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AIDS among Asians and Pacific Islanders in the United States

  • Pascale M Wortley
    Correspondence
    Address correspondence and reprint requests to: Pascale Wortley, MD, 1600 Clifton Rd., MS E-47, Atlanta, GA 30333
    Affiliations
    Division of HIV/AIDS Prevention—Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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  • Russ P Metler
    Affiliations
    Division of HIV/AIDS Prevention—Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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  • Dale J Hu
    Affiliations
    Division of HIV/AIDS Prevention—Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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  • Patricia L Fleming
    Affiliations
    Division of HIV/AIDS Prevention—Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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      Abstract

      Objective: To characterize Asians and Pacific Islanders in the United States with reported acquired immunodeficiency syndrome (AIDS).
      Methods: AIDS surveillance data reported through June 1998 were analyzed. Characteristics of cumulative case patients, rates of AIDS incidence in 1996 through 1997, and trends from 1982 through 1996 were analyzed.
      Results: Through December 1998, 4,928 Asian and Pacific Islander adults and 46 Asian and Pacific Islander children with AIDS were reported in the United States. Of the total cases, 89% were in men, and 79% of those were in men who have sex with men (MSM). Five states, which account for 63% of the Asian and Pacific Islander population in the United States, reported 78% of the cases: California (45%), Hawaii (12%), New York (15%), Texas (3%), and Washington (3%). Of the 92% of Asian and Pacific Islander patients with country of birth information, 59% were foreign-born, a percentage that corresponds to the distribution in the general population. The overall incidence rate per 100,000 for 1996 through 1997 was 12.8 (21.3 for men; 3.3 for women). The highest rate was in the Northeast (15.9), followed by the West (13.8), South (10.6), and Midwest (5.7). Tuberculosis, reported for 6% of Asians and Pacific Islanders, was higher among foreign-born than among U.S.-born Asians and Pacific Islanders (8% and 4%, respectively). Between 1982 and 1996, AIDS incidence among MSM increased and peaked in 1994. Among heterosexual contacts and injection drug users, incidence has increased but remained low.
      Conclusions: The AIDS epidemic among Asians and Pacific Islanders in the United States has primarily affected MSM and is concentrated in a few states where most Asians and Pacific Islanders reside. Prevention activities should include consideration of cultural diversity and an understanding of cultural norms regarding sexuality. Additional information on risk behaviors and seroprevalence among Asian and Pacific Islander MSM is needed to better guide prevention planning.

      Keywords

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      References

      1. U.S. Bureau of the Census. P25–1130 population projections of the United States by age, sex, race, and Hispanic origin 1995 to 2050. Available at: http://www.census.gov/prod/1/pop/p25-1130/. Accessed on 2/1/00.

        • Choi K.H
        • Yep G
        • Kumekawa E
        HIV prevention among Asian and Pacific Islander American men who have sex with men.
        AIDS Educ Prev. 1998; 10: 19-30
      2. Centers for Disease Control and Prevention. HIV/AIDS surveillance report. 1999;11:1–42.

        • Office of Management and Budget
        Directive no. 15.
        in: Statistical policy handbook. U.S. Department of Commerce, Office of Federal Statistical Policy and Standards, Washington, DC1978
      3. Asia; screens 3/103 — 4/103. In: The New Grolier Electronic Encyclopedia [CD-ROM database] (version 4.2). Grolier Electronic Publishing, Inc.; 1991. Available from Online Computer Systems, Inc.

        • Karon J.M
        • Devine O.J
        • Morgan W.M
        Predicting AIDS incidence by extrapolating from recent trends.
        in: Mathematical and statistical approaches to AIDS epidemiology. Springer Verlag, New York1989: 58-88 (lecture notes in biomathematics)
        • Green T.A
        Using surveillance data to monitor trends in the AIDS epidemic.
        Stat Med. 1998; 17: 143-154
        • Karon J.M
        • Green T.A
        • Hanson D.L
        • Ward J.W
        Estimating the number of AIDS-defining illness diagnoses from data collected under the 1993 AIDS surveillance definition.
        J Acquir Immune Defic Syndr Hum Retrovirol. 1997; 16: 116-121
        • Karon J.M
        • Buehler J.W
        • Byers R.H
        • et al.
        Projections of the number of persons diagnosed with AIDS and of immunosuppressed HIV-infected persons, 1992–1994. Centers for Disease Control and Prevention, Atlanta, GA1993
      4. U.S. Bureau of the Census. State population estimates by age, race, sex, and Hispanic origin:1990–1997. Available at: http://www.census.gov/population/ estimates/st−sasrh−html. Accessed on 1/15/99.

