Little is known about cultural patterns of sexual behavior among Asian-Americans that might affect HIV transmission or about attitudes that might have an impact on educational efforts with this population. Even less is known about bisexual and homosexual behavior among Asian-Americans. Although the number of AIDS cases among Asian-Americans is increasing more rapidly than in the nation as a whole (Centers for Disease Control and Prevention, 1990, 1996), HIV/AIDS has tended to remain a hidden phenomenon in the Asian community (Yep, 1993). Earlier in the epidemic there was evidence that persons of Hispanic or Asian backgrounds were less likely than their White cohorts to have heard about AIDS (Albrecht, Levy, Sugure, Prohaska, & Ostrow, 1989). Asian-American youth had less accurate knowledge about HIV/AIDS than their non-Asian cohorts (DiClemente, 1987; Strunin, 1991), especially regarding knowledge of how to prevent transmission (Horan & DiClemente, 1993). Asian cultural restraints may inhibit direct discussion of sexual activities (Horan & DiClemente, 1993; Moore & Erickson, 1985).
There is a risk of overgeneralizing among Asian cultures. The stereotype that Asian-American youth are less sexually active than their non-Asian cohorts may be true of Chinese-American high school students but may not apply to other Asian-American groups, such as Filipino youth (Horan & DiClemente, 1993) and may be limited to behaviors concerned with initiating sexual activity (Cochran, Mays, & Leung, 1991). After sexual activity was initiated among Asian-American youth, the heterosexual practices in which they engaged and their inconsistent use of condoms were similar to those of their Non-Asian counterparts (Cochran et al., 1991).
As HIV infection continued to rise among heterosexuals, in particular heterosexual women, interest grew in bisexual behavior as one of the possible paths of transmission (Anderson & May, 1992; Crawford et al., 1992; Doll & Beeker, 1996; Doll, Peterson, Magana, & Carrier, 1991). There is some evidence that bisexual behavior is more common in non-White cultures (Kumar & Ross, 1991) and non-White subcultures in the U.S. (Chu, Peterman, Doll, Buehler, & Curran, 1992; Diaz et al., 1992; Harry, 1990). Empirical data for Asian-Americans are lacking, but the value placed on fulfilling family roles (Atkinson, Morten, & Sue, 1993) and the expectation that the son will marry and continue the family name and progeny suggest that in Asian-American culture homosexuality may more likely be expressed in bisexual lifestyles than in exclusively homosexual behavior. "Most Asian cultures are neither asexual nor extremely repressed" (Chan, 1992, p. 9), but sexuality is only expressed within the private sphere. This privacy makes it possible for homosexual behavior to go unnoticed. Engaging in homosexual behavior may not produce "guilt" or be viewed as "taboo" if the normal roles and expectations are met and the homosexual behavior occurs privately.
In general, Asian cultures value putting the family first, respecting and obeying elders, formalized personal relationships, and male dominance. In contrast, the emphasis in dominant American culture is on putting the individual first, informal personal relationships, equality of genders (at least in theory), and a youth-centered and future-directed orientation (Locke, 1992). Western gay culture's emphasis on making homosexuality part of one's public identity may directly violate Asian norms and "shame" the family. The reliance on the family identity and family esteem rather than the individual identity and self-esteem (Roland, 1988) has implications for the study of sexual behaviors.
The concepts of same-gender versus other-gender attraction and the labels gay, bi, and straight are recent Western constructions (Katz, 1995). In East Asian societies, as well as in much of earlier Western society, the …