Study Summaries

These studies were presented at the Healthy Living Campaign for South Asians: A Forum on Sexual Health on April 26, 2006. Detailed summaries of each study are provided below.

Chinese and South Asian Religious Institutions in New York City: Perceptions of HIV/AIDS and Involvement in HIV-Related Prevention and Care

John J. Chin, Ph.D., Joanne Mantell, Ph.D., Linda Weiss, Ph.D., Mamatha Bhagavan The New York Academy of Medicine, Division of Health Policy
Religious institutions in Asian immigrant communities are in a unique position to confront the challenges of the HIV epidemic for the populations they serve. However, there has been little research on whether these institutions are willing or able to take a role in HIV-related prevention or care. As part of a larger exploratory study on Asian immigrant community institutions and HIV/AIDS in New York City, we interviewed leaders and members of four New York City-based religious institutions about their knowledge and attitudes about HIV/AIDS and their willingness to be involved in HIV-related services. The four institutions included a Chinese Buddhist temple, a Chinese Christian church, an Indian Hindu temple, and a South Asian mosque.

In general across the four religious institutions, though to varying degrees, HIV was an issue that the religious institutions seemed hesitant to embrace. Some were hesitant because of their belief that the larger community would feel uncomfortable with the issue, while others were hesitant because they themselves had stigmatizing attitudes about HIV or did not believe it was a concern for Asian/Pacific Islander communities. The hesitancy to embrace HIV at the religious institutions was tempered by their traditions of compassion and community service, which formed the foundation for a wide range of community service activities, including health fairs, which sometimes, though rarely, included HIV information.

Poor knowledge about HIV transmission appeared highly related to stigmatizing or fearful attitudes about HIV. In some cases, knowledge about HIV was very low, with some respondents believing that HIV could be transmitted by sharing soap or a drinking glass or through casual contact with someone who is HIV-positive. Several leaders and members expressed conflict between their desire to help people living with HIV/AIDS or get involved in HIV prevention education and their fear of contracting HIV or being stigmatized by their association with HIV. Some were convinced that helping a person with HIV would surely lead to one's own HIV infection.

Some religious leaders felt that involvement in HIV prevention education was not necessary because their teachings on moral restraint and proper conduct (e.g., abstinence) were sufficient to protect community members from HIV. Other leaders agreed that religious institutions should directly teach community members about HIV prevention. Some of these leaders, however, insisted that HIV prevention education should include religious teachings that forbid homosexuality and non-marital sex.

While respondents did not fully and unequivocally embrace involvement in HIV-related work, they often expressed the view that involvement in HIV would be consistent with their traditions of compassion and community service. Almost all agreed that it would be appropriate and important for their institutions to play a role in promoting health in their communities, even if they were reluctant to take on HIV specifically. At three of the four institutions, respondents indicated that formal policies or religious teachings would not be a barrier to their involvement in HIV-related prevention or care. However, it is important to note that some respondents reported that religious teachings would constrain the content of prevention messages to the extent that they might conflict with public health interests.

The research indicates that engaging Asian immigrant religious institutions in HIV-related activities might require helping them identify activities that are consistent with their institutional cultures and religious teachings. While some religious institutions might be comfortable with taking a direct and active role in HIV prevention or care, others might be more comfortable with increasing basic awareness through charitable or other activities, such as prayer. Because of religious institutions important role in shaping social norms and attitudes in Asian immigrant communities, the importance of their involvement in basic awareness-raising about HIV should not be under-estimated.

This is an exploratory study designed to begin describing a relatively unknown area. Because this research includes only four of the many Chinese and South Asian religious institutions in New York City (and a relatively small number of respondents from each institution), its findings are not necessarily generalizable to other Asian religious institutions. Similarly, the institutions in our study are not necessarily representative of other institutions of the same faith. An important next step will be to further explore these issues in a larger study involving a greater number of religious institutions.

Cultural Influences on Family Planning in the South Asian Community

Nereida Correa, MD, MPH, Medical Director, MIC Women's Health Services, Medical and Health Research Association of New York City
Health care that is culturally sensitive and recognizes the special needs of diverse communities is a key aspect of assuring that the challenges of promoting sexual health and preventing sexually transmitted disease are met. In focus groups that included South Asian women from Pakistan and Bangladesh we were able to explore the perceived family planning needs of several ethnic groups of women who receive care in our women's health centers in New York City.

We will present our findings which suggest that cultural influences, attitudes and beliefs as well as the relationship with her husband play a key role in a woman's ability to plan her pregnancies and to use strategies to prevent disease. We will present cases that illustrate our findings and provide opportunities for discussion of their implications in the planning of health care for South Asian women and their families.

South Asian Immigrant Women's HIV/AIDS Related Issues:
An Exploratory Study of New York City

Margaret Abraham, Roopa Chakkappan, Malabika Das, Sapna Patel, Sung Won Park
To date, HIV/AIDS has not received much attention as a public issue within the South Asian immigrant communities in the United States. Despite the rapid increase in the South Asian population, there is a severe paucity of published research on HIV/AIDS related issues among South Asians in the United States. This presentation will draw upon the findings of an exploratory four month, multi-method, project on South Asians Immigrant HIV/AIDS related issues. The key goals are: (1) To better understand South Asian Immigrant Women's HIV/AIDS related issues by examining HIV/AIDS knowledge, perceptions, attitudes, and perceived susceptibility in the South Asian immigrant community in New York City. (2) To assess their knowledge of available resources and utilization of services. (3) To explore strategies for effective outreach with regard to education, prevention, and treatment of HIV/AIDS for South Asian communities in the United States. (4) To share the findings with South Asian and Asian communities and to provide recommendations to the Department of Health and Human Services.

The findings of this study indicate that the lack of public discussion on HIV/AIDS among South Asian communities is frequently interlocked with cultural and structural factors. Key cultural barriers include denial of the prevalence of risky sexual behaviors among South Asians, fear of stigma and isolation by family and community members as well as patriarchal norms and values that influence gender relations. Key structural issues include the high cost of health care and lack of health insurance, mistrust of government agencies due to fear of breach of confidentiality, and fear that information sharing by institutions will negatively impact immigration-related issues.

Recommendations to address the issues identified in this exploratory study based on valuable community input will also be briefly discussed. These include:(1) To improve data collection and reporting so as to develop a reliable baseline; (2)To address barriers to access and utilization of services in policy and practice; (3) To increase community collaboration and input; (4) To develop a multilevel, multi-strategy approach to HIV/AIDS Education, Prevention and Treatment (5) To change community outlook including emphasizing the importance of a community-based response to increasing HIV/AIDS awareness, prevention and treatment; and (6) To consider gender throughout the design, implementation, and evaluation of HIV/AIDS programs including involving women, particularly those impacted by HIV/AIDS in developing strategies for the planning and implementation of policies and programs.