1. Social and Environmental Factors Related to Risk for STD/HIV among Asian Massage Parlor Workers in San Francisco Health Project for Asian Women (HPAW)

2. Demographics Demographics (n = 43) Age34 years (22 – 52) Birthplace98% Foreign born Reasons for coming to US 37% Economic, 28% Refugee 14% Prostitution, 14% Marriage Length of living in US11 years (2 – 30) Marital Status39% Single, 22% Separated/Divorce 15% Married, 15% Living w/ partner 10% Widowed Parental Status68% Mother

3. STD/HIV Related Sexual Behaviors Financial Benefit “I say that okay I go to work, then for example, normally he gives me 100, but now he gives me 300, 400, while I’m having no money. So, I’m willing to risk it. I need the money, so I take the risk.” Regular Customers “If we trust our clients, then we’ll do it without condoms. We get more money (when) we trust them. (When) we see their appearance and don’t trust them, then we shouldn’t do it.”

4. STD/HIV Related Sexual Behaviors No Choices “Yes, very often, once a customer was drunk. He was very large. He did not want to wear a condom. What could I do? He grabbed my hand, so I wrapped a towel between my legs.” Harmful Practices to Women’s Heath  Douching “If the condom broke or whatever, I clean inside and I put alcohol.”  Health Care Access

5. Social & Environmental Factors Socioeconomic Issues “My family in Thailand does not have much money... I work to help pay back the debts and to support my family here, too. I’m supporting both sides.” Immigration & Legal Status “We have to do it because we don’t have a degree. Working at McDonald’s doesn’t make much money to support your family in Vietnam and children. So, I have to work…” English Proficiency “They (doctors) just did routine check-up. But, when they gave me instructions, I didn’t understand what they wanted me to do. I did what other friends told me from past experience.”

6. Conclusions Large volume of male customers Underserved and understudied population Need to be addressed in the public health community and social service providers to promote Asian masseuses’ health and well-being

7. HPAW Project Staff Principal Investigator: Tooru Nemoto, Ph.D. Research Associate: Don Operario, Ph.D Research Associate: Mariko Iwamoto Project Assistant: Serena Wong Health Educator: Yungju Oh Health Educator: Caitlyn Nguyen Health Educator: Myan Nguyen Mariko Iwamoto 415-514-3381 miwamoto@psg.ucsf.edu