InterPress News Service (IPS); Friday, 10 October 1997.
Sumegha Agarwal

The World Health Organisation lists Australia as relatively bright spots in the region's AIDS map, with reported cases of HIV and AIDS cases declining in recent years.

But social and health experts say it takes extra efforts and sensitivity to reach ethnic minorities with the same messages about safe sex and prevention addressed to other Australians.

Even getting people in these communities to talk about sexuality is a challenge, as the Sydney-based Positive Speakers' Bureau found out.

The group recently organised two courses for people with HIV from culturally and linguistically diverse backgrounds, so they could share their stories to help dispel myths about the illess. But "nobody came forward", Paul Maudlin of the bureau recalls.

Maudlin says this was a very difficult thing to do, "to talk about your own life, which some people can't do'. Like other people, many members of ethnic communities "fear they may be ridiculed", he added.

Studies by different agencies, including the Multicultural HIV/AIDS Education and Support Service (MHAS), show that minority groups and people from non-English speaking backgrounds tend to have low levels of access to mainstream services and inadequate awareness about HIV/AIDS issues.

Often, patients from ethnic communities present themselves to health services only when they are very sick and showing AIDS- defining symptoms, health experts say.

Cultural barriers exist to addressing issues such as men who have sex with men, prostitution and drug use. Talking about sexuality issues are a no-go zone for many minorities. A number believe the HIV/AIDS pandemic afflicts only immoral people or homosexuals.

"One of the major challenge or barrier is that there is a myth that HIV affects immoral people, where sexuality is seen as free and attainable outside traditional marriage structures," says Wa'el Sabri of the MHAS.

"The response that often comes is 'why we need (to know) about this? We've religion and culture to protect us against the HIV virus" Sabri explained. "It's similar when the issue is drug use among ethnic minorities. (They say) it doesn't exist, and if they do use drugs they don't talk about it."

Others pay little attention the HIV/AIDS, being more concerned about more immediate concerns like making a living. Said Sabri: "Migrants first have to deal with the issue of finding a house, job, schools for children. The question is how do we put HIV/AIDS on their agenda. It's not there at all."

Many among Australia's multi-cultural community have heard about the pandemic, but denial remains very strong. "Often in their countries of origin, HIV is not talked about because of culture and religion, fear of unemployment and also hard economic situation," Sabri said.

The recognition that a different approach is needed to reach these communities has spurred experts to innovate. For instance, if it is taboo to openly talk about sex, other images, like a bird, may be used to spread key messages.

In one HIV education project for people with Spanish-speaking backgrounds, the condor, a popular bird in South America, was used to convey the message of safe sex. An earlier campaign used posters with the slogan 'Play it safe. Use a condom' to target soccer fans among ethnic minorities.

People with HIV say many social and cultural taboos, which persist despite the fact that they are in another land, present a double barrier to getting proper information and care.

Claude Fabian, an HIV-positive homosexual from Argentina, says these barriers are "isolating" people to the point that they fail to get health care. "Ultimately, if people don't access services and information, they're not able to make considered and educated decisions about treatment and they're going to die," he said.

Fabian, who came to Australia when he was 11, says he is lucky to have the support of family and the gay community. "Otherwise, people from South American backgrounds find it very difficult to deal with these issues particularly because of the influence of Catholicism in South American culture," he added.

But Brent Allan, supervisor of the Asian project at the AIDS Council of New South Wales Inc, believes that like any other community, ethnic communities are dynamic and health workers "have to understand the nuances".

"The challenge is no more or bigger than the challenge to provide information and services for other communities. It could be the same as providing services for women and gay men," he said.

Wa'el agrees, but says that "between them (ethnic minorities) and mainstream there is almost a 10-year gap (in terms of dealing with HIV/AIDS issues)".

John, not his real name, is an HIV-positive homosexual from an Arabic background whose story was published in the 'National Aids Bulletin'.

"How can I tell my parents? What would they think? Not only that I have HIV but I'm gay. How can they face it? It's not my death I'm worried about, it's my parents' feelings, their reputation, especially when the rest of my relatives find out," he explained.

Sabri says cases like John's stress the need for cultural inputs when reaching out to people who ostensibly live a western lifestyle after moving to Australia but remain under pressure to conform to their communities' traditional views.

"It's true you can adopt another lifestyle and you can try to assimilate into another culture, but it's very difficult to change your position on fundamental issues," John said.

"You can assume that the parents may have changed their views about sexuality since they've been living here for last 30 years, but there are some cultural issues which are difficult to change," Sabri explained.

Health workers say it is easier to talk about sexuality and other sensitive issues with the younger generation. There have also been positive developments, like an HIV education project for women among the Arabic Muslim Shiite community that was launched with religious leaders' blessing.

But experts say more needs to be done in raising awareness about HIV/AIDS among Australia's culturally diverse community.

Michael Camit, consultant with New South Wales Multicultural Health Communication Service, says it is time to review which groups define the HIV/AIDS agenda in the country, to see how ethnic communities can be better reached.

At present it is the gay community, but Camir says it is time for "people from othter cultures to set the agenda". He added, "Diversity around HIV/AIDS is not reflected in the media. Nobody wants to touch the combination of HIV and diversity."

Many are not surprised. After all, the National Centre in HIV Epidemiology and Clinical Research, which is responsible for national data on AIDS/HIV, does not collect ethno-specific data, except for Aboriginal and Torres Strait Islanders. (END/IPS/AP-HD- PR/SA/JS/97)

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