Spirituality is very important for many African Americans. The relationship between an
individual and the faith community is a critical source of strength that can help prepare clients to
succeed in substance abuse treatment. In addition, many African Americans have strong social
networks. They may have friends or a pastor with whom they might share information they
would not share with a substance abuse counselor. These confidants might act as "co -therapists"
for the client. It can be helpful for clients if counselors can identify and integrate clients' co-
Along these lines, for African Americans with substance use disorders and HIV/AIDS, support
groups of friends may be more likely to be helpful and less undermining than support groups of
families. This is perhaps due to the lingering stigma of the ways in which HIV/AIDS is acquired-
-both intravenous drug use and homosexual activity are still highly stigmatized acts within many
African American communities. Thus, activating family supports may be difficult, and providers
should encourage clients to participate in support groups composed of their peers.
Asian Americans
Asians and Pacific Islanders are a culturally and linguistically diverse people from the Asian
continent and the Pacific Islands. In the United States, they include nearly 40 different
nationalities, 50 different ethnic groups, and more than 100 languages and dialects. Asians and
Pacific Islanders comprised 4 percent of the total U.S. population in 1999. From July 1998
through June 1999, they accounted for 0.7 percent of all adult and adolescent HIV cases (these
include only persons reported with HIV infection who have not developed AIDS), and 0.4
percent of adult and adolescent AIDS cases. Of the total AIDS cases reported for this population
through December 1998, 89 percent were in men; 79 percent of those were reported in men who
have sex with men (CDC, 1999b). Among women, nearly half the cases (48 percent) are
associated with sex with an infected or high-risk partner, and 17 percent are reported from IDU
The increasing size and diversity of the Asian and Pacific Islander population make it difficult to
discuss group norms regarding substance abuse. Norms for alcohol and tobacco use vary by
culture and there appear to be no norms governing the consumption of narcotics or other
substances.
Service providers also should shed the notion of the "model minority," which often typecasts
Asians and Pacific Islanders and limits treatment access. Often, Asians and Pacific Islanders
believe the model minority myth and feel isolated when they test positive or report substance
abuse disorders. They may also feel they have let down their families and communities.
Despite differences in cultural norms and mores among Asians and Pacific Islanders, cross-
cultural beliefs in the importance of group and collective identity, service, and responsibility
suggest the use of treatment strategies that incorporate biological or constructed families and
communities rather than a focus on individual behavior change. Moreover, treatments that
emphasize nonverbal or indirect communication skills, not confrontation, may be more culturally
