Revising the American dream: how Asian immigrants adjust after an HIV diagnosis.
OBJECTIVE
We explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population.


BACKGROUND
Asians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate.


METHODS
A mixed-methods study was conducted.


METHODS
Thirty in-depth interviews were conducted with HIV-positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross-sectional audio computer-assisted self-interviews were conducted with a sample of 50 HIV-positive Asians and Pacific Islanders. Content analysis was used to analyse the in-depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self-actualization. The study took place from January-June 2013.


CONCLUSIONS
Major themes were extracted from the interview data, including self-actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self-actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self-actualization and those who believed they could still achieve their 'American dreams'. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self-actualize and those who still believed they could 'make their dreams come true.'


CONCLUSIONS
Acculturation levels influence depression and self-actualization in the HIV-positive Asians and Pacific Islanders population. Lower acculturated Asian Americans achieved a lower degree of self-actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self-actualization.
School of Nursing, Yale University, Orange, Connecticut, USA.
Wei-Ti
WT
Chen
School of Nursing, Northeastern University, Boston, Massachusetts, USA.
Barbara
B
Guthrie
School of Social Work, University of Washington, Seattle, Washington, USA.
Cheng-Shi
CS
Shiu
School of Public Health, Yale University, New Haven, Connecticut, USA.
Lixuan
L
Wang
School of Nursing, Yale University, Orange, Connecticut, USA.
Zhongqi
Z
Weng
Department of Psychiatry and Neurobiology, Yale University, New Haven, Connecticut, USA.
Chiang-Shan
CS
Li
Department of Health Promotion and Education, National Taiwan Normal University, Taipei, Taiwan.
Tony Szu-Hsien
TS
Lee
School of Nursing, University of California, San Francisco, California, USA.
Emiko
E
Kamitani
APICHA Community Health Center, New York, New York, USA.
Yumiko
Y
Fukuda
HIV/AIDS Service, Chinese-American Planning Council Inc, New York, New York, USA.
Binh Vinh
BV
Luu
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D001213:Asian / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D012495:San Francisco
American dream; Asian; HIV; acculturation; depression; immigrants; nursing; self-actualization; stress