AIDS, HIV and STD among Japanese and Japanese-Americans in San Francisco, California, USA

Facilitators and barriers to HIV testing among Asians in the United States: a systematic review

Asians have the highest rate of undiagnosed HIV in the United States. Limited research on factors implicated in HIV testing among this population presents a barrier to monitoring and addressing HIV testing disparities. To examine predictors of HIV testing among Asians in the United States, a systematic search of articles published from January 1997 to December 2017 was conducted using four electronic databases, including Medline, PubMed, PsycINFO, and Web of Science. Twenty-two articles were included according to predefined inclusion criteria: peer-reviewed, published in English, took place in the United States, included participants at least 18 years of age, reported data specifically on Asians or Asian subgroups, and assessed HIV testing. Included studies were assessed by methodological quality scoring. Individual-level factors such as HIV knowledge and HIV risk perceptions were commonly reported facilitators of HIV testing. Studies placed less attention on community, institutional, or structural level factors predicting HIV testing. Sorely warranted are high quality, longitudinal studies that examine HIV testing among Asians in the United States. Multi-level theoretical frameworks that examine HIV testing among Asians with attention to ethnic subgroups are needed to improve understanding of HIV testing and to develop targeted testing interventions.

The role of international migration in infectious diseases: the HIV epidemic and its trends in Japan

Globalization and its associated international migrations facilitate the spread of infectious diseases. This article reports trends in and discusses the relation between international migration and HIV infection in Japan. The authors analyze relevant literature, drawing on government and other sources. Among foreigners in Japan, there were 27.0 reported HIV and 9.3 reported AIDS cases per million in 1990, and 52.9 HIV and 38.8 AIDS cases per million in 2000. These rates were initially 45 to 90 times the population prevalence of HIV and AIDS among Japanese, but are now only 10 to 20 times the prevalence among Japanese, as HIV becomes an increasing problem for the Japanese population. HIV-infected foreigners who are uninsured are at a disadvantage for diagnosis, counseling, and treatment compared with insured persons, and at a significantly higher risk for low CD4 counts. For all sections of Japan's population, counseling and testing are inadequate, and surveillance of behavioral risk, infection, and disease is limited. International migrants are at increased risk for HIV transmission and at a disadvantage for care and treatment. Japan needs both to develop policies that assist migrants and to respond to the growing threat among its nonmigrant population.

An opportunity for prevention: prevalence, incidence, and sexual risk for HIV among young Asian and Pacific Islander men who have sex with men, San Francisco

OBJECTIVES

We investigated HIV prevalence and incidence and related risk factors among young Asian and Pacific Islander (API) men who have sex with men (MSM).

DESIGN

We conducted a cross-sectional survey.

METHODS

A venue-based sample of 496 young API MSM in San Francisco completed face-to-face questionnaires and received HIV counseling and testing.

RESULTS

HIV prevalence was 2.6% and annualized HIV incidence was 1.8% per year. In multivariate analysis, being American-born, having 51+ lifetime sex partners, and having attended a "circuit party" (multiday large MSM gatherings) were associated with HIV infection. Forty-seven percent of the sample reported unprotected anal intercourse in the past 6 months.

CONCLUSIONS

The current levels of HIV prevalence, HIV incidence, and sexual risk behavior suggest an emerging HIV epidemic among young API MSM in San Francisco.