Hsiao Chiang, who is very active in the homosexual community, says that AIDS has been a continuous source of stress to homosexuals. But their level of awareness is very high, so they have their blood tested regularly and take preventative measures. This contrasts with the situation of the average person, who is less likely to protect himself.Just an STD?
Research indicates that HIV is continually mutating and there are now 10 strains. Identifying the strain helps identify the source of the infection. Chen Hao-yung, head of the National Institute of Preventive Medicine's virology section, says that statistical analysis indicates that HIV-B, of North American origin, is most common in Taiwan, accounting for 67% of all HIV infections. The second most common variety is the Southeast Asian HIV-E, which accounts for 23% of all cases on the island. These two types of HIV are transmitted through sexual activity.
Chen Yi-ming says that the critical factor in more than 80% of AIDS transmission in Taiwan is sexual activity.
Chen Shou-chien says that overseas the rate of infection is higher from the sharing of needles by intravenous drug-users. But in Taiwan, there are relatively few intravenous drug-users and needles are easy to come by. Therefore this group accounts for a much smaller percentage of the island's AIDS cases.
"In Taiwan, AIDS is a venereal disease," says Troy Lee. In the past, LOFAA's primary mission was caring for AIDS victims. However, the group gradually realized that the key to AIDS prevention is education of those members of the public who are not infected with the virus. "If even sex is difficult to talk about, how can we talk about AIDS?" Li believes that AIDS prevention must begin with sex education.AIDS victims' rights
HIV-positive persons often can't bring themselves to face their own families. Even if the have the courage to do so, pressures from the outside world leave them no place in society.
A survey conducted last year by Hsu Mei-ling and Huang Shu-chen, a professor in the department of health education at National Taiwan Normal University, revealed that 56.7% of respondents felt that in order to protect the health of others, those who are HIV positive or suffer from AIDS should not be allowed to work outside their homes. In addition, 25% of respondents felt that children who suffer from AIDS should not be allowed to attend school.
Clearly, Taiwan still has far to go to guarantee the rights of AIDS victims.
In 1994, there was the case of a boy surnamed Chen who contracted AIDS through a blood transfusion administered after a car accident. When he returned to school, all 22 students in his class withdrew from the school.
Fortunately for the boy, though he was lonely for a period of his childhood, he didn't lose his right to a public education. That is not the case for older victims, who have no rights to even register for university and graduate entrance exams at some schools, much less to study. The expulsion of the HIV-positive Tien Chi-yuan from NTNU, where he was a student in the fine art department, was big news for a time. Finally, under pressure from public opinion, the university allowed Tien to complete his studies by mail and telephone.The right to work
The problem is not limited to education. AIDS victims also suffer discrimination in the workplace.
When the three-in-one "drug cocktail" was made available to Taiwan's AIDS victims in April of last year, many returned to a reasonable degree of health. DOH statistics indicate that both the frequency and duration of their hospital stays declined.
Han Sen, who was infected with the AIDS virus 13 years ago, began taking the three-in-one treatment last year. He says that although his condition still cannot be cured and he must continue taking medication for the rest of his life, he feels more hopeful than he did before. "I was never sure how much time I had left. Now, I feel I can plan my life for the next five years."
Chang Wei says that in the past, HIV-positive persons asked, "How long have I got?" Now they are beginning to ask, "What kind of job do I want to look for?"
But social attitudes have pressured HIV-positive persons into keeping their condition to themselves, especially in the workplace, in order to get by.
The health of one person who worked in the finance industry forced him to check into the hospital. When his boss found out that it was for AIDS, he immediately fired him.
In order to keep their condition secret, when HIV-positive persons get sick and have to stay in the hospital, they do not claim sick leave, instead using their vacation time.
In some fields, however, it is not easy to keep one's condition a secret. In the restaurant and hotel businesses, for example, health considerations mean that employees undergo regular blood tests. If a test shows that someone is HIV positive, the boss is usually notified before the victim, and the victim is fired.
