摘要：Objectives . We examined ethnic variations in high-risk sexual behaviors among Asian and Pacific Islander (API) adolescents in comparison with White adolescents. Methods . We obtained data from the 2003 Hawaii Youth Risk Behavior Survey on 4953 students in grades 9 through 12. We conducted χ2 and logistic regression analyses on these data to examine the prevalence of high-risk sexual behaviors among Japanese, Filipino, Native Hawaiian, and White adolescents. Results . We found significant ethnic variation in prevalence of high-risk sexual behaviors among API adolescents. Relative to White adolescents, Native Hawaiian adolescents were most likely to engage in lifetime sexual intercourse, recent sexual intercourse, and sexual initiation before age 13 years; Japanese adolescents were least likely to engage in these behaviors. Filipino adolescents were least likely to use substances before last sexual intercourse and condoms during last sexual intercourse. Conclusions . Our findings suggest divergent patterns of risk among API ethnic groups, underscoring the heterogeneity of API subgroups and emphasizing the need for health disparities research on disaggregated API ethnic groups. The findings of such research should be used to design ethnically relevant interventions aimed at mitigating the negative health consequences of high-risk sexual behaviors. High-risk sexual behaviors among adolescents are a significant public health concern in the United States. These behaviors account for increasing rates of premature morbidity and mortality by contributing to risk of unintended teen pregnancy, HIV/AIDS, and other sexually transmitted diseases (STDs). Complications associated with adolescents' sexual risk behaviors may take years to manifest and may seriously compromise adolescents' health and quality of life in adulthood. The Asian and Pacific Islander (API) adolescent population appears to be at heightened risk for the negative consequences of high-risk sexual behaviors. Some have described HIV/AIDS among the soaring API population worldwide as a global pandemic. 1 Although prevalence of STDs, HIV/AIDS, and pregnancy has been lower among API adolescents than among adolescents from other ethnic groups, it is suspected that Asians and Pacific Islanders underreport and misreport STD and HIV infection because of cultural norms that look unfavorably upon sexual risk behaviors. 1 , 2 For example, the relatively low prevalence of STDs among API adolescents 3 may be partially caused by cultural norms that discourage API youths from seeking immediate treatment for STDs, thereby placing them at even greater risk for negative health consequences of STDs. The Centers for Disease Control and Prevention has reported that API adolescents and adults constitute the largest proportion of individuals by ethnicity who are tested at HIV testing sites where anonymity is preserved. 1 Because anonymous HIV testing data are not included in national HIV surveillance reports, the number of Asians and Pacific Islanders reported to be living with HIV infection is likely underestimated. Also, although reported rates of HIV/AIDS among API adolescents are low, certain sexual risk behaviors that contribute to HIV/AIDS risk are as prevalent among API adolescents as they are among adolescents from other ethnic groups. 4 Although Asians and Pacific Islanders comprise dozens of racial/ethnic groups and speak nearly 500 languages and dialects, 1 national surveys and studies typically categorize all Asians and Pacific Islanders as an aggregate racial group. The evidence suggests important ethnic-group differences among API adolescents, 5 but these differences are obscured in national studies that typically focus on White, African American, and Hispanic populations while combining all API groups into 1 category; in addition, few studies have been published on ethnically disaggregated API data. Consequently, there is a lack of data on prevalence of sexual risk behaviors among API subgroups. We believe that API subgroups differ in their sexual-risk profiles as a result of variations in underlying cultural and socioeconomic factors that may affect sexual risk behaviors. Thus, to learn more about the sexual-risk profiles of API subgroups, we examined variations in high-risk sexual behaviors among adolescents from 3 API ethnic subgroups that are populous in Hawaii: Japanese, Filipinos, and Native Hawaiians.
