1. The mental health and sexual health crisis among API women Hyeouk Chris Hahm, Ph.D., LCSW Associate Professor, Boston University School of Social Work Supported by National Institute of Mental Health Grant (NIMH, 1 K01 MH086366-01A1) Presented at the State of the Asian Women’s Health, May 29, 2013

2. 1.Mental Health/substance use

3. High prevalence of complete suicides Asian-American women aged 15-24: ▫ Alarming increase in suicide mortality rate, rising from 2.7 deaths per 100,000 in 2000 to 5.3 deaths per 100,000 in 2009 (CDC, 2012. Health United States, 2011. Table 39.) ▫ Most rapidly rising rates of completed suicide of all races and both genders in the same age group, increasing by 96.3% from 2000-2009. Native American women had the second largest increase (81.1%) (National Center for Health Statistics, 2012)

4. High Prevalence of Suicidality (higher than the national average)

5. High Prevalence of Substance Use (Hahm et al, 2013, n=720) nPrevalence (%) Soft Drug Use 25034.7% Hard Drug Use (alone or combined with soft drug) 7610.6% Legal Drug Use History of cigarette use only 3310.12% History of cigarette plus marijuana use 10331.60% Illegal Drug Use History of marijuana only 11434.97% Hard Drug Use History of hard drug use only 103.07% History of hard drug, cigarette, and marijuana use 5215.95%

6. 2. Sexual Health

9. Rising incidence of HIV/AIDS among API women (2004-2007, CDC)

10. Heterosexual contacts, the greatest reason for HIV transmission (2001-2008, CDC)

11. Complex intersection bet mental health and sexual health Forced sex history 2-8 times more likely to use alcohol/drugs, cope with problems by drinking alcohol, get pregnant, and engage in HIV risk behaviors, compared to their counterparts API women who experienced multiple types of childhood maltreatment had 3-12 times greater odds of reporting depression (Hahm, 2012)

12. 3. Patterns of service utilization

13. a. HIV testing: the lowest proportion (Hahm et al., 2009)

14. b. Underutilization of mental health services (Abe-Kim, 2007)

15. c. Lowest use of services among API sexual abuse children (Rau & Dicremente, 1992)

16. Where Do We Go from Here? API women should not suffer alone-- Design culturally specific intervention Community mobilization to raise awareness Increase presence of Asian Americans in research Focus on prevention, early intervention Educate providers about Asian American mental health issues

17. Thank you from Asian-American Sexual Health Initiative Project (AWSHIP)

18. Intersectionality Framework