Wednesday, August 20, 2008

The Cost of a Closed Culture

by Steve Villano

While the world’s attention was riveted on Beijing last week, mine was focused on a Chinese friend of mine who was visiting New York. He had come to New York for a visit, and I was the first person he told that he was HIV Positive.

He had known since May, but was terrified of telling anyone in his home country about his HIV status. He knew how people would react, and it would not be the way the fans at the “Bird’s Nest” in Beijing were cheering their athletes.

My friend is not a teenager; he is close to 40 years old, single, has an extraordinarily successful career, and considerable wealth. There was no financial barrier to seeing a doctor for him—only a cultural one.

So, he came to New York on vacation, and told me his HIV status, and that he was not on any medications, did not know his T-cell count, nor his viral load. I did what anyone who has worked many years in the area of HIV/AIDS education and prevention would do—I arranged for him to see a doctor, get re-tested, find out some important facts about his status, and get on meds, if he needed them.

We scheduled an appointment for him with a top physician at APICHA—the Asian/Pacific Islander Coalition on HIV/AIDS. He was a “self-pay” patient—a rarity at many financially strapped AIDS service organizations—but that did not matter. He was treated with the same dignity and compassion that all of APICHA’s clients receive—and they serve the largest number of Asian/Pacific Islanders in the entire Northeastern US.

My friend was impressed with the quality of care he received, the comfortable and confidential manner in which he was treated, and the fact that his case was handled in a completely medical/scientific and non-judgmental way. He only wished he could get the same kind of care in his home country.

He learned from the doctor he saw at APICHA that his T-cell count and viral load were well within normal range, he was STD-free, and that he did not need to go on medication just yet. He was told he needed to see a doctor every three or four months for an updated assessment of T-cells and viral load—in the event it became necessary to place him on an anti-retroviral drug routine. That would not be a problem, he said, if he lived in NYC or in the US, but getting such care at home might be as difficult as defeating Michael Phelps in a swimming competition.

My friend is fortunate that he found out early that he was HIV positive, can travel the world at will, and pay for doctors in NYC or San Francisco or Europe. But, there are millions of others just like him, without means or access to medical care, whose cultures force them to keep their HIV status very quiet, until the virus makes its presence impossible to hide, or to live with.

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