HIV RISK AMONG ASIAN MASSEUSES NEMOTO ET AL. HIV RISK AMONG ASIAN WOMEN WORKING AT MASSAGE PARLORS IN SAN FRANCISCO Tooru Nemoto, Don Operario, Mie Takenaka, Mariko Iwamoto, and Mai Nhung Le The purpose of this paper is to describe working conditions, health outcomes, so- cial, and psychological factors related to HIV risk among Asian women who work at massage parlors in San Francisco. We conducted environmental map- ping to identify communities and massage parlors where Asian women work as masseuses, and conducted survey interviews with 100 masseuses using venue-based snowball sampling. Difficult work conditions contributed to partic- ipants’ HIV risk, including multiple sex customers each workday, long working hours, physical and verbal abuse from customers, economic pressures, and poor access to health care. Inconsistent condom use for vaginal sex with customers was positively associated with their fatalistic ideas and weak norms toward prac- ticing safe sex with customers. Interventions should address cultural and occupa- tional contexts in which Asian masseuses engage in sex work, and should focus on altering massage parlor policies and work environments. As the AIDS pandemic enters its third decade, women of color have emerged as one of the highest risk groups for new HIV infections (Karon, Fleming, Steketee, & De Cock, 2001). However, research on HIV among women of color has focused mostly on Afri- can American and Latina women, showing that unprotected sexual behavior, victims of sexual abuse, and social inequality contribute to their high rates of infection (CDC, 2001; Champion, Shain, Piper, & Perdue, 2001; Harlow et al., 1998; Maldonado, 1997). In this paper, we address a neglected subgroup of women of color who con- front alarming risk for HIV and other adverse health outcomes: Asian women who work at massage parlors in San Francisco. This target population is typically invisible to the larger society, but their public health needs are urgent. Very limited data focus on HIV and other public health issues among Asian women in the United States. Stereotypical views of Asians as a “model minority” that faces few socioeconomic disparities relative to African Americans and Latinos may AIDS Education and Prevention, 15(3), 245–256, 2003 © 2003 The Guilford Press 245 Tooru Nemoto, Don Operario, Mie Takenaka, Mariko Iwamoto, and Mai Nhung Le are with the Center for AIDS Prevention Studies, University of California, San Francisco. This study was funded in part by the University of California AIDS Research Programs (UARP), Grant No. R97-SF-082. The points of view and opinions expressed in this paper are solely those of the authors and are not those of the UARP. Address correspondence to Tooru Nemoto, Ph.D., Center for AIDS Prevention Studies, University of Cali- fornia San Francisco, 74 New Montgomery Street, Suite 600, San Francisco, CA 94109; E-mail: tnemoto@psg.ucsf.edu