A Multilevel Approach to Understanding HIV-Related Behavior among Asian/Pacific Islander Men who have Sex with Men: A Daily Process Study

Date of Completion

January 2011

Keywords

Psychology, Social|GLBT Studies|Health Sciences, Public Health|Sociology, Individual and Family Studies|Gender Studies

Degree

Ph.D.

Abstract

Current epidemiological paradigms, predicated on research with gay White men, inadequately account for HIV/AIDS prevalence and incidence rates among men who have sex with men of color living in the United States. Among Asian/Pacific Islander men who have sex with men, an epidemiological conundrum exists whereby high levels of sexual risk-taking are matched with consistently low prevalence rates. The current study highlighted how a White hegemonic male ideology that dominates gay male culture and degrading stereotypes place gay Asian men at a disadvantage in sexual negotiation. For them, race-based sexual politics makes salient their contentious racial identity, which in turn should affect sexual risk-taking behavior. ^ The present research reconceptualized notions of risk and vulnerability to be a conjoint function of individual survival needs and how the local social ecology affords those needs. Relevant needs of gay Asian men were identified and measured using a daily process, ecological method, and geographical social climate data were obtained. Recruitment efforts spanned over six months targeting community-based organizations and events, media forums, and word-of-mouth. A total of 117 Asian/Pacific Islander men who have sex with men met eligibility criteria to participate in a three-week, daily diary study, of whom 58 ( M age = 26.90, SD = 6.09) met minimum criteria for inclusion in final analyses. Results demonstrated (a) an ecological basis for identity concerns as gay Asian men (Hypotheses 1a-b); (b) variability in daily stress, social and sexual behaviors, and their relationships (Hypotheses 2-3; Hypothesis 5); (c) identity concerns and their influence on the relationship between daily social affiliation and sexual/drinking behavior (Hypothesis 4a-b), Identity concerns guided everyday behavior to influence vulnerability. Such daily behaviors included seeking positive social experiences in building an accepting community. The present work contributes to a contextualized understanding of HIV-risk and vulnerability among gay Asian men, one that explicates present epidemiological patterns. Methodologically, the study demonstrated the efficacy and feasibility of daily process methods for an ecological approach to behavior. Theoretically, the study contributes to understanding HIV/AIDS in a context of risk and vulnerability that is ecologically based in a system of social inequality. Implications for theory-development and intervention are discussed in consideration with extant behavior-change theories. ^

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