By SOMA SEN
I keep hearing the voices of colleagues and friends that have been part of the AIDS epidemic compare it to the current COVID-19 pandemic. In fact Dr. Kathy Creticos, Director of Infectious Disease at Howard Brown Health spoke about the politicization of both the pandemics.
“Here we are in 2020 with this disease that kills people, that we don’t have any treatments for, that we really don’t understand the full manifestation and presentation biology of the virus,” Creticos said In the final segment of an interview with Contagion during International AIDS Society (IAS) AIDS 2020 Virtual Sessions. “We’re really dealing in the same situation as in the HIV epidemic.”
Her words make me reflect on the levity with which the Raegan administration treated the AIDS epidemic and it’s parallel to the Trump administration’s treatment of the current pandemic. However, she makes an important distinction between the two when she says, “I think a lot of it has to do with the fact that COVID affects everybody, but HIV was certainly perceived as not affecting everybody.”
As an Asian American researcher with more than 15 years of experience in this area, whenever, I bring up the issue of the scourge of HIV/AIDS in our community, the common response both from inside and outside the community is “It’s not a problem in this community.”
This characterization obfuscates a very perilous fact – lack of testing. When people don’t test, they don’t know their status.
Asian Americans are among the fastest growing racial and ethnic groups in the United States. The popular rhetoric fueled by the Model Minority Myth fans the perception that this community is without problems. This is a major impediment to ongoing research studying HIV prevention in this community.
How can one fight a problem if it does not exist?
Data suggests that while the HIV incidence rates in the United States in general has remained stable, the rate of new infections in the Asian American community particularly in the age groups 25-34 years and 55 years and older has increased over the past four years with the latter group accounting for a 43% increase.
Since the CDC’s recognition of the AIDS epidemic on June 5th, 1981, we have lost more than 700,000 lives to AIDS and approximately 1.1 million individuals are living with HIV in this country.
Major strides have been made in terms of the medical interventions such as prevention and treatment, yet why does HIV still plague us?
The answer lies in the idea that a disease has two sides; a biological side and a social side, and HIV is no exception.
Medical interventions respond to biological factors, whereas how we as a society respond to epidemics such as the AIDS epidemic and the current pandemic is a reflection of the human condition. Unfortunately, as with the current pandemic, pernicious forces of misinformation, rumor, stigma, discrimination, social inequities, etc. that were rife during the inception of the AIDS epidemic in the U.S., still continue to rage.
The CDC reports that 22 percent of Asian Americans living with HIV/AIDS in the United States are undiagnosed compared to 13 percent of the general population. While HIV may have become a chronic disease in many communities, in the Asian American community, an HIV diagnosis blooms into full blown AIDS within a year, indicating late stage diagnoses. Most of new HIV diagnoses in this community occur in men, constituting approximately 85 percent of new infections, with Asian American men who have sex with men (MSM) representing 47% of the increase.
AIDS was initially seen as the “gay disease” or the “gay plague” and this perception forever sealed the fate of HIV to be linked with homophobia. This is particularly true for the Asian American community and culture that value harmony, family, and ancestry that are grounded in the dominant social narratives of hyper masculinity and heteronormativity.
Such sentiments are reflected in comments such as, “If you are HIV+ you must be gay or you must be promiscuous.”
So what does it mean to be an Asian American with HIV+ status? It means that a person with HIV+ status has not only brought shame to their current families, but also to their ancestors and their descendants. The resulting sadness, guilt, isolation are unfathomable. HIV-stigma therefore, is a major deterrent to testing and prevention in my community and the only way to change hearts and minds is through reframing harmony, family, and ancestry to embrace all of our members, and to remind ourselves that we collectively suffer when one or more of us suffers.
In a world that is seeing a pandemic create unbelievable suffering, now more than ever, we need to come together as a community and do our part in eradicating AIDS.
Soma Sen is a Professor in the School of Social Work at San Jose State University and a Public Voices Fellow with The OpEd Project.