HIV Risks and Testing Behavior among Asians and Pacific Islanders: RESULTS

30 Oct
2009

Of the 187 individuals who responded to the HITS-API survey, 165 (88%) met the inclusion criteria. HITS-2000 recruited 314 participants, of whom 235 (75%) were included. Table 1 shows the demographic characteristics of both cohorts. HITS-API respondents were younger, had higher incomes and were less likely to be homeless or IDU. API respondents in HITS-2000 were comparable to those in HITS-API except that more HITS-API participants were of multiple race/ethnicity (data not shown). The most common API ancestries of participants in HITS-API were Filipinos (33%), followed by Chinese (19%), Vietnamese (17%) and Japanese (15%). Most (96%) HITS-API respondents had heard or seen HIV (treating HIV infection) prevention messages within a year of the survey; the most common venues were newspapers/magazines (72%), health centers (72%), television (68%), bus/bus stop (61%), billboards (58%) and radio (50%). Questions about prevention messages were not asked in the HITS-2000 survey.


Table 1. Characteristics of Respondents to the HIV Testing Survey for Asians and Pacific Islanders (HITS-API), 2002-2003 and the HIV Testing Survey in 2000 (HITS-2000)—Seattle, WA

HITS-APIHITS-2000
N=165N=270
Race/Ethnicity*

%

%
Asian

84

6
Pacific Islander

31

3
Other/multi-race

38

91
Sex
Male

74

82
Female

25

18
Transgender1<1
Age
18-24

52

17
25-29

15

17
30+

33

66
Education
Did not complete HS

10

11
HS diploma or equivalent

21

30
Some college

35

31
College/postgraduate

35

28
Employment
Employed

64

59
Unemployed

36

41
Housing Situation
Rent home/apartment

47

50
Own home

13

11
Homeless

7

16
Other

33

23
Monthly Income
<$ 1,000

19

31
$1,000-$1,999

19

25
$2,000-$2,999

16

22
$3,000+

47

23
Risk Category

Men who have sex with men 55

40
Injection drug users

9

44
Heterosexuals

36

16
* Race/ethnicity groups were not mutually exclusive, totals
exceed 100%; HS: high school

Over half of MSM in HITS-API (59%) and 47% in HITS-2000 with at least one nonprimary partner in the previous year reported always using condoms. Significantly more heterosexuals in HITS-API with nonprimary partners always used condoms compared with heterosexuals in HITS-2000 (52% versus 31%, RR=1.7, 95% CI=1.0-2.9). Heavy alcohol use, defined as five or more alcoholic beverages in a single day within the previous month, was reported significantly more by the HITS-API participants than HITS-2000 (42% versus 29%, RR=1.5, 95% CI=1.1—1.9). However, noninjection drug use was significantly less prevalent in HITS-API (55% versus 77%, RR=0.7, 95% CI=0.6-0.8), and a lower proportion shared injection drug needles and/or equipment (11% versus 18%, RR=0.6,95% CI=0.4^1.0).

Respondents were asked to describe their chances of getting HIV (treating HIV infection when used in combination with other medicines) A significantly higher proportion in HITS-API felt they had some chance of getting HIV (90% versus 71%, RR=1.2, 95% CI=1.1-1.3). Almost twice as many HITS-API respondents as HITS-2000 respondents felt they had a low chance of getting HIV (62% versus 36%, RR=1.5,95%CI=1.3-1.7).

Excluding IDU, less than half of respondents in both surveys reported unsafe behavior in the previous year. IDU in HITS-API were less likely to report unsafe behavior than IDU in HITS-2000 (53% versus 71%, not statistically significant). HITS-API respondents were significantly less likely than HITS-2000 respondents to have ever been tested for HIV (70% versus 89%, RR=0.8, 95% CI=0.7-0.9). Less than half (47%) of HITS-API participants reported getting HIV (treating HIV infection when used along with other medicines) tested in the previous year, a significantly lower proportion than HITS-2000 participants (72%, RR=0.8, 95% CI=0.7-0.9). Thirty-two percent of HITS-API participants reported getting HIV tested on a regular basis, e.g., every six months or at the same time every year, significantly fewer than in HITS-2000 (46%, RR=0.7,95% CI=0.6-0.8).

Table 2. Percentages of Respondents Reporting HIV Testing Behavior, by Unsafe Behavior and Perceived Risk, HIV Testing Survey for Asians and Pacific Islanders (HITS-API) and HIV Testing Survey 2000 (HITS-2000)— Seattle, WA

HITS-API

HITS-2000
Testing in Past YearTesting in Past Year

Yes

NoYes                 No
Any unsafe behavior

48

5276                   24
No unsafe behavior

46

5469                   31
RR (95% CI)*

1.1 (0.8-1.5)

1.1 (0.9-1.3)
Any perceived risk

49

5170                   30
No perceived risk

25

7570                   30
RR (95% CI)*

1.8 (0.8-4.3)

1.0 (0.8-1.2)
High/Medium Risk      Low/No RiskHigh/Medium Risk  Low/No Risk
Any unsafe behavior

38

6257                   43
No unsafe behavior

22

7822                    78
RR (95% CI)*

1.7 (1.0-2.7)**

2.6 (1.8-3.8)**
* RR: relative risk, 95% CI: 95% confidence interval; ** p<0.05

For both surveys, there was no association between unsafe behavior and testing in the past year (Table 2). Forty-eight percent of HITS-API respondents reporting unsafe behavior were tested for HIV in the previous year. For both studies, no statistically significant associations were found between perceptions of HIV risk and testing in the previous year, but HITS-API respondents who perceived any chance of getting HIV were significantly less likely to be tested for HIV in the previous year relative to HITS-2000 respondents (49% versus 70%, RR=0.6, 95% CI=0.5-0.9). Both HITS-API and HITS-2000 respondents reporting unsafe behaviors were significantly more likely to perceive a medium-to-high chance of getting HIV than respondents not reporting unsafe behavior. However, only 38% of HITS-API participants who reported unsafe behaviors perceived a medium-to-high chance of getting HIV compared with 57% of HITS-2000 respondents (RR=0.7, 95% CI=0.5-0.9). buy vardenafil online

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