The Orange County Board of Supervisors on Tuesday gave the go-ahead for a $213,000 study aimed at gauging how hard AIDS has hit the county's large Vietnamese community and how people there are responding.
Without discussion, supervisors approved spending $212,987 to staff and fund the program. But Ronald S. Rubino, the county's budget director, said the county expects to be reimbursed for that amount from the federal government, which is also taking part in the study.
The project represents a rare look into AIDS among Vietnamese-Americans, and will examine what officials say is a commonly held perception that Asian communities have largely escaped the epidemic.
But partly because extensive studies have not been done, some Vietnamese leaders and county health officials appear to be undertaking the project with very different ideas about what it may reveal.
Dr. Penny Weissmuller, the County Health Care Agency's manager of disease control, said the project could verify the perception that AIDS has not had much effect on the Asian community. If so, the findings could offer suggestions for limiting the spread of the deadly illness elsewhere, she added.
"There's a widely held belief that there's less HIV infection among Asians--that may or may not be true," Weissmuller said. "So this is a way of determining the level of infection . . . and the knowledge and attitudes that may explain it."
But Tuong Nguyen, executive director of the Vietnamese Community of Orange County Inc., who has worked with county officials in preparing the study, fears that AIDS may be "a hidden problem" among Orange County's more than 70,000 Vietnamese residents--the largest population outside Vietnam.
AIDS treatment centers and educational outlets "just don't exist" in the Vietnamese community, Nguyen said, suggesting that the disease may have spread more quickly than is generally realized.
"I hope it's not so," he said, "but by tradition, the Vietnamese people don't tell other people about their diseases--it's shameful. They keep it to themselves. . . . This is a very sensitive issue."
Indeed, a study proposal that accompanied Tuesday's action notes that among Vietnamese, "repression of discussion of anything relating to sexuality is common, and a strongly negative social stigma is associated with sexually transmitted diseases."
According to the study proposal, researchers will conduct AIDS tests on "blind" samples obtained through Vietnamese medical offices. They will also pass out door-to-door surveys, and visit bars, pornography shops, massage parlors and other sites to interview residents about their sexual practices and attitudes.
Among the questions proposed:
* "Have you heard about a disease called AIDS?"
* "Can you get AIDS by sitting on toilet seats?"
* "Do you treat yourself with Chinese medicines?"
* And, agree or disagree: "AIDS is not a significant problem for Vietnamese."
Researchers in San Francisco conducted a similar AIDS study with the Asian community there last year. Nonetheless, "little is known about Vietnamese sexual behavior in general," Orange County researchers said in their study proposal.
The proposal points to anecdotal evidence suggesting that local Vietnamese frequent prostitutes in Tijuana. And it warns that "the Vietnamese population in Southern California may in fact be a highly vulnerable group at risk for HIV because of sociocultural factors and behavioral practices."
Several Vietnamese leaders said they believe that residents will welcome the study and cooperate with researchers. But some remain skeptical as to whether the study will reveal any real problem.
"I think the (positive HIV) results will be very, very low," said Dr. Hung Nguyen, who has an internal-medicine practice in Westminster and has spoken with county health officials about the project.
"I talk with my colleagues, and nobody's talking about AIDS in the Vietnamese community," he said. "Most Vietnamese are monogamous, and they don't have extramarital sex."