. Neilands is with the Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco
| | - Torsten B Neilands
- John J. Chin is with the Department of Urban Policy and Planning, Hunter College, City University of New York, New York, NY. Torsten B. Neilands is with the Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco
| |
Collapse
|
11
|
Arista P, Tepporn E, Kwon S, Rideout C, Patel S, Chung M, Bautista R, Trinh-Shevrin C, Ko-Chin K. Recommendations for implementing policy, systems, and environmental improvements to address chronic diseases in Asian Americans, Native Hawaiians, and Pacific Islanders. Prev Chronic Dis 2014; 11:E202. [PMID: 25412025 PMCID: PMC4241370 DOI: 10.5888/pcd11.140272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Emphasis has increased recently on disseminating high-impact, population-wide strategies for the prevention of chronic diseases. However, such strategies are typically not effective at reaching Asian Americans, Native Hawaiians, Pacific Islanders, or other underserved communities. The objectives of this article were to 1) present the methods of the Strategies to Reach and Implement the Vision of Health Equity program in which 15 community-based organizations in the United States and the Pacific region implemented evidence-based policy, systems, and environmental improvements in their local communities and 2) provide recommendations for using these tailored approaches in other communities and geographic locations. Further support is needed for organizations in tailoring these types of population-wide strategies. Implementing population health improvements should be adapted to maximize effectiveness to decrease chronic diseases in these populations and ultimately eliminate racial/ethnic health disparities.
Collapse
Affiliation(s)
- Pedro Arista
- Asian & Pacific Islander American Health Forum, 450 Sutter St, Ste 600, San Francisco, CA 94108. E-mail:
| | - Ed Tepporn
- Asian & Pacific Islander American Health Forum, San Francisco, California
| | - Simona Kwon
- New York University School of Medicine, Department of Population Health, New York, New York
| | - Catlin Rideout
- New York University School of Medicine, Department of Population Health, New York, New York
| | - Shilpa Patel
- New York University School of Medicine, Department of Population Health, New York, New York
| | - Marianne Chung
- Asian & Pacific Islander American Health Forum, San Francisco, California
| | - Roxanna Bautista
- Asian & Pacific Islander American Health Forum, San Francisco, California
| | - Chau Trinh-Shevrin
- New York University School of Medicine, Department of Population Health, New York, New York
| | - Kathy Ko-Chin
- Asian & Pacific Islander American Health Forum, San Francisco, California
| |
Collapse
|
12
|
Chen WT, Guthrie B, Shiu CS, Yang JP, Weng Z, Wang L, Kamitani E, Fukuda Y, Luu BV. Acculturation and perceived stress in HIV+ immigrants: depression symptomatology in Asian and Pacific Islanders. AIDS Care 2014; 26:1581-5. [PMID: 25059642 DOI: 10.1080/09540121.2014.936816] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Asians and Pacific Islanders (API) are among the fastest growing minority groups within the USA, and this growth has been accompanied by an increase in HIV incidence. Between 2000 and 2010, the API HIV infection rate increased from 4.5% to 8.7%; however, there is a paucity of HIV-related research for this group, and even less is known about the prevalence and correlates of antiretroviral therapy adherence behavior, quality of life, impact of stress, and efficacious self-management among HIV+ API Americans. This paper examines how acculturation and perceived stress affect depression symptomatology and treatment seeking in the HIV+ API population. A series of cross-sectional audio computer-assisted self-interviews were conducted with a convenience sample of 50 HIV+ API (29 in San Francisco and 21 in New York City). The relationship between acculturation and perceived stress was analyzed, and the results indicate that for those HIV+ API who reported low or moderate acculturation (as compared to those who reported high acculturation), stress was significantly mediated by depression symptomology. Interventions to address acculturation and reduce perceived stress among API generally and Asians specifically are therefore needed.
Collapse
Affiliation(s)
- Wei-Ti Chen
- a School of Nursing , Yale University , Orange , CT , USA
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Wong FY, Nehl EJ, Han JJ, Huang ZJ, Wu Y, Young D, Ross MW. HIV testing and management: findings from a national sample of Asian/Pacific islander men who have sex with men. Public Health Rep 2012; 127:186-94. [PMID: 22379218 DOI: 10.1177/003335491212700207] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES We examined reasons for and barriers to participating in HIV voluntary counseling and testing for Asian/Pacific Islander (A/PI) men who have sex with men (MSM) in the U.S. METHODS We collected data between June 2007 and September 2009 in a study known as Men of Asia Testing for HIV, using a cross-sectional community-based participatory design. This national study was conducted in seven U.S. metropolitan cities through a coalition of seven community-based organizations. RESULTS Participants included 445 self-identified A/PI MSM aged ≥18 years. Perception of being at risk was the number one reason for testing behaviors. For first-time testers, structural barriers (e.g., language barriers with health professionals) and fear of disclosure (e.g., sexual orientation not known to parents) were deterrents for nontesting in the past. Among previously known HIV-positive men, 22% were not seeing a doctor and 19% were not taking any HIV medications. CONCLUSIONS HIV testing, care, and treatment policies would be less than optimal without addressing barriers to testing, including stigma related to sexual orientation, among A/PI MSM.
Collapse
Affiliation(s)
- Frank Y Wong
- Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA 30322, USA.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Hahm HC, Lee CH, Choe JYU, Ward A, Lundgren L. Sexual Attitudes, Reasons for Forgoing Condom Use, and the Influence of Gender Power among Asian-American Women: A Qualitative Study. JOURNAL OF AIDS & CLINICAL RESEARCH 2011. [PMID: 22866240 DOI: 10.4172/2155-6113.s1-004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND PURPOSE: HIV/AIDS prevalence among Asian-American Pacific Islanders (APIs) is low yet rapidly increasing. Prior research from other populations indicates that HIV risk behaviors are associated with specific adverse/risk factors including depression, drug use, history of child sexual abuse, and forced sex. However, no studies have explored the attitudes about sexual risk behaviors and condom use between API women with adverse experiences versus women without such experiences. This qualitative study compares descriptions of sexual history and condom use between the two groups of women. METHODS: A random sample of 24 sexually active API women (16 in the adverse group and 8 in the non-adverse group) was selected for in-depth interviews from a larger study, which included 501 Korean, Chinese, and Vietnamese survey participants. FINDINGS: 14 out of the 16 women in the adverse group described complex sexual histories, with greater number of partners, more casual partners, and the combined use of alcohol/drugs and sex. The 8 women in the non-adverse group had fewer partners who were more long term. However, for both groups of women, condom use was inconsistent. Also, the majority of the women in both groups reported that either they themselves or they together with their partners had decided whether or not to use condoms. Yet 4 women in the adverse group showed lower gender power, with their partners being the primary decision-maker for condom use. CONCLUSION: Given the inconsistent condom use for both groups, all women in this study were at risk for HIV/AIDS. Consistent with prior research, a sub-group of the women in the adverse group with lower gender power seemed particularly at higher risk. Future HIV prevention interventions need to target all API women while screening for lower gender power to identify those with the highest risk of HIV.
Collapse
Affiliation(s)
- Hyeouk Chris Hahm
- Assistant Professor, Boston University School of Social Work, Boston, Massachusetts, USA
| | | | | | | | | |
Collapse
|