Data limitations. This could lead to the underestimation of HIV infection in this population. CDC provides support and technical assistance to health departments and community-based organizations to deliver prevention programs for Asians, such as The Banyan Tree Project. Stop HIV. Expand All Collapse All.
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Bibliography CDC. Accessed March 23, Accessed April 2, Selected national HIV prevention and care outcomes [slide set]. Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among Asian-American women. AIDS Behav ;16 1: Examining barriers to care: AIDS Care ;24 US Census Bureau. The first of these scenarios related to what the participant described as making a poor decision. I pretty much do it [not use condoms] with people I know and trust I guess they could have HIV and not know about it … Like I have not always used a condom … I don't know why, I just didn't.
Just a momentary decision and I just didn't make a very good decision but I can't do anything about it now. Another man, the only one who reported being HIV-positive, noted that he looked for opportunities to have bareback sex, that is anal sex without condoms with other HIV-positive men. However, he did use condoms when having sex with men who are HIV-negative. Hence the reason why the bareback website is a good way of identifying with other positive men which I don't use condoms with.
It may however recognize that the men have other priorities which do not support health-promoting behaviours but which they see as preferable. Several men spoke about a contested area of using condoms for anal sex with a boyfriend or life partner.
Some men discussed how they had agreed with their partner not to use condoms for anal sex. Because I'd never had sex before I met my boyfriend … we've both been tested [negative] so we're pretty happy with that, so we decided not to, yeah [use condoms]. Yeah I used condoms with everyone until I met [name of person]. Like neither of us had had much penetrative sex and condom use wasn't much of an issue because I just didn't have that much anal sex.
But yeah once we'd started seeing each other we decided we wouldn't use condoms because of both our sexual histories there was no risk. That [decision] went with a strong requirement to talk about who we were seeing and what we were doing and stuff…. He didn't want to use condoms and I'm just really lenient. I didn't enjoy the sex at all because deep down I'm really afraid but I'm just not strong enough to say no. I like to be safe, but once I had sex with a guy whom I met on Grindr, he didn't want to use condoms.
I was very afraid to do that, but I just accepted because I thought he was clean [meaning HIV negative] and neat and we just had sex without a condom. That's why I just went for an HIV test. South Asian 5 of 8 men interviewed and Chinese 4 of Men who moved to New Zealand in the last 5 years were much more likely to have been tested overseas—with the most recent test often in relation to immigration processes. I go like every 3 months [to be tested] but sometimes I had a worry [didn't use a condom] I would go sooner … I rush to it.
Yes one time here and before I come here there was once because I had to do a medical check-up. One of these men reported he used condoms for anal sex but still decided to be tested; while the other noted that he did not see the need as he only has oral sex. I just test for the sake of being tested. I had one done in June but I knew I would be fine because I had safe sex … So far the people I have met, they all agree to use condoms. Several men identified where they had an HIV test. Other men reported being tested at Auckland Sexual Health Services a service of the local district health board.
Only one of the men identified getting tested by their general practitioner family doctor. I went to NZAF to get tested. I always do it every year to make sure and my partner does that as well. I never did it back home because I was scared if I go people would know and see me. So when I first came here I went to the Burnett Clinic.
Yeah, I've actually done it quite a few times over the years with Body Positive, because they have that fast testing and I've actually been to them for a regular check-up kind of thing. Even with my GP we do it annually so yeah I test and I don't feel ashamed of it. Several men described the barriers to testing including not knowing how to access an HIV test and difficulties discussing sexual health issues with their general practitioner.
I haven't had any sexual health check-ups so far and like I would love to go to a different GP [general practitioner] if I have to but I am just not comfortable discussing my sexual health with my current GP. Several noted how very prominent these campaigns were; many of the messages seen were in public spaces such as on billboards and at bus stops, and online including Facebook. Love your Condom and Get it On! When you search gay stuff it will pop up like Get it On!
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Love your Condom, sometimes on Facebook … yeah it is a good message. The men also understood the HIV health promotion message was about safe sex—that is, the use of condoms for anal sex. These messages were identified as being clear, strong, and relevant. You mean the two campaigns?
Yeah it is very relevant. I used to see a lot of these posters on bus stops and things like that … It's really relevant especially for people from the gay community. There was a mixed view about the message content—some men noted they were effective without being explicit; whereas others described the campaigns as highly and overtly sexualized. One concern was the campaign may contribute to negative views linking being gay to sex. The one thing I haven't liked about it is it makes other people, like straight people think gay people are really promiscuous.
Another view was that a sexualized focus in the campaigns did not sufficiently acknowledge the importance of relationships presumably over casual sex , which he identified as a feature of Asian culture. I think it is about the culture because Asians are more into relationships. I mean more loyal to each other, but white guys, while not being racist, tend to be more active and promiscuous in sexual activities. I think condom advertising campaigns should get across the importance of relationships. In other respects, the current health promotion activities were described as engaging well enough with Asian MSM.
Some participants felt greater diversity including Chinese and South Asian men and different body types would enhance engagement with the messages. This was seen as best integrated into current campaigns and undertaken in a natural way without highlighting Asian men specifically. I don't especially feel marginalised by the sort of information being given out but I don't strongly identify … it's a problem that a lot of these images and I guess a lot of the information assumes sort of like white and upper middle class sort of gay men, which is problematic.
I think we need to have a little bit more, well a lot more actually of Asian representation in campaigns like just the face would be good … because it will resonate much more within the community, with the gay Asian group.
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Two men mentioned it would be useful to have information about homosexuality available in Asian languages for parents of gay and bisexual men. This might help to destigmatize homosexuality. I guess like the one thing that I feel like there has been in terms of my parents there haven't been that many resources for them to access. I think there hasn't been resources where they can go and find out information that is accessible for them. So that has been annoying I think from my perspective because it is difficult to educate them about something that is difficult to talk to them about … so something in Mandarin or in different languages would be useful.
Nevertheless this ongoing burden of HIV demands that effective HIV health promotion and prevention initiatives be provided. In particular, understanding the views of particular groups of MSM who may be more vulnerable, such as Chinese and South Asian MSM, will assist in relevant health promotion responses.
The results of our study are that the men interviewed had a strong understanding of the benefits of using condoms for anal sex. They also reported strong recall of HIV health promotion campaigns which seek to influence men's behaviours through a promotion of a single, unequivocal message to always use a condom for anal sex.
Consequently, there is a strong case for continuing to base HIV health promotion around such social marketing initiatives. However, in line with other local research, the men in this study did not always report consistent condom use.
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A range of reasons why this happened were documented including using ways to assess the HIV status of potential partners and the belief that using condoms is unnecessary for men in relationships. These all give opportunities for more tailored interventions to supplement the more generic social marketing messages. One area that may require further attention is in relation to men who were compelled to have sex that they were not comfortable with i.
Although there has been some research from New Zealand around this issue, the ways that ethnic minority men are made to feel vulnerable remain unknown. Future initiatives might include ways for such men to be able to more successfully negotiate the use of condoms for anal sex but also to encourage an environment where having respectful and non-coercive sex is everyone's responsibility.