In the Asian community “saving face” is the term used for protecting one’s dignity and family honor. In these private, close-knit communities the public airing of dirty laundry is not advised. To their credit the mythical “model minority” have kept their private lives private and enjoy the advantages of the mystery that ever seem to surround them. But in every community there is a dirty underbelly. For on their otherwise spotless laundry are signs of dirty secrets that if left untouched will rend the very fiber of their community. Their blemish is their attitude towards HIV/AIDS.
For demographic purposes Asians and Pacific Islanders (A&PIs) have been lumped unceremoniously into one census checkbox. They are all very different but one commonality is the ease with which they succumb to this dreaded disease. According to the Banyan Tree Project, A&PIs have the fastest growing rate of new HIV infections of all races in the US. Women are infected at greater rates than men, with 86% of women being infected through heterosexual contact. Even more shocking, one in three A&PIs with HIV do not know they have been infected.
So why the secrecy? Talking about sex is a cultural taboo so there is less understanding of the associated risk factors. In addition, A&PI women do not feel empowered enough to discuss sexual issues, such as condom use, with their sexual partners. Another reason for the increase in infection is the lack of health insurance. Approximately 17-21% of A&PIs are uninsured or underinsured when compared to Whites with 11%. Perhaps more damaging than all is the belief that they must live up to high expectations even if it means risking their lives.
Today the Banyan Tree Project celebrates National Asian and Pacific Islander HIV/AIDS Awareness Day. They have specifically targeted A&PI women with the slogan “Saving face can’t make you safe. Talk about HIV– for me, for you, for everyone.” The first order of business in any public health campaign is to educate, but action steps must be taken as well. Let us do our part to not only educate but also encourage action. First we must help A&PI women remove the burden of the stigma of perfection, the language barriers they face and improve their access to care. Today let us celebrate greater knowledge and a surer path. If they must save face let them at least live to enjoy the honor.