Uplifting Asian and Pacific Island Communities: A Conversation with Keiva Lei Cadena

National Asian and Pacific Islander HIV/AIDS Awareness Day, initially created by the Banyan Tree Project and the San Francisco Community Health Center on May 19, 2005, is a day to raise awareness of the impact of HIV on Asian and Pacific Islander communities.  

During NAPIHAAD, we recognize ongoing efforts to promote HIV prevention, testing and treatment among Asian and Pacific Islander (API) communities in addition to efforts to combat stigma within this community. In acknowledgement of this day, AIDS United reached out to activist, advocate and co-executive director of the Positive Women’s Network, Keiva Lei Cadena, for a conversation about her continued efforts to support Asian and Pacific Islander communities with her work in the HIV space, as a Native Hawaiian herself: 

I was born in the San Francisco Bay Area, and Hawaii and the Bay have both been my home for most of my life. I was on my own at a very young age, so I’ve seen a lot and experienced a lot as a brown and very androgynous child, as a trans woman, as a Native person. Life certainly was not easy. This year will be 20 years since my HIV diagnosis. My life today is certainly not what I thought it was going to be when I was first diagnosed in August of 2004.  

I got into HIV outreach work in 2011, just after I achieved one year of recovery from addiction. A position as a part-time receptionist was available at the same HIV service organization where I was receiving case management. I had been through a lot over the years, and it was a very fragile time for me. I knew many of the folks that worked there, and I felt like it was a safe place for me to be and earn a living. I didn’t think so much about “serving my community” then. I was still very much in survival mode. But it was a very important time in HIV. Obama was president, Linkage to Care was born and services organizations were starting to bridge the divide between prevention work and care services. I was quickly drawn into being meaningfully involved in working with people living with HIV. I realized how important it was for me to see other folks like me doing well. I wanted to be that for other Hawaiians, other trans girls, and other people with HIV that were struggling to show up for the support they needed. 

I was really involved in 12 step recovery during that time, and I knew that the work I was doing on myself had a lot to do with me, through the help of recovery, taking the power out of HIV stigma and showing others what being strong while living with HIV looked like. I also knew it was a way to repair my sprit from the crazy life I had been living before sobriety. 

Living in Hawaii, as a Kanaka Maoli (Native Hawaiian) I had a different responsibility to my own people. Call it equity, call it being impartial, I just knew that my family struggled just like so many other Hawaiians have, and still do. I was building programs, and I was facilitating conversations and moments where people could get a look into the lives of people living with HIV. I always wanted that to stand out for other Hawaiians and make it clear that my work and my messages were centered towards my cultural and familial roots.   

Keiva Lei Cadena (far right) speaking at the AIDSWatch 2024 Fireside Chat.


We asked Cadena what she has learned about the impact of HIV on API communities: 

Honestly, I only feel comfortable speaking about Hawaiian and other Pacific Island people. Although Hawaiians have so much historical connection to many Asian people and cultures, our experiences are different in many ways. Health care and access is one difference for sure. Hawaii is a melting pot of ethnic backgrounds, but look at Pacific Island people in other parts of the continental US. You don’t see our communities very intertwined, socially, economically, or culturally, we’re very different. When I was growing up, the boxes to check were, “Black”, “White”, “Latino” or “Other”. I feel like someone just took the “Other” box and changed it to Asian & Pacific Islander. And that is very telling of the way we’ve approached HIV among Asian and Pacific Island and all Native communities. I feel like we are “the rest”. But I know how Hawaiians have been impacted by HIV and negative health outcomes. The biggest problem is, it’s still not ok to talk about it. I guess in that perspective we Asians and Pacific Islanders are similar, we are not talking about HIV in our communities – and what’s worse, no one else is either. 

For me, National Asian and Pacific Islander HIV/AIDS Awareness Day means that I can have an excuse to go to community leaders and say, “Hey! Let’s have this conversation today.” It gives folks permission to pay attention to something that we all have been taught to look away from. We have so many opportunities to save lives and prevent new cases of HIV in young Hawaiians, but many of them don’t even know about it. Every awareness day is the gateway to getting people talking. It’s been over 40 years. We shouldn’t be cringing when we hear HIV or AIDS in a sentence. But people still do. 

HIV stigma remains a persistent barrier to many from seeking testing, treatment and care – and has been identified as a primary barrier in API communities. We asked Cadena what efforts providers, community organizations and others can take to combat this stigma and ensure API communities receive the care they need. 

Well  HIV testing should be normalized in health care. Primary care providers should be prepared to speak with any patient about sexual health and know how to properly navigate to the necessary care they need. Especially if that person identifies as LGBQ+ or Trans or a person of color, extra attention needs to be paid to vulnerable communities.  Educators should be having these conversations with learners, community organizations should be invited into schools and schools should want to be involved with these community organizations. Young people need to know where to go. Folks are busy trying to protect young people from lifesaving information because of how they feel about HIV! Make that make sense.   

Additionally, when I started taking HIV medication in 2006, I moved home to Hawaii. I felt it would be better for me. I’m very proud to be Hawaiian, I come from a people that were warriors and navigators that mastered the ocean with only the stars, that looks at our land base as a relative rather than a piece of property and believe in our core that our responsibility was sustaining land – in turn – sustaining life. Asian and Pacific Island cultures both have very deep roots in humility, respect, reciprocity, and for us Hawaiians, aloha. We know how lifesaving those cultural practices and values were prior to any foreign contact. And if I know the value it had back then in sustaining the health and wellness of my people for thousands of years, that is all the evidence I need to prove how those practices and values, even in their simplest forms, can help other Hawaiians live in the modern day as well.  

Cadena’s responses have been lightly edited for length and clarity. To learn more about what you can do on National Asian and Pacific Islander HIV/AIDS Awareness Day, click here.