A Reflection on the Cultural Implications of Asian Immigrants/Asian-Americans Receiving an HIV/AIDS Diagnosis.

I spent the Thanksgiving weekend studying in depth...for seven hours...about HIV/AIDS, and its implications in the mental health field. I have previous experience at La Clinica de la Raza's department of mental health in Oakland, California, providing mental health treatment services and case management to Latino beneficiaries of the Ryan White Program. Although I do hold prior clinical knowledge about the existentially painful and profound complexity of grief that arises after receiving an HIV/AIDS diagnosis, I sought this opportunity to study some new information.

A little tidbit that I learned...

Six percent of those living with HIV/AIDS in the United States are of Asian cultural heritage...

This is particularly interesting to me, based on my experience working with Asian immigrants and Asian-American clients. Many times when I start psychotherapy with a client who identifies as Asian or Asian-American, I often struggle to gain complete information about whether there is a history of mental health problems in the family. I remember one Vietnamese client shared that she suspects that probably there are plenty of mental health problems, but no one ever talked about it or showed any outward behaviors, "because that's just the way it is. No one would have be caught dead having a panic attack or admitting they were depressed in front of anyone. It's all about looking good." Some Asian immigrants and Asian-Americans have shared in therapy sessions about the nearly impossible expectations and standards there are within their unique cultural community. Honor, wealth, achievement, the display of happiness, and success are values that have been shared with me as culturally important....which also, are often anxiety provoking. 

Considering that six percent of at least 168,000 people in the United States living with HIV or AIDS are of Asian cultural identity, I surmise that members of this particular cultural group may experience a uniquely difficult and distressing response to a new HIV/AIDS diagnosis. Receiving this diagnosis as someone with the aforementioned cultural values and norms could certainly lead to profound and severe levels of depression, death-related anticipatory anxiety, isolation from other people, and intense internal self-shaming.

Of course, one cannot generalize about members of a culture or ethnicity, given the high amount of diversity within cultures, countries, families, and individuals. Since I practice psychotherapy from a cultural lense, I always like to expand my knowledge of other cultures, and openly invite conversation regarding the cultural implications of one's mental health, physical health, or situational problems, on one's unique identity and experience.