Cindy Liao

ANSO 14
Professor Wright
No Action Without Protection!
I remember the first time I encountered the acronym STD, or sexually
transmitted diseases. It was a hot gloomy summer day. The scorching California sun
brought the temperature up to an unbearable 102 degrees. I dragged my feet to the
usually-unused classroom down by the tennis courts. It was fifth period, right after
lunch and all I could think of was my adequately-cooled room and my soft fluffy bed.
Everybody hated this class but it was state-required so nobody could get out of it.
That state-required health class was when I met STD and when I met HIV/AIDS.
That was freshmen year of high school though it may seem a little late for some of
you to learn about STDs. That term had never meant much to me, even now. My
curiosity took over thought when I accidentally glanced over this Taiwan news
headline about World AIDS Day.
HIV, or human immunodeficiency virus, is a virus that, in a nutshell, weakens
our immune system and breaks down our very own defenses against foreign objects.
HIV is transmitted through bodily fluids (semen, blood etc) and is most often
transmitted through unprotected sexual activities and sharing of needles within the
illegal drug community. HIV can have a patent period of up several years; thus, those
who are HIV carriers may not be aware that they are carriers. Left untreated, HIV can
cause AIDS, or acquired immunodeficiency syndrome. In the early stages of AIDS
infection, the patient may experience a brief period of influenza-like syndrome. Later
1

on, the immune system is compromised more and more and makes the patient
susceptible to tuberculosis and tumors.
Ever since the discovery of HIV in 1981, this epidemic has spread all over the
world and Taiwan was unfortunately not lucky enough to escape this series of
unfortunate events. Taiwans first reported case occurred on December 1984 on a
foreign transit traveler. The first reported case of local inhabitants occurred on
February 1986. The numbers skyrocketed ever since. There are in fact 29,665
reported cases thus far in Taiwan. Of these 29,665 cases, 93.39% are males and 6.61%
are females. As for age groups distributions, 72.24% are 20-49 years old and 20.08%
are 15-24 years old. After a series of government interventions to raise awareness and
actively reinforcing practice of safe sex and discouraging unsanitary needle exchange,
20,477 or 87.17% of all people living with AIDS are treated.
Some of you may not be aware (I was not) that December 1st is World AIDS
Day. There was a three-week AIDS prevention exhibit in Wanhua District, Taipei City
in honor of World AIDS Day. This is part of the government attempt and strategy to
raise awareness among the community about AIDS and to publicize the different
ways that could prevent this epidemic from spreading. The theme for this three-week
AIDS prevention exhibit was Close the Gap. The Taiwanese government strove to
close the gap between HIV prevention and treatment. Strategies promoting the
prevention HIV effective but unhelpful to those who are already HIV carrier, the
government further developed strategies to that promote HIV/AIDS treatment. If the
gap, or time frame, between HIV prevention and treatment is closed, the population as
a whole would benefit much more. Of course, popular events such as this three-week
2

HIV prevention exhibit will not appeal to a lot of the population. To further raise
awareness of this pressing issue among different age groups and social groups, the
government appointed Mr. H. H. and Stanley to support its effort to combat AIDS.
Mr. H. H. is a famous illustrator that came up with a famous cartoon character Mei
Mei (this cartoon character is not famous, not surprisingly, in the United States). Mei
Mei became the spokesman of this three-week HIV prevention exhibit. Stanley, or
arsablue as people known him as online, is a famous blogger (again, this blogger is
not famous in the United States). Stanley uploaded government-issued interactive
video promoting safe sex. Furthermore, everyone who watched these videos would be
eligible to enter a lottery and have a chance to win NT$500 (which is around $15 by
the way).
The two most common ways that HIV spread are unprotected sexual activities
and sharing of needles within the illegal drug abuse community. The Taiwanese
government addressed both of these ways of transmitting with different strategies.
Apart of popular blogger Stanleys interactive videos promoting safe sex, the
Taiwan Center for Disease Control and the Department of Public Health of the
College of Medicine in National Cheng Kung University launched a program named
Sex Police: The Surveillance and Guidance of Safe Sexual Activity. The name of
program doesnt really say much about the essence of the program itself. The program
focuses on the Friendly, Healthy and Safe Business Certification. The main type and
chain of business where unprotected sexual activities were observed was saunas,
especially homosexual saunas. There are a lot of bathhouses and saunas in Taiwan and
most of them, or at least the ones that Ive been to, are family-friendly and do not
3

