Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: Although AAPI adolescents have lower rates of sexual experience and HIV infection than other ethnicities, the stereotype of AAPIs as a “model minority” does not fit when considering HIV risky sexual behaviors. Specifically, after initial intercourse, many AAPI adolescents have sex as frequently as other ethnic groups, few (11%) practice consistent condom use, and their knowledge about risks of HIV and other sexually transmitted infections (STIs) is lower than that of other groups. Given these worrisome statistics, studies are needed to determine factors related to AAPIs' HIV risky sexual behaviors. This study examines whether STI diagnosis during adolescence is associated with HIV risky sexual behaviors, controlling for predisposing factors and problem behaviors.

Methods: A nationally representative sample of AAPIs (n=1,183, 51.5 % female, age 18-25) enrolled in Wave III (2001) of the Add Health was analyzed. HIV risky sexual behaviors were measured with 6 variables: no condom during most recent sex, first sex before age 15, multiple sex partners, paying for sex, being paid for sex, and needle injection of cocaine or heroin. Chi-squared tests and multiple regression analyses were conducted, accounting for the complex survey design.

Results: 85.1 % of the total sample reported at least one type of HIV risky sexual behavior (no condom during most recent sex -- 26%, first sex before age 15 -- 11.9%, multiple sex partners -- 32.3%, paying for sex -- 3.5%, being paid for sex -- 2.8%, needle injection -- 1%. ). In bivariate analyses, 40% of those with 4 or more risky sexual behaviors (highest risk group, N=11) were diagnosed with at least one STI compared to 4.3% of those without risky sexual behaviors (lowest risk group, N=111) (p = .006). All of the highest risk group reported binge drinking compared to half of the lowest risk group (p =.006). About 40% of the highest risk group reported school expulsion compared to 6.4% of the lowest risk group (p = .001). More than 40% of the highest risk group reported gang involvement compared to less than 9% of the lowest risk group (p = .01). Using a proportional odds model, having STIs in both Wave II (during adolescence) and Wave III (during young adulthood) and binge drinking were significantly associated with HIV risky sexual behaviors, controlling for predisposing factors such as age, gender, education, family structure, place of birth, school expulsion, gang involvement, and having any positive mentor since age 14.

Implication for practice or policy: The majority of AAPI youth and young adults reported at least one HIV risky sexual behavior. This study demonstrates that binge drinking and being diagnosed with STIs during adolescence and young adulthood increased the likelihood of HIV risky sexual behaviors during young adulthood. To prevent the spread of HIV infection in this fast-growing AAPI population, family, health and social service organizations working with AAPIs could provide youth alcohol education, screening and referral, and more STI diagnostic services and sex education, in order to reduce involvement in sexual risk behaviors.