High 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.
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Presentation on theme: "High 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."— Presentation transcript:
High 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
Presentation Outline Background Study 1 Asian Counseling and Testing (ACT) Study 2 Community, Health, and Identity (CHAI) Directions for Future Research
Background: U.S. API Population Fast growing ethnic group in the U.S. 9% 4.5% 1.6%
Background: U.S. API Population Six ethnic groups make up 85% of the API population. 71% are foreign-born.
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
Background: AIDS and U.S. APIs 87% of all APIs with AIDS are male.
Background: AIDS and U.S. APIs 71% of API men with AIDS are MSM.
Background: Studies of API MSM Few HIV prevalence studies with a large sample of API MSM.
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
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.
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
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
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
CHAI: 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
CHAI : Characteristics of Participants with One or More Partners in the Past Six Months (N=193)
CHAI : Associations of Respondent & Partner Characteristics to Unprotected Anal Intercourse: Multivariate Results Respondent’s age (being older; AOR, 1.14) Number of sexual partners, past 6 months (2+; AOR, 2.78) Partner type (primary partner; AOR, 5.01) Partner’s ethnicity (API; AOR, 2.79) AOR, adjusted odds ratio
Summary: ACT Low HIV prevalence High level of unprotected anal intercourse
Summary: CHAI High rate of interracial sexual partnerships Higher frequency of unprotected anal intercourse with API partners
Conclusion Sexual network patterns possibly responsible for: - high sexual risk - low HIV prevalence
Program Implications Target social/sexual networks instead of specific ethnic groups
Study 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
Directions for Future Research Descriptive studies - Sexual networks and HIV risk Intervention studies - Network-based interventions