HIV Knowledge, HIV Risk Behaviors, and Testing Among Chinese, Korean, and Vietnamese Women in the U.S

Background and Purpose: The interdependence between social determinants of health and racial/ethnic disparities is widely recognized in HIV literature, with ethnic minority women being disproportionately affected when compared with White women. In 2017, the CDC reported that one in five Asian Americans do not know their HIV serostatus, making them the racial group with the highest estimated rate of undiagnosed HIV. Moreover, Asian Americans are typically diagnosed during later stages of the virus, increasing the likelihood of transmission. The purpose of this study was to better understand utilization in this population by assessing (1) lifetime prevalence of HIV testing, (2) levels of HIV/AIDS knowledge, and (3) whether higher levels of HIV/AIDS knowledge were associated with increased likelihood of testing for sexually active, unmarried young Asian American women who were screened for participation in the Asian Women’s Action for Resilience and Empowerment (AWARE) group psychotherapy intervention.

Method: Cross-sectional analysis was used to study the sexual health practices and knowledge of 128 Chinese-, Korean-, Vietnamese- American women who had at least one sexual intercourse in the past 3 months.   Prior lifetime HIV testing, time since last HIV test, and sexual practices were recorded using clinical interviews. The AIDS Behavior Risk Assessment and HIV Knowledge Questionnaire were used to determine HIV risk factors and HIV knowledge, respectively.  Data were assessed for associations between (1) baseline characteristics, HIV risk factors, and HIV testing; (2) baseline characteristics, HIV risk factors, and HIV knowledge scores, and (3) HIV knowledge and HIV testing. The interaction between HIV knowledge and age group with respect to testing was also assessed.

Results: Of the 128 participants, 45% reported lifetime HIV testing, with 21% reporting testing within the past year.   Less than one in five (n=24; 19%) of high-risk participants reportedly received annual HIV testing. Younger age (<21 years) was associated with both significantly less testing (68% versus 24%) and HIV/AIDS knowledge (78% versus 68%).

Conclusions and Implications: Results indicate that CDC testing guidelines, which advise a minimum of annual screening for high-risk individuals, with routine screening for anyone between the ages of 13-64, were not met. Future efforts should focus on HIV/AIDS education for young Asian American women who reported significantly less HIV testing behavior and knowledge. Other strategies to increase utilization may include assurance of confidentiality and increasing cultural sensitivity of interventions. Improved knowledge about safer sex practices could lead to changes in high-risk behavior and reduce future transmission.