CDC H IV/A IDS Fact Sheet

HIV/AIDS among

Asians and Pacific

Islanders

1-800-CDC-INFO (232-4636)

In English, en Español

24 Hours/Day

cdcinfo@cdc.gov

http://www.cdc.gov/hiv 

Revised August 2008

In recent years, the number of AIDS diagnoses 

among Asians and Pacific Islanders has increased 

steadily. Although Asians and Pacific Islanders 

account for approximately 1% of the total number 

of HIV/AIDS cases in the 33 states with longterm, confidential name-based HIV reporting, the 

Asian and Pacific Islander population in the United 

States is growing [1].

STATISTICS

HIV/AIDS in 2005 

(The following bullets are based on data from the 33 states 

with long-term, confidential name-based HIV reporting. For 

a list of the 33 states, see the box, before the References 

section.)

• An estimated 417 Asians and Pacific Islanders 

were given a diagnosis of HIV/AIDS, 

representing 1.1% of the 37,331 cases diagnosed 

that year [2].

• Of the 475,220 persons living with HIV/AIDS, 

2,996 (0.6%) were Asians and Pacific 

Islanders [2]. 

• Of those given a diagnosis, 78% were men, 21% 

were women, and 1% were children (under 13 

years of age) [2]. 

• The numbers of HIV/AIDS cases may be larger 

than reported because of underreporting or 

misclassification of Asians and Pacific Islanders.

Race/ethnicity of persons (including 

children) with HIV/AIDS diagnosed 

during 2005

Note. Based on data from 33 states with long-term, 

confidential name-based HIV reporting.

Transmission categories for Asian and 

Pacific Islander adults and adolescents 

living with HIV/AIDS, 2005

Note. Based on data from 33 states with long-term, 

confidential name-based HIV reporting.
H IV/A IDS among AS IANS AND PAC IF IC ISLANDERS

2

Transmission categories for Asians and 

Pacific Islander adults and adolescents 

living with HIV/AIDS, 2005 (cont.)

Note. Based on data from 33 states with long-term, 

confidential name-based HIV reporting.

AIDS in 2005 

(For information about AIDS surveillance, see the box, before 

the References section.)

• Of the estimated 483 Asians and Pacific 

Islanders who received an AIDS diagnosis in 

2005, 389 (81%) were men, and 92 (19%) were 

women. One Asian and Pacific Islander child 

(under 13 years of age) received a diagnosis of 

AIDS [2]. 

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

was lowest for Asians and Pacific Islanders 

(3.6 per 100,000 population), compared with 

54.1 per 100,000 for blacks (including African 

Americans), 18.0 per 100,000 for Hispanics, 7.4 

for American Indians and Alaska Natives, and 

5.9 per 100,000 for whites [2]. 

• An estimated 4,276 Asians and Pacific Islanders 

were living with AIDS, representing 1% of the 

421,873 people known to be living with AIDS in 

the 50 states and the District of Columbia [2].

• From the beginning of the epidemic through 

2005, an estimated 7,659 Asians and Pacific 

Islanders were given a diagnosis of AIDS [2]. 

• An estimated 97 Asians and Pacific Islanders 

with AIDS died in 2005. From the beginning of 

the epidemic through 2005, an estimated 3,383 

Asians and Pacific Islanders with AIDS died, 

representing less than 1% of the 530,756 persons 

in the 50 states and the District of Columbia who 

died with AIDS [2].

• Of persons given a diagnosis of AIDS during 

1997–2004, 81% of Asians and Pacific Islanders 

were alive 9 years after diagnosis, compared 

with 75% of whites, 74% of Hispanics, 67% of 

American Indians and Alaska Natives, and 66% 

of blacks [2].

Race/ethnicity of adults and adolescents 

living with HIV/AIDS, 2005

Note. Based on data from 33 states with long-term, 

confidential name-based HIV reporting.
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H IV/A IDS among AS IANS AND PAC IF IC ISLANDERS

RISK FACTORS AND BARRIERS 

TO PREVENTION

Although the proportion of diagnoses of HIV 

infection and AIDS for Asian and Pacific Islander 

adults and adolescents remains small relative to 

other racial/ethnic groups, no evidence indicates 

significantly lower levels of risk behaviors among 

this group [3, 4]. Asians and Pacific Islanders are 

likely to face challenges associated with the risk 

for HIV infection, especially in some regions of 

the country and for some specific ethnicities within 

the broader Asian and Pacific Islander group.

