This dissertation project examined protective factors against HIV infection among API MSM. First, we evaluated the literature for scientific evidence that may explain the lower HIV prevalence among API MSM. Four of the ten hypotheses provided some partial explanations or needed further investigation: 1) API MSM's sexual networks may be primarily composed of MSM of low HIV risk profiles; 2) Prevalence of seroadaptive behaviors is higher among API MSM; 3) HIV-positive API MSM have better access to care and treatment; 4) Ethnic heritage acculturation may be protective. Second, we examined race and age mixings among API MSM. It appeared that overall patterns of race and age mixing among API MSM tended to be more assortative. API MSM were more likely to be partnered with other API men than expected and the age difference between API participants and their partners were narrower than that among other participants. In addition, young API MSM were more likely to be aware of their partners's HIV status as a majority of their partners were main partners. Finally, we found that prevalence of seroadaptive behaviors differed little by race/ethnicities, which does not point to seroadaptation as protecting API MSM against HIV infection. Of concern, the significantly lower prevalence of serodisclosure behaviors among API MSM did not appear to translate into lower levels of seroadaptation.
Our findings have significant public health implications. First, more research on how structural factors affect HIV infections among MSM are needed. Second, the socio-cultural and structural contexts of partner selection need to be explored. Third, public health professionals should be aware of changing behaviors within MSM communities so that new and innovative interventions can be developed. Fourth, a strength-based approach to studying protective factors against HIV infection among API MSM is overdue. Qualitative studies are needed to develop some strength-based conceptual frameworks. Fifth, it seems that certain Asian/API cultural issues or values would be worth investigating. Lastly, while HIV prevalence remains low among API MSM, bio-behavioral surveillance should keep monitoring HIV incidence and risk behaviors among this population and culturally appropriate interventions should be delivered to them, before it is too late to intervene.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-12022009-163722 |
| Date | 27 January 2010 |
| Creators | Wei, Chongyi |
| Contributors | Ronald Stall, Patricia I. Documet, Mark S. Friedman, Anthony J. Silvestre |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-12022009-163722/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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