Revising the American dream: how Asian immigrants adjust after an HIV diagnosis

J Adv Nurs. 2015 Aug;71(8):1914-25. doi: 10.1111/jan.12645. Epub 2015 Mar 5.


Aim: We explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population.

Background: Asians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate.

Design: A mixed-methods study was conducted.

Methods: Thirty in-depth interviews were conducted with HIV-positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross-sectional audio computer-assisted self-interviews were conducted with a sample of 50 HIV-positive Asians and Pacific Islanders. Content analysis was used to analyse the in-depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self-actualization. The study took place from January-June 2013.

Discussion: Major themes were extracted from the interview data, including self-actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self-actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self-actualization and those who believed they could still achieve their 'American dreams'. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self-actualize and those who still believed they could 'make their dreams come true.'

Conclusion: Acculturation levels influence depression and self-actualization in the HIV-positive Asians and Pacific Islanders population. Lower acculturated Asian Americans achieved a lower degree of self-actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self-actualization.

Keywords: American dream; Asian; HIV; acculturation; depression; immigrants; nursing; self-actualization; stress.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Asia / ethnology
  • Asian / psychology*
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / psychology
  • Humans
  • Male
  • Middle Aged
  • New York
  • San Francisco