Why Don’t APAs Get Tested For HIV?
June 27, 2003
This Friday is National HIV Testing Day, but how many Asian Pacific Americans do you think are going to walk into their doctor’s office or an AIDS service organization and ask for an HIV test? My guess is not that many.
In fact, the San Francisco Department of Public Health reported that 2,124 APAs took an HIV test last year at one of their counseling and testing sites. Considering that there are 198,162 APAs above the age of 18 in San Francisco, this is pretty abysmal.
So how can we get more APAs to get tested? This April, the Centers for Disease Control and Prevention (CDC) announced a new initiative that they hoped would reduce the spread of HIV. As part of this new initiative, CDC will be funding community-based organizations to conduct HIV testing and prevention counseling for people living with HIV/AIDS. While I agree with the overall goal of the new initiative — to reduce barriers to early diagnosis of HIV infection and increase access to quality medical care — I am concerned that this increased emphasis on HIV testing comes with the cost of de-prioritizing other important HIV prevention interventions.
In my opinion, the full continuum of HIV prevention includes not only HIV testing, but also health education and risk reduction strategies such as peer counseling, condom distribution, prevention case management for high-risk HIV-negative people and social marketing. Together, these programs focus on increasing knowledge about HIV transmission, raising self-awareness of risk for HIV infection and motivating individuals to not engage in unprotected sex or share injection-drug use needles.
So why don’t more APAs get tested for HIV? In my experience, many APAs do not get tested because they cannot get services in their own language (including basic education and testing), do not have insurance, are legally barred from public programs such as Medicaid and are unfamiliar with the U.S. medical system. Furthermore, HIV and sex are still considered taboo topics in many APA cultures, and some APAs may not get tested because they fear the stigma that APAs living with HIV/AIDS often face from their friends, families and communities. Many APAs, especially women, are not identified as being at-risk for HIV and thus are not offered HIV testing by their doctors.
CDC’s new initiative will not address these issues; therefore, it is unlikely that the number of APAs getting tested will increase. I strongly feel it is important for more APAs to know their HIV status. However, I believe this will only happen through HIV testing in combination with culturally competent and linguistically accessible health education and risk reduction programs.
But are APAs at risk for HIV? Often in APA communities we mistakenly believe that HIV/AIDS is a disease that only affects other racial groups, gay men and drug users. We incorrectly assume that as APAs, we cannot get infected with HIV. All we have to do, however, is look at the alarming HIV infection rates in our home countries across the Pacific Ocean to know that this is not so. As of December 2001, there have been 6,157 diagnosed cases of AIDS among APAs in the United States. Here in San Francisco, there have been 845 diagnosed AIDS cases among APAs.
As an APA community, we need to realize that anyone who engages in unprotected sex or shares needles for injecting drugs is potentially putting herself or himself at risk for getting infected with HIV. We need to address the stigma that still exists in our communities. Every APA must know that although there is still no cure for HIV/AIDS, there are several treatment options that can enhance the quality of life for those who are living with HIV/AIDS.
I encourage all APAs in the Bay Area to face up to our denial and our fears. Take an important step in preserving our individual health, the health of our families and the health of our communities. Take advantage of the free HIV testing and counseling services offered by the Asian & Pacific Islander Wellness Center in San Francisco (www.apiwellness.org) or Asian Health Services in Oakland (www.ahschc.org) in honor of National HIV Testing Day.
Dr. Ho Luong Tran is the president and CEO of the Asian & Pacific Islander American Health Forum, a national advocacy organization dedicated to promoting policy, programming and research efforts to improve the health and well-being of APA communities.
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