Many Asian American and Pacific Islander (AAPI) men in the U.S. at high risk for HIV have never undergone serological testing. In one recent study, 62% of HIV-positive AAPI men were unaware of their HIV status at the time of testing. Moreover, according to another recent study 45.6% of AAPIs with an AIDS diagnosis cite illness as the primary reason for being tested for HIV, a significantly higher proportion in comparison to their Caucasian counterparts. However, little is known about factors that influence testing among AAPI men. Because delayed testing is often associated with an initial presentation of advanced disease, higher health care costs, and disease morbidity, studies of testing behaviors are vital. Among cumulative AIDS cases in AAPIs, proportionately more are men at sexual risk for HIV (71%) whereas all men at sexual risk for HIV make up 56% of cumulative AIDS cases among men in the U.S., a fact that underscores the significance of understanding the HIV-related risks of AAPI men. It is estimated that of the 10.9 million AAPIs in the U.S., 6.7 million (61.4%) are foreign-born and 7 million (63.7%) ages 5 and above speak an AAPI language at home. In the Asia and Pacific region, it is estimated that 7.2 million people are living with HIV or AIDS. Evidence suggests that demographic and socio-cultural, including ethnic identification, are major determinants of HIV-related risk behavior -- in Asia, in foreign-born AAPI men in the U.S., and in U.S.-born AAPI men. Given the explosion of the AIDS epidemic in the Asia and Pacific region, understanding emerging patterns of risk (including migration, cultural stigmatization, and sex tourism) become more important than ever. Furthermore, the impact of social networks and norms remains understudied. To our knowledge there is only one published study among AAPI men on the disclosure of HIV status to social network members. AAPIs may face greater challenges to disclosure due to cultural constraints, despite the fact that greater openness to social networks is positively associated with knowledge of HIV status. The accretion of larger structural and network level factors contributes to individual psychology and risk behaviors that ultimately determine the decision of whether or not to seek HIV testing. Therefore, the Georgetown University's School of Nursing and Health Studies, together with one national AAPI health advocacy organization and eight (8)AAPI community-based organizations (CBOs) in the U.S. propose a national five-year study: (1) to estimate the prevalence and incidence of HIV infection among AAPI MSM; (2) to describe the socio-cultural and individual-level correlates of HIV testing and knowledge of HIV infection status among AAPI MSM; (3) to examine the socio-cultural and individual level correlates of HIV risk among AAPI MSM; and (4) to evaluate a consortium model framework for conducting scientific, community-based HIV research. ? ?
