1 HIV/AIDS among Asians and Pacifi c Islanders, November 2004

HIV/AIDS among Asians 

and Pacifi c Islanders

Asians and Pacifi c Islanders account for less than 

1% of the total number of HIV/AIDS cases in the 

United States. However, in recent years, the number of AIDS diagnoses in this group has increased 

steadily. The Asian and Pacifi c Islander population in the United States is also growing [1].

STATISTICS

Cumulative Effects of HIV Infection 

and AIDS (through 2002)

• The estimated number of AIDS cases diagnosed among Asians and Pacifi c Islanders in 

the United States increased from 346 in 1998 

to 478 in 2002 [2].

• Through 2002, an estimated 6,924 Asians and 

Pacifi c Islanders had been given a diagnosis 

of AIDS. Among adults and adolescents with 

a diagnosis of AIDS, 87% were men and 13% 

were women [2].

• Through 2002, in 30 areas with long-term, 

confi dential name-based HIV reporting (see 

box, p. 3), an estimated 1,262 had a diagnosis 

of HIV infection or AIDS [2].

• Through 2002, AIDS was diagnosed for 59 

children (under 13 years of age) [2].

• Of persons given a diagnosis of AIDS since 

1994, a larger proportion of Asians and Pacifi c Islanders (69%) were alive 9 years after 

diagnosis, compared with 64% of whites, 61% 

of Hispanics, 58% of American Indians and 

Alaska Natives, and 55% of African Americans [2].

• The numbers of HIV and AIDS cases may 

be larger than reported because of underreporting or misclassifi cation of Asians and 

Pacifi c Islanders.

AIDS in 2002

• An estimated 400 men, 76 women, and 1 child 

(under 13 years of age) were given a diagnosis 

of AIDS [3].

• The rate of AIDS diagnosis, by race/ethnicity, 

was lowest for Asians and Pacifi c Islanders 

(4.9 per 100,000 adults and adolescents) [2].

• Less than 1% of the estimated 384,906 people 

living with AIDS in the United States were 

Asians and Pacifi c Islanders [2].

HIV/AIDS in 2002

• At the end of 2002, less than 1% of the estimated 281,931 persons living with HIV infection or AIDS in the 30 areas with long-term, 

confi dential name-based HIV reporting were 

Asians and Pacifi c Islanders [2].

• In these 30 areas, an estimated 147 adults and 

adolescents were given a diagnosis during 

2002 (80% men, 20% women) [3].

• For men and women, the largest estimated 

numbers of diagnoses were for those aged 

25–34 years, followed by those aged 35–44 

years [3].

Race/ethnicity of persons living with AIDS in 2002
 2 HIV/AIDS among Asians and Pacifi c Islanders, November 2004

RISK FACTORS AND BARRIERS 

TO PREVENTION

Sexual Risk Factors

Although Asians and Pacifi c Islanders account 

for less than 1% of AIDS cases reported nationally, subgroups in some metropolitan areas may 

be at high risk for HIV infection. In a study of 503 

Asian and Pacifi c Islander men who have sex with 

men (MSM), aged 18–29 years, in San Francisco, 

the overall HIV prevalence was nearly 3%. Being 

of Thai ethnicity, being born in the United States, 

being older, or having ever attended a “circuit 

party” or special MSM social event was associated with HIV infection. Of these 503 men, 48% 

reported having had unprotected anal intercourse 

during the past 6 months [4]. Also, the rates of 

sexually transmitted infections among these men 

were high [5].

Substance Abuse

According to a study of Filipino American methamphetamine users in the San Francisco Bay 

Area, methamphetamine use was strongly associated with HIV-related risk behaviors, including 

infrequent condom use, commercial sex activity, 

and low rates of HIV testing [6]. In a study of 

young Asian and Pacifi c Islander MSM, more than 

half used “party drugs,” including MDMA (3,4-

methylenedioxymethamphetamine, or “ecstasy”), 

inhaled nitrites, hallucinogens, crack, and amphetamines. The use of drugs and alcohol was associated with unprotected anal intercourse [7].

Cultural and Socioeconomic Diversity

Among Asians and Pacifi c Islanders, there are 

many nationalities—Chinese, Filipinos, Koreans, 

Hawaiians, Indians, Japanese, Samoans, Vietnamese, and others—and more than 100 languages 

and dialects. The subgroups differ in language, 

culture, and history. Because many are foreignborn, they experience cultural and language 

barriers to receiving public health messages. As a 

group, Asians and Pacifi c Islanders represent both 

extremes of socioeconomic and health issues. 

For example, although more than a million Asian 

Americans live at or below the federal poverty 

level, as a group, Asian American women have 

the longest life expectancy of any racial or ethnic 

group. Tailoring prevention interventions to meet 

the needs of this culturally and socioeconomically 

diverse population remains challenging [8].

Limited Access to, or Use of, Health 

Care and Prevention Services

Because of language and cultural barriers, lack 

of access to care, and other issues, many Asians 

and Pacifi c Islanders underuse health care and 

prevention services. A study of HIV service use 

among 653 Asians and Pacifi c Islanders showed 

that a relatively high proportion had advanced 

disease and used hospital-based services. Few of 

them used HIV case management services, housing assistance, substance use treatment, or health 

education services [9].

PREVENTION

The annual number of new HIV infections among 

all people in the United States declined from 

a peak of more than 150,000 cases in the mid1980s and has stabilized at approximately 40,000 

cases since the late 1990s. Minority populations 

are disproportionately affected by the HIV epidemic. To reduce further the incidence of HIV, 

CDC announced a new initiative, Advancing HIV 

Prevention (http://www.cdc.gov/hiv/partners/

ahp.htm), in 2003. This initiative comprises 4 

strategies: making HIV testing a routine part of 

medical care, implementing new models for diagnosing HIV infections outside medical settings, 

preventing new infections by working with HIVinfected persons and their partners, and further 

decreasing perinatal HIV transmission. 

