Sidelights | Raise Your Hand If You Have an Infected Friend Around You

Everyone here, could those of you who have a friend who is an HIV-positive person raise your hand?

——Director Ch'en Yen-han, Taiwan Gida Association

As the speakers concluded their self-introductions and the lecture officially began, the speaker posed this question to the audience. Perhaps out of reluctance to raise their hands for various reasons, or perhaps because they believed they had never been in contact with an infected person, no hands were raised in the audience. However, according to Director Ch'en, there are approximately 40,000 people living with HIV in Taiwan, meaning about one in every 500 to 600 people is infected.
Yet why do people not intuitively feel like they have come into contact with someone living with HIV? Why is it so difficult for infected individuals to open up and share their HIV-positive status with others? This is a question worth keeping in mind as the lecture begins.

The Stigmatization of Homosexuals and People Living with HIV

Do people with chaotic private lives get HIV? Are all homosexuals HIV carriers? Do people living with HIV donate blood to secretly test for HIV? Does AIDS spread through kissing? Various alarmist rumors circulate in society. Myths and intensive sensationalism by anti-gay groups have worsened misconceptions and the stigmatization of the homosexual community. Even though the public has received relevant educational campaigns, having knowledge is one thing; influenced by social trends under this climate, homosexuality and HIV are frequently tightly bound together.

Even though statistical data show that about 70 percent of HIV infections stem from male-male sexual behavior, some information needs to be understood first: HIV transmission mainly occurs through three routes: 1. blood transmission, 2. sexual transmission, and 3. mother-to-child vertical transmission. Because male homosexuals primarily engage in anal sex, and the anatomy is not naturally intended to serve as a sexual organ, it may be easier for wounds to occur during the process. Wounds and blood are one of the routes of HIV transmission.
Even among heterosexuals, unsafe sexual behavior carries the same risk of infection. Therefore, HIV infection is unrelated to "male-male sexual behavior"; "unsafe sexual behavior" is the primary cause.

In the lived experiences shared by the speaker, their partner once refused to kiss them due to their HIV-positive status. This demonstrates that the public worries about transmission routes that are impossible, while holding prejudices and incorrect concepts regarding communities of infected individuals. Concept-building generally stems from education, and the speaker also pointed out the predicament of insufficient health education under Taiwan's current educational system.

Refusal of Care? Cold Remarks and Differential Treatment When Seeking Medical Attention

Perhaps because dentistry is a field where contact with blood is more likely compared to other departments, people living with HIV often need to find clinics on a "friendly list" to receive treatment when visiting the dentist, and may even face "refusal of care," resulting in infringed rights. Reflecting on this "friendly list," we can imagine how many countless accumulated experiences of patients being rejected produced this result.

A lawyer also shared an experience where a client suffered discriminatory remarks from medical staff during medical treatment. Furthermore, beyond verbal remarks, there were actual acts of differential treatment, such as displaying reluctance to touch and extreme disgust through body language toward instruments used by the client and clothes they had changed out of. All of these behaviors are implicitly sharp blades wounding the homosexual and HIV-positive community.

Controversies Stemming from Article 21 of the HIV Infection Control and Patient Rights Protection Act: Underground Epidemics and the Abuse of Law

Passed in 1990, the full title is the "HIV Infection Control and Patient Rights Protection Act." Article 21 states: "Those who know they are infected, conceal it, and engage in risky sexual behavior with others or share needles, diluents, or containers for injection, resulting in the transmission of the infection to others, shall be sentenced to fixed-term imprisonment of not less than five years and not more than twelve years."
This penalty is equivalent to the crime of serious physical injury. Heavy criminal liability generates social problems: "If I don't get tested myself, do I no longer need to worry about being punished? Going without a test means remaining innocent, right?" This mindset will drive the epidemic of this disease underground, thereby creating difficulties for prevention and control. Furthermore, is the concept of "concealment" overly subjective? After an infected person and the other party engage in consensual sexual behavior, might the other party suddenly turn around and use this article to threaten the infected person? These are all potential abuses that deserve attention.

Both people living with HIV and the homosexual community bear numerous stigmas and labels. Even when infected individuals have reduced their viral load through treatment and stable medication to a state where it is medically non-infectious, they still face special treatment. The various stigmas and oppression society harbors toward diseases actually make people living with HIV afraid to fight for their rights when they are violated. To avoid being labeled as "abnormal," special communities often remain silent.
People often demonize things different from themselves due to a lack of understanding, and incorrect knowledge deeply entrenches these pre-existing prejudices. To smooth over this social phenomenon, breaking through myths is an indispensable action. Ignorance is more terrifying than disease, and promoting correct knowledge is our shared task alongside society.