The impact of sexuality and race/ethnicity on HIV/AIDS risk among Asian and Pacific Island American (A/PIA) gay and bisexual men in Hawai'i.

The prevalence of HIV/AIDS in Asian and Pacific Island Americans (A/PIAs) has been relatively low in proportion to other racial/ethnic groups in the United States. However, HIV infection among A/PIA gay and bisexual men, and men who have sex with men has steadily increased in urban and other geographic areas with large Asian and Pacific Island populations. In this study of race/ethnicity and HIV risk among A/PIA gay and bisexual men in Hawai'i, respondents reported significant conflicts between loyalty to one's A/PIA family of origin and the enactment of individual sexual identity. Idealization of love and intimacy, intentional decisions to suspend safer sex practices, and Pacific Island cultural expressions of giving to others are all factors that may compromise HIV risk reduction in this population. Implications for HIV/AIDS prevention focus on integrating A/PIA, gay/bisexual, and "local" (born and raised in Hawai'i) identities in the development of multilevel interventions.