Exposure category of Asian and Pacifi c Islander 

adults and adolescents with HIV/AIDS diagnosed 

in 2002
 3 HIV/AIDS among Asians and Pacifi c Islanders, November 2004

Understanding HIV and AIDS Data

In the United States, Asians and Pacifi c Islanders 

are emerging as an at-risk group. CDC is conducting demonstration projects on using social networks to reach high-risk persons in communities 

of color. Additionally, CDC’s Minority AIDS Initiative (http://www.cdc.gov/programs/hiv09.htm) 

explores the disparities in minority communities 

at high risk for HIV and what can be done to reduce those disparities. Examples of CDC-funded 

projects focused on the Asian and Pacifi c Islander 

population include prevention programs in New 

York City for young MSM, education and outreach programs in Philadelphia for those at risk 

for HIV infection, and prevention services in San 

Francisco for people of Filipino or Vietnamese 

descent and for Asian and Pacifi c Islander women. 

AIDS surveillance: Through a uniform system, CDC 

receives reports of AIDS cases from all US states and 

territories. Since the beginning of the epidemic, these 

data have been used to monitor trends because they 

are representative of all areas. The data are statistically 

adjusted for reporting delays and for the redistribution 

of cases initially reported without risk. As treatment has 

become more available, trends in new AIDS diagnoses 

no longer accurately represent trends in new HIV infections; these data now represent persons who are tested 

late in the course of HIV infection, who have limited 

access to care, or in whom treatment has failed.

HIV surveillance: Monitoring trends in the HIV 

epidemic today requires collecting information on 

HIV cases that have not progressed to AIDS. Areas 

with confi dential name-based HIV infection reporting requirements use the same uniform system for data 

collection on HIV cases as for AIDS cases. A total of 30 

areas―the US Virgin Islands and 29 states (Alabama, 

Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, 

Iowa, Louisiana, Michigan, Minnesota, Mississippi, 

Missouri, Nebraska, Nevada, New Jersey, New Mexico, 

North Carolina, North Dakota, Ohio, Oklahoma, South 

Carolina, South Dakota, Tennessee, Utah, Virginia, West 

Virginia, Wisconsin, and Wyoming)―have collected 

these data for at least 5 years, providing suffi cient data 

to monitor HIV trends and to estimate risk behaviors for 

HIV infection. Recently, 9 additional areas have begun 

confi dential name-based HIV surveillance, and data from 

these areas will be included in coming years.

HIV/AIDS: This term includes persons with a diagnosis of HIV infection (not AIDS), a diagnosis of HIV 

infection and a later diagnosis of AIDS, or concurrent 

diagnoses of HIV infection and AIDS.

REFERENCES

1. United States Bureau of the Census. The Asian 

population: 2000. Census 2000 Brief. Available at http://www.census.gov/prod/2002pubs/

c2kbr01-16.pdf. Accessed July 13, 2004.

2. CDC. HIV/AIDS Surveillance Report 2002;14:

1–40. Also available at http://www.cdc.gov/

hiv/stats/hasrlink.htm. Accessed July 8, 2004.

3. CDC. Cases of HIV infection and AIDS in the 

United States, by race/ethnicity, 1998–2002. 

HIV/AIDS Surveillance Supplemental Report 

2004;10(1):1–38. Also available at http://

www.cdc.gov/hiv/stats/hasrlink.htm. Accessed 

July 8, 2004.

4. Choi K, McFarland W, Neilands TB, et al. Low 

HIV prevalence but high sexual risk among 

young Asian-American men who have sex with 

men: HIV prevention opportunities. Presented at the XIV International Conference on 

AIDS; July 2002; Barcelona, Spain. Abstract 

MoPeC3434.

5. McFarland W, Chen S, Weide D, Kohn R, 

Klausner J. Gay Asian men in San Francisco 

follow the international trend: increases in 

rates of unprotected anal intercourse and sexually transmitted diseases, 1999–2002. AIDS 

Education and Prevention 2004;16:13–18.

6. Nemoto T, Operario D, Soma T. Risk behaviors of Filipino methamphetamine users in San 

Francisco: implications for prevention and 

treatment of drug use and HIV. Public Health 

Reports 2002;117(suppl 1):S30–S38.

7. Choi K, McFarland W, Chu PL, et al. Heavy 

“party” drug and polydrug use and associated 

sexual risk for HIV among young Asian men 
 4 HIV/AIDS among Asians and Pacifi c Islanders, November 2004

For more information . . .

CDC National STD & AIDS Hotlines

1-800-342-AIDS

Spanish: 1-800-344-SIDA

Deaf: 1-800-243-7889

CDC National Prevention

Information Net work

P.O. Box 6003

Rockville, MD 20849-6003

1-800-458-5231

Web Resources

NCHSTP: http://www.cdc.gov/nchstp/od/

nchstp.html

DHAP: http://www.cdc.gov/hiv

NPIN: http://www.cdcnpin.org

who have sex with men. Presented at the XIV 

International Conference on AIDS; July 2002; 

Barcelona, Spain. Abstract E10725.

8. CDC, Offi ce of Minority Health. Asian 

American populations. Available at http:

//www.cdc.gov/omh/Populations/AsianAm/

AsianAm.htm. Accessed May 13, 2004.

9. Pounds MB, Conviser R, Ashman JJ, Bourassa 

V. Ryan White CARE Act service use by 

Asian/Pacifi c Islanders and other clients in 

three California metropolitan areas (1997–

1998). Journal of Community Health 2002;27:

403–417.