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Deaf-REACH's HIV Prevention Program Speaks the Deaf Community's Language

November 25, 2013

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If someone accesses services, specifically HIV testing, at Deaf-REACH, if they were to be diagnosed, what is your linkage to care like?

For our preliminary positives, we have agreements with several different places. One place that's particularly good with dealing with the deaf community, and knows how to hire an interpreter, is Whitman-Walker, which is a huge clinic here in D.C.

One thing that we do is presentations for health service providers, to try to bridge the gap between the deaf community and hearing service providers by teaching them the dos and don'ts of deaf behavior, deaf culture, how to hire a qualified interpreter. That way, if a deaf person comes in, it's not that shocking -- it's hard enough to come in for a confirmatory HIV test. Especially if you walk in and the person says, "Oh, my God; they're deaf. What am I going to do?"

So we teach them how to hire and use an interpreter -- for instance, to speak directly to the deaf client as opposed to speaking to the interpreter and saying, "Tell him / tell her" -- which you're not supposed to do.

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Most of the time, we make the appointments for the client, which tends to be easier than to set up the interpreter, and make sure that they've hired an interpreter. Then we ask them if they'd like us to go with them, even just to show up and make sure that there's an interpreter there and that they are as comfortable as possible, and then just walk through the process with them.

Does Deaf-REACH offer mental health services for deaf individuals who are also HIV positive?

We have the capability, yes.

That's great. What's your role at Deaf-REACH?

I'm the director for the HIV prevention program. I oversee the day-to-day functioning of the program. I write the grants. I oversee two HIV prevention specialists. I go out and I do outreach. I do testing. I tend to do a little bit of everything. I run the Facebook page and the Twitter account. Any attempts at solicitations are all made by me.

Whose idea was it to start a YouTube series? I saw one of your YouTube videos; as a hearing person, it's kind of jarring to see a YouTube video and then not have any sound. The first time, I thought: Are my speakers off?

Yeah, that was mine. We started doing that because American Sign Language is a language that has completely different grammatical structure than English. If we have everything posted online in English, it's kind of completely ignoring our target population, which is the signing deaf community.

So we decided that we wanted a signing version so everything was bilingual, so that those people that are strong ASL users can understand it in their first language.

Can you roughly translate what the person is saying in the YouTube video?



It says:

Welcome to the HIV prevention program. We're the only agency in the Washington, D.C., area that offers HIV education to the deaf and hard-of-hearing community. What does our program do? We offer free HIV testing, HIV education for groups and individuals, HIV outreach. We go to deaf events. We do GLBT socials, government socials. We also give out safe sex kits. What do they look like? Here, this is an example of what one looks like. It tends to include male, female condoms, different kinds of condoms inside. We do counseling, one-on-one, referrals. And lastly, we help you develop your negotiation skills for condom usage.

HIV is still here, and so is prevention. If you're interested in any of our services or if you have questions, please contact us or email us. And we can find any referrals. If you would like us to present or have any suggestions about where we should go to give out condoms, let us know. We'd love to hear feedback from you and the community.

You can email us at hiv@deafreach.org.

And that is basically the translation of what Robert, our HIV specialist, is signing.

What are some next steps and future goals for Deaf-REACH's HIV prevention program?

We are trying to form agreements with a lot of clinics. Since we do have a unique set of services, we're trying to forge collaborations, because the future of HIV funding is shifting from intervention-based to dealing with prevention with positives. So we are trying to stay with the current shifts in HIV prevention and forge collaborations with different clinics in Virginia, D.C., and Maryland. We are expanding our services into Virginia and Maryland, and also trying to link with clinics.

For instance, at the two health departments in Virginia, we offer HIV testing once a month. We're trying to use the clinics; that way we can still offer the preliminary testing, and deaf clients can come and we can sign, using sign language, native language, as opposed to using an interpreter. Then our agreement reads that any preliminary positives we have, we refer to the health department for confirmatory testing.

You mentioned that Maryland is the only state that has someone's auditory capability as part of an intake form.

Under Special Populations, it asks, "Deaf or hard-of-hearing?" While I was working in Maryland, we successfully got a code for American Sign Language to put down under Languages on the encounter forms, as well. So Maryland does recognize deaf and hard-of-hearing on the encounter forms, and also American Sign Language as a language.

Is that something that Deaf-REACH also wants to take up in Virginia?

We would love to take that up in Virginia and D.C. D.C. doesn't have it on their testing encounter forms, either. I think the Departments of Health all over the country need to adapt more to the Maryland model, because we're able to get statistics -- we can get statistics on other minorities, and especially linguistic minorities. But that's one we can't get. If they ask it on the testing encounter form, then we're able to get more of a snapshot of the deaf community: Where are they going to get tests? Are they going to health departments, or are they coming to places like Deaf-REACH? Are they going to their doctors? So we're trying to figure out where they are getting tested, because the numbers of deaf people that are getting tested are going down. I don't know if it's because HIV is not as terrifying as it was in the '90s, and people aren't so paranoid now that the talk around HIV and AIDS isn't as severe as it used to be. I'm not sure if that's why there are fewer people coming in to get tested.

What are some of the specific barriers for deaf people to getting an HIV test? If someone were to read this, and they know someone who is deaf, what's one way that they can assist them with getting an HIV test?


How to Put on a Condom (American Sign Language)


I think it's finding somewhere that is knowledgeable about deaf people, and knows that we are required under the Americans With Disabilities Act to hire an interpreter, which makes the entire experience completely different for the deaf client, as opposed to struggling to communicate, or writing back and forth. HIV and AIDS is such a complicated concept. How are you going to use that using just gestures if you don't know sign language, and you're trying to communicate?

And also positive, just the word itself, in ASL is kind of seen as a good thing. Like, you know, to sign think positive is two signs put together to mean optimistic. So, a lot of times when we do presentations, one of the first questions we'll ask is, "HIV positive: What does it mean?" And we try to say, "Have HIV" or "HIV in the body," and emphasize that that's what it means, as opposed to using "HIV positive" and "HIV negative" -- because it can often be misinterpreted.

So I would suggest that they go somewhere that knows how to work with an interpreter or, if there's a place like Deaf-REACH, that offers signing staff. There are a lot of health clinics now that do have staff that sign, especially if there's a large deaf community in the area. And that they know their rights for hiring an interpreter and being referred.

Anyone that emails us, if they email us, no matter where they are, we try to figure out a place. Even if that means us calling a clinic and asking, "We know a deaf person that wants to come in and get an HIV test. Can you hire an interpreter? Can you schedule it?"

The hard thing is a lot of times people get HIV tests off the fly. It will just be random: "Oh, a 20-minute HIV test; OK, I'll go in there and do that." When they're just doing walk-ins, it's hard to have an interpreter ready. So that's another sort of complication, especially, that we find for referring people for STD testing -- a lot of it is on a walk-in basis. It's hard to say, "At this time they're going to be there," when it's a walk-in clinic.

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