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TitleClinician's Guide to Working with Asians and Pacific Islanders Living with HIV
LanguageEnglish
File Size1.0 MB
Total Pages20
Document Text Contents
Page 1

Clinician’s Guide to
Working with Asians
and Pacific Islanders
Living with HIV

Daniel D. Yu, MSW
Asian & Pacific Islander Wellness Center

Page 10

Guide to Working with Asians and Pacific Islanders Living with HIV
16

Treatment Adherence and Hope
Even when Asian and Pacific Islander patients have
established a routine of care within the context of
Western medical and social services, cultural values
and beliefs can interfere with their ability to maintain
or improve their treatment. Patients may experience
hopelessness and fatalism, preventing them from
continuing or enhancing their care. Hopelessness
may also be related to low self-esteem and feelings of
having disappointed one’s family by contracting HIV.
By balancing feelings of hope and sadness, a patient
can develop a vision of survival.

INTERVENTIONS
• Teach patients about

the structure of the
medical care system

• Create an
empowerment
narrative

• Establish a
multidisciplinary
care team

• Establish peer
intervention

Service Goals for Asians
and Pacific Islanders
Living with HIV

Guide to Working with Asians and Pacific Islanders Living with HIV
17

Linguistically and
Culturally Sensitive Care
Language barriers and cultural alienation from
services can interfere with a patient’s motivation to
seek and adhere to medical treatment, including HIV
medication regimens. Services should be provided by
HIV physicians who can communicate with the patient
in their language of choice. If such practitioners are
unavailable, medical providers are encouraged to
link patients to a social service provider (case worker,
social worker, or peer advocate) who can interpret
information for the client within the context of an
ongoing relationship.

If untrained interpreters or family members
are utilized, providers should be sensitive to the
intermediary’s personal biases which may interfere
with the communication of information. Patients may
also be unwilling to discuss personal information in
front of family or close friends.

INTERVENTIONS
• Link patient to social service provider

• Educate providers about culturally
sensitive services

• Establish a multidisciplinary care team

Your patient may express their wishes
or desires through silence or non-verbal
communication, expecting that you
will notice their silence and address
what they need.

Page 11

Guide to Working with Asians and Pacific Islanders Living with HIV
18

Service Goals for Asians
and Pacific Islanders
Living with HIV

Belief in Western Treatment
and Traditional Methods of Healing
Lack of familiarity with Western treatment and
care models can cause Asian and Pacific Islander
patients living with HIV to mistrust their medical
care. Patients may have to incrementally build faith
in Western approaches. To develop trust, a medical
provider is advised to take time and proceed slowly.
Building trust is more effective if the patient’s
traditional beliefs are not devalued by Western medical
providers. A provider does not have to subscribe to
a patient’s belief systems in order to show respect.
Patients who experience respect and curiosity from
providers are more likely to disclose problems and
concerns, and adhere to prescribed treatment plans.

INTERVENTIONS
• Educate providers about

culturally sensitive services

• Teach and offer a bicultural
approach to service access

• Show respect for traditional
approaches to healing

• Establish peer intervention

Guide to Working with Asians and Pacific Islanders Living with HIV
19

Integrate HIV Into Identity
A common reaction to an HIV-positive diagnosis is
denial or avoidance. For Asians and Pacific Islanders,
this reaction is compounded by concerns for their
family. An HIV-positive patient may feel that they have
disappointed their family or may worry that they will
not be able to fulfill their family obligations. A patient
who integrates their diagnosis into their identity can
better seek and maintain participation in treatment.

INTERVENTIONS
• Assess integration of HIV

diagnosis into identity

• Pace delivery of information

• Develop an alliance

Sense of Control
Over Treatment and Services
Overwhelmed by language barriers, Western service
systems and terminology, frank discussions of sexuality,
difficult feelings, and an unfamiliar belief system of
health and healing, Asian and Pacific Islander patients
can feel hopeless and alienated from their own care.
Allowing the patient a sense of control over their
care relies on providers who can establish culturally
sensitive and informed relationships with the patient.

INTERVENTIONS
• Create an empowerment narrative

• Teach patients about the structure of
the medical care system

• Practice direct communication

• Teach and offer a bicultural approach to care

Page 19

Guide to Working with Asians and Pacific Islanders Living with HIV
34

Asian & Pacific Islander
Wellness Center, continued

A&PIWC’s Research & Technical Assistance program builds

HIV prevention capacity in organizations and communities

throughout the United States and its Pacific Territories and

conducts community-based research. We have provided

technical assistance to more than 45 organizations including

community-based HIV/AIDS agencies serving Asians and

Pacific Islanders and gay Asian and Pacific Islander groups.

Two of A&PIWC’s national model programs focus on

utilization of and adherence to HIV treatments.

In contrast with many models, A&PIWC’s Multi-

Lingual Treatment Case Management helps clients

manage immediate and ongoing needs alongside the longer

term issues of living with HIV. This model combines health

assessment, treatment

education and coaching,

planning and follow-

up within a service-

based case management

setting. When clients

Due to the Treatment Case Management
model that Asian & Pacific Islander
Wellness Center has piloted, some of our
promising successes are occurring among
immigrant men, women and youth who,
even facing linguistic and socioeconomic
barriers, have been among the first to
benefit from new treatments.

Willie L. Brown, Jr.
Mayor, City & County of San Francisco

Guide to Working with Asians and Pacific Islanders Living with HIV
35

can take care of their psychosocial needs, they can also be

engaged more in assessing their health and making

informed treatment decisions. Multi-Lingual Treatment

Case Management increases the number of clients who

know about and access optimum HIV treatments. Clients

utilize services earlier, regardless of English fluency;

measurably enhance their interaction with primary care

providers; and increase compliance with drug regimens,

as measured by chart reviews.

In partnership with Project Inform, A&PIWC

sponsors the Treatment Education Certification

Program (TECP), a 21-hour course for non-medical HIV

service providers designed to train on HIV pathogenesis,

standards of care, antiviral strategies, opportunistic

infections, research, clinical trials and access issues,

adherence, benefits, referral resources, and strategies for

working with multiply-diagnosed and underserved clients.

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