Revising the American dream: how Asian immigrants adjust after an HIV diagnosis

Abstract

Aim We explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population. Background Asians and Pacific Islanders are among the fastest growing minority groups in the US. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate. Design A mixed-methods study was conducted. Methods Thirty in-depth interviews were conducted with HIV-positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross-sectional audio computer-assisted self-interviews were conducted with a sample of 50 HIV-positive Asians and Pacific Islanders. Content analysis was used to analyze the in-depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self-actualization. The study took place from January - June 2013. Discussion Major themes were extracted from the interview data, including self-actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self-actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self-actualization and those who believed they could still achieve their ‘American dreams’. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self-actualize and those who still believed they could ‘make their dreams come true.’ Conclusion Acculturation levels influence depression and self-actualization in the HIV-positive Asians and Pacific Islanders population. Lower-acculturated Asian Americans achieved a lower degree of self-actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self-actualization.

Involving immigrant religious organizations in HIV/AIDS prevention: The role of bonding and bridging social capital

“…Among the undocumented, who are more likely to be men migrating without their families, their HIV risk increases en route to the United States via sexual contact with high risk partners or through drug use (Achkar et al, 2004; Chin et al, 2007a, 2007b; Joint United Nations Programme on HIV/AIDS (UNAIDS), 2013). Second, many face significant environmental and behavioral risk factors after arriving in the United States, such as high rates of poverty, low rates of education, low levels of HIV/AIDS knowledge and testing, limited access to medical care, and high levels of risky behaviors (Bhattacharya, 2004; Chen et al, 2015; Chin et al, 2007a; Kang et al, 2005, 2000; Zaidi et al, 2005). Beyond the individual level, HIV/AIDS stigma among Chinese immigrants remains persistent (Chen et al, 2015; Kang et al, 2005).…”

“…Second, many face significant environmental and behavioral risk factors after arriving in the United States, such as high rates of poverty, low rates of education, low levels of HIV/AIDS knowledge and testing, limited access to medical care, and high levels of risky behaviors (Bhattacharya, 2004; Chen et al, 2015; Chin et al, 2007a; Kang et al, 2005, 2000; Zaidi et al, 2005). Beyond the individual level, HIV/AIDS stigma among Chinese immigrants remains persistent (Chen et al, 2015; Kang et al, 2005). This stigmatization has consequences that increase HIV/AIDS risk, including delays in HIV testing and care (Bhattacharya, 2004; Kang et al, 2011), marginalization and isolation of individuals living with HIV/AIDS (Chen et al, 2015; Chin et al, 2005), increased mental illness due to stress and a heightened sense of shame (Chin et al, 2007b; Kang et al, 2005), and lost opportunities for prevention education (Kang et al, 2000).…”

“…Beyond the individual level, HIV/AIDS stigma among Chinese immigrants remains persistent (Chen et al, 2015; Kang et al, 2005). This stigmatization has consequences that increase HIV/AIDS risk, including delays in HIV testing and care (Bhattacharya, 2004; Kang et al, 2011), marginalization and isolation of individuals living with HIV/AIDS (Chen et al, 2015; Chin et al, 2005), increased mental illness due to stress and a heightened sense of shame (Chin et al, 2007b; Kang et al, 2005), and lost opportunities for prevention education (Kang et al, 2000). …”

Facilitators of and barriers to HIV self-management: Perspectives of HIV-positive women in China

“…For women who did not have a child or who had adult children, as they brought their HIV under control, they redefined the meaning of life and even, in some cases, considered finding a partner (Cahill & Valadez, 2013; Chen et al, 2015). However, even when their HIV was under control, the women worried that they would be considered “abnormal” or worried about infecting any future partner they might find (Zhou, 2008).…”

Life priorities in the HIV-positive Asians: a text-mining analysis in young vs. old generation

“…In this study, several in-depth interviews conducted among Chinese, Taiwanese, and Asians in San Francisco were combined to form a large qualitative dataset (Chen, 2013; Chen et al, 2013, 2015). Although Asians reflect diverse backgrounds, many of them follow similar cultural norms, especially with strong family values (Asian & Pacific Islander Wellness Center, 2011).…”