Sexual Risk Factors

Most of the Asians and Pacific Islanders who are 

infected with HIV are men who have sex with 

men (MSM) [2]. A cause for concern is research 

that points to rising levels of risk behaviors among 

Asian and Pacific Islander MSM in certain areas of 

the country, for example, indications that an HIV 

epidemic is emerging among young Asian and 

Pacific Islander MSM in San Francisco [5]. 

The findings of other studies support this concern. 

In a San Francisco study of 503 Asian and Pacific 

Islander MSM aged 18–29 years, the overall 

HIV prevalence was nearly 3%. This prevalence 

varied significantly by ethnicity, ranging from 0% 

for Vietnamese MSM to 13.6% for Thai MSM. 

Being of Thai ethnicity, having been 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 [6]. Another 

study conducted in San Francisco showed that the 

rates of unprotected anal intercourse and sexually 

transmitted diseases among young Asian and 

Pacific Islander MSM during 1999–2002 surpassed 

the rates for white MSM [7].

High-risk heterosexual contact is the primary way 

Asian and Pacific Islander women become infected 

with HIV [2]. In focus groups, Asian and Pacific 

Islander women noted cultural taboos against 

discussing sexual topics and power differentials 

between genders as reasons for difficulty in getting 

their partners to use condoms. Domestic violence 

is also a concern, as is lack of knowledge about 

HIV/AIDS and lack of culturally and linguistically 

appropriate HIV prevention programs and 

materials [8].

Substance Use

The use of methamphetamines and other drugs has 

been shown to be an important factor associated 

with unprotected anal intercourse among Asian 

and Pacific Islander MSM. According to a study 

of Filipino American methamphetamine users in 

the San Francisco Bay Area, methamphetamine 

use was strongly associated with behavioral risk 

factors for HIV infection, including infrequent 

condom use, commercial sex activity, and low 

rates of HIV testing [9]. In a study of young 

Asian and Pacific Islander MSM, more than 

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

methylenedioxymethamphetamine, or “ecstasy”), 

inhaled nitrates, hallucinogens, crack, and 

amphetamines. The use of drugs or alcohol was 

associated with unprotected anal intercourse [10].

Low HIV Testing Rates

HIV testing is an important consideration for 

Asians and Pacific Islanders. Testing rates are 

lower for Asians and Pacific Islanders as a group, 

despite their risk factors for HIV infection. Data 

from an HIV testing survey in Seattle indicated 

that of the Asians and Pacific Islanders surveyed, 

90% perceived themselves at some risk for HIV 

infection, yet only 47% had been tested during 

the past year [11]. Also, CDC’s Behavioral Risk 

Factor Surveillance System found that Asians and 

Pacific Islanders are significantly less likely than 

members of other races/ethnicities to report having 

been tested for HIV [12]. 

Low HIV testing rates also affect the stage of 

HIV disease at which diagnosis is made. CDC 

surveillance shows that for many Asians and 
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H IV/A IDS among AS IANS AND PAC IF IC ISLANDERS

Pacific Islanders, the diagnosis of HIV infection 

is made late in the course of disease. In 2004, 

44% of Asians and Pacific Islanders received an 

AIDS diagnosis within 1 year after their HIV 

infection was diagnosed. This is in comparison to 

37% of whites, 40% of blacks, 41% of American 

Indians/Alaska Natives, and 43% of Hispanics 

[2]. Increasing the number of Asians and Pacific 

islanders who are tested will allow those who are 

infected to begin health-sustaining treatment and 

can help to reduce further transmission of 

the virus.

A study that showed an increase in testing (from 

63% to 71%) between its first and fourth years 

(1999 to 2002) found that recent testing was most 

significantly and consistently associated with 

knowledge of testing sites to which respondents 

felt comfortable going [13]. This finding points 

to the importance of culturally and linguistically 

relevant health services.

Cultural and Socioeconomic 

Diversity

Among Asians and Pacific 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 

Asians and Pacific Islanders living in the United 

States are foreign-born, they may experience 

cultural and language barriers to receiving public 

health messages. Additionally, many health 

surveys are administered only in English and 

perhaps Spanish, a situation that may cause 

miscommunication or exclude Asians and Pacific 

Islanders who do not speak English. 

