HIV-related sexual risk assessment among Asian/Pacific Islander American women: an inductive model

Current HIV/AIDS rates among Asian/Pacific Islander (A/PI) women in the United States are disproportionately low (CDC, 1998). However, there is evidence to suggest that risk for HIV is present, based upon studies on risk behaviors and markers for risk as well as demographic factors that may facilitate transmission among this population. Because a particular threat to A/PI women is heterosexual transmission, which accounts for nearly half of all cases (CDC, 1998), prevention efforts should focus on risk within sexual contexts and how such risk is assessed and acted upon. Using a qualitative methodology, the present study investigated how A/PI American women assess their HIV-related risk in sexual interactions. Based on extensive interview data, an inductive model of risk assessment was generated consisting of cultural and sexual risk schemata. Findings suggest the influence of cultural schemata on sexual risk schemata, which in turn influence whether condoms or HIV tests are requested. Specifically, the cultural values of reticence regarding sex, the accommodation of others and a traditional romantic ideal inhibit open discussion with partners about HIV as well as requests for safer sex behaviors. Instead, A/PI women tend to engage in non-explicit, inferential assessments of partners' risk, which may contribute to an illusory sense of control and safety. Consistent with previous studies on other groups of women, these findings further extend and elucidate theory and prevention strategies for this population.