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The purpose of this paper is to describe working conditions, health outcomes, social, and psychological factors related to HIV risk among Asian women who work at massage parlors in San Francisco. We conducted environmental mapping to identify communities and massage parlors where Asian women work as masseuses, and conducted survey interviews with 100 masseuses using venue-based snowball sampling. Difficult work conditions contributed to participants' HIV risk, including multiple sex customers each workday, long working hours, physical and verbal abuse from customers, economic pressures, and poor access to health care. Inconsistent condom use for vaginal sex with customers was positively associated with their fatalistic ideas and weak norms toward practicing safe sex with customers. Interventions should address cultural and occupational contexts in which Asian masseuses engage in sex work, and should focus on altering massage parlor policies and work environments.
As the AIDS pandemic enters its third decade, women of color have emerged as one of the highest risk groups for new HIV infections (Karon, Fleming, Steketee, & De Cock, 2001). However, research on HIV among women of color has focused mostly on African American and Latina women, showing that unprotected sexual behavior, victims of sexual abuse, and social inequality contribute to their high rates of infection (CDC, 2001; Champion, Shain, Piper, & Perdue, 2001; Harlow et al., 1998; Maldonado, 1997). In this paper, we address a neglected subgroup of women of color who confront alarming risk for HIV and other adverse health outcomes: Asian women who work at massage parlors in San Francisco. This target population is typically invisible to the larger society, but their public health needs are urgent.
Very limited data focus on HIV and other public health issues among Asian women in the United States. Stereotypical views of Asians as a "model minority" that faces few socioeconomic disparities relative to African Americans and Latinos may underlie the oversight of Asian health issues (Chen & Hawks, 1995). However, mounting evidence has revealed increasing AIDS cases among Asians. In San Francisco, Asian/Pacific Islander (API) AIDS cases had the second highest percentage increase (225%) among all racial groups and AIDS was the second leading cause of death among APIs aged 25 through 44 (San Francisco Department of Public Health [SFDPH], 2001). Findings have shown...