Despite increasing need for HIV prevention research and intervention programs, the voices and stories of Asian and Pacific Islander men who have sex with men (API MSM) have remained absent from HIV prevention literature. Five focus groups with API MSM (N = 38) were conducted to identify psychological, social, and cultural factors related to HIV risk and protection. Six themes were identified based on focus group discussion: (a) dual-identity status, (b) coming out and disclosure issues, (c) relationships and dating, (d) substance use, (e) sexual risk reduction strategies, and (f) health and social services. Narrative data indicate that multilevel HIV prevention intervention strategies are necessary for addressing the unique psychosocial and behavioral HIV risk factors among API MSM, such as dual stigma stemming from homophobia and racism, discomfort with sexuality, power dynamics and stereotypes in relationships with White men, substance use, and low utilization of health and social services.