Experiences of and Responses to Social Discrimination among Asian and Pacific Islander Gay Men: Their Relationship to HIV Risk
As the HIV/AIDS epidemic enters its third decade, rates of infection continue to rise in ethnic minority populations. Though the prevalence of HIV among Asian and Pacific Islander (A&PI) gay men remains to be clearly documented, research has shown that these men engage in relatively high rates of HIV risk behavior. The social discrimination that minority gay men experience may impact their HIV risk behavior and mental health (Díaz & Ayala, 2001). This article examines the experiences of and response to social discrimination among A&PI gay men, and their links to HIV risk behaviors. The study analyzes 166 narrative episodes of discrimination, as well as data on HIV risk obtained from in-depth interviews with 23 A&PI gay men. Results showed that A&PI gay men experience types of discrimination across a variety of contexts. Homophobia and anti-immigrant discrimination were linked to confrontation and social network-based responses whereas discrimination based in stereotypes of passivity / submission were linked with self-attribution. A&PI gay men who used confrontational, social network-based or avoidance response types showed less HIV risk than those who did not. Conversely, A&PI gay men who responded to discrimination with self-attribution showed greater HIV risk behaviors. These findings indicate that experiences of social discrimination and responses to discrimination may impact A&PI gay men's well-being and health.
Chng, C.L., & Géliga-Vargas, J. (2000). Ethnic identity, gay identity, sexual sensation seeking and HIV risk taking among multiethnic men who havesex with men.AIDS Education and Prevention, 12(4), 326–339. Medline, Google Scholar Chng, C.L., Wong, F.Y., Park, R.J., Edberg, M.C., & Lai, D.S. (2003). A model for understanding sexual health among Asian American/Pacific Islander menwho havesex with men (MSM) in the United States. AIDS Education and Prevention, 15(Suppl. 1), 21–38. Link, Google Scholar Choi, K., Han, C., Hudes, E.S., & Kegeles, S. (2002). Unprotected sex and associated risk factors among young A&PI men who have sex with men. AIDS Education and Prevention, 14(6), 472–481. Link, Google Scholar Choi, K., Kumekawa, E., Dang, Q., Kegeles, S.M., Hays, R.B., & Stall, R. (1999). Risk and protective factors affecting sexual behavior among young A&PI men who have sex with men: Implications for HIV prevention. Journal of Sex Education and Therapy, 24(1–2), 47–55. Crossref, Google Scholar Choi, K., Lew, S., Vittinghoff, E., Catania, J.A., Barrett, D.C., & Coates, T.J. (1996). The efficacy of brief group counseling in HIV risk reduction among homosexual A&PI men. AIDS, 10, 81–87. Crossref Medline, Google Scholar Choi, K., Yep, G.A., & Kumekawa, E. (1998). HIV prevention among A&PI American men who have sex with men: A critical review of theoretical models and directions for future research. AIDS Education and Prevention, 10(Suppl. 3), 19–30. Medline, Google Scholar Crocker, J., Major, B., & Steele, C. (1998). Social stigma. In D. Gilbert, S.T. Fiske, & G. Lindzey (Eds.), Handbook of social psychology (pp. 504–553). Boston: McGraw-Hill. Google Scholar Díaz, R.M. & Ayala, G. (2001). Social discrimination and health: The case of Latino gay men and HIV risk. New York: National Gay and Lesbian Task Force. Google Scholar Díaz, R.M., Ayala, G., Bein, E., Henne, H., & Marin, B. (2001). The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: Finding from 3 US cities. American Journal of Public Health, 91(6), 927–932. Crossref Medline, Google Scholar Eckholdt, H., & Chin, J. (1997). Pneumocystis carinii pneumonia in Asians and Pacific Islanders. Clinical Infectious Diseases, 24, 1265–1267. Crossref Medline, Google Scholar Eng, D.L. (2001). Racial Castration: Managing Masculinity in Asian America. Durham, NC: Duke University Press. Google Scholar Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 992–1003. Crossref Medline, Google Scholar Holahan, C.J., & Moos, R.H. (1987). Personal and contextual determinants of coping strategies. Journal of Personality and Social Psychology, 51, 946–955. Crossref, Google Scholar Krieger, N. (1999). Embodying inequality: A review of concepts, measures, and methods for studying health consequences of discrimination. International Journal of Health Services, 29(2), 295–352. Crossref Medline, Google Scholar Krieger, N., & Sidney, S. (1996). Racial discrimination and blood pressure: The CARDIA study of young Black and White adults. American Journal of Public Health, 86, 