        • U.S. Bureau of the Census
        Current population survey, March 1997. U.S. Bureau of the Census, Washington, DC1998
        • Wortley P.M
        • Fleming P.L
        AIDS in women in the United States.
        JAMA. 1997; 278: 911-916
      5. Centers for Disease Control and Prevention. AIDS among racial/ethnic minorities—United States, 1993. MMWR Morb Mortal Wkly Rep 1994;43:644–7, 653–5.

        • Nwanyanwu O.C
        • Conti L.A
        • Ciesielski C.A
        • et al.
        Increasing frequency of heterosexually transmitted AIDS in southern Florida.
        Am J Public Health. 1993; 83: 571-573
        • Castro K.G
        • Lifson A.R
        • White C.R
        • et al.
        Investigations of AIDS patients with no previously identified risk factors.
        JAMA. 1988; 259: 1338-1342
        • Kelly J.J
        • Chu S.Y
        • Diaz T
        • Leary L.S
        • Buehler J.W
        Race/ethnicity misclassification of persons reported with AIDS.
        Ethn Dis. 1996; 1: 87-94
      6. Revisions to the standards for the classification of federal data on race and ethnicity. Federal Register 1997;62:58781–90.

        • Lemp G.F
        • Hirozawa A.M
        • Givertz D
        • et al.
        Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men.
        JAMA. 1994; 272: 449-454
        • Osmond D.H
        • Page K
        • Wiley J
        • et al.
        Infection in homosexual and bisexual men 28 to 29 years of age.
        Am J Public Health. 1994; 84: 1993-1997
        • Seage G.R
        • Mayer K.H
        • Lenderking W.R
        • et al.
        HIV and hepatitis B infection and risk behavior in young gay and bisexual men.
        Public Health Rep. 1997; 112: 158-167
        • Choi K.H
        • Coates T.J
        • Catania J.A
        • Lew S
        • Chow P
        High HIV risk among gay Asian and Pacific Islander men in San Francisco.
        AIDS. 1995; 9: 306-307
        • Matteson D.R
        Bisexual and homosexual behavior among Chinese, Filipino, and Korean-American men.
        J Sex Res. 1997; 34: 93-104
      7. Los Angeles County Department of Health Services, HIV Epidemiology Program. An epidemiologic profile of HIV/AIDS in Los Angeles County. Los Angeles: Los Angeles County Department of Pubic Health Services, January 1999.

        • Schuster M.A
        • Bell R.M
        • Nakajima G.A
        • Kanouse D.E
        The sexual practices of Asian and Pacific Islander high school students.
        J Adolesc Health. 1998; 23: 221-231
        • Upchurch D.M
        • Levy-Storms L
        • Sucoff C.A
        • Aneshensel C.S
        Gender and ethnic differences in timing of first sexual intercourse.
        Fam Plann Perspect. 1998; 30: 121-127
        • Meston C.M
        • Trapnell P.D
        • Gorzalka B.B
        Ethnic and gender differences in sexual behavior between Asian and non-Asian university students.
        Arch Sex Behav. 1996; 25: 33-72
        • Horan P.F
        • DiClemente R.J
        HIV knowledge, communication and risk among white, Chinese, and Filipino-American adolescents in a high prevalence AIDS epicenter.
        Ethn Dis. 1993; 3: 97-102
        • Kahn J.R
        • Kalsbeek W.D
        • Hofferth S.L
        National estimates of teenage sexual activity.
        Demography. 1988; 25: 188-204
        • Sullivan P.S
        • Nakashima A.K
        • Purcell D.W
        • Ward J.W
        Geographic differences in noninjection and injection substance use among HIV-seropositive men who have sex with men.
        J Acquir Immune Defic Syndr Hum Retrovirol. 1998; 19: 266-273
        • Hu D.J
        • Dondero T.J
        • Mastro T.D
        • Gayle H.D
        Global and molecular epidemiology of HIV.
        in: Wormser G.P AIDS and other manifestations of HIV infection 3rd ed. Raven Press, New York1998: 27-40
        • May K.H
        • Wong F.Y
        Epilogue.
        AIDS Educ Prev. 1998; 10: 94-95
        • Hu D.J
        • Fleming P.L
        • Castro K.G
        • et al.
        How important is race/ethnicity as an indicator of risk for specific AIDS-defining conditions?.
        J Acquir Immune Defic Syndr Hum Retrovirol. 1995; 10: 374-380
      8. Reported tuberculosis in the United States, 1998. Atlanta, GA: Centers for Disease Control and Prevention: 1999;1–84.

        • Sackoff J.E
        • Torian L.V
        • Frieden T.R
        • Brudney K.F
        • Menzies I.B
        Purified protein derivative testing and tuberculosis preventive therapy for HIV-infected patients in New York City.
        AIDS. 1998; 12: 2017-2023