HIV risk behaviors among unmarried Asian American young women in the context of culture and family: A qualitative study

Objectives: This study explores how Asian American (AA) young women describe engagement in HIV risk behaviors within the context of gender roles, cultural conflicts, and family dynamics.

Methods: We conducted semi-structured in-depth interviews with nine AA women who are children of immigrants (between 18-35 and identifying as Chinese, Korean, or Vietnamese). Participants were selected from 93 women who had completed a Computer Assisted Self Interview (CASI). This pilot study is part of a larger mixed-method study, designed to describe mental, physical, and sexual health; sexual risk behaviors; and substance use among Asian American women in the greater Boston area.

Results: Three themes emerged: Ideal Asian women, rebellion, and unprotected sex. First, although AA women resented the image of the ideal Asian women, they nonetheless desired to live up to it. This mismatch between ideal and reality led AA women to have low self-image and feelings of inadequacy. Second, parents' demand for compliance from, as well as promotion of ideal images of, their daughters (denying mental health problems, requiring high academic and career performance) precipitated rebellion and engagement in risk behaviors (e.g., drug use) among Asian American women. A majority of AA women reported high use of binge drinking and marijuana. Third, unprotected sex was very common among these women, especially when they believed they were in monogamous relationships.

Conclusions: There is a crucial need for HIV/AIDS preventive programs for Asian American women that target familial and contextual factors including cultural beliefs, gender roles, and power disparities.