Health Educator Fights AIDS and Resulting Social Stigma in Asian Community

Asian Americans for Community Involvement (AACI) provides health services for the Asian community in Santa Clara county.

Many of us turn a blind eye to HIV/AIDS, despite the fact that over 33 million people worldwide live with it today. Many cringe when the words barely are spoken and others exude repugnance when a person with HIV/AIDS walks into the room. There is a huge social stigma surrounding the disease, which is why Malaya Arevalo is so dedicated to his work as a health educator in the HIV/AIDS Education & Prevention Program at Asian Americans for Community Involvement (AACI).

Arevalo, who immigrated to America from the Philippines as a child, has been involved with HIV/AIDS education and prevention since the age of 16. “I worked with the San Mateo County AIDS Program in high school and also with Asian Health Services in Chinatown in Oakland…,” he says to me slowly, chuckling as I burn holes in my paper trying to scribble down his every word. He takes another bite of his Rice Krispie treat and continues, “Sexual reproductive health has always been my main interest… especially in adolescents. You are at such an interesting age you know, you are exposed to so many different things, so it’s important for youth to be educated.”

Arevalo has done an amazing amount of work concerning HIV/AIDS education and preventative practices throughout the San Jose area, including working closely with the Asian American Health Coalition (AAHC) and the Asian & Pacific Islander Wellness Centers across the Bay Area. He helped start a local event celebrating National Asian American and Pacific Islander HIV/AIDS Awareness Day on May 19, and has facilitated several World’s AIDS Day walks and events. He also works very closely with other community organizations and trains young Asian American and Latino gay men to become “health workers” and to spread education and awareness in their communities.

According to a 2010 report by the Centers for Disease Control and Prevention (CDC), the number of Asian Americans with AIDS has climbed 10 percent in each of the last five years. In 2006, there were more than 15,000 Asian Americans estimated to be living with AIDS, primarily contracted through male-to-male or heterosexual contact. Thirty percent, more than in any other ethnic group, were undiagnosed -- they did not know they had it at all. In one study, even though most Asian Americans and Pacific Islanders interviewed realized that they were at high risk for infection, less than half had been tested for HIV/AIDS in the past year.

“There is definitely a social stigma surrounding AIDS. Sex and homosexuality is taboo in most Asian communities, which is why many people do not seek help,” said Dr. Stephanie Li, a doctor at the AACI health clinic. “Privacy and not wanting to burden others are often cultural values in many Asian communities; sex is private. Talking about it can be seen as airing dirty laundry so to speak, so many people avoid it completely, creating a larger disparity.”

When asked about the social determinants that might worsen this health disparity, Arevalo said, “Many people find themselves being completely shunned by the rest of their community once they come out with the truth; ‘saving face’ is a traditional cultural value.” He agreed with Li and said that the shame and denial from others in the community has a great impact on one’s willingness to get help. “I mean, why do we have to be secretive and go into private just to get tested? HIV/AIDS testing should be a routine thing, like a flu shot.”

Arevalo also identified education, or rather miseducation, as another social force that shapes health outcomes. He said that because Asian Americans are at lower risk than other groups for many health conditions, they are commonly overlooked and therefore may not learn about the diseases they are at higher risk of getting. “Hospitals do not prioritize HIV/AIDS testing, especially among their Asian American patients, mainly because they are not considered to be as in as much peril as other ethnic groups,” said Arevalo.

And it is not only doctors that contribute to the lack of awareness about the HIV/AIDS disparity among Asian Americans, Arevalo said: The State of California has recently issued a number of health grants that target HIV/AIDS in youth, however the focus is specifically on African American youth. “There needs to be grants that target all ethnic groups if we want to see a change: HIV/AIDS has a global impact," said Arevalo passionately. "It shouldn’t be because you’re in a special group but because you are in this country. The only people targeting Asian Americans are Asian Americans.”

Language barriers are also a huge issue for many Asian Americans wanting to receive care. “I see an overwhelming amount of patients with HIV/AIDS who have immigrated here in the last five years, mainly from South Asia,” Li said. More often than not there are no translators available, leaving patients feelings confused, frustrated, and skeptical about the treatments they receive. Arevalo speaks three languages himself: Tagalog, Vietnamese, and Mandarin. The AACI staff speaks over fifty languages in all, including Chinese, Arabic, Croatian, and Punjabi.

“We always have to stay hopeful; that’s the most important thing," Arevalo said. "But we are at a time now where messages have to change… It is a much different time now so we have to change how we relate to the disease. We need to move ‘upstream’ and really try to standardize HIV in healthcare.”