HIV And AIDS In Asian And Pacific Islander Community

By Chaleampon Ritthichai

To Lee Zhu, AIDS is something he will never get. Although he admits that he visited a house of prostitution once last year, the 32-year-old immigrant
from China says that he will never go for an HIV test. Asians, he says, "normally don't get AIDS."

At first glance, it might seem Zhu has good reason to believe that.

According to the Department of Health, there were only 778 reported cases of Asians and Pacific Islanders with HIV and AIDS as of June 2000--less than one percent of the total 113, 252 New York City cases--while African Americans accounted for 43 percent, Latinos 32 percent and 24 percent for whites.

But recent studies show that this number is misleading because Asians and Pacific Islanders, especially new immigrants, are less likely to report their cases. When they do, most already have full-blown AIDS, reducing their treatment options.

"Asians are twice as likely to be diagnosed with AIDS at the time of their first HIV testing," said Dr.Ezner Kang, a clinical psychologist at Columbia University who is studying HIV positive Asians and Pacific Islanders.

The lateness in HIV testing among Asians and Pacific Islanders stems from the lack of knowledge about HIV and AIDS, cultural prejudice against the disease and language barriers.

"There are still a lot of misconceptions of how the disease is transmitted," said Jenie Tung, a Volunteer Project Coordinator at Asia Pacific Islander Coalition on HIV and AIDS (APICHA).

Many new immigrants from Asian countries believe that AIDS is only a "Western" or "gay" disease, she said.

In an effort to raise awareness of the disease in Asian Pacific communities, outreach groups such as APICHA had used several different approaches, from handing out multilingual fliers to giving away condoms.

"Our goal is to reach high-risk groups. We have peer educators to go to places like bath houses, night clubs and massage parlors," said Niha Abhyjkar, Community Health Outreach Intervention Counseling and Education Coordinator at APICHA.

However, many Asian Pacific immigrants do not consider themselves high-risk and believe that they are immune to the disease. "They associate HIV with a certain population such as those who frequent prostitutes, homosexuals and drug users," Abhukar said.

This prejudice against the disease creates complacency among Asian Pacific immigrants and a stigma against those who are infected with HIV. Afraid of being ostracized by family and friends, some avoid getting tested even if they are in a high-risk group.

In an extreme case, one patient refused care at an agency simply because there was an "HIV Service" sign in front of the building, Dr. Kang said.

The situation is even more dire among undocumented and illegal immigrants. Studies show that most shun public health agencies for fear of being reported to The Immigration and Naturalization Service (INS) and eventually deported.

" Most undocumented immigrants found out that they were HIV positive only after they had collapsed and been sent to an emergency room," Dr. Kang said.

NAVIGATING THROUGH THE SYSTEM

For Asians and Pacific Islanders who choose to get tested for HIV, the bureaucracy of public health agencies can be overwhelming, especially for non-English speakers.

"Even when you speak English, trying to navigate the system is already hard enough. For non-English speakers, it can be a daunting experience," said Dr.Kang, whose study shows that language barrier is a major reason for delaying access to care among HIV-positive Asian and Pacific Islanders.

According to Susan Jacob, a Community Outreach Worker at APICHA, the Department of Health offers free HIV testing services but many Asians and Pacific Islanders find the choice of interpreters, limited to only three languages – English, Spanish and Chinese – an obstacle.

To reduce language barrier, APICHA offers free HIV counseling and testing in five Asian languages, Mandarin, Cantonese, Japanese, Korean and Hindi. These languages represent the largest Asian and Pacific Islander population with the highest AIDS case rate in New York City.

"Having a counseling session with someone who speaks their language also gives an opportunity to clear misconceptions about HIV and AIDS and to talk about risks that individual clients face," Jacob said.

Since APHICHA started offering free HIV testing last May, more than 130 Asians and Pacific Islanders have used the service. But outreach workers are not content.

"There’s a long way to go," said Abhukar, noting that there is still a large number of new immigrants who are uninformed about HIV and AIDS.

To understand the scope of the problem, Dr.Kang suggested that the number of Asians and Pacific Islanders with HIV in New York City is proportional to the immigration from Asia and Pacific countries.

In its annual report last November, the Joint United Nations Program on HIV and AIDS (UNAIDS) predicted that the spread of AIDS in Asia Pacific in the next decade may surpass the 22.5 million cases in sub-Saharan Africa to become the largest infected region in the world.

Combine this with the massive increase of Asian Pacific immigration to New York City, Dr. Kang warned, "We’re basically waiting for an epidemic to explode."

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