Abstract
We explored issues underlying sexual risk among young (ages 18-25) Asian and Pacific Islander (API) men who have sex with men (MSM). We conducted in-depth interviews with 40 young API MSM in San Diego and Seattle in 1997-98. Study participants were administered a 2-hour, semi-structured, open-ended interview. Detailed summaries of the taped interviews were transcribed and coded for themes. We identified 8 factors related to risky sexual behaviors: negative feelings about oneself, being “closeted,” trusting a partner in a relationship, wishing to please a partner, passion that overwhelms judgment, being high on alcohol or drugs, sexual attitudes in the gay and Asian communities, and the lack of support in Asian families. Seven major themes emerged as motivations for engaging in protective behavior: having a positive self-image, having conservative sexual values, living with one's parents, sexual attitudes in the gay and Asian communities, family values, overt urging by the family, and wishing to avoid hurting one's parents. The risk and protective factors affecting sexual behavior among young API MSM may be organized into five major types: individual, interpersonal, situational, family, and community. This typology of the motivations underlying risky and protective behavior may serve as the conceptual framework of a comprehensive prevention program that aims to modify behavior from different perspectives. Given the complex nature of human behavior, a multitiered intervention would be more likely to succeed than unidimensional or conventional programs targeting only personal attitudes and beliefs related to HIV.