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

描述(由申请人提供)：这项建议是为了进一步了解美国亚裔美国人和太平洋岛民(AAPI)男男性行为者(MSM)的社会角色。AAPI文化中的性的社会结构并不像欧美文化那样在异性取向或同性恋取向之间建立相同的二分法。因此，AAPI MSM可能会或可能不会认为自己是同性恋，也可能会或可能不会感觉到他们的性行为与他们的社会角色或性取向之间的联系。AAPI男男性接触者中的社会角色或感知的性取向在多大程度上与耻辱、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行为有关尚不清楚。此外，与男性发生性关系的耻辱、羞耻和丢脸是否会影响酒精、烟草和其他药物(ATOD)的使用，以及ATOD的使用/滥用与该人群中艾滋病毒风险较高之间的关系，需要进行调查。这项研究意义重大，因为与其他种族/民族的MSM相比，AAPI MSM的累计艾滋病病例比例(72%)位居第二，仅比白人MSM低两个百分点。按比例计算，AAPI男男性接触者(53%)在2000年艾滋病病例数量上排名第二，再次排在白人MSM(62%)之后(疾病控制和预防中心，2001)。因此，GWU SPHHS CHSRP与华盛顿特区亚太岛民健康伙伴关系提出了一项为期五年、分两个阶段的混合方法(定性和定量)的研究：1.检验性习俗、羞耻感或耻辱等社会文化因素，这些因素在华盛顿特区18岁及以上的一群自认为是中国人、菲律宾人和越南同性恋/双性恋男性和男男性同性恋者中扮演着性认同和性取向的角色。2.审查男性队列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.审查在男性队列中使用/虐待吸毒者中羞耻(或耻辱)与同性恋和双性恋之间的关系。基于Wong和Edberg(2001)的三个领域的概念性(即母国背景、移民/移民经历/历史和美国经历/情况)模型和方法设计，三(3)个具体目标将通过七(7)个研究问题针对选定的一组变量进行检验。

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.