As a group, Asians and Pacific 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 ($20,650 for a family of 4 living in the 48 

contiguous states or the District of Columbia), 

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 [14, 15].

Data Limitations

The low number of HIV cases among Asians and 

Pacific Islanders may not reflect the true burden of 

the epidemic on this population. Not all states with 

large Asian and Pacific Islander populations have 

been conducting HIV surveillance long enough to 

be included in CDC’s surveillance. For example, 

California, where a large proportion of Asians and 

Pacific Islanders live, began HIV surveillance only 

during the past few years; thus, its HIV data are 

not included in CDC surveillance reports. 

Additionally, race/ethnicity misclassification 

in medical records may contribute to the 

underreporting of HIV/AIDS among Asians and 

Pacific Islanders [12].

Limited Use of Services

Because of language and cultural barriers, lack 

of access to care, and other issues, many Asians 

and Pacific Islanders underuse health care and 

prevention services. A study of the use of HIV 

services by 653 Asians and Pacific Islanders 

showed that a relatively high proportion had 

advanced disease and used hospital-based 

services. Few of them, however, used HIV 

case management services, housing assistance, 

substance use treatment, or health education 

services [16].

PREVENTION

CDC estimates that 56,300 new HIV infections 

occurred in the United States in 2006 [17]. 

Populations of minority races/ethnicities are 

disproportionately affected by the HIV epidemic. 

In the United States, Asians and Pacific Islanders 

are emerging as a group that is at risk for 

HIV infection.
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H IV/A IDS among AS IANS AND PAC IF IC ISLANDERS

To reduce the incidence of HIV, CDC released 

Revised Recommendations for HIV Testing 

of Adults, Adolescents, and Pregnant Women 

in Health-Care Settings in 2006. These 

recommendations advise routine HIV screening 

of adults, adolescents, and pregnant women in 

health care settings in the United States. They also 

address the need to reduce barriers to HIV testing. 

In 2003, CDC announced an initiative, Advancing 

HIV Prevention (http://www.cdc.gov/hiv/topics/

prev_prog/AHP). 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 HIV-infected persons and their partners, and 

further decreasing perinatal HIV transmission.

CDC, through the Minority AIDS Initiative 

(http://www.cdc.gov/programs/hiv08.htm) 

supports efforts to reduce the health disparities 

experienced in communities of persons of minority 

races/ethnicities who are at high risk for HIV 

infection. CDC provides funds to communitybased organizations that focus primarily on 

Asians and Pacific Islanders and provides 

indirect funding through state, territorial, and 

local health departments to organizations serving 

this population. An example of CDC-funded 

projects focused on the Asian and Pacific Islander 

population include an organization in New York 

City that provides client services, education, 

training, and technical assistance to Asian and 

Pacific Islander MSM who are at high risk, female 

and transgender sex workers, and female sex 

partners of men who are HIV-positive or at high 

risk for HIV infection.

Understanding HIV and AIDS Data

AIDS surveillance: Through a uniform system, CDC 

receives reports of AIDS cases from all US states and 

dependent areas. Since the beginning of the epidemic, 

these data have been used to monitor trends. The data 

are statistically adjusted for reporting delays and for 

the redistribution of cases initially reported without risk 

factors. 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 confidential name-based HIV infection reporting 

requirements use the same uniform system for data 

collection on HIV cases as for AIDS cases. A total 

of 33 states (Alabama, Alaska, Arizona, Arkansas, 

Colorado, Florida, Idaho, Indiana, Iowa, Kansas, 

Louisiana, Michigan, Minnesota, Mississippi, Missouri, 

Nebraska, Nevada, New Jersey, New Mexico, New 

York, North Carolina, North Dakota, Ohio, Oklahoma, 

South Carolina, South Dakota, Tennessee, Texas, Utah, 

Virginia, West Virginia, Wisconsin, and Wyoming) 

have collected these data for at least 5 years, providing 

sufficient data to monitor HIV trends and to estimate 

risk behaviors for HIV infection. 

HIV/AIDS: This term is used to refer to 3 categories of 

diagnoses collectively: (1) a diagnosis of HIV infection 

(not AIDS), (2) a diagnosis of HIV infection and a later 

diagnosis of AIDS, and (3) concurrent diagnoses of 

HIV infection and AIDS.
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H IV/A IDS among AS IANS AND PAC IF IC ISLANDERS

REFERENCES

1. US Census Bureau. The Asian population: 2000. Census 

2000 Brief. Available at http://www.census.gov/prod/

2002pubs/c2kbr01-16.pdf. Accessed April 30, 2007. 

