HIV – Taiwan’s Festering Wound

HIV/AIDS in Taiwan is being compared to a festering wound.

Co-written by Kenton X. Chance, Michael Wijaya & Kervin Lloyd

November 2009

Many non-Asians who come to Taiwan see Taiwanese as sexually conservative and want to explore sexually with an “exotic” ethnic group. However, younger generations of Taiwanese are becoming increasingly liberal and experimental with their sexual conduct. This has contributed to an HIV/AIDS epidemic that has tripled in the past six years. Of the 17,966 cases of HIV diagnosed in Taiwan, 715 were foreigners. They come primarily from other Asian countries. However, the United States, with 40 cases, the most for a Western nation, features prominently on the list, which also includes England, Canada, Brazil, Nigeria, Swaziland, and South Africa. Some foreigners assume that Taiwanese are less promiscuous. This reflects a stereotypical view of Asians and their expressions of their sexuality. Could it then be that this prejudiced view, coupled with a culture that snobs overt sexual expressions, has tacitly encouraged sexual encounters that have exposed many, Taiwanese and expatriates alike, to HIV/AIDS?

Convenient stores, many of which are open 24 hours a day, all year round, punctuate the Taiwanese landscape. Condoms have been proven to be the most effective defense against HIV/AIDS for the sexually active. And, various types of condoms are readily available for purchase at these convenient stores for as little as NT$70 (US$2) for a pack of three. However, studies have shown that in Taiwan the majority of HIV/AIDS infections result from sexual activity. Since condoms are so readily available, why are so many people in Taiwan contacting HIV/AIDS through sexual activities? Is it that they are not using condoms or are not using them correctly? Why do Taiwanese 20 to 29 years – the age when most Taiwanese are pursuing tertiary education and most like aware of the dangers of HIV/AIDS – account for the bulk, 37%, of all infections?

More and more Taiwanese teenagers and young adults under the age of 25 are becoming sexual active, a point noted by Japanese Dr. Joseph Limoli Deyama, who volunteers with persons living with or affected by HIV/AIDS in Taiwan. He says that like their Japanese counterparts, an increasing number of Taiwanese teenagers are having one-night-stands. According to him, the internet has contributed to the quadrupling of instances of casual sex during the past few years. However, while Dr. Deyama notes that condom usage among these youth “is extremely low”, he speaks of the contribution of Taiwanese men who go on sexual escapades overseas and bring the virus home to their wives.

“Taiwanese working men have Asia’s worst rate of using condoms…. When you put all these major factors together, Taiwan has a potential tidal wave or tsunami-type situation. The wave has already begun to grow,” Dr. Deyama says.

Of the foreigners and Taiwanese who responded to an online survey about HIV/AIDS in Taiwan, 34.3% were between ages 20 and 25, the group most at risk, while another 31.4% were between 26 and 30 years. Of all the respondents, 62.8% gauged their overall Chinese ability as ranging from “intermediate” to “native speaker”. This suggests that they would recognize and understand most health-related information in the media and public places. However, an overwhelming majority of the respondents, 62.9%, said that they had never seen HIV/AIDS awareness information in Taiwan. A further 25.7% said that they had seen such information “somewhat often” while 5.7% said that they had seen it “often” and “quite often”, respectively. None of the respondents said that they had seen such information”very often”.

Additionally, while 42.9% of respondents said that they thought the HIV/AIDS prevalence in Taiwan was “similar to most countries”, 54.1% did not know that the number of persons diagnosed with the disease here had tripled in the past six years. A further 84% of those surveyed did not know that 715 foreigners had been diagnosed with HIV/AIDS in Taiwan. Taiwanese and many national of Southeast Asian countries often describe themselves as being “shy”, especially when it comes to discussing sex-themed issues. However, while 45.7% of the survey respondents were Asians, only 22% of them said that they would be embarrassed to buy condoms at a convenient store or other business outlet.

Interviews of Taiwanese and international students at Ming Chuan University International College (Taipei) provided some insights into what might be the cause of the spike in the number of HIV/AIDS cases in Taiwan. The two foreigners interviewed (one Latino male and one Afro-Caribbean female) described their Chinese ability as average and basic, respectively. They said however, that they would be able to recognize HIV/AIDS awareness information in Taiwan, especially if it included the red ribbon, an international sign for HIV/AIDS awareness. However, both of them said that they had never seen any information about the disease in the year that they have been living here.

Findings weren’t very different among the two Taiwanese students either. The female student said that she “seldom” hears anything about HIV/AIDS in Taiwan. She said that sex with multiple partners and homosexuality expose individuals to the disease. When asked how individuals can protect themselves again the disease, the student said, “Behave yourself.” It was not until she was asked about condoms specifically did she respond “Oh yes, yes!”

On the other hand, the male student, like the female foreigner, knew that the number of confirmed cases of HIV/AIDS in Taiwan had tripled within the past six years. A foreign teacher at the university had informed her class of that reality a week or so before. However, while the female foreign student had no idea about HIV/AIDS prevalence before that class, the male Taiwanese said that he “could feel that it was increasing” because he “heard that many high school students were having unprotected sex”. The male Taiwanese student did not know “exactly” how HIV is contracted.

“I heard, of course that it has to involve sexual intercourse and I heard [about] blood; like if there are any infection with like injuries or like blood. I heard that if that thing mixes along with sex, this is high checked.”

He was not sure where he has learnt about HIV/AIDS and other Sexually Transmitted Diseases, offering “friends and anywhere”. His parents, on the issue of sex and HIV/AIDS, had only told him “to be careful”.

That same student could not distinguish between contraceptives and the HIV/AIDS mitigating effect of condoms against HIV/AIDS. Asked how an individual might protect himself/herself from HIV/AIDS, the student responded, “Make sure you shower before you have sex.” After a pause, he added, “Actually, that doesn’t work, right? This question beats me, sorry.”

All of the students interviewed knew that they could buy condoms at convenient stores and, except the Taiwanese female, said that they won’t be embarrassed to buy them. “I will tell my boyfriend, to get it,” she said. The Taiwanese students knew that they could also get condoms free at certain government-run health facilities although they did not know which ones exactly. The male Taiwanese student said that he would be embarrassed to go to these facilities to get condoms. The students also felt that the government of Taiwan was not doing enough to sensitize residents about the HIV epidemic. They suggested that the government use the mass media to communicate these messages.

The female foreign student said that before her teacher spoke about HIV/AIDS they had gotten the feeling that “it was not much of a problem”.

“Here, it’s like it does not exist,” she said.

And so, here in Taiwan, a culture still admired by many as being one of the few that remain true to conservatism, this epidemic continues to boil, just below the surface, like a festering wound.

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One thought on “HIV – Taiwan’s Festering Wound

  1. Hi Kenton.

    I have sent you an email that I would like to refer some information in this article and waiting for you reply :) Thank you so much!

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