Renting a home, getting medical treatment, finding work. . . . AIDS victims face discrimination in every facet of their lives. And even in death, they are denied their rights.
In the name of preventing the spread of infection, Taiwan's mortuaries do not accept AIDS victims. When an AIDS victim dies, the body is usually sent to a crematorium immediately.
NTU Hospital's Chang Li-yu says that in order to alleviate some of the difficulties faced by AIDS victims' families after their death, the hospital's social workers will help arrange to make the hospital's chapel available to allow families and friends to hold a short funeral service. As a result, the funerals of many AIDS victims are held in hospitals.
Last year, revisions to the "Articles on the Treatment and Prevention of AIDS" were passed which included guarantees of HIV-positive persons' rights to education, medical treatment and work. They also increased the fine for the violation of these rights to a minimum of NT$30,000 and a maximum of NT$150,000.
But most feel that these revisions will be talked up far more than they will be implemented. When society is still unable to genuinely accept HIV and AIDS sufferers, of what use are these laws?To tell or not to tell?
This lack of acceptance on the part of society makes those with HIV unwilling to admit it. Victims find it difficult to tell even family and loved ones, creating a blind spot for prevention and treatment.
The struggle to decide whether to tell is not unique to Taiwan; victims in other countries face the same problem. This year, a law was passed in New York State which states that if the victim does not tell his or her sexual partner, his doctor has the right to do so.
In order to protect an AIDS sufferer's right to privacy, Taiwan's "Articles on the Treatment and Prevention of AIDS" stipulate that administrative personnel cannot reveal this information without reason. As a result, if the victim decides not to tell a sexual partner, no one can compel him to. This has led to a number of tragedies.
The wife of an HIV-positive man was hit with a bolt from the blue when the Institute for VD Control asked her to come in for a blood test. The reason given was that her husband had come in for a test. They were, however, unable to tell her the results of her husband's test. This husband did not want to infect his wife and on one occasion, used a condom. However, faced with his wife's suspicions, he didn't dare continue to do so. As a result, his wife was also infected.
Yang Ming University's Chen Yi-ming, who is also secretary-general of the Chinese Society of Preventive Medicine, says that in Taiwan there are currently 60 known cases of infection by a spouse, most of which involve a husband infecting his wife.
The "Articles on the Treatment and Prevention of AIDS" stipulate that if an HIV positive person infects an unknowing partner with HIV, the former is punishable by up to seven years in prison. For most wives, however, punishment doesn't change the fact of their infection. Moreover, having their husband in jail is of no help to them if they want to keep their family going. Therefore, most wives choose not to prosecute.
This is another blind spot which exists in the treatment and prevention of the disease. Twu Shiing Jer, director of the Taipei City Bureau of Health, says that when a hospital diagnoses an HIV infection, it is almost impossible to trace its origin. Sometimes the victim fears being blamed by his infector for having let out his secret. Sometimes, the victim simply doesn't know who infected him. "What use is it for me to see patients? Behind every one I see another 20 or 30 are waiting."
Chang Li-yu says the question of telling is the one she most commonly encounters in the AIDS ward. "We advise them to let at least one family member know so if something happens there is someone we can contact to help." Chang says this person is usually a sibling.
But in the face of social pressures, many of those infected with HIV don't know where to turn. Chen Shou-chien says that the Taipei Institute for VD Control loses contact with around one-fourth of the HIV-positive persons who pass through its hands. The main reason is that the use of false names and addresses by the victims makes it difficult to trace them. Not the problem, the solution
"Saying that AIDS prevention is an immunological problem is not so accurate as saying it is a social reform movement," says Twu Shiing Jer, who has devoted himself to AIDS prevention work for many years.
Twu feels that AIDS prevention isn't simply a case of being compassionate towards its victims and accepting them, but even more importantly, through this acceptance, encouraging them to come out into the open.
By doing so, they can receive medical treatment. They can also provide those who are not infected with accurate information. This would be a win-win situation.
"We are not the problem. We are the solution." So states the Global Network for People Living with AIDS.
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