Since April of last year, AIDS cases on Taiwan have been appearing one after the other. From last year's total of forty or fifty, the number has climbed to the current 87. People from university students to prostitutes have fallen under its shadow. There is no room for doubt--this modern plague is on Taiwan.

Although Taiwan is relatively slightly affected on a global scale, and compared to the U.S. (1,500,000 cases) or Japan (more than 1,000) is "safe," nevertheless recent developments have caused many in the medical profession to warn against complacency.

Chuang Cho-yen, convener of the AIDS Prevention Committee of the Depart-ment of Health and director of Taoyuan Provincial Hospital, says that recent developments unmistakably mean the disease has become "localized" and "diversified." Of the first four cases, three homosexuals (two Americans, one overseas Chinese student) could all have been infected abroad. One merely passed through the airport, and two made their contacts in a circle composed mostly of foreigners on Taiwan. But this April a case was discovered in which the individual, a homosexual, had never been abroad and had no foreign sexual partners. This case shattered the myth that one was safe by avoiding foreigners and generated a certain panic "in the circle." The director of the Bureau of Disease Control at the Depart-ment of Health, C. H. Chuang, could not help shaking his head: "AIDS, in going from an 'imported epidemic' to a 'localized' one, necessarily found roots here and a channel by which to spread."

The sixth case was a prostitute who had worked in her profession for twenty years, from Taichung to Keelung to Kao-hsiung. Moreover, she was at first unaware she had the disease and continued to accept customers.

Chuang Cho-yen pointed out that her case indicated that the disease had achieved wide geographical spread and that it had entered the heterosexual community. Edwin H. Yen of the Graduate School of Health Education at National Taiwan Normal University expressed the view that judging by the trend in other countries, "The peak has not yet been reached do-mestically."

Will Taiwan follow in the wake of the U.S. and Europe? C. H. Chuang is optimistic, because AIDS is not passed easily from person to person, but can only be passed through transference of blood or body fluids (especially sperm) through sexual intercourse, blood transfusions, common use of needles, and so on. Moreover, one does not certainly get AIDS at first contact; it often takes repeated contacts before the disease is transmitted.

The number of carriers on Taiwan, even if calculated at 100 per active case, would only be 400. And over half of the known 82 carriers (40) are hemophiliacs. The latter are at high risk because most of the blood for transfusions comes from the U.S. Taking National Taiwan University Hospital for example, of 200 hemophelia cases examined, 37 tested positive for AIDS. Still, compared to the figure of 70 percent for the U.S. or 30 to 50 percent for Japan, the figure is not high.

Since November, 1985, the Department of Health has ordered all imported blood treated with heat to block the AIDS virus and ordered that hemophiliacs be found and tested. Blood donation centers have been required since March 1986 to screen all blood.

Alas, transmission by sex continues to grow. Random sexual behavior with many partners without condoms is widely seen as "suicidal." Homosexuals and prostitutes, however, inevitably drawn to the risk, are the biggest worries for AIDS prevention.

Homosexuals account for the second largest number of carriers (19), but three of the five who have developed symptoms are gay, including one married bisexual. Anal sex, which frequently causes bleeding, makes transmission of the disease easy. Further, many gays, lacking the guarantees of marriage, move from sex partner to sex partner rapidly.

Ko Ying-chin of the School of Public Health at Kaohsiung Hospital provides another worrying stat: About 40 percent of homosexuals are bisexual, many married with children. While in the course of normal sexual activity the woman has the protection of secretions, ten to thirty percent are still infected. And if pregnant, there is almost no way for the baby to avoid the disease.

The best way to prevent the disease is to find the carriers and trace their contacts to find out who has been infected. But since homosexuality is held in such low esteem, and gays must maintain the facade of social propriety, getting names and con tacts is extremely difficult. There is even a fear that some gays, self-destructive from living a double-life, could see AIDS as a way of retribution and transmit it deliberately. Even some hemophiliac AIDS victims tell no one for fear of causing unneeded panic and fear.

Prostitutes are the other area of concern. Legal prostitutes get compulsory checkups. Ones in business for themselves get tested only with the occasional arrest, and even then they are back on the streets before results are back. Worse, there is no way to trace their usually nameless clients and contacts.

The only real way to stay safe is through intelligent sexual behavior: limiting one's partners, avoiding high-risk groups, using condoms. . . . And one must also make sure that one's sex partner is observing the same ground rules.

One must also try to get medical help to "bar the door." Certain symptoms (continual fever, exhaustion, cold perspiration) may suggest a test for AIDS. Available treatment in the ROC is not less than that available abroad, but so far the cases have been discovered too late.

Edwin H. Yen suggests that domestic sex education has been inadequate and fears that AIDS ignorance could lead to inadequate caution or unnecessary panic. For example, those who use condoms are still seen as somewhat odd.

In the shadow of AIDS, a higher level of consciousness about sex is absolutely necessary. If "love" may lead to "death," is love worth it?

[Picture Caption]

Shown is an anti-AIDS demonstration in England. (photo by Vincent Chang)

AIDS is fearsome. Medical workers demand self-protection: masks, gloves, safety glasses,and the thorough sterilization of equipment are indispensable parts of the routine.

Love and Death have been brought together in this "Twentieth Century Black Death"--this is the face of AIDS.

Will the high wall of moral teaching allow AIDS to spread quietly in its shadow?

AIDS is fearsome. Medical workers demand self-protection: masks, gloves, safety glasses,and the thorough sterilization of equipment are indispensable parts of the routine.

Love and Death have been brought together in this "Twentieth Century Black Death"--this is the face of AIDS.