Crossing Intersections: Challenges Facing Asian American, Native Hawaiian, Pacific Islander and Lesbian, Gay, Bisexual, Transgender Youth: Exploring Issues and Recommendations

The experiences and the everyday life stories of lesbian, gay, bisexual, and transgender (LGBT) youth who are also Asian American, Native Hawaiian, and Pacific Islander (AANHPI) are not well-known or documented in the literature about LGBT or AANHPI communities. To help address this lack of information and knowledge, this article highlights some of the issues that these youth face and offers recommendations regarding data collection, cultural competency, and utilization of an intersectional lens of race/ethnicity and sexual orientation to ensure changes will be considered to policies that affect these populations. The policy recommendations focus on issues such as bullying and sexual and reproductive health.

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Adolescents’ perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey

BMC Health Services Research ◽

10.1186/s12913-021-07278-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Martha J. Decker ◽

Tara V. Atyam ◽

Catherine Gilmore Zárate ◽

Angela M. Bayer ◽

Consuelo Bautista ◽

...

Keyword(s):

Sexual Orientation ◽

Reproductive Health ◽

Sexual And Reproductive Health ◽

Native Hawaiian ◽

Sexual Experience ◽

Pacific Islander ◽

Perceived Barriers ◽

Test Results ◽

Living Situation ◽

Race Ethnicity

Abstract Background Adolescents may forego needed sexual and reproductive health (SRH) services due to a variety of concerns and barriers. The purpose of this study is to compare adolescents’ perceptions of these barriers by participant characteristics including race/ethnicity, gender, sexual orientation, housing situation, and sexual experience. Methods Adolescents in a California-wide sexual health education program completed an anonymous survey at baseline (N = 10,015) about perceived barriers to using SRH services. Logistic regression analyses that accounted for the clustered data structure assessed differences by gender, age, sexual orientation, race/ethnicity, living situation, and sexual experience. Results The majority of participants were Hispanic/Latino (76.4%) with an average age of 14.9 years, and 28.8% had sexual experience. Half of the youth reported concerns about test results (52.7%), cost of services (52.0%), and confidentiality of services (49.8%). When controlling for other characteristics, youth identifying as transgender/non-binary/multiple genders had the highest odds of perceiving cost (odds ratio (OR) 1.89) and confidentiality (OR 1.51) as barriers. Increasing age was associated with decreasing odds of all barriers. Sexual orientation was a consistent predictor, with LGBQ+ youth having higher odds of perceiving test results (OR 1.21), cost (OR 1.36), and confidentiality (OR 1.24) as barriers. Asian or Pacific Islander/Native Hawaiian youth had higher odds of perceiving test results (OR 1.68) and cost (OR 1.37) as barriers. In contrast, Black youth had lower odds of reporting cost (OR 0.65) and confidentiality (OR 0.77) as barriers. Younger respondents and youth who identified as female, transgender/non-binary/multiple genders, LGBQ+, and Asian or Pacific Islander/Native Hawaiian had higher odds of reporting five or more barriers compared to reference groups. Conclusions The majority of adolescents face barriers to accessing appropriate SRH services, with females, gender-minority youth, younger adolescents, LGBQ+ youth, and Asian and Pacific Islander/Native Hawaiian youth more likely than others to report barriers. Access to SRH services can be improved through strengthening linkages between clinics and SRH education programs, providing youth-friendly clinical services, and ensuring youth have sufficient information, skills, and support to access care. Trial registration Approved by California Health and Human Services Agency’s Committee for the Protection of Human Subjects [12-08-0658, 11/30/2017].

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Toward improved health: disaggregating Asian American and Native Hawaiian/Pacific Islander data

American Journal of Public Health ◽

10.2105/ajph.90.11.1731 ◽

2000 ◽

Vol 90 (11) ◽

pp. 1731-1734 ◽

Cited By ~ 120

Keyword(s):

Asian American ◽

Native Hawaiian ◽

Pacific Islander

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Prostate Cancer Disparities in Risk Group at Presentation and Access to Treatment for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study With Disaggregated Ethnic Groups

JCO Oncology Practice ◽

10.1200/op.21.00412 ◽

2021 ◽

Author(s):

Bhav Jain ◽

Kenrick Ng ◽

Patricia Mae G. Santos ◽

Kekoa Taparra ◽

Vinayak Muralidhar ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Asian Indian ◽

