Substance Use/HIV in 3 DC Southeast Asian Communities

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Very little data exist on substance use/abuse and HIV- related risk practices among Southeast Asian population in the U.S. George Washington University School of Public Health and Health Services' Center for Health Services Research and Policy, Development Services Group, Inc., and the Center for Applied Linguistics are, therefore, proposing to conduct a study to investigate the characteristics, prevalence and cultural context of substance use/abuse and HIV-related risk practices among the Vietnamese, Cambodian, and Laotian communities of the Washington, DC metropolitan area. The study will combine ethnographic qualitative strategies with quantitative approaches in order to provide data on both risk practices (behavior) and the socio- cultural framework in which these practices are embedded. Three culturally (competent) modified and translated (Vietnamese, Khmer, and Lao) versions of the quantitative instrument will be developed - composed of elements from the National Household Survey on Drug Abuse, together with questions taken from Centers for Disease Control and Prevention's Behavioral Risk Factor Survey, National Institute on Drug Abuse's Risk Behavior Assessment, and from an instrument developed in an ongoing federally funded demonstration study targeting Asian immigrants and refugees living with AIDS/HIV - for use in person and with audio-enhanced computer and self-administered interview (AUDIO- CASI) technology in order to minimize under-reporting. Acculturation and stress/well-being measures will be added to the survey. The qualitative component will include participant observation, focus groups, and extended qualitative interviews concerning culturally-specific attitudes, beliefs and social patterns surrounding substance use/abuse and HIV-related risk practices. Both general population and targeted sub-samples will be included in the study. Comparisons will be made between and within the three national/ethnic groups. Six research questions will be examined in which substance use/abuse and HIV-related risk practices among and within the three targeted Southeast Asian populations are assessed against the following variables: ethnic/national group; date and character of immigration; socioeconomic status; degree of acculturation; cultural proscription concerning shameful behavior; generation/age; birthplace (U.S./not U.S.); (for youth) participation in a gang; and social marginality.