Family Influences On Risk and Protective Factors for Unsafe Sex Among Gay API Men

BACKGROUND AND PURPOSE: In two previous studies examining the experiences of Asian Pacific Islander men who have sex with men (API MSM), families were found to be both a source of risk and protective factors for unsafe sex (Choi et al. 1999, Yoshikawa et al. 2004). While both sets of authors noted that API families can be a source of protective and risk factors, neither explored why this may be the case. The question to ask is, what are the conditions that lead API families to be a source of risk and what are the conditions that lead API families to be a source of protection? In this paper, we address the gap in the literature by examining the situational factors that may make families a source of support or risk for unsafe sex among API MSM. METHODS: Sample: Twenty-five MSM were recruited from San Francisco through snowball sampling methods. The age of the participants ranged from 18 to 39 years with a mean age of 28 years. Among the sample, 18 were born in Asia, 1 was born in Canada, and 6 were born in the U.S. Procedures: Interviews were conducted using a semi-structured, qualitative interview protocol covering topics including identity, identity conflict, coming out, and sexual behaviors. Analysis: Analysis followed qualitative description methods as outlined by Sandelowski (2000). Qualitative description draws from the general tenets of naturalistic inquiry in that, there is no pre-selection of variables to study, no manipulation of variables, and no a priori commitment to any one theoretical view of a target phenomenon and is particularly useful in providing a comprehensive summary of a little known or understood phenomenon. RESULTS: Analysis revealed three broad themes that influenced whether families provided risk or protection for unsafe sex. First, the men's perception of family obligation and avoiding shame influenced how they perceived sexual risk behaviors. Second, the level of family participation in the “everyday” lives of the men provided a source of support for some of the men. Finally, the men's internalization of what they perceived to be “Asian” values influenced their attitudes towards unsafe sex. Men who strongly identified with their perception of “Asian” values were less likely to engage in unsafe sex. CONCLUSION AND IMPLICATIONS: For many API MSM, perceived cultural norms including beliefs about the family and the need to maintain family harmony influence their sexual behavior, both positively and negatively. Although we suggest that prevention efforts with API MSM should focus on recruiting family members as potential allies to promote safer sex behaviors, it is important to keep in mind that there are API MSM who may not respond positively to this approach. Rather than viewing all API MSM as belonging to one cultural group and attempting to develop an intervention program to target all API MSM, it will be imperative that practitioners keep in mind that there are stark differences in API MSM's personal beliefs and attitudes toward their families that may influence the types of intervention methods that will be successful.