May 19 is National Asian & Pacific Islander HIV/AIDS Awareness Day and World Hepatitis Day. This blog post is one of a series on the impact of HIV and Hepatitis B in Asian & Pacific Islander communities. As A&PIs, you may not believe that you are at risk for these diseases, but you are. Follow our posts throughout the week for different perspectives and stories from our community.
The month of May is commemorated in the US as Asian Pacific American Heritage Month. During this month we celebrate our diversity in culture, traditions, history and language. Also, yesterday was National Asian & Pacific Islander HIV/AIDS Awareness Day. It’s important to acknowledge the significant impact our cultural norms have on how we view health, disease and sexuality. As a community we are all influenced by this in one way or another, whether we are recent immigrants or second or third generation.
Cultural and Linguistic Competence….Before I even begin to talk about this issue, it’s important to understand what this means. When I researched the generally accepted definition, I found a few thousand articles, but the Agency for Healthcare Research and Quality seems to capture its essence as it relates to health “The ability of healthcare providers and healthcare organizations to understand and respond effectively to the cultural and linguistic needs brought by the patient to the healthcare encounter. Cultural competence requires organizations and their personnel to: value diversity, assess themselves, manage the dynamics of difference, acquire and institutionalize cultural knowledge, adapt to diversity and the cultural contexts of individuals and communities served. ”
The lack of doctors and healthcare providers who have appropriate linguistic and cultural competencies creates a major barrier to quality HIV/AIDS care for Asian & Pacific Islanders. Imagine walking into a clinic where no one speaks your language and then tries to talk to you in loud voices as if increasing the volume will suddenly make them understandable… especially in our culture where respect is a central part of our lives….it makes you cringe. Navigating the healthcare maze, tackling issues of health insurance and immigration status, trying to explain your concerns in a manner that falls outside the commonly accepted western terminology is a nightmare. Even though we get “categorized” as Asian & Pacific Islanders, among us we have many, many languages, and I am not even counting the several hundred local dialects. Add to this the cultural intricacies of centuries of practices and beliefs, and you will just begin to understand what can only be called the tip of the iceberg.
This is not a new issue and I am not the first or the last person to talk about it. Many experts have written about it and there are hundreds of courses/trainings/workshops on cultural competence. Does this mean that you can take a course in cultural competence and become culturally competent…is that all it takes? Experience has shown me that the practice of cultural competence is one of continuous learning and exploration. That’s why the providers who have been successful in providing quality HIV/AIDS are the ones who create an accepting and respectful environment and have a diverse staff with multiple language skills and cultural backgrounds.
As Paul M. Schyve, M.D., Senior Vice President, The Joint Commission says, “Linguistically and culturally appropriate care has a direct impact on quality and safety, and is a growing issue that is not going to go away.”