Abstract

Background. In the US women are the fastest growing group for sexually transmitted infections (STIs), including HIV and AIDS. In addition, the estimated AIDS cases among female adults and adolescents, aged 13-19, increased from 7% in 1985 to approximately 26% in 2002. Most infections occur by heterosexual transmission with 53% occurring through contact with a high-risk sexual partner. While overall HIV/AIDS rates in the Asian Pacific Islander (API) community remain low, they are rising and HIV testing rates, one of the major prevention strategies for HIV, are lower than that of other populations. Furthermore, very little is known about APIs HIV/AIDS behavioral risks, HIV testing behaviors, and sexual decision making despite the fact that APIs are one of the fastest growing racial/ethnic populations in the US.

Purpose. The purpose of this study is to explore if and how acculturation is related to HIV testing and other HIV preventive behaviors in female undergraduate Southern Californian API students.

Analysis. A mixed methods study was conducted in two phases. In phase one, grounded theory methods (N=25) were used to explore the young API women’s contextual thoughts and experiences surrounding sexual risk and prevention, including HIV testing. Based on this qualitative information and a conceptual model guided by Acculturation, the theory of gender and power, and dimensions of the AIDS Risk Reduction Model we developed and then administered a survey to 299 API women. In Phase two SPSS version 17.0 was used for all descriptive, factor analyses, bi-variable (One-Way ANOVAs, Independent sample t-tests, and Simple linear regressions) and multivariable analyses. As a model building strategy we bi-variably explored variables/factors associated with intention for testing and used multiple linear regression to test the model.

Results. Despite overall high levels of knowledge about HIV and AIDS there remain some misconceptions about modes of transmission and causation; also, knowledge does predict intention to use HIV testing in this population. Generally our young API females were highly acculturated to the US culture but reported very conservative sexual behaviors. Acculturation to the US culture was not associated with increased testing intentions. With a mean age of twenty 60% of respondents reported never having had a sexual partner and those who were sexually active had a lifetime sexual partner mean of 2.4. Of those who were sexually active 54% reported inconsistent condom use and 14% reported having been tested for HIV- clearly they were worried about their risk. When we explored intention for HIV testing, those that have three or more sexual partners, had higher knowledge about testing and HIV, being sexually active, had higher self perceptions of risk and experiences related to risk, felt that women and men were both susceptible to HIV, and felt that testing had advantages were more likely to have intentions for testing.

Implications/Significance to Health Education. In API culture sexual conservatism is expected and discussions of sexuality remain taboo making it difficult for the young women to protect themselves from HIV/AIDS and STIs, let alone reveal the true nature of their potential risks to their families. However, even in this conservative group of young API women more supportive attitudes about HIV testing, making sure that condoms were used during intercourse, and a sense that both men and women are equally at risk resulted in higher HIV testing intentions. Clearly interventions for young API women need to address these factors and aim to harmonize the concept of conservative cultural expectations with the implementation of protective behaviors once women become sexually active.

School

School of Public Health

First Advisor

Susanne Montgomery

Second Advisor

Helen Hopp Marshak

Third Advisor

Rodger L. Beatty

Degree Name

Doctor of Public Health (DrPH)

Degree Level

Ph.D.

Year Degree Awarded

2010

Date (Title Page)

12-2010

Language

English

Library of Congress/MESH Subject Headings

Acquired Immunodeficiency Syndrome; HIV Infections; Women's Health -- ethnology; Sexual Behavior; Risk-Taking; Health Education; Acculturation; Asian Americans -- Health and hygiene; Pacific Islander Americans -- Health and hygiene

Type

Dissertation

Page Count

xiv; 189

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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