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Sunday, Dec. 7, 2003

MEDIA MIX

Japan's refusal to embrace sex education fuels spread of AIDS


U.S. President George W. Bush may be the best example of how ignorance can be wielded as a weapon, but most people who take advantage of their ignorance prefer to use it as a shield. Tadao Eguchi, the president of the hotel company that operates the hot-spring resort that canceled the reservations of a group of former Hansen's disease patients last month, defended the hotel by saying that the Kumamoto prefectural government, which made the reservation, neglected to tell the hotel the guests once had Hansen's disease. Because the hotel management "lacked sufficient knowledge," he said, its action, which he indicated was discriminatory, was "only natural."

News photo
When hotel boss Tadao Eguchi (left) was asked why he banned former Hansen's disease sufferers from using a hot-spring resort he runs he claimed it was "only natural" as his staff lacked knowledge of the condition. A similar lack of awareness about how AIDS is spread is likely to see the number of cases shoot up in Japan.

Eguchi's remark has been roundly condemned, but the "ignorance defense" he employed is still in popular use. It was recently revealed that a preschool in Kofu rejected a student who had a parent, the school somehow learned, who was HIV-positive. The child was not, but the school still felt the child's presence would disturb other students' parents, who presumably might not know that you can't get AIDS from someone who doesn't have it.

Ignorance cuts both ways, especially when it comes to HIV. On the one hand, discrimination of the type practiced at the Kofu preschool intensifies the social stigma that HIV-positive people carry. On the other hand, people who don't know how HIV is contracted and spread are more likely to contract and spread it.

Ignorance was the rule last Monday, which was World AIDS Day seemingly everywhere but in Japan. Though events were held here, the media, caught up in the tragedy that occurred over the weekend in Iraq, ignored them almost totally. The reason for the neglect is more than just a matter of editorial priority. For years, Japan has characterized AIDS as everyone else's problem, since the infection rate is believed to be much lower here than it is in other countries.

That's probably true, but it's difficult to know for sure because testing is not encouraged. According to the Health, Labor and Welfare Ministry, about 1,000 Japanese people "became aware" that they were HIV-positive last year. Half are homosexuals who, because they are considered high risk, tend to get tested more often. The other half are heterosexuals, who tend to not get tested so much. Extrapolating for population and probability, it's natural to conclude that the number of actual heterosexual infections is much higher, and the ministry estimates that the number of confirmed HIV-positive people in Japan will rise from this year's 5,500 to about 50,000 by 2010.

Or it won't. It all depends on whether or not young people are made aware of the risks. According to the U.N. Population Fund, half of all new HIV infections in the developed world fall in the 15-24 age bracket. Right now, the incidence of sexually transmitted diseases, a good barometer of the probability of HIV infection, is rapidly rising among this age group in Japan.

This demographic was well represented last Tuesday at a discussion of HIV/AIDS on the Waseda University campus. About 300 students attended the presentation, which was both educational for the data it offered and refreshing for the attitudes on display. In addition to a young, earnest, besuited health ministry official, the panel consisted of an HIV-positive activist, a gay writer, a 45-year-old woman who mostly writes about her own copious sexual history, and a "charisma host" -- essentially a legal gigolo.

The mood was matter-of-fact and often frisky regarding the subject of safe sex. While discussing the difficulties of condom use in the heat of the moment, the charisma host brought up an occupational hazard: "Can you imagine a host wearing a condom?" The gay writer replied that he was really turned on by "black condoms." The woman writer explained breezily how she uses fellatio to apply condoms to partners who neglect to put them on.

The ministry official sat red-faced through most of this exchange, but he said that his department was trying to get the word out to young people that they should protect themselves and get tested if they believe they're at risk. The problem is that the health ministry doesn't have access to schools. That's the jurisdiction of the Education Ministry, which is much more skittish about sex education.

To the government, sex education tends to be a political issue rather than a health issue. Last summer, a Tokyo school for the developmentally disabled was punished for teaching sex education using cloth dolls with genitalia. Some members of the Tokyo Metropolitan Assembly were so offended by teachers instructing students about menstruation and ejaculation that they hung the dolls, naked, in the assembly building, as if they had been lynched. The Sankei Shimbun ran an article about the incident entitled "Adult Sex Products in the Classroom."

This is ignorance that borders on gross public malfeasance. The STD chlamydia has been contracted by an alarming proportion of young people in Japan, and these people usually don't know they have it. People with chlamydia have a 25 percent greater chance of contracting HIV. If that isn't enough to scare the authorities, then they might be interested to learn that chlamydia can also cause sterility.

The Waseda panel discussed these matters in an open and nonthreatening manner, dispelling the stigma of HIV while clarifying what "safe sex" really means. Ignorance is not only dangerous, they implied, it's stupid. According to the UNPF, most young people in the developed world learn about sex from "peers and the media." The authorities may not like sex education, but the fact is kids already know about intercourse. They just don't know enough.



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