Asian American ◽

Native Hawaiian ◽

Risk Group ◽

Pacific Islander ◽

Pacific Islanders ◽

Native Hawaiians ◽

High Risk Disease

PURPOSE We identified (1) differences in localized prostate cancer (PCa) risk group at presentation and (2) disparities in access to initial treatment for Asian American, Native Hawaiian, and Pacific Islander (AANHPI) men with PCa after controlling for sociodemographic factors. METHODS We assessed all patients in the National Cancer Database with localized PCa with low-, intermediate-, and high-risk disease who identified as Thai, White, Asian Indian, Chinese, Vietnamese, Korean, Japanese, Filipino, Hawaiian, Pacific Islander, Laotian, Pakistani, Kampuchean, and Hmong. Multivariable logistic regression defined adjusted odds ratios (AORs) with 95% CI of (1) presenting at progressively higher risk group and (2) receiving treatment or active surveillance with intermediate- or high-risk disease, adjusting for sociodemographic and clinical factors. RESULTS Among 980,889 men (median age 66 years), all AANHPI subgroups with the exception of Thai (AOR = 0.84 [95% CI, 0.58 to 1.21], P > .05), Asian Indian (AOR = 1.12 [95% CI, 1.00 to 1.25], P > .05), and Pakistani (AOR = 1.34 [95% CI, 0.98 to 1.83], P > .05) men had greater odds of presenting at a progressively higher PCa risk group compared with White patients (Chinese AOR = 1.18 [95% CI, 1.11 to 1.25], P < .001; Japanese AOR = 1.36 [95% CI, 1.26 to 1.47], P < .001; Filipino AOR = 1.37 [95% CI, 1.29 to 1.46], P < .001; Korean AOR = 1.32 [95% CI, 1.18 to 1.48], P < .001; Vietnamese AOR = 1.20 [95% CI, 1.07 to 1.35], P = .002; Laotian AOR = 1.60 [95% CI, 1.08 to 2.36], P = .018; Hmong AOR = 4.07 [95% CI, 1.54 to 10.81], P = .005; Kampuchean AOR = 1.55 [95% CI, 1.03 to 2.34], P = .036; Asian Indian or Pakistani AOR = 1.15 [95% CI, 1.07 to 1.24], P < .001; Native Hawaiians AOR = 1.58 [95% CI, 1.38 to 1.80], P < .001; and Pacific Islanders AOR = 1.58 [95% CI, 1.37 to 1.82], P < .001). Additionally, Japanese Americans (AOR = 1.46 [95% CI, 1.09 to 1.97], P = .013) were more likely to receive treatment compared with White patients. CONCLUSION Our findings suggest that there are differences in PCa risk group at presentation by race or ethnicity among Asian American, Native Hawaiian, and Pacific Islander subgroups and that there exist disparities in treatment patterns. Although AANHPI are often studied as a homogenous group, heterogeneity upon subgroup disaggregation underscores the importance of further study to assess and address barriers to PCa care.

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OncotypeDx scores according to race/ethnicity and age in a diverse cohort of breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e12512 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e12512-e12512

Author(s):

Eileen Chen ◽

Corinne Jones ◽

Ian Pagano ◽

Jami Aya Fukui

Keyword(s):

Breast Cancer ◽

White Women ◽

Native Hawaiian ◽

Breast Cancer Incidence ◽

Pacific Islander ◽

Oncotype Dx ◽

Age At Diagnosis ◽

Similar Distribution ◽

Incidence And Mortality ◽

Race Ethnicity

e12512 Background: Breast cancer incidence and mortality rate differ across racial/ethnic populations in the US, but little is known about the relationship between Oncotype DX scores and race/ethnicity. Oncotype DX scores are used in early stage, hormone positive breast cancers to estimate the likelihood of breast cancer recurrence and benefit from receiving chemotherapy. Most available literature assesses disparities between race and receipt of an Oncotype DX score, with only some assessing distribution of scores by race. Populations previously studied mainly focus on Black compared to White women, with very few including Asian and Native Hawaiian/Pacific Islander subpopulations. When included, they are often grouped together as Asian/Pacific Islander. Current studies suggest there is a similar distribution of scores among Black and White women, but some studies report that Black women may be more likely to have high-risk scores. Methods: We examined 476 unique breast cancer cases in the Hawaii Pacific Health system diagnosed in 2018-2020. We used univariable and multivariable analyses on all of those cases that received an Oncotype DX score to determine correlation to age and race. Results: In 328 breast cancer cases that received an Oncotype DX score, age of diagnosis ranged from 29 to 84 with race/ethnicity including Japanese (n = 90, 27%), White (n = 78, 24%), Filipino (n = 54, 17%), Native Hawaiian (n = 52, 16%), Chinese (n = 24, 7%), and other (n = 30, 9%) populations. Cases with age at diagnosis between 60-69 (n = 118, 36%) were found to have a mean Oncotype DX score of 13.91 (CI 12.19-15.62, p = 0.04) which was statistically lower than other ages groups on both univariable and multivariable analysis. We found no other significant relationships between Oncotype DX score and race or age at diagnosis on our analyses. Conclusions: These findings contribute more information about Oncotype DX scores within Asian and Native Hawaiian populations to the available literature.

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