Lance Toma is the executive director of API Wellness in San Francisco, an LGBTQ and people of color community health center in San Francisco that transforms lives by advancing health, wellness, and equality. Lance has been working in HIV for over 20 years, and his work is firmly grounded in social justice.
This May 19 is National Asian & Pacific Islander HIV/AIDS Awareness Day. We caught up with Lance to learn more about the significance of this day, the barriers faced by Asian and Pacific Islander (API) communities, and his motivations for doing this work.
How did you became involved in this field?
As a gay man, I feel like I've grown up learning about and being part of the HIV community. I was an HIV educator in college and as a social worker I ran a queer youth program in Chicago. A significant part of that program was about HIV prevention, care, and testing. But, as with many queer youth programs, that's just one part of the picture. My focus has always been to look at the whole person and the community where they live. That has always informed my work.
I started at API Wellness because it gave me the opportunity to support and shape programs targeting Asians and Pacific Islanders (API) at risk for and living with HIV. Over the 17 years I've been here, we've taken our lessons learned to expand our reach and provide comprehensive services to the most vulnerable in San Francisco, including people of color and the transgender community.
Most recently, API Wellness became a Federally Qualified Health Center (FQHC) in 2015 and we provide primary care to everyone and anyone who needs it. It's inspiring and motivating to me to see how we evolve as HIV organizations. What we do matters and it is so critical that our organizations play a part in the broader health care movement.
What barriers to testing and care exist for Asian and Pacific Islander communities?
Stigma and shame with respect to HIV and LGBTQ issues are still prevalent within the API community and impact how an individual does or does not access HIV resources, whether or not they are living with HIV. This stigma creates a level of stress which can affect mental health, decisions around substance use, and has an overall impact on the wellness of API communities.
We definitely see that API communities are not accessing testing as readily as others. APIs are the least likely race to get tested for HIV and it's estimated that 20% of APIs who are living with HIV don't know it. Also, our community members are testing too late; a good proportion of our community members are diagnosed when they are in late stages of HIV progression. There is so much work to be done around raising awareness and providing language and culturally competent services and resources to our communities.
How has API Wellness worked to counter these barriers to better serve API communities?
As we've grappled with stigma and made addressing and confronting stigma a priority over the years, we've seen that storytelling is a vital tool. Through the Banyan Tree Project, we work with our constituents to teach them to create their own digital stories -- including developing visuals, sound, and narrative -- that we share widely on social media and at events in communities across the country. We have seen how important it is for people to hear a person's own truth about the impact of HIV on their life or how detrimental the stigma and discrimination they have felt from their own communities or families can be. This helps us achieve our goal of changing hearts and minds.
Why is National Asian and Pacific Islander HIV/AIDS Awareness Day critical?
When it comes to HIV, a lot of silence, shame, and stigma exists within our API communities and families. This is a day to share the stories of our community members to change hearts and minds within our communities. Erasing HIV stigma and breaking the silence is necessary to our families and our survival.
API Wellness helped lead a number of organizations to spearhead the creation of this day in 2005. Since then, we have continued to work to raise awareness and ensure that this day is on people's radars, especially in API communities.
Are there any specific advocacy areas that are critical to your community?
We continue to have to keep our communities on the radar on all levels -- local, state, and federal. We need to pay attention to the API community and ensure that we are not falling off the radar. We need resources targeted to our cultural and linguistic needs.
For this year specifically, we are trying to push and educate our communities about PrEP. This year, our national slogan is "saving face can't make you safe; get PrEP." That really is about making sure that all of our community members are knowledgeable about PrEP and how to access it.
How do you stay motivated in your work?
There's so many organizations and people doing this work and we are all family. We are all in this fight together and that motivates me. That we stay connected and continue to learn from each other about the needs of communities of color, women, youth, and transgender communities, that in and of itself is super inspiring to me.
Also, the advances around HIV that we're seeing are huge. API Wellness is part of the San Francisco Getting to Zero consortium, a collective impact initiative to reduce both HIV infections and HIV deaths by 90% from their current levels by 2020. To me, it is so inspiring that we really can get to zero over time -- it is not unrealistic. We can only do that if we engage communities of color, transgender communities, and low income and poor communities and that is my passion. I have always been driven to make sure that people of color and our most marginalized and vulnerable communities are engaged. That's my goal, my work, and what keeps me in it.
Sarah Hashmall is communications manager at AIDS United.