1370–1378. Crossref Medline, Google Scholar Lalonde, R.N., & Cameron, J.E. (1994). Behavioral responses to discrimination: A focus on action. In M.P. Zanna & J.M. Olson (Eds.), The psychology of prejudice: The Ontario symposium (Vol. 7, pp. 257–288). Mahwah, NJ: Erlbaum. Google Scholar Lazarus, R.S. (2000). Toward better research on stress and coping. The American Psychologist, 5, 665–712. Crossref, Google Scholar Major, B., Quinton, W.J., & McCoy, S.K. (2002). Antecedents and consequences of attributions to discrimination: Theoretical and empirical advances. In M.P.Zanna,(Ed.), Advances in experimental social psychology (pp. 251–330). San Diego: Academic Press. Google Scholar Major, B., Spencer, S., Schmader, T., Wolfe, C., & Crocker, J. (1998). Coping with negative stereotypes about intellectual performance: The role of psychological disengagement. Personality & Social Psychology Bulletin, 24(1), 34–50. Crossref, Google Scholar Manalansan, M.F. (1996). Double minorities: Latino, Black, and Asian men who have sex with men. In R.C. Savin-Williams & K.M. Cohen (Eds.), The lives of lesbians, gays, and bisexuals: children to adults (pp. 393–415). New York: Harcourt Brace. Google Scholar McCrae, R.R., & Costa, P.T. (1986). Personality, coping, and coping effectiveness in an adult sample. Journal of Personality, 54, 385–405. Crossref, Google Scholar Meyer, I.H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36, 38–56. Crossref Medline, Google Scholar Meyer, I.H. & Dean, L. (1995). Patterns of sexual behavior and risk taking among young New York City gay men. AIDS Education and Prevention, 7 (Suppl.), 13–23. Medline, Google Scholar Miller, C. T., & Major, B. (2000). Coping with prejudice and stigma. In T. Heatherton, R. Kleck, & J.G. Hull (Eds.).The social psychology of stigma (pp. 243–272). New York: Guilford. Google Scholar Monteith, M.J., Devine, P.G., & Zuwerink, J.R. (2000). Self-directed versus other-directed affect as a consequence of prejudice-related discrepancies. In C. Stangor (Ed.), Stereotypes and prejudice: Essential readings (pp. 305–322). Philadelphia, PA: Psychology Press. Google Scholar Nemoto, T., Operario, D., Soma, T., Bao, D., Vajrabukka, A., & Crisostomo, V. (2003). HIV risk and prevention among Asian/Pacific Islander menwho havesex with men: Listen to our stories. AIDS Education and Prevention, 15(Suppl. 1), 7–20. Link, Google Scholar Noh, S., Beiser, M., Kaspar, V., Hou, F., & Rummens, J. (1999). Perceived racial discrimination, depression and coping: A study of Southeast Asian refugees in Canada. Journal of Health and Social Behavior, 40, 193–207. Crossref Medline, Google Scholar Peterson, J.L., Bakeman, R., Stokes, J., & the Community Intervention Trial for Youth Study Team (2001). Racial/ethnic patterns of HIV sexual risk behaviors among young men who havesex with men.Journal of the Gay and Lesbian Medical Association, 5(4), 155–162. Crossref, Google Scholar Pierce, G.R., Sarason, I.G., & Sarason, B.R. (1996). Coping and social support. In M. Zeidner & N. Endler (Eds.), Handbook of coping: Theory, research, applications (pp. 434–451). New York: Wiley. Google Scholar Steele, C. M. (1997). A threat in the air: how stereotypes shape the intellectual identities and performance. American Psychologist, 52, 613–629. Crossref Medline, Google Scholar Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks, CA: Sage. Google Scholar
- United Nations Joint Programme on HIV/AIDS (2001). AIDS epidemic update: December 2001. Geneva: Author. Retrieved May 12, 2003, from www.unaids.org. Google Scholar
Valleroy, L.A., MacKellar, D.A., Karon, J.M., Rosen, D.H., McFarland, W., Shehan, D.A., Stoyanoff, S.R., LaLota, M., Celentano, D.D., Koblin, B.A., Thiede, H., Katz, M.H., Torian, L.V., & Janssen, R.S. (2000). HIV prevalence and associated risks in young men Who have sex with men. Journal of the American Medical Association, 284(2), 198–204. Crossref, Google Scholar Wong, F.Y., Chng, C.L., & Lo, W. (1998). A profile of six community-based HIV prevention programs targeting A&PI Americans. AIDS Education and Prevention, 10(Suppl. 3), 61–76. Medline, Google Scholar Wortley, P.M., Metler, R.P., Hu, D.J., & Fleming, P.L. (2000). AIDS among A&PIs in the United States. American Journal of Preventive Medicine, 18, 208–214. Crossref Medline, Google Scholar Yoshikawa, H., Wilson, P.A., & Chae, D. (2002, July). Demographic, psychosocial, and neighborhood predictors of HIV risk among Asian / Pacific Islander men who have sex with men in New York City. Paper presented at the 14th World AIDS Conference, Barcelona, Spain. Google Scholar