2. CDC. HIV/AIDS Surveillance Report, 2005. Vol. 17. 

Rev ed. Atlanta: US Department of Health and Human 

Services, CDC: 2007:1–46. Available at http://www.cdc.

gov/hiv/topics/surveillance/resources/reports/. Accessed 

June 28, 2007.

3. Hou S-I, Basen-Engquist K. Human immunodeficiency 

virus risk behavior among white and Asian/Pacific 

Islander high school students in the United States: does 

culture make a difference? Journal of Adolescent Health

1997;20:68–74. 

4. Peterson JL, Bakeman R, Stokes J, and the Community 

Intervention Trial for Youth Study Team. Racial/ethnic 

patterns of HIV sexual risk behaviors among young men 

who have sex with men. Journal of the Gay and Lesbian 

Medical Association 2001;5:155–162.

5. Raymond HF, Chen S, Truong H-H, et al. Trends in 

sexually transmitted diseases, sexual risk behavior, and 

HIV infection among Asian/Pacific Islander men who 

have sex with men, San Francisco 1999–2005. Sexually 

Transmitted Diseases. Published online, 

August 28, 2006.

6. Choi K, McFarland W, Neilands TB, et al. Low HIV 

prevalence but high sexual risk among young AsianAmerican men who have sex with men: HIV prevention 

opportunities. XIV International Conference on AIDS; 

July 2002; Barcelona, Spain. Abstract MoPeC3434. 

7. 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. 

8. Jemmott LS, Maula EC, Bush E. Hearing our voices: 

assessing HIV prevention needs among Asian and 

Pacific Islander women. Journal of Transcultural 

Nursing 1999;10:102–111.

9. 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. 

10. Choi K, McFarland W, Chu PL, et al. Heavy “party” 

drug and polydrug use and associated sexual risk for 

HIV among young Asian men who have sex with men. 

XIV International Conference on AIDS; July 2002; 

Barcelona, Spain. Abstract E10725. 

11. Kahle EM, Freedman MS, Buskin SE. HIV risks and 

testing behavior among Asians and Pacific Islanders: 

results of the HIV Testing Survey, 2002–2003. Journal 

of the National Medical Association 2005;97:13S–18S. 

12. Zaidi IF, Crepaz N, Song R, et al. Epidemiology of HIV/

AIDS among Asians and Pacific Islanders in the United 

States. AIDS Education and Prevention 2005;17:

405–417. 

13. Do TD, Hudes ES, Proctor K, Han C-S, Choi K-H. HIV 

testing trends and correlates among young Asian and 

Pacific Islander men who have sex with men in two U.S. 

cities. AIDS Education and Prevention 2006;18:44–55.

14. CDC, Office of Minority Health. Asian American 

populations. Available at http://www.cdc.gov/omh/

Populations/AsianAm/AsianAm.htm. Accessed 

April 30, 2007.

15. US Department of Health and Human Services. The 

2007 HHS poverty guidelines. Available at http://aspe.

hhs.gov/poverty/07poverty.shtml. Accessed 

April 30, 2007.

16. Pounds MB, Conviser R, Ashman JJ, Bourassa V. Ryan 

White CARE Act service use by Asian/Pacific Islanders 

and other clients in three California metropolitan 

areas (1997–1998). Journal of Community Health

2002;27:403–417.

17. Hall HI, Ruiguang S, Rhodes P, et al. Estimation 

of HIV incidence in the United States. JAMA. 

2008;300:520-529.

For more information . . . 

CDC HIV/AIDS

http://www.cdc.gov/hiv

CDC HIV/AIDS resources

CDC-INFO

1-800-232-4636

Information about personal risk and where to get 

an HIV test

CDC National HIV Testing Resources

http://www.hivtest.org

Location of HIV testing sites

CDC National Prevention Information 

Network (NPIN)

1-800-458-5231

http://www.cdcnpin.org

CDC resources, technical assistance, and publications

AIDSinfo

1-800-448-0440

http://www.aidsinfo.nih.gov

Resources on HIV/AIDS treatment and 

clinical trials