Title: High Sexual Risk But Low HIV Prevalence Among Asian And Pacific Islander (API) Men Who Have Sex With Men (MSM)
1High Sexual Risk But Low HIV Prevalence Among
Asian And Pacific Islander (API) Men Who Have Sex
With Men (MSM)
- Kyung-Hee Choi
- Center for AIDS Prevention Studies (CAPS)
University of California, San Francisco, San
Francisco
UC
SF
University of California San Francisco
2Presentation Outline
- Background
- Study 1
- Asian Counseling and Testing (ACT)
- Study 2
- Community, Health, and Identity (CHAI)
- Directions for Future Research
3Background U.S. API Population
- Fast growing ethnic group
- in the U.S.
9
4.5
1.6
4Background U.S. API Population
- Six ethnic groups make up 85 of the API
population. - 71 are foreign-born.
5- Background AIDS and U.S. APIs
- A small number of AIDS cases
- - 6,1032 AIDS cases as of December 2001
- - 0.76 of all U.S. AIDS cases
6Background AIDS and U.S. APIs
- 87 of all APIs with AIDS are male.
7Background AIDS and U.S. APIs
- 71 of API men with AIDS are MSM.
8- Background Studies of API MSM
- Few HIV prevalence studies with a large sample of
API MSM. -
-
9- Research Questions
- What is the prevalence of HIV among API MSM?
-
ACT Study - What can explain the current levels of HIV
prevalence among API MSM? -
CHAI Study
10Study 1 ACT Study
11- ACT Methods
- 496 API MSM aged 18 to 29 years.
- Recruited from 30 randomly selected gay venues in
San Francisco from January 2000 to September
2001. - Completed interviewer-administered
questionnaires. - Tested for HIV, hepatitis B, chlamydia, syphilis,
and gonorrhea.
12ACT Sample Characteristics (N496)
13- ACT Prevalence of HIV, HBV, STDs
- HIV Infection
- - 2.6 HIV-positive
- HBV Infection
- - 28.5 markers for past or current HBV
infection - - 8.7 markers for chronic HBV infection
- STD Infection
- - 2.9 positive for chlamydia
- - 0.5 positive for syphilis
- - 0.4 positive for gonorrhea
14- ACT Sexual Risk Behaviors,
- Past Six Months ()
- Number of male partners (median, 2)
- 0
6 - 1
31 - 2-5
44 - 6
19 - Unprotected anal intercourse
- Any 47
- Insertive
39 - Receptive
35
15- ACT Predictors of HIV Infection Multivariate
Results - Having larger number of sexual partners
- in the lifetime (AOR, 1.003)
- Older age (AOR, 1.26)
- Lifetime attendance of a circuit party
(a series of parties held for MSM special events
AOR, 4.31) - AOR, Adjusted odds ratio
16Study 2 CHAI Study
17CHAI Methods
- 303 API MSM aged 18 to 39 years
- Recruited from informal social networks and gay
venues in Los Angeles from July 1999 to March
2000 - Completed interviewer-administered questionnaires
18CHAI Characteristics of Participants with One or
More Partners in the Past Six Months (N193)
19CHAI Partner Characteristics (N320)
20CHAI Associations of Respondent Partner
Characteristics to Unprotected Anal Intercourse
Multivariate Results
- Respondents age (being older AOR, 1.14)
- Number of sexual partners, past 6 months (2
AOR, 2.78) - Partner type (primary partner AOR, 5.01)
- Partners ethnicity (API AOR, 2.79)
- AOR, adjusted odds ratio
21Summary ACT
- Low HIV prevalence
- High level of unprotected anal intercourse
22Summary CHAI
- High rate of interracial sexual partnerships
- Higher frequency of unprotected anal intercourse
with API partners
23Conclusion
- Sexual network patterns possibly responsible for
- - high sexual risk
- - low HIV prevalence
-
24Program Implications
- Target social/sexual networks
- instead of specific ethnic groups
25Study Limitations
- Limited generalizability to those
- - English-speaking, acculturated, and educated
- - frequent gay-identified venues
- - live in areas with a high concentration of
APIs - Underreporting of
- - respondents risk behavior
- - sexual partners risk behavior
26Directions for Future Research
- Descriptive studies
- - Sexual networks and HIV risk
- Intervention studies
- - Network-based interventions