HIV Testing and HIV Knowledge Among Sexually Active Young Chinese, Korean, and Vietnamese Women

Background: Although Asian American women have higher levels of education and income compared to other racial/ethnic groups of women, persistent disparities in HIV testing behaviors and HIV knowledge exist in this population.  Fears of social discrimination and a lack of family and community support around sexual health education drive low rates of HIV testing and high rates of delayed testing, underreporting, and silence related to HIV/AIDS in these women.  The goal of our study is to assess the correlates of HIV testing and HIV knowledge among sexually active Chinese, Korean, and Vietnamese young women. 

Methods:  Using a computerized survey, we collected data from Asian American women between 18 to 35 years old during the clinical screening for the first cohort of the Asian Women’s Action for Resilience and Empowerment (AWARE) clinical trial between September 2013 and August 2014 in Boston, MA.  Out of 233 women who were initially screened, a total of 108 met the demographic criteria for clinical assessment.  The predominant reason for not meeting demographic criteria was not having had a history of being sexually active.  Participant HIV knowledge was assessed using the HIV Knowledge Questionnaire (HIV-KQ-45).

Results: The mean age of the sample was 24 years old.  Ninety-four percent of women were in college or graduated from college.  Thirty percent reported that they were not exclusively heterosexual while 91% of women reported having had vaginal intercourse.  Over half (54%) of women had never been tested for HIV, and two in five (38%) had never been tested for sexually transmitted infections (STIs).  Women who talked with their partners about AIDS before having sex had 3 times greater odds of being tested for STIs.  Among Asian-American women that reported having vaginal sex within the past 3 months, 64% reported that they did not consistently use condoms, but only one in two women in the sample has been tested for HIV.  A majority of women (85%) received HIV/AIDS information at school and only 6.5% received information from their home.  Overall, HIV knowledge was low with participants having a mean score of 73.5% on the HIV-KQ-45.  Among specific categories of HIV knowledge, knowledge on HIV treatment (57%) and prevention (70%) were found to be lower than knowledge pertaining to transmission and symptoms.  Women who had been tested for HIV, on average, scored 8.8 percentage points higher than those that had never been tested (t=-2.2, df=89, p=0.03).Older women tended to have better HIV knowledge (Pearson correlation coefficient=0.24383, p=0.02) and were more likely to have been tested (t=-4.90, df=97, p<0.0001).

Conclusions and implications:   Despite a high educational level, the average score on the HIV-KQ-45 for this population was similar or lower than other populations in the US.  The low scores on HIV knowledge indicated that educating this population, notably on prevention and treatment and among younger women, is necessary and may lead to increased HIV testing.  Innovative tools should be developed to increase HIV knowledge and access to HIV testing for Asian-American women.