Japan's Aids time bomb/Fighting India's Aids apathy

May 4, 2006

http://news.bbc.co.uk/2/hi/europe/4735006.stm

more on aids

Japan's Aids time bomb

http://news.bbc.co.uk/1/hi/world/asia-pacific/3890689.stm

By Jonathan Head BBC correspondent in Tokyo The focus of most of the delegates to the International Aids Conference in Bangkok is on the enormous problems posed by the disease to developing countries.

It's always been somewhere in the back of my mind, HIV, but I'm afraid I've never done much to protect myself in the past

Kuki Uchikawa, university student

But it is not just the poor who are unprepared to deal with Aids. In Japan, one of the world's wealthiest societies, awareness of the risks posed by the disease is almost non-existent among many young people, and yet their sexual behaviour is increasingly risky. While HIV infection rates in Japan remain officially low at around 6,000, experts fear the real total could be higher, and will get a lot worse unless attitudes begin to change to a disease many Japanese believe only foreigners can catch.

One Friday a month, gynaecologist Dr Tsuneo Akaeda visits Club Jamaica, one of dozens of places in Tokyo where young Japanese party till sunrise. He gives free blood tests for HIV - with almost immediate results. University student Kuki Uchikawa, who has taken the test, said: "It's always been somewhere in the back of my mind, HIV, but I'm afraid I've never done much to protect myself in the past. This is the first time I've decided to come and find out more about the disease." Among the volunteers helping Dr Akaeda is Mariko - she is 18, and has only just become aware of the risk HIV poses to her generation. Poor education "We never had much sex education at school. We were taught little about contraception, or how you catch HIV or other diseases. Teachers just don't feel comfortable talking about sex," she said.

HIV tests are being offered in Japan's clubs

Her friend, Madoka Izumi, also a high school student, agreed. "I go to a girl's school, and we've never been able to learn what boys think about sex. They've taught us some of the physical sides of sex, but none of the emotional aspects, so we're not really prepared to deal with it," she said. Yusuke Izumi, a university student, said: "I don't remember getting any sex education at school - we just talked about it among ourselves, about the things we did with girls." Adults are probably oblivious about teenagers' sexual activity, Mariko said. "Parents always think their children are different. They can't imagine them having sex or having abortions. They can only think of them studying hard at school." By the age of 17, more than a third of teenagers in Japan have already had sex at least once. There are other statistics which Dr Akaeda finds even more alarming. Sexually-transmitted diseases are rising rapidly among young women - a sure sign of having sex with multiple partners but without using condoms. "Teenagers these days are very casual about sex. They're happy to have sex with anyone they meet - they use phrases like 'let's play together?' "I gave away vouchers for free STD tests to girls, and found that 82% them were infected. "It's incredible. I suspect a lot of them may have HIV as well." In Japan, sex has become a freely-traded commodity, seemingly unconstrained by moral concerns. Dozens of pornographic cable TV channels on sale here, and yet sales of condoms have been falling for several years. Condom dearth "We're very concerned about the negative image of condoms among young people, because it's not just HIV, but other sexually-transmitted diseases which are spreading," said Toshiaki Ishii, of the Okamoto Condom Co Ltd. "We're trying to find ways to make them more appealing, but so far without success. I think the lack of sex education is partly to blame for this," he said. The absolute number of people infected with HIV in Japan is still quite small - but unlike other developed countries, every year that number keeps rising.

There could be a price to pay for young people's blissful ignorance

And yet there is still a marked reluctance here to discuss the problem openly, or to run the kind of hard-hitting awareness campaigns that would wake this country up to the danger it faces. That reluctance prevails even in the corridors of Tokyo's city government. Ida Mami, of the Medical Service's Division, is sounding the alarm over Aids awareness, but said getting more explicit sex education in schools is not easy. "It is a sensitive issue. We have to start with what's possible, and avoid provoking a reaction from conservatives. If we push too hard on discussing condoms and safe sex in classrooms, some people may demand we stop all HIV education," she explained. A start of sorts has been made in one of Tokyo's most elite girls' schools. They invited Dr Akaeda to educate, not the pupils, but their mothers - though only a handful turned up. His use of graphic illustrations and even more graphic statistics had its intended effect - to shake any illusions they may have that their daughters are somehow immune to the wave of adolescent promiscuity sweeping Japan. Social taboo Actually talking about sex to their children, though, is another matter. "Well it's rather difficult to bring this subject up in a casual way. If I can find the right opportunity, I hope I will feel able to discuss it," said one mother. "I think this is a subject our children are already interested in, so I guess they'll understand if we raise it with them," another said. Young people often seem like Japan's golden generation, unburdened by the work ethic of their parents, enjoying more leisure, more affluence, more security. In such a cosseted environment it is hard to imagine the spectre of Aids. But it is here, and they don't seem to realise.

