Search

Asian immigrants in the U.S. are far less likely to have health insurance or use health care services than both U.S.-born Asians and non-Hispanic Whites. Furthermore, Asian immigrants who access the U.S. health care system are less likely than non-Hispanic Whites to receive high-quality services. This paper reviews four barriers faced by Asian immigrants to participating in the U.S. health care system fully: (1) linguistic discordance between providers and patients; (2) health-related beliefs and cultural incompetency of health systems; (3) issues related to accessing health services; and (4) discrimination in the health care system. Interventions to improve the health of Asian immigrants must address barriers experienced at multiple levels, including those that occur interpersonally and institutionally, as well as broader societal factors that affect health care access and quality.

This study examined the influence of experiences of racism, homophobia, and anti-immigrant discrimination on depressive symptoms and HIV risk among a sample of Asian and Pacific Islander (A&PI) gay men (N = 192). In addition, the potential protective influences of conversations about discrimination with gay friends and with family were explored. These men reported high rates of depressive symptoms (45% above the clinical cutoff on the Center for Epidemiological Studies-Depression scale) as well as HIV risk behavior (31% reporting at least one episode of unprotected anal intercourse (UAI) in the last 3 months). Controlling for income, ethnicity, age, and relationship status, experiences of racism were associated with higher levels of depressive symptoms, and experiences of anti-immigrant discrimination were associated with higher rates of secondary-partner UAI. Conversations about discrimination with gay friends and with family were associated with lower levels of primary-partner UAI. The combination of low levels of discussion with family about discrimination with high levels of experienced discrimination (of all three types) was associated with higher rates of UAI. Implications for mental health and HIV prevention interventions for A&PI gay men are discussed.