Remembering Asia's battle with AIDS

David Ho, director and Chief Executive Officer of the New York-based non-profit Aaron Diamond AIDS Research Center, had some grim news to deliver at the Fourth National Asian and Pacific Islander HIV/AIDS Awareness Day on May 19.

On the 25th anniversary of the discovery of the virus (it was announced in a paper published in the journal Science on May 20, 1983), a protective vaccine remains elusive, he said.

The reasons: The virus is seldom controlled by the immune system, super infection (infection with a second strain) has been well documented, and traditional approaches such as vaccination with inactivated virus (or a protein unique to HIV's surface) have failed. In addition, HIV is extremely resistant to antibodies in the human immune system, Ho, who was Time's Man of the Year in 1996, pointed out. It is extremely plastic and rapidly escapes from immune recognition, he added.

Asian and Pacific Islanders form approximately 4.6 per cent (over 13 million) of the US population. About 7 per cent (over 1 million) of New York State's population consist of APIs, and there are over 800,000 APIs (9.9 per cent) in New York City, according to a presentation by Punkin Clay Stephens, senior associate for Prevention Sciences and Applied Epidemiology at the AIDS Institute, New York State Department of Health.

In New York State, there were 112,308 people living with HIV/AIDS at the end of 2005. Asian and Pacific Islanders represent one per cent of this population.

John Chin, an associate professor at Hunter College who spoke at the gathering of about 50 people (mostly researchers and people coordinating community-based initiatives) at New York University Langone Medical Center, is studying the role of immigrant religious institutions in HIV awareness.

Immigrants rely on community institutions for social support, and a large number of these institutions are religious organisations, he said. Preliminary findings from the five-year study that started in 2007 suggested that the people heading these agree that religious institutions should be involved in health-related activities, but only 13 per cent of Buddhist temples and 22 per cent of Christian institutions are actually engaged in it. This engagement ranges from organising public prayers, religious talks and conducting educational workshops on health-related matters.

As part of the programme, the audience also learnt about three community organisations that work in the field: The Asian & Pacific Islander Coalition on HIV/AIDS, which is meant to be a one-stop shop to meet the needs of those diagnosed with HIV, the New York University School of Medicine-based South Asian Health Initiative that was formed in response to the health needs of the growing immigrant community, and the Chinese-American Planning Council, which was formed in 1965 in response to the influx of Chinese immigrants.

Sapna Pandya, coordinator of the South Asian Health Initiative, provided the audience a brief timeline of the AIDS epidemic in South Asia, particularly in India, where between 2.3 million and 3.1 million infections were reported in 2006.

The first HIV case in India was reported in 1986 in a commercial sex worker. The next year, the first transfusion-related case came to light. In 1987, the first HIV case was documented in Lahore, and the same year the Pakistan government launched its national AIDS control programme. India created the National AIDS Control Organisation under its Ministry of Health and Family Welfare in 1992.

Pandya listed the milestones, like the pharmaceutical company Cipla's offer of anti-retroviral at $350 a year in 2001, Bill Gates's $100 million aid to NACO in 2002, and the Balbir Pasha campaign in Maharashtra – imparting HIV/AIDS education in a conversational tone through a fictional character. Before that, there were basic prevention messages, Pandya said, "But this campaign took AIDS awareness to another level."

APICHA provides care and treatment for Asian and Pacific Islanders living with HIV/AIDS and their families, helps them combat the stigma and related discrimination, and works to prevent the spread of the virus.

Among the services offered are a multilingual (including Bengali and Urdu) toll-free hot line, pre-and post-test HIV counseling, free and confidential conventional as well as rapid (where results arrive in 20 minutes) HIV testing, and referral to appropriate services.

Seventy-eight per cent of Asian & Pacific Islander New Yorkers are foreign-born and 49 per cent have limited English proficiency.

Larry Tantay, MSM programme coordinator at APICHA, said among the barriers to care are limited English skills, poverty, lack of health insurance, the stigma attached to HIV, little information about HIV in the immigrants' home countries, and health care not being a priority. APIs have higher rates of being diagnosed with HIV and AIDS simultaneously and higher rates of delaying treatment.

Suki Terada Ports, executive director of Family Health Project (created in 1989 to raise awareness about HIV/AIDS's impact on communities of color) moderated the event.