Addressing HIV/AIDS risk among Asian American/Pacific Islander (AA/PI) Men who have Sex with Men (MSM) can be a challenge. Several cultural factors and misperceptions within the general AA/PI community and mainstream gay community cause most to remain largely silent on the subject.
One of the major barriers to raising awareness among the AA/PI community overall is addressing the diverse needs of this population. Contrary to some common racial stereotypes about AA/PIs, not all AA/PIs speak one language or share common cultural values or world views.
AA/PIs consist of distinct cultural ethnicities that speak well over 100 languages and dialects. Also, AA/PIs in the U.S. are at varying levels of acculturation from being born in the U.S. and having high English proficiency to being recent immigrants with very little or no English skills, therefore having less access to English-only HIV/AIDS prevention and services.
Culturally speaking, many AA/PI cultures avoid the topic of sex. This cultural tendency lends to a socialized stigma around having frank, educational talks around sexual health. This in turn puts all AA/PIs at increased risk for STD transmission. This tendency to avoid discussing sex coupled with how different AA/PI communities uniquely express homophobia can be an additional barrier for gay/bi AA/PI men to feel empowered enough to seek information on HIV/AIDS prevention. This is especially if some of these men are still in the closet with their own sexual orientation and maybe even not identifying as gay or bisexual.
Perceptions of actual HIV risk among MSM AA/PIs have also made it difficult to prioritize funding. In mainstream culture, AA/PIs have been portrayed in American movies and television as sexless martial arts eunuchs or nerdy and anal-retentive foreign-exchange students from Asia, i.e., safe, risk-adverse, and always following the rules. These perceptions are further driven by the fact that HIV+ AA/PIs make up approximately 1% of all HIV/AIDS cases in the U.S.
But this low percentage is ultimately deceptive. Because AA/PIs aren't seen to be at risk, AA/PIs are not nearly as often encouraged to test for HIV as with other ethnic groups. Nevertheless, health departments in the state of Illinois and beyond continue to take HIV+ Asian/Pacific Islanders and combining these numbers with HIV+ Native Americans into an ethnic category only known as 'Other.' This practice makes it a challenge to fund AA/PI-targeted HIV prevention projects because it renders AA/PIs invisible and non-existent.
What is also true is the fact that Asian/Pacific Islander gay/bi males are still disproportionately affected by HIV/AIDS among those who are HIV+ and identify as Asian/Pacific Islander in the U.S. Currently, about 75% of all HIV+ AA/PI males in the U.S. identify unprotected sex with other men as their primary risk for HIV transmission.
The spread of an online barebacking community has also found its way among gay/bi Asian/Pacific Islander men, adding a newer, more frightening challenge to providing gay/bi AA/PI HIV prevention. An example of this can be found in a Yahoo group called AsianBarebackers which currently has 4,631 subscribed members.
A report just finished by the Asian Pacific Islander Wellness Center in San Francisco has also shed some light on the issue of unsafe sex among gay/bi AA/PIs, which surveyed over 270 AA/PI-identified MSMs from all across the country, including Chicago. Some of the major findings were a high rate of unprotected anal receptive sex (13.6% with multiple male partners within the last 3 months), a high percentage of AA/PI MSMs not testing regularly (44% reported not having had an HIV test within the last 12 months), and a low willingness to disclose HIV status (42% of those surveyed declined to reveal their HIV status.)