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Cardiovascular disease (CVD) and acute coronary syndrome (ACS) have become major health concerns for people living with HIV (PLWH) as life expectancy has increased with antiretroviral therapy. Studies suggest that motivation to seek health care is associated with knowledge, self-efficacy to engage in the health care system, and self-perceived risks for CVD and ACS. Using cross-sectional data collected from 67 un-/under-insured Asian PLWH in California, we explored the levels of knowledge about CVD, self-efficacy for recognizing ACS symptoms and seeking health care, and self-perceived risk for CVD and ACS, and how HIV stigmatization and acculturation predict these three constructs. Our sample had limited knowledge and low self-perceived risk but had high self-efficacy. Stigmatization was negatively correlated with self-efficacy (p = .004) and acculturation was a positive predictor of knowledge (p = .013). Economically vulnerable Asian PLWH need culturally appropriate interventions to improve their knowledge and self-perceived risks for CVD and ACS.

Cardiovascular disease (CVD) and acute coronary syndrome (ACS) have become major health concerns for people living with HIV (PLWH) as life expectancy has increased with antiretroviral therapy. Studies suggest that motivation to seek health care is associated with knowledge, self-efficacy to engage in the health care system, and self-perceived risks for CVD and ACS. Using cross-sectional data collected from 67 un-/under-insured Asian PLWH in California, we explored the levels of knowledge about CVD, self-efficacy for recognizing ACS symptoms and seeking health care, and self-perceived risk for CVD and ACS, and how HIV stigmatization and acculturation predict these three constructs. Our sample had limited knowledge and low self-perceived risk but had high self-efficacy. Stigmatization was negatively correlated with self-efficacy (p = .004) and acculturation was a positive predictor of knowledge (p = .013). Economically vulnerable Asian PLWH need culturally appropriate interventions to improve their knowledge and self-perceived risks for CVD and ACS.

Background: Asian Pacific Islander is the only racial group which significantly increased in estimated annual percentage of HIV newly diagnosed individuals between 2001-2008. As rates of HIV infection rise in the Asians population, it is important for us to increase our understanding about what facilitates HIV infection in this population and to focus on decreasing HIV related morbidity and mortality. Stigma, an important concept in the field of international HIV research, is increasingly being associated with access to prevention, care, and treatment outcomes in the population of people living with HIV in the US. Objective: The purposes of my dissertation study were: (1) to report on the steps taken to develop a HIV stigma scale that are relevant for Asians living with HIV (ALH) and test the psychometric properties of the scale; (2) to assess the level of stigma experienced by ALH by using the scale and explore the association to the acculturation and self-rated general health in a sample of ALH; and (3) to explore the level of knowledge, attitudes, and self-perceived risk of cardiovascular disease (CVD) and acute coronary syndrome (ACS) in a sample of ALH and how these factors are influenced by the stigma.Methods: This study used a convenience sample comprised 83 ALH from November 2010 to June 2013 (n=5 in face-to-face interviews, n=11 in focus groups, and n=67 in cross-sectional study). Results: This study developed the first HIV stigma scale culturally adapted to ALH and found the HIV stigma was often experienced by ALH and negatively associated to acculturation and health outcomes. Also, the study sample had limited knowledge of, positive attitude toward, and low self-perceived risk regarding CVD and ACS. HIV stigmatization was independently correlated with attitude; acculturation was an independent predictor of level of knowledge. Conclusions: Such a high level of HIV stigma experienced by ALH, poor knowledge, positive attitude, and low self-perceived risk of

Background: Asian Pacific Islander is the only racial group which significantly increased in estimated annual percentage of HIV newly diagnosed individuals between 2001-2008. As rates of HIV infection rise in the Asians population, it is important for us to increase our understanding about what facilitates HIV infection in this population and to focus on decreasing HIV related morbidity and mortality. Stigma, an important concept in the field of international HIV research, is increasingly being associated with access to prevention, care, and treatment outcomes in the population of people living with HIV in the US. Objective: The purposes of my dissertation study were: (1) to report on the steps taken to develop a HIV stigma scale that are relevant for Asians living with HIV (ALH) and test the psychometric properties of the scale; (2) to assess the level of stigma experienced by ALH by using the scale and explore the association to the acculturation and self-rated general health in a sample of ALH; and (3) to explore the level of knowledge, attitudes, and self-perceived risk of cardiovascular disease (CVD) and acute coronary syndrome (ACS) in a sample of ALH and how these factors are influenced by the stigma.Methods: This study used a convenience sample comprised 83 ALH from November 2010 to June 2013 (n=5 in face-to-face interviews, n=11 in focus groups, and n=67 in cross-sectional study). Results: This study developed the first HIV stigma scale culturally adapted to ALH and found the HIV stigma was often experienced by ALH and negatively associated to acculturation and health outcomes. Also, the study sample had limited knowledge of, positive attitude toward, and low self-perceived risk regarding CVD and ACS. HIV stigmatization was independently correlated with attitude; acculturation was an independent predictor of level of knowledge. Conclusions: Such a high level of HIV stigma experienced by ALH, poor knowledge, positive attitude, and low self-perceived risk of

Substance use among people living with HIV is high, and screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach to addressing the issue. We examined whether patients would participate in a technology-based SBIRT program in an urban HIV clinic. An SBIRT intervention was programmed into the clinic's web-based patient portal linked to their personal health record. We examined: demographic, health, HIV, and substance use characteristics of participants who completed the web-based intervention compared to those who did not. Fewer than half of the 96 participants assigned to the web-based SBIRT completed it (n = 39; 41 %). Participants who completed the web-based intervention had significantly higher amphetamine SSIS scores than those who did not complete the intervention. Participants whose substance use is more harmful may be more motivated to seek help from a variety of sources. In addition, it is important that technology-based approaches to behavioral interventions in clinics take into consideration feasibility, client knowledge, and comfort using technology.

