| Cultural features of HIV risk among men of Pakistani and Indian heritage were examined through semi-structured face-to-face interviews using features of ethnography and grounded theory. Respondents were well educated and of Christian, Hindu, Muslim, and Sikh religions. They were born in the U.S., India, Pakistan, or Africa. They ranged in age from 20 to 59 years old and half were married. Five of the 26 men self-identified as gay. Fourteen key informants and community immersion experiences supplemented the study.;Most respondents reported a strong connection with their cultural identity, despite ambivalence. Only the gay respondents and fathers of young adults considered HIV/AIDS to be an issue meriting attention among South Asians in the U.S. They reported usual absence of discussion of sex in childhood homes and adult relationships. They felt stigmatization by South Asians regarding sexuality, sexual identity, and HIV/AIDS was common.;Most respondents raised in the United States believed they and other South Asians began dating later than Americans. Seventeen of the 26 respondents felt that premarital sex was acceptable, and 13 had engaged in sex prior to marriage. Most disapproved of sex outside marriage after marrying, and none reported sex outside marriage. Eight of the 26 men had experienced sex with five or more partners over their lifetime. Five of the 21 non-gay respondents had engaged in sex with prostitutes. Condom use was reported as inconsistent by most gay respondents, and most heterosexual respondents reported condom use only with prostitutes. Drinking alcohol socially was common.;An ecological model of human behavior was adapted for use in organizing examples of public, institutional, community, family, and individual factors for this culturally defined sample in terms of influences on their health behaviors in the arena of sexuality. Recommendations, also organized by the ecological model of influence, emphasized public and media support for community level efforts to improve awareness of HIV/AIDS and to overcome denial and stigmatization. |
