These institutions are missing a vital opportunity to reach masses of immigrants for whom a temple or mosque is the only connection with a formal support system and therefore a potentially critical source of life-saving health information, said lead author John J. Chin, Ph.D., Senior Research Associate in the Academy Division of Health Policy. "Religious institutions in Asian immigrant communities are very influential and in a unique position to confront the challenges of the HIV epidemic for the communities they serve," Chin said. "The conversation about HIV is often nonexistent among Asian immigrants, and religious institutions need to take the lead to change that to prevent transmission in their communities, and assist those who are already infected."
Academy scientists funded by the National Institutes of Health conducted 17 in-depth interviews with leaders and members of a Buddhist temple in Chinatown, a Hindu temple in Queens, and an Islamic center and mosque in Queens. All immigrants interviewed were from China, India, or Bangladesh. Researchers speaking in English, Mandarin, or Urdu assessed each person's knowledge of HIV/AIDS, attitudes toward the disease, and willingness to be involved in HIV-related services. This is the first systematic study of Asian immigrant religious institutions' willingness to take a role in HIV prevention or care in the United States.
The findings were striking. Some leaders of Asian religious institutions said they believe HIV poses only a minimal risk for the Asian community, Chin and colleagues found, and most respondents said that HIV prevalence was relatively low or nonexistent in their respective communities. Others felt the community would be too uncomfortable discussing HIV in a religious setting, largely because Asians generally consider sex outside of marriage, homosexuality, and drug use to be taboo subjects and "inappropriate" to discuss in a religious setting. Still other leaders hold their own stigmatizing attitudes about HIV and did not want to get involved for that reason.
Some respondents surveyed said they feared they would contract HIV if they became active in HIV prevention and education. In fact, some said they believe that HIV can be contracted by sharing soap or a drinking glass with an HIV-positive person or through casual contact. Other leaders feared they would be shunned in their communities if they offered HIV education or helped HIV-positive people, researchers found. Furthermore, some leaders felt it unnecessary to become involved in HIV education because their worshipers are protected by religious teachings of moral restraint and abstinence.
Even though most religious leaders and members expressed little interest in becoming involved in HIV-related work, many acknowledged such work would be consistent with their traditions of compassion and community service, and some leaders embraced the idea of involvement in HIV prevention education so long as their basic message could be that non-marital and homosexual sex are absolutely forbidden. These religious institutions are awash in "the tension between morality and compassion," Chin explained. Almost all of those interviewed agreed that it is important for the institutions to play a role in promoting general health in the community, though not to address HIV specifically. Their involvement could have a tremendous impact on preserving and protecting the health of New York City's Asian immigrants and those with whom they come in contact, Chin said. AIDS has reached epidemic proportions in parts of the Asia-Pacific region including China and India, with an estimated 8.2 million people living with the disease as of the end of 2004.
"Language and cultural barriers, as well as discrimination, isolate many immigrants from the wider society," said Chin, whose parents immigrated from Korea in the late 1950s. "They therefore rely heavily on immigrant community institutions to obtain social, economic and other supports. In the case of HIV, this role is especially important because of the social stigma surrounding HIV and the potentially dire health consequences of not understanding how to prevent transmission of the virus."
The research project is part of the Study of Asian Community Institutions, a three-year examination of the roles played by Asian immigrant community institutions, including religious institutions, in shaping social norms that promote or impede HIV prevention efforts within Asian communities. Dr. Chin is the Principal Investigator for that study. Co-authors of the current research project include Academy Senior Research Associate Linda Weiss, Ph.D. The Academy is carrying out the study in partnership with the Asian & Pacific Islander Coalition on HIV/AIDS, the Chinese-American Planning Council, the South Asian Health Project, and other community organizations. The study was funded by the National Institute of Child Health and Human Development of the NIH.
The New York Academy of Medicine, the country's premier urban health policy and intervention center, focuses on enhancing the health of people living in cities through research, education, advocacy, and prevention. It is home to the second largest medical collection open to the general public in the United States. Visit us online at www.nyam.org.
Journal
AIDS Education and Prevention