HIV risk and bisexual behaviors among API MSM

Objective: Asian and Pacific Islander (API) men who have sex with men (MSM) consistently have lower HIV sero-prevalence compared to other racial/ethnic groups. The study aimed to describe their HIV risk behaviors in relation to social and cultural factors. Methods: A total of 186 API MSM (18 years and over) in California were recruited from an online survey panel for a 30-minute structured survey. Participants were: Chinese (25%), Filipino (23%), Japanese (16%), Vietnamese (9%), and multi-racial Asians (9%); 43% were born in the U.S.; and 67% had a bachelors degree or higher. Results: Over half of the participants reported having had sex with a woman, while self-identifying as gay (53%), bisexual (30%), and straight (14%). Among those who have been tested for HIV (72%), 4.5% reported being HIV positive. More than half (54%) had engaged in oral or anal sex with a casual male partner in the past 6 months, and only 46% and 39% always used a condom for receptive or insertive anal sex, respectively. They met casual partners at gay bars or clubs (27%) and through the Internet (71%), friends (33%), and personal ads (26%). They had engaged in unsafe sex because they felt more intimate and knew partners' sero-status. Conclusion: Bisexuality among API MSM must be further investigated and addressed in HIV prevention programs.