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Instruments to measure HIV stigma in people living with HIV in the United States or in Asia may not be sensitive enough to capture the stigma experienced by Asians living with HIV (ALWH) in the United States. Our purpose was to adapt the shortened Berger Stigma Scale to be culturally appropriate for ALWH in the United States. We conducted a mixed-method study (i.e., five in-depth face-to-face interviews, six subject matter expert reviews, two focus groups [n = 11]) to generate new scale items and a cross-sectional survey (n = 67) to evaluate the psychometric properties of the adapted scale called Stigma Scale for ALWH. The scale contains 13 items with three subscales (personalized stigma/disclosure, negative self-image, public attitude) with good reliability (α = 0.92 overall) and validity. We describe the Stigma Scale for ALWH that is culturally appropriate to measure HIV stigma experienced by ALWH in the United States.

Instruments to measure HIV stigma in people living with HIV in the United States or in Asia may not be sensitive enough to capture the stigma experienced by Asians living with HIV (ALWH) in the United States. Our purpose was to adapt the shortened Berger Stigma Scale to be culturally appropriate for ALWH in the United States. We conducted a mixed-method study (i.e., five in-depth face-to-face interviews, six subject matter expert reviews, two focus groups [n = 11]) to generate new scale items and a cross-sectional survey (n = 67) to evaluate the psychometric properties of the adapted scale called Stigma Scale for ALWH. The scale contains 13 items with three subscales (personalized stigma/disclosure, negative self-image, public attitude) with good reliability (α = 0.92 overall) and validity. We describe the Stigma Scale for ALWH that is culturally appropriate to measure HIV stigma experienced by ALWH in the United States.

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 acculturation and reducing depression to achieve self-actualization.

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 acculturation and reducing depression to achieve self-actualization.

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.

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.

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.

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. © 2014 © 2014 Taylor & Francis.

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.

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.