Asian sexual taboos hinder AIDS knowledge

By Marwaan Macan-Markar
July 9, 2002

BANGKOK - The specter of HIV/AIDS moving from the margins of society to the mainstream should prod Asians into taking a hard look at taboos that help spread the pandemic - including how openly they talk about sex.

But how much Asians frankly talk about the matter is mixed, say experts promoting the need for more candid discussions on the links between sex and the AIDS-causing human immunodeficiency virus (HIV) in Asia.

There are progressive attempts toward this end by groups in Thailand and the Philippines, yet even in them, as in most other Asian countries, a "culture of silence" prevails inside homes.

Parents need to be part of the education process, says Michael Tan, a medical anthropologist at the University of the Philippines and activist on reproductive health issues, including HIV/AIDS. "We need to educate parents so they can feel comfortable to handle the issues.

Tan adds that the allure of sex figures prominently in the mass media, yet issues such as the importance of safe sex - including condom use and concerns over risky sexual behavior - are seldom discussed. Even when they are discussed, such as in the Philippines, the talks have "little effect".

None of these discussions occur at home, where "parents feel uncomfortable about sex talk", and where the talks would have the most meaning to a youth, Tan says.

A parallel case is found in Thailand, which is often hailed as an Asian leader in bold measures to break cultural taboos that hindered frank, public discussions on the dangers of unprotected sex in a country seriously affected by HIV/AIDS.

"The Thai school system has responded. The curriculum is moving toward a broader sexual theme," says Greg Carl, who works on HIV/AIDS and behavior change at the Southeast Asia division of the United Nations Children's Fund (UNICEF). "In Thailand, the curriculum requires that condom use should be demonstrated."

However, these classes, often taken by the school health teacher himself, lack a frank and direct language that youth could relate to and gain from.

"The discussions are detached and vague," adds Carl. "The teachers have not been trained to deal with this in a non-prescriptive and non-judgmental manner." India, too, offers a similar dual reality. It has a peer education program that seeks to address the links between sex and HIV/AIDS in universities, praised by the Joint United Nations Program on HIV/AIDS (UNAIDS), but that does not mean that public discussions about sex any easier to have.

"The peer education program has been accepted by government policy-makers. This enables youth to talk with their peers on sex and HIV/AIDS," says Swarup Sarkar, former head of the UNAIDS South Asia division. "The media are also talking about it."

However, these efforts have still not shaken the dominant attitude among Indians of feeling "shy and shameful to discuss anything related to sex in the public domain", asserts Shaleen Rakesh of the Naz Foundation, a New Delhi-based trust that deals with sexual-health issues.

"Only the youth in urban, metropolitan cities are beginning to feel freer to discuss these issues amongst themselves. But even this is not true universally," he adds. "They still feel embarrassed and hesitant because the environment is constantly policing them and judging them on these matters."

The need for such discussions in both the public and private realm has gained greater urgency in light of a UN report on HIV/AIDS released last Tuesday, which reveals that 435,000 people died from AIDS in Asia and the Pacific last year.

Likewise, those who stand to gain most from candid discussions are the region's youth - also the ones at great risk of bearing the brunt of the pandemic, adds the "Report on the Global HIV/AIDS Epidemic" released by UNAIDS.

At the end of 2001, there were 1.1 million young people between the ages 15-24 in South Asia and 740,000 in East Asia and the Pacific living with HIV. Some 62 percent of them were women in South Asia. In East Asia and the Pacific, women were 49 percent of the number of people with HIV.

The preponderance of female carriers in the Asia-Pacific reflects the global trend, which shows that 7.3 million young women and 4.5 million young men had HIV at the end of last year.

In all, Asia-Pacific was home to more than 6.6 million people living with HIV at the end of 2001. That makes it the region with the most number of people with HIV after sub-Saharan Africa, which has 28.5 million people with HIV.

India has some 3.97 million people living with HIV, which makes it the country with the most number of people with HIV in the world after South Africa, and Thailand has 670,000 people with the AIDS virus.

These numbers may increase in the future given what a companion report to the UNAIDS publication reveals - "that the vast majority of young people have no idea how HIV/AIDS is transmitted or how to protect themselves from the disease".

This report points out that in four Southeast Asian countries - Cambodia, Vietnam, Indonesia and the Philippines - 58-95 percent of girls aged 15-19 have at least one major misconception of how HIV can be transmitted.

Thus, UNICEF argues, there is no substitute to an open, frank exchange of information about sex and HIV to protect young people.

"Adolescents must learn the facts before they become sexually active, and the information needs to be regularly reinforced and built on, both in the classroom and beyond," it states in the report "Young People and HIV/AIDS: Opportunity in Crisis".

At the heart of any education efforts should be the "ABCs of Prevention", where young people must be encouraged to "abstain from sex [or] delay the first sexual experience, be faithful to one partner [and] consistently use a latex condom properly", the report adds.

Many Asian countries are heading down this road, but experts agree that the region still has many miles to travel to achieve what the youth need - a regular, frank flow of information about sex and HIV/AIDS.

Copyright 1999-2004, AsianSexGazette.com.  All rights reserved.  No content may be reproduced in whole or part without written permission.  Please contact us via the link below for re-print and syndication policies.