Asian & Pacific Islander Wellness Center
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Asian and Pacific Islander Gay Men and Transgenders with HIV

Asian & Pacific Islander Wellness Center, San Francisco, CA

If every new HIV infection involves a person with HIV, why do most prevention programs only target HIV- persons? People who have HIV deserve to have interventions to help them stay safe and play an active role in stopping the epidemic. In the Spring of 2001, AIDS Partnership California (APC) initiated the primary Prevention for Positives (P3) Initiative, awarding grants to six ethnic minority CBOs to conduct formative research on what people of color with HIV want and need in an HIV prevention program. Two CBOs also developed HIV prevention programs based on the formative research findings.

Because little is known about the prevention needs of people with HIV, conducting formative research is key to developing interventions that are effective, culturally competent, and welcomed by the community served.

Target audience

Asian & Pacific Islander (A&PI) Wellness Center serves a wide range of A&PI clients in San Francisco, CA. For the P3 project, A&PI Wellness began E Kuli'ana Kakou!, which focuses on A&PI gay men and male-to-female transgendered persons with HIV.

Why A&PI gay men and transgenders?

• San Francisco's AIDS incidence among A&PI is over six times higher than the A&PI AIDS incidence for the rest of the nation.
  
  
• A&PI AIDS cases in San Francisco account for approximately 15% of cumulative A&PI cases in the U.S.
  
  
• A&PIs account for 10% of all transgender AIDS cases in San Francisco.
  
  
• One study found a seroprevalence rate of 27% among A&PI transgender persons.
  

Needs identified through formative research

API Wellness conducted focus groups and individual interviews with A&PI gay/bisexual men, transgenders, women, substance abusers and community leaders. Because the research gave insufficient data on the needs of A&PI women and substance users with HIV, they decided to focus on gay/bisexual men and transgenders.

• Mental health issues
  
  • Anger management and self control
    
  • Guilt and denial of status
    
  • Relationship and disclosure with partner, family, friends
    
  • Depression, self-esteem
    
  • Planning for new life ahead
    
  • Identity development
    
  • Shame and silence around sex work and substance abuse
    
  
  
• Prevention issues
  
  • Risk Reduction
    
  • Safer sex
    
  • Safer drug use
    
  
  
• Care and general health issues
  
  • Awareness of medications and treatments
    
  • Alternative therapy
    
  • Nutrition and diet
    
  • Exercise
    
  
  
• Social issues
  
  • Social isolation
    
  • Personal and community empowerment
    
  • Level of acculturation
    
  • Language proficiency
    
  • Community responsibility
    
  
  
• Transgender-specific issues
  
  • Social isolation
    
  • Self defense, safety, domestic violence
    
  • Legal rights
    
  • Substance use/abuse
    
  • Medication/nutrition related to hormone therapy
    

How A&PI Wellness addresses these needs

E Kuli'ana Kakou! seeks to motivate behavior change though the integration of psychotherapy, primary care education, social events and community building. Based on the formative research findings, they have implemented the following program:

• Psychotherapy
  
  • Individual psychotherapy
    
  • Group therapy: three 6/8-week group sessions that offer support as well as problem-solving skills
    
  
  
• Treatment education workshops
  
  • Basic (newly diagnosed)
    
  • Intermediate
    
  • Advanced (long term survivors)
    
  
  
• General health and wellness
  
  • Gym Program
    
  
  
• Free five week gym membership
  
  
• Ten sessions personal training
  
  
• Buddy system - clients work out in pairs
  
  
• Nutrition for bodybuilding
  
  • Nutrition Program
    
  
  
• Monthly hands-on nutrition sessions
  
  
• Clients help prepare meals; nutritionist provides food and nutritional analysis
  
  
• Modification of Asian recipes for healthier nutrition
  
  
• Social support/community-building
  
  • Monthly theme-based events
    
  • Annual events: picnic, Lunar New Year banquet, etc.
    
  
  
• Transgender-specific support
  
  • Social activities
    
  
  
• Arts and crafts
  
  
• Makeovers
  
  • Self defense classes
    
  • Networking events
    

Lessons Learned

• Persons with HIV need access to psychotherapy services
  
  
• Monolingual clients must be meaningfully involved in services
  
  
• Gay men and transgenders need separate spaces
  

AIDS Partnership California (APC) is a private-public funding collaborative that includes foundation and corporate funders and the California State Office of AIDS.

APC is a program of Northern California Grantmakers, an association of 160 foundations and corporate giving programs.

Email: apc@ncg.org

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