have sexual activities going on. Those that do are required by the government to be
Friendly, Healthy and Safe Business Certified. These saunas provide free condoms by
the counter and some brochures about safe sex (but lets honest, who is really going to
read a brochure in the sauna). This program was launched in 2011. Follow up research
studies showed that saunas are the principal place for the young population to have
sex anymore but they are still popular and prominent for the middle aged to develop
sexual relationships. The effectiveness of this program is still unknown and further
studies have been carried out; however, since condoms are more accessible in
certified saunas, it is safe to assume that people in certified saunas are having more
protected sex than those in uncertified saunas.
Illegal drug use first appeared during the Japanese Colonial Period (18951945) in which opium smoking was prominent. The colonial government adopted a
gradual prohibition policy from 1897 to 1930. This policy supplied opium addicts
with the opium licensing system and gradually resulted in a controllable situation.
With the introduction of synthetic drug, methamphetamine in the early 1990s.
Methamphetamine is a Schedule II controlled substance in the 1971 United Nations
(UN) Convention on Psychotropic Substances. Unfortunately, Taiwan was deprived of
UN membership since 1971 due to numerous political reasons. The 1971 Convention
of Psychotropic Substances against methamphetamine was not implemented. With
this situation on hand and with the number of HIV/AIDS infected people increasing
almost exponentially, the Taiwan Center for Disease Control enacted in 1998, the Act
for Prevention and Control of Illicit Drug Hazard. This act sought to encompass the
policies and to compensate for the lack of UN anti-drug conventions. Furthermore,
4

this new act granted an illicit drug user the status of diseased offender, which
allows addicts to seek treatment in government-designated hospitals without being
reported or indicted. Along with this act and the government granting free access of
HAART to all citizen-addicts in 1997, the estimated HIV transmission rate decreased
by 53% in 2002. HAART is the use of multiple antiretroviral drugs.
Apart from all the policies described above, the government continued these
HIV policies in the 2000s when the abuse of club drugs such as MDMA, ketamine
and heroin appeared. A National Pilot Harm Reduction Program (PHRP) was
introduced in August of 2005 with measures including needle/syringe exchange
programs and methadone maintenance treatment programs. Studies and research were
carried out in Taiwan to further understand the HIV/AIDS virus and the most
effective way to treat and prevent it. The Center of Disease Control conducted a
population-based retrospective cohort study from 1997 to 2006 on the impact of
HAART initiation timing on HIV-TB co-infected patients. The results showed that
that starting HAART during TB treatment is associated with better one-year survival.
While problems related to illicit drug and unprotected sexual activities will
probably linger for a while in the future, the Taiwan experience has clearly shown that
the harm reduction and raising awareness policies, with its core humanistic values and
public health-oriented and pragmatic efforts, is the key to effectively manage HIV
transmission problems.

Works Cited
Chen, Bo-Chie. "The Analysis of Surveillance and Effectiveness of the."
www.cdc.gov.tw. Center for Disease Control, R.O.C. Taiwan , 10 Dec. 2013.
Web. 29 Jan. 2015.
Normand, Jacques, Jih-Heng Li, Nicholas Thomson, and Don Des Jarlais. "Harm
Reduction." Journal of Food and Drug Analysis. U.S. National Library of
Medicine, Oct. 2013. Web. 29 Jan. 2015.
Normand, Jacques, Julio Montaner, Chi-Tai Fang, Zunyou Wu, and Yi-Ming Chen.
"HIV: Seek, Test, Treat, and Retain." Journal of Food and Drug Analysis. U.S.
National Library of Medicine, 29 Sept. 2014. Web. 29 Jan. 2015.
"Taiwan CDC Collaborates with Well-known Illustrator to Create Large-scale
Installation in Promotion of HIV/AIDS Prevention and Treatment Prior to World
AIDS Day." www.cdc.gov.tw. Center for Disease Control, R.O.C. Taiwan, 27
Nov. 2014. Web. 29 Jan. 2015.
Yang, Chin-Hui, Kuan-Jung Chen, and Jih-Jin Tsai. "The Impact of HAART Initiation
Timing on HIV-TB Co-infected Patients, a Retrospective Cohort Study."
Biomedicalcentral.com. BMC Infectious Diseases, 4 June 2014. Web. 29 Jan.
2015.