AimWe explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population.BackgroundAsians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate.DesignA mixed-methods study was conducted.MethodsThirty 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 analyse 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.DiscussionMajor 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.'ConclusionAcculturation 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 ac

Substance use among people living with HIV is high, and screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach to addressing the issue. We examined whether patients would participate in a technology-based SBIRT program in an urban HIV clinic. An SBIRT intervention was programmed into the clinic's web-based patient portal linked to their personal health record. We examined: demographic, health, HIV, and substance use characteristics of participants who completed the web-based intervention compared to those who did not. Fewer than half of the 96 participants assigned to the web-based SBIRT completed it (n = 39; 41 %). Participants who completed the web-based intervention had significantly higher amphetamine SSIS scores than those who did not complete the intervention. Participants whose substance use is more harmful may be more motivated to seek help from a variety of sources. In addition, it is important that technology-based approaches to behavioral interventions in clinics take into consideration feasibility, client knowledge, and comfort using technology.

AimWe explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population.BackgroundAsians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate.DesignA mixed-methods study was conducted.MethodsThirty 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 analyse 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.DiscussionMajor 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.'ConclusionAcculturation 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 ac

Asians and Pacific Islanders (API) are among the fastest growing minority groups within the USA, and this growth has been accompanied by an increase in HIV incidence. Between 2000 and 2010, the API HIV infection rate increased from 4.5% to 8.7%; however, there is a paucity of HIV-related research for this group, and even less is known about the prevalence and correlates of antiretroviral therapy adherence behavior, quality of life, impact of stress, and efficacious self-management among HIV+ API Americans. This paper examines how acculturation and perceived stress affect depression symptomatology and treatment seeking in the HIV+ API population. A series of cross-sectional audio computer-assisted self-interviews were conducted with a convenience sample of 50 HIV+ API (29 in San Francisco and 21 in New York City). The relationship between acculturation and perceived stress was analyzed, and the results indicate that for those HIV+ API who reported low or moderate acculturation (as compared to those who reported high acculturation), stress was significantly mediated by depression symptomology. Interventions to address acculturation and reduce perceived stress among API generally and Asians specifically are therefore needed.

Asians and Pacific Islanders (API) are among the fastest growing minority groups within the USA, and this growth has been accompanied by an increase in HIV incidence. Between 2000 and 2010, the API HIV infection rate increased from 4.5% to 8.7%; however, there is a paucity of HIV-related research for this group, and even less is known about the prevalence and correlates of antiretroviral therapy adherence behavior, quality of life, impact of stress, and efficacious self-management among HIV+ API Americans. This paper examines how acculturation and perceived stress affect depression symptomatology and treatment seeking in the HIV+ API population. A series of cross-sectional audio computer-assisted self-interviews were conducted with a convenience sample of 50 HIV+ API (29 in San Francisco and 21 in New York City). The relationship between acculturation and perceived stress was analyzed, and the results indicate that for those HIV+ API who reported low or moderate acculturation (as compared to those who reported high acculturation), stress was significantly mediated by depression symptomology. Interventions to address acculturation and reduce perceived stress among API generally and Asians specifically are therefore needed.

PurposeThe purpose of the study was to explore and understand knowledge and attitudes about food, diet, and weight control, focusing on barriers and motivators to reduce risk of developing type 2 diabetes.MethodsSix focus groups were conducted in May and June 2010. The groups were stratified by sex. A total of 35 ethnically diverse samples with a high risk for type 2 diabetes participated. The average age was 51 ± 10.6 years, and 57% of the sample represented women.ResultsFour themes emerged from the focus groups: (1) demonstrated knowledge and source of knowledge, including participants' basic understanding of "good" and "bad" food and what constitutes a "healthy diet" and trusted sources of information; (2) perceptions of food and diet, encompassing how participants expressed their perception of and interaction with food and diet; (3) sense of control over dietary intake, reflecting participants' discussion of their perceived ability to control their eating patterns and food choices; and (4) eating behaviors, describing participants' patterns of eating and perceived barriers to eating a healthy diet.ConclusionsStudy findings demonstrate that eating healthy requires a complex interaction between individual perceptions of food and sense of control over eating patterns and sociopolitical and economic structural factors that restrict healthy eating options while promoting unhealthy ones. Programs for long-term eating behavioral change necessary to reduce type 2 diabetes and obesity need to incorporate strategies that address individual-level factors of perception of food and sense of control over eating patterns, as well as structural level factors such as poverty and food insecurity.