HIV/AIDS Among the South Asians in the USA

[Guest guest]

Denial Marks South Asians' HIV/AIDS Experience

By Akhilesh Upadhyay

New York, May 9 (IPS) - Ask any HIV/AIDS outreach workers in New York

how the city's fast growing South Asian community is faring in its new

home and they are most likely to say, ''old habits die hard''.

''South Asians believe that AIDS is something that doesn't happen to

them,'' says Gurpreet Clair of the city's APICHA (Asian & Pacific

Islander Coalition on HIV/AIDS). ''They associate it with morality.''

Traditional fixation with family privacy and prestige coupled with low

rates of health insurance coverage means South Asians are less likely

to seek professional assistance, say civil society groups. And while

they are as promiscuous as others, South Asians are also less likely

to discuss sex and dating topics with their friends, family members or

anyone else.

One study of 165 Asian Indian adolescents in the New York area found

that while the majority of them knew about HIV/AIDS, many had crucial

gaps in their knowledge about how the disease is transmitted.

''I have never seen Nepali or for that matter any Asian parents

discuss sex or AIDS with their children openly,'' says Kiran Thapa, a

social worker with Help Nepal who has extensive experience working

with high school students from immigrant families in New York.

''Even among the second-generation Asians, AIDS is still a taboo in

the family circles and these children grow up less equipped when it

comes to handling AIDS than others.''

It is left to outreach organisations to better equip New York's South

Asians, and publicise patterns that they have observed over the years.

Most of the South Asians seeking assistance with APICHA, for example,

are married couples in their 30s and 40s: unsuspecting wives who were

infected by their husbands, who first got the deadly virus through

female prostitutes or gay sex.

Some groups work with the tens of thousands of South Asian taxi

drivers. ''The drivers are obviously exposed to a lot and they need

to be prepared,'' says Lobo of Cab Watch, adding it is

important to make the drivers aware of the risks of unprotected sex.

A nongovernmental organisation (NGO) Cab Watch provides advice to more

than 6,000 members in New York City. More than 45 percent of them are

ethnic South Asians.

The U.S. government lumps South Asians in the ''Asian and Pacific

Islander'' category, a group that has reported increasing rates of

newly diagnosed AIDS cases in recent years, while rates have been

declining for most racial groups.

Few U.S. states have compiled figures on HIV/AIDS prevalence among the

South Asian subgroup, but a 1999 study by California's department of

health found 26 Indians infected with HIV, the virus that causes AIDS.

Though the prevalence of 0.9 percent was smaller compared to other

large Asian communities - Chinese (2.9 percent of the population),

Filipinos (2.7 percent), Vietnamese (1.3 percent), research workers

warn that the figure could only be the proverbial tip of the iceberg.

''This is just in California alone and is thought to be an

underestimate due to underreporting,'' says Ushma Upadhyay, a

research writer at Hopkins University School of Public Health.

''While it may seem like a small number, it's too large a number in

light of the lack of tailored health services for this ethnic group,''

says Upadhyay. ''This number also disproves the belief that (HIV/AIDS)

does not exist among the South Asian community and that there is no

risk of the number increasing exponentially.''

She assumes the numbers are similar in the states of New Jersey, Texas

and New York.

According to the 2000 census, Indians, Pakistanis, Sri Lankans and

Bangladeshis are among the fastest growing immigrant groups in New

York City - all registering more than 100 percent growth over 1990

numbers. Numbering almost 200,000, Indians make up the largest Asian

community in the city after Chinese, who have a much older history of

immigration in the United States.

The 2000 census also revealed that most South Asians are new

immigrants who spend a lot of time among themselves, and maintain

their old habits. On a recent weekend, many stores in

Heights, or ''Little India'', buzzed with shoppers from the

subcontinent, busy buying home favourites like saris, salwaars and

samosas.

An estimated 850,000 to 950,000 people in the United States currently

live with HIV, and about 40,000 new infections occur every year. Some

6,300 Asian and Pacific Islanders are HIV infected, according to the

U.S. Centers for Disease Control.

''It's urgent to work on promoting better dialogue about sexual and

reproductive health in South Asian American communities,'' says

Vandana Tripathi, of Planned Parenthood of New York.

''The idea that one goes to the doctor only when very sick has carried

over here,'' she adds. ''Our communities have very low rates of

utilising preventive reproductive health services like pap smears.

And, we have low insurance rates, so it's harder to access services.''

Some 64 percent of South Asians in Queens, one of five of New York

City's boroughs, have no health insurance, according to a study done

last year by the New York Asian American Network for Cancer Awareness,

Research and Training.

Twenty percent of the HIV/AIDS-positive people who seek counselling

with Clair's APICHA in New York are South Asians, most of whom came

for assistance only after they were very sick.

There are some ominous signs that the low usage of health services is

having a negative impact, Tripathi warns. Chlamydia rates, for

example, rose 32.9 percent among Asians in 1998, the highest growth

rate of all racial groups. The number one sexually transmitted

disease (STD) in the United States today, chlamydia is particularly

common among teens and young adults.

Despite the high risk, many South Asians still associate AIDS with

stereotypes - it infects white men who have sex with men, and taxi

drivers. ''There is a feeling in our community that it is only the

taxi drivers who get AIDS,'' says Clair. ''But it's as much the white-

collar workers. In fact, it's across the board.''

What is particularly disturbing is that the level of AIDS awareness

remains low even among South Asian professionals, she adds. This

could expose them to greater risks when they travel to their home

countries. At any given time a quarter of U.S. adult Indians are

believed to be in India, a country with more than four million HIV

cases - second only to South Africa - and the U.S. government warns

that the number could shoot up to 20-25 million by 2010.

''Blood is yet not adequately protected in India,'' says

Groetzinger, a public health Ph.D. candidate in Chicago who

specialises on the sexual health of South Asian Americans. ''This

issue of international transmission is not discussed yet.''

Outreach workers with APICHA also found out that social expectations

and parental pressure have led many South Asian men to lead a double

life - one of a heterosexual family man in public and of a homosexual

in private.

''Arranged marriages and living in joint families create unnecessary

pressures which often means leading a double life,'' says Help Nepal's

Thapa, ''one approved by your traditional family members and friends,

and another away from your community''.

Planned Parenthood of New York City

http://www.ppnyc.org/homepage.html)

APICHA (http://www.apicha.org/apicha/pages/clientservices/index.htm)

Source: http://194.183.22.90/ips%

5Ceng.nsf/vwWebMainView/BE021DC9ED93947CC1256D21007141E4/?OpenDocument

Cross posted from sapha