Sexuality, HIV/Drug in 3 Groups of Asian/Gay/Bi Men/MSM

描述（由申请人提供）：本提案是对进一步了解在美国发生男男性行为（MSM）的亚裔美国人和太平洋岛民（AAPI）男性社会角色的需求的回应。在AAPI文化中，性取向的社会建构并不像欧美文化那样建立异性恋或同性恋取向的二分法。因此，亚裔男同性恋者可能会也可能不会认为自己是同性恋，也可能会也可能不会认为他们的性行为与他们的社会角色或性取向之间存在联系。社会角色或被感知的性取向在多大程度上与AAPI男同性恋者的污名、羞耻和丢脸有关，以及这些是否反过来与艾滋病毒相关的风险态度和做法有关，目前尚不清楚。此外，与男性发生性行为的污名化、羞耻感和丢脸感是否反过来影响了酒精、烟草和其他药物（ATOD）的使用，以及ATOD的使用/滥用与这一人群中更高的艾滋病毒风险之间的关系，都需要探讨。这项研究具有重要意义，因为与其他种族/民族的男同性恋者相比，亚太裔男同性恋者的累积艾滋病病例比例第二高（72%），仅比白人男同性恋者低两个百分点。按比例计算，2000年，亚太裔男同性恋者（53%）在艾滋病病例中排名第二，再次排在白人男同性恋者（62%）之后（疾病控制和预防中心，2001年）。因此，GWU SPHHS CHSRP与华盛顿特区的亚洲和太平洋岛民保健伙伴关系一起，提出了一项为期五年、分两阶段、混合方法（定性和定量）的研究，目的是：研究社会文化力量，如性观念、羞耻感或污名在性身份和性取向中扮演的角色，在一群自我认同的中国、菲律宾和越南同性恋/双性恋男性和男同性恋者中扮演的角色，年龄在18岁及以上，生活在华盛顿特区。2. 研究男性群体中与艾滋病毒相关的风险态度和行为中羞耻（或耻辱）与同性恋和双性恋之间的关系。3. 研究男性群体中使用/滥用ATOD的羞耻感（或污名）与同性恋和双性恋之间的关系。基于Wong和Edberg（2001）的三领域，概念性（即母国背景，移民/移民经验/历史和美国经验/情况）模型和方法设计，三(3)个具体目标将通过针对选定的一组变量的七(7)个研究问题进行检查。

DESCRIPTION (provided by applicant): This proposal is responsive to the need to further understand social roles among Asian American and Pacific Islander (AAPI) men who have sex with men (MSM) in the U.S. The social construction of sexuality in AAPI cultures does not establish the same dichotomy between heterosexual or homosexual orientation as European-American culture. Thus, AAPI MSM may or may not identify as gay, and may or may not perceive a connection between their sexual behavior and their social role or sexual orientation. The extent to which social roles or perceived sexual orientation are related to stigma, shame, and loss of face among AAPI MSM, and whether these are in turn related to HIV-related risk attitudes and practices is unclear. Moreover, whether the stigma, shame, and loss of face of having sex with men in turn influence use of alcohol, tobacco, and other drugs (ATOD) needs to be explored, as does the relation between ATOD use/abuse and higher risk for HIV in this population. This research is of great significance because, compared to MSM in other racial/ethnic groups, AAPI MSM have the second highest proportion of cumulative AIDS cases (72%) -- only two percentage points lower than white MSM. Proportionately, AAPI MSM (53%) rank second in number of AIDS cases in Year 2000, again after white MSM (62%), (Center for Disease Control and Prevention, 2001). The GWU SPHHS CHSRP, together with the Asian & Pacific Islander Partnership for Health, Washington, DC, therefore, proposes a five-year, two-phase, mixed approach (qualitative and quantitative) study to: 1. Examine socio-cultural forces such as sexual mores, shame, or stigma that play a role in sexual identity and orientation among a cohort of self-identified Chinese, Filipino, and Vietnamese gay/bisexual men and MSM ages 18 and above living in the metropolitan Washington, DC area. 2. Examine the relationship between shame (or stigma) and homosexuality and bisexuality in HIV-related risk attitudes and practices among the cohort of men. 3. Examine the relationship between shame (or stigma) and homosexuality and bisexuality in ATOD use/abuse among the cohort of men. Based on Wong and Edberg's (2001) three-domain, conceptual (i.e., home country background, migration/immigration experience/history, and U.S. experience/situation) model and methodological design, the three (3) Specific Aims will be examined by seven (7) research questions against a selected set of variables.