http://news.bbc.co.uk/1/hi/world/south_asia/3886883.stm

Fighting India's Aids apathy

By Sanjoy Majumder BBC News Online correspondent, in Bombay

India is home to one in seven HIV-positive peopleIndia is looking at ways to contain the spread of the Aids epidemic - but many of its citizens don't want to talk about the issue. The world's second most populous country has one of the highest infection rates - and more than five million HIV/Aids cases. To counteract the spread of the virus, the government recently launched its biggest anti-Aids initiative to date. But efforts are hampered by the fact that most Indians still find sex and Aids taboo subjects. Stigma In a corner of the St Katherine's Home in Bombay (Mumbai) a group of children are enjoying their playtime.

Caring for Aids orphans in Bombay - India's 'Aids capital'But despite their singing and laughter these are not typical five-year-olds - all of them are HIV positive. They were infected by their parents before they were born and were brought here sick and, in some cases, close to death. In a society where families are the main source of support, they are looked after by nurses and nuns. Sister Shanti has 30 children in her care at this orphanage. She says the hardest part for her is when people turn their back on children as young as these. "It disturbs me when people discriminate against them. "They have this disease through no fault of their own. They too have a right to live," she says. Ignorance For years many in India ignored the growing threat of Aids. Many simply could not imagine it was something that could affect them.

One always hears about Aids and how it's this big problem - I think it's just hype

Sanjay Nirupam Shiv Sena party Down a crowded street in the heart of Bombay is the Unison clinic, one of the few in the city that deals with HIV patients. Ram Kewar is on one of his regular visits - he is among 20 HIV-infected people who come here every day. He was infected by the virus a few years ago and since then has passed it on to members of his family. He says he had never even heard of the disease, far less about how it can be transmitted. "I thought it was just my fate to have got it. It was only much later that I found out why it had happened to me." The new Indian government has identified Aids as one of its priorities. But the biggest problem is combating ignorance - and that includes people who are very influential.

Campaigning for the use of condoms in BombaySanjay Nirupam is a politician belonging to the right-wing Shiv Sena party, an ally of the former Indian government and the main opposition party in Bombay. He believes the issue is being overplayed. "One always hears about Aids and how it's this big problem. But I have personally never come across anyone with Aids or seen anyone dying of the disease," he says. "I think it's just hype." Taboo topic But it's a problem which is not just confined to the poor or uneducated, or even the conservative.

If a customer refuses to use a condom we return his money and turn him away

Monica Bombay sex worker It spreads across Indian society. In a trendy Bombay cafe young men and women draw on cigarettes and sip long cocktails. They are part of cosmopolitan Bombay's elite - upwardly mobile, liberal and well-informed. This is one section of Indians who are more open to talking about Aids - but they would never think of doing so at home. "It has to do with sex and that's something which is an absolute taboo," says twenty-something Rocky Bhatia. "Most families simply will not bring it up." Sign of hope But there's hope at the other end of the social divide. Falkland Road right in the heart of the city is Bombay's red light district. For years activists have worked closely with the sex workers operating out of tiny rooms and filthy alleyways off this busy street.

Sex workers: Aware of the pitfalls It's a move that is now paying dividends. Monica is a sex-worker who has seen many of her colleagues die. In the past decade, Aids has claimed the lives of thousands of sex workers. Now they are learning to be more careful. Volunteers regularly visit every brothel handing out boxes of condoms and carrying out regular medical tests. "If a customer refuses to use a condom we return his money and turn him away," says Monica. "It doesn't matter how much money he offers us. Our lives are more important." It is a small sign of success for a problem that needs to be tackled on a much larger scale. Otherwise, it is estimated that in the next 10 years India could have more Aids cases than all of Africa.