title: Lower HIV prevalence among Asian/Pacific Islander men who have sex with men: a critical review for possible reasons.
abstract: We conducted a critical literature review for possible reasons that may explain the lower HIV prevalence observed among API MSM compared to MSM of other races/ethnicities. Trends emerging from the literature suggest that traditional individual-level factors-unprotected anal intercourse, substance use, STD prevalence, rates and frequency of HIV testing, and utilization of HIV prevention services-do not appear to be related to the lower HIV prevalence among API MSM. Some evidence suggests that socio-cultural and structural factors might be the more critical forces in determining racial/ethnic disparities of HIV among MSM. For API MSM, these factors include structures of sexual networks, access to and reception of medical care and treatment among HIV-positive MSM, and influences of different levels and types of acculturation. Moreover, emerging risk reduction strategies, such as seroadaptive behaviors, could play a role. Future research should address these factors in intervention design. In addition, better theories of resilience and measurement of strengths and protective factors are needed to enhance the efficacy of HIV interventions.
authors.affiliation: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA. chw57@pitt.edu
authors.forename: Chongyi
authors.initials: C
authors.lastname: Wei
authors.forename: H Fisher
authors.initials: HF
authors.lastname: Raymond
authors.forename: Frank Y
authors.initials: FY
authors.lastname: Wong
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Silvestre
authors.forename: Mark S
authors.initials: MS
authors.lastname: Friedman
authors.forename: Patricia
authors.initials: P
authors.lastname: Documét
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.forename: Ron
authors.initials: R
authors.lastname: Stall
mesh_terms: D001294:Attitude to Health / Q000208:ethnology; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology* / Q000517:prevention & control / Q000635:transmission; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology*; D015497:HIV-1; D018451:Homosexuality, Male / Q000208:ethnology* / Q000523:psychology; D006801:Humans; D008297:Male; D044468:Native Hawaiian or Pacific Islander / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D036301:Qualitative Research; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex