Research That Matters (January 17 - 20, 2008)

Objectives: Although the HIV epidemic is spreading rapidly in the U.S., 25% of HIV-positive individuals are unaware of their status. HIV/STIs are spread by those who are uninformed of their status, and this lack of HIV/STIs testing contributes to the rising numbers of HIV/STIs. The prevalence of HIV/STIs among Asian Americans is lower than other ethnicities, yet the rate of growth is considerable, posing an increased need for understanding the predictors of their testing behaviors. The goal of this study is to examine the predictors of the HIV/STI testing behaviors of AAPIs using nationally representative sample of AAPI population. This will be crucial in promoting early diagnosis, accessing effective treatment, and developing HIV/STI prevention policy of AAPIs.

Methods: A nationally representative sample of Asian Americans (n=1195, 48% women, age 18-27), from wave III (2001) of the National Longitudinal Study of Adolescent Health, was analyzed. HIV/STI testing behavior was measured by using, “Have you ever gone to see a doctor or nurse because you thought you might have a STD or HIV?” Logistic regression analysis was used to assess the predictors of STI testing behavior among Asian Americans while controlling for age, gender, and sexual orientation.

Results: 86.8 % had not tested for HIV/STIs in the past year. After controlling for age, gender, and sexual orientation, having a history of STI (OR: 6.7) and U.S. birth status (OR: 1.6) were significantly associated with STI testing behaviors. In addition, various sexual risk behaviors were significantly associated with testing behaviors: having multiple sex partners (OR: 2.4), having paid money for sex (OR: 6.6), first sexual intercourse before 15 years old (OR: 2.4), drinking alcohol while having sex (OR: 1.5). Access to health care and failure to receive medical care were not associated with testing behaviors.

Implications: The prevalence of HIV/STIs testing among Asian Americans is very low (13.2%). This prevalence is the lowest compared to other ethnic groups in the U.S. This demonstrates that various sexual risk behaviors, diagnosis of HIV/STIs, and US born increases the likelihood of HIV/STIs testing behaviors among Asian Americans. To prevent the spread of HIV/STIs induction in this fast growing population, urgent efforts are needed to promote HIV/STI testing by raising awareness and education.