| Living With AIDS - December 1st is World AIDS Day |
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| February 2006 | |
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Laura Lau’s clients are men and women in desperate need. They are battling pain, suffering and face death daily. Many rely on Lau and her staff more than they do on their own family and friends. Lau works with men and women with advanced stages of HIV/AIDS. Her organization, AIDS Services In Asian Communities (ASIAC) serves the Asian American and Pacific Islander community in the Philadelphia area. And the demand for their services is growing not only because of the growing numbers of Asian immigrants who come to the United States every year - newer populations are exposed to the risk of HIV infections each day – but more significantly because of a culture of silence that breeds ignorance and denial. “What’s driving the epidemic,” says ManChui Leung, HIV technical assistant for the APIA Health Forum, “is the silence in the community.” Even though HIV and AIDS are major health crises in many Asian countries, immigrants who come to the United States often do not think it affects them. To many from the more developed countries, the perception is often that HIV/AIDS is becoming a manageable disease. “In a lot of ways it isn’t,” says Jury Candelario, division director of the Asian Pacific AIDS Intervention Team based in Los Angeles. “That perception is part of the reason we have been seeing a rise in HIV infections since 2002.” Yet because of variety of factors including a culture that shuns discussion and/or education about the disease, there isn’t enough data to prove the AAPI community’s need for funds and aid from the government and other sources. A study by the Asian Pacific Islanders American Health Forum found that the number of reported cases of AIDS reported among AAPIs in the United States as of December 2003 — 6,791 cases (5,890 men and 901 women) — represents less than 1 percent of the total number of cases. But the study also found that lack of detailed HIV surveillance, underreporting and misclassification often mask the true impact of the HIV epidemic on AAPIs. There is no way to tell just how many AAPIs have HIV, suffer from AIDS or may be at risk. The AAPI community gets lumped together in the “other” category of most government and census studies, Lau says. And a study done from 1987-1994 on race/ethnicity misclassification of persons reported with AIDS found that 12 percent of cases of AIDS in AAPIs were listed incorrectly on death certificates and four of 12, or 33 percent, were reported inaccurately on AIDS case reports. Financial and linguistic barriers are also a problem as is a lack of education. Even as awareness about HIV/AIDs increases in the community, mistaken beliefs about who is at risk still exist.
Women account for 13 percent of AIDS cases among AAPIs and that number is growing. An alarmingly high number of AAPI women with AIDS, 24 percent, actually identified themselves as not at risk compared to 12 percent of white women. Among the HIV cases, 46 percent of AAPI women failed to identify themselves as “at risk,” compared to 27 percent of white women, according to a study by the APIA Health Forum. These women find out only when their husbands get sick or when they have children and their children get sick. Even then they don’t always seek treatment. Many AAPIs who are infected with HIV do not seek medical assistance because they are afraid of the impact their positive status will have on their families, Leung says. If a woman tells her husband about her status, he or the family may prevent her from getting help,” Leung says. As with many other social problems, such as domestic violence, there is still a strong stigma attached to HIV/AIDS. The fear of being ostracized, especially in small, close-knit AAPI communities, is often enough to prevent a patient from speaking up. “The fear of talking about sex, let alone HIV is still the biggest part of the equation,” Candelario says. “There is still the shame of discussing these issues with family.” Further, many in the AAPI community buy into the “model minority myth” and think that Asians are model citizens in every way. And a model citizen certainly would not contract a disease like HIV/AIDS. A lack of preventive health care, such as regular physicals, adds to the problem, Candelario says. AAPI women are particularly neglectful of their own health. Many are more likely to ensure medical care for their husbands and families than for themselves, which only perpetuates the problem. “It is important that we look at women’s health holistically,” Leung says. “There is a real need to invest in women’s health in the community. Improving women’s health will help community health.” For more information: |
“People
still think that only gay men or women who do drugs and have multiple
partners are at risk,” she says. “If you are a heterosexual woman who
has been married for 30 years, even if you know about HIV/AIDS, you
don’t see why any of the information is relevant to you.”
