Social and Cultural Contexts of HIV Risk Behaviors among Asian and Pacific Islander (API) MSM

Objectives: This study aimed to describe social and cultural contexts of sexual risk behaviors among API MSM in order to develop HIV prevention programs.

Methods: A total of 15 API MSM who were sexually active participated in three focus groups. The participants were: Filipino (67%) and Chinese (20%); m=29 years old; 30% reported being HIV positive.

Results: Heavy alcohol use was reported among participants, consuming alcohol at bars/clubs, as well as parties and private situations. Many participants also reported having had unprotected sex with men they met at the bar/clubs while being intoxicated. They used alcohol and marijuana to reduce their anxiety to meet casual sex partners. Participants expressed that Caucasians often perceive them as submissive and exotic, and that they felt being overpowered and manipulated by Caucasian partners during sexual encounters. Some participants reported feeling humiliated or uneasy when having unprotected receptive anal sex with Caucasians. Participants also expressed difficulties in coming out and being gay because of their families' pressure on heterosexual marriage.

Conclusions: Frequent anonymous sex under the influence of substances among API MSM must be addressed by HIV prevention programs. Also, the programs need to address how to negotiate safe sex with Caucasian partners who have cultural biases against API MSM, and/or are older and take advantage of API MSM financially and psychologically.