Sexual Attitudes, Reasons for Forgoing Condom Use, and the Influence of Gender Power among Asian-American Women: A Qualitative Study

Authors: Hyeouk Chris Hahm, Christina H Lee, Ja-yoon “Uni” Choe, Anna Ward, and Lena Lundgren.

This article is a qualitative study that examines the influence of gender power on sexual attitudes, HIV-risk behaviors and reasons for forgoing condom use.

This article is accessible for free at PubMed Central and as a PDF.


Background and purpose

HIV/AIDS prevalence among Asian-American Pacific Islanders (APIs) is low yet rapidly increasing. Prior research from other populations indicates that HIV risk behaviors are associated with specific adverse/risk factors including depression, drug use, history of child sexual abuse, and forced sex. However, no studies have explored the attitudes about sexual risk behaviors and condom use between API women with adverse experiences versus women without such experiences. This qualitative study compares descriptions of sexual history and condom use between the two groups of women.


A random sample of 24 sexually active API women (16 in the adverse group and 8 in the non-adverse group) was selected for in-depth interviews from a larger study, which included 501 Korean, Chinese, and Vietnamese survey participants.


14 out of the 16 women in the adverse group described complex sexual histories, with greater number of partners, more casual partners, and the combined use of alcohol/drugs and sex. The 8 women in the non-adverse group had fewer partners who were more long term. However, for both groups of women, condom use was inconsistent. Also, the majority of the women in both groups reported that either they themselves or they together with their partners had decided whether or not to use condoms. Yet 4 women in the adverse group showed lower gender power, with their partners being the primary decision-maker for condom use.


Given the inconsistent condom use for both groups, all women in this study were at risk for HIV/AIDS. Consistent with prior research, a sub-group of the women in the adverse group with lower gender power seemed particularly at higher risk. Future HIV prevention interventions need to target all API women while screening for lower gender power to identify those with the highest risk of HIV.