Bay Area Reporter - July 6, 2001
David Fraser

Jazmine, Re-fried, Long Grain, Puff, and Rice-a-Roni, The San Francisco Treat are:

A) varieties of rice

B) ambassadors of HIV prevention, otherwise known as the Asian & Pacific Islander Wellness Center's Rice Girls.

See, you are pretty damn sharp.

But here's a few things you may or may not know:

o In the U.S., Asians and Pacific Islanders (APIs) face higher rates of major diseases than whites. The tuberculosis infection rate is five times higher than that in the overall population. Last year APIs accounted for 65 percent of all TB cases in San Francisco.

o There are also disproportionately high rates of hepatitis B, diabetes, and cancer.

o Forty percent of APIs nationwide don't speak English fluently.

o A Centers for Disease Control and Prevention study found that APIs have the highest proportions of HIV testing conducted at so-called anonymous sites. Yet often diagnosis comes only in late stages of the disease, according to media reports.

o In San Francisco, where APIs make up 31 percent of the population, nearly one in two youth are of that heritage.

Advocates for the community - really a series of communities with commonalties and differences - have made major strides but face huge challenges, according to staff at the API Wellness Center interviewed recently at their Polk Street offices by the Bay Area Reporter.

Performers and Orasure

One approach in the center's wellness outreach came through Pride, where the Rice Girls and other headliners promoted safer sex and wellness messages from their stage. Overall, 54 API visitors to Pride got oral HIV tests on the spot.

Featured performers ranged from the GAPA Dance Company to Filipina singer Yvette to Hawaiian cabaret star Matt Yee to the Sawatdee Thai Classical Dance Group organized by the center's Thai/Lao health educator, Timmy Promlack.

Such approaches are part of the center's comprehensive physical, mental, and social health efforts for the API community. For example, with the help of a $10,000 grant in May from Pacific Bell, the center is running QUACK (Queer Asian & Pacific Islander Chicks). QUACK targets lesbian, bisexual, transgender, and queer women under age 26.

"We are incredibly heartened that Pacific Bell is assisting our efforts to empower young women to care for themselves and their communities while looking critically at the complex intersection of identity and oppression in their lives," said API Executive Director John Manzon-Santos.

As he and his colleagues describe it, overall life for many APIs in the U.S. may be more a roundabout than an intersection, or perhaps a Los Angeles freeway interchange.

Many APIs thread through daily issues of overlapping identities of culture, ethnicity, native place, language ability, trying to merge into issues of multiculturalism, assimilation, and perception by others.

Often, people run into racism, homophobia, and a host of problems from inside and outside the communities or groups they identify with.

Such problems are familiar for APIs born or raised here; for immigrants and refugees - a big part of the center's clientele - these issues can be overwhelming. Limited language is often a huge barrier to health.

Languages

Manzon-Santos and his paid staff of around 50 people juggle a 15-course banquet of programs and services in 18 languages, from Chamoru spoken in Guam to Gujrati and Hindi of South Asia to Tagalog and Visayan of the Philippines, as well as varieties of Chinese and several other tongues.

Not to mention services for the deaf in American Sign Language.

"More and more, we see ourselves as a community center for APIs and our allies," said Manzon-Santos, who views his gay identity as closely linked to his Asian identity. "We are trying to deal with the key issue of isolation. Our own experiences as APIs is often splintered and isolating, especially among immigrants and refugees."

Much of the center's work involves peer education and client centered models. As such, API Wellness is linked into a network of community organizations and foundations, including the upcoming AIDS Walk, which helped fund the center's total budget of $2.6 million in the last fiscal year.

Medical issues and HIV

Denial and taboo around medical issues are of course familiar to many marginalized people, and some not so marginalized. Many immigrants and refugees - not limited to APIs - arrive in San Francisco with little or no notion of HIV/AIDS. But APIs are at very high risk.

A center report last year quoted a New York Times editorial: "Asian Americans, especially new immigrants, are largely uneducated about AIDS.

More than any other ethnic group, Asian Americans do not get diagnosed with AIDS until the disease is already in its later stages. This reflects a dearth of Asian-language educational materials ... Stepping up AIDS education efforts would help increase understanding."

The Times praised community groups' efforts and urged public support for them.

Outreach

The center, formed from two existing organizations, took innovative steps to break the denial and taboo on HIV in the mid-1990s with its multilingual HIV treatment case management model. This, plus outreach and HIV testing programs, have "made San Francisco the exception" to the problem of ignorance, the report said.

As in many communities of color, the issue of gay sexuality is a mine field. Because of the high risk levels for HIV and STD infection among youth, many of the center's programs, like AQUA, target young people.

First generation residents are also a key client base, according to Ron Nieberding, the center's director of development and communications.

"We use the peer model a lot," Nieberding said. "We hire people from those communities to work directly with first generation clients."

Denise Tang, the center's associate director of community services, points to a plethora of options for LGBT visitors.

Asked hypothetically what she would say to a closeted Korean lesbian, Tang laughed and said, "I'd send her to the Queer Korean Family Project."

Besides making referrals to many such groups, the center also hosts gatherings by many groups, offering a safe space for people from the Tenderloin, for young queers, and for transgenders. Considerable outreach targets the sex worker community, which has a large transgender population and is heavily HIV-infected.

Many API women with limited skills who don't have much English end up in massage parlors, Tang said. "That population is not going to move out of the parlors to go look for health care, so we go there to talk to them. It's often a question of establishing trust."

In the end, Tang said, once trust is established, "people come here to the center because it's a group of very committed, very passionate people."

For more information about API Wellness Center, go to www.apiwellness.org, or call (415) 292-3400.
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Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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