Contextualization of HIV and HPV risk and prevention among Pacific Islander young adults in Southern California

Abstract

HIV and sexually transmitted human papillomavirus (HPV) are associated with each other and with the development of comorbid cancer. Current epidemiology indicates that among Pacific Islanders in the United States, young adults are at highest risk of HIV and HPV. In our inductive community based participatory research study, we used focus groups and key informant interviews (March – August 2010) with young adults, parents, community leaders, and providers (n = 95) to identify and contextualize factors that shape HIV and HPV risk and prevention among young adults in Chamorro and Tongan communities in Southern California. We identified nine themes that incorporated the following principal factors: misinformation and otherization; dominant concerns regarding premarital pregnancy; restricted intergenerational communication; family shame and privacy; gendered manifestations of religio-cultural norms; barriers impeding access to sexual health resources; parents’ role in prevention; community vs. individual responsibility; and family and ethnic pride. Our thematic findings fit well with Rhodes’ “risk and enabling environment” heuristic (2009), which we used to contextualize risk and prevention at micro and macro levels of physical, social, economic, and policy environments. We propose the addition of a separate cultural environment to the heuristic and conclude that a focus on applying individual and community agency at the micro-level would be an approachable starting point for intervention for our local Pacific Islander communities and groups in similar ecological contexts globally. Enhanced community-led education programs and engagement of religious and other community leaders to facilitate intergenerational communication could counteract taboos that obstruct prevention.

Samoan migrants’ perspectives on diabetes: A qualitative study

“…18 Reluctance to engage with health care providers has been described in relation to other health problems that are viewed as stigmatising and risking family reputation in Pacific communities. 19 A diagnosis of diabetes could be a threat to self-pride and to their standing in the community for the men in our study. Men with diabetes have emphasised the importance of being active and economically independent to their overall health.…”

“…Shame and a feeling of failure can be a barrier to help‐seeking for those with diabetes, resulting in denial of the condition as well as reluctance to disclose their diagnosis to family members, especially amongst men . Reluctance to engage with health care providers has been described in relation to other health problems that are viewed as stigmatising and risking family reputation in Pacific communities …”

Awareness of Human Papillomavirus (HPV) Infection among Indigenous Males in North America and Oceania

“…Analysis of the methodologies of the selected papers indicated that most of the researchers (ten out of fourteen) adopted a qualitative approach (Dela Cruz et al, 2016;Devries et al, 2010;DiStefano et al, 2012;2013;Henderson et al, 2018;Hodge, 2014;Itty et al, 2014;Nonzee et al, 2018;Soon et al, 2015); three were based on quantitative analysis (Dwojak et al, 2015;Gabster et al, 2019;Tom et al, 2016); and one had a mixed-methods approach (Hodge et al, 2011).…”

A scoping review: The utility of participatory research approaches in psychology

“…These teams typically relied on regular contact (i.e., meetings, conferences, and focus groups) to discuss and resolve challenges in research design and at other stages of the projects. The formation of advisory groups, comprised of both academic and community participants, was common in research with Indigenous Peoples (e.g., McWhirter, Mununggirritj, Marika, Dickinson, & Condon, ; Novins et al, ; Palacios & Kennedy, ; Richards & Mousseau, ; Smith, Christopher, & McCormick, ), HIV/AIDS‐focused studies (e.g., Abelsohn et al, ; Andrasik et al, ; Baptiste et al, ; Burkhalter et al, ; DiStefano et al, ; Nyamathi et al, ; Vallely et al, ), and research with older adults (e.g., Guo & Phillips, ; Klemm, Rempusheski, & Teixeira, ; Ottmann, Laragy, Allen, & Feldman, ; Perry & Ziemba, ; Scharlach & Sanchez, ; West & Graham, ; Wethington et al, ). These efforts were sometimes described as attempts to address inherent power imbalances between university researchers and participants (e.g., Tobias, Richmond & Luginaah, ).…”

“…McWhirter, Mununggirritj, Marika, Dickinson, & Condon, 2012;Novins et al, 2012;Palacios & Kennedy, 2010;Richards & Mousseau, 2012;Smith, Christopher, & McCormick, 2004), HIV/AIDS-focused studies (e.g., Abelsohn et al, 2015;Andrasik et al, 2012;Baptiste et al, 2006;Burkhalter et al, 2013;DiStefano et al, 2012;Nyamathi et al, 2004;Vallely et al, 2009), and research with older adults (e.g., Guo & Phillips, 2006;Klemm, Rempusheski, & Teixeira, 2013;Ottmann, Laragy, Allen, & Feldman, 2011;Perry & Ziemba, 2014;Scharlach & Sanchez, 2011;West & Graham, 1999;Wethington et al, 2007). These efforts were sometimes described as attempts to address inherent power imbalances between university researchers and participants (e.g., Tobias, Richmond & Luginaah, 2013).…”