UNAIDS says in its latest report that the number of HIV infections has globally dropped by 17% in the past five years. This seems like good news but it is not. There are still too many people being newly infected every year.

联合国艾滋病规划署在最近的一份报告中提及,全球艾滋病感染率在过去五年中已经下降百分之十七。这个数字看似乐观,但实则不然,每年仍有太多的人们染上艾滋病。

For China numbers vary between 700,000 and 1 Million and certainly these numbers are still too low as many people who are HIV infected are not aware of their infection or do not dare declaring themselves. HIV and AIDS remain a threat and a taboo, and that it is why it is important to talk about this disease like we do today. It is not easy to talk about AIDS because it is a sexually transmissible disease and so if we talk about AIDS we have to about sex and morals.

在中国艾滋病的感染人数大约介于七十万至一百万之间,但这个数字远低于实际状况,因为有太多的感染者可能没有意识到自己已受感染,甚或不敢公开自己得病。艾滋病不单是一种威胁也是一个禁忌话题,而这正是为什么我们今天对它的探讨如此重要,谈论艾滋病并不容易,因为它是一种经由性接触传播的疾病,当我们谈论艾滋时,不可避免的,我们也会谈论到性与道德。

I will present here what I call four deadly beliefs about AIDS. I call them deadly beliefs because people who believe any of these four propositions are at high risk of being contaminated and hence to contribute to the spread of the disease. Yet, these beliefs are thick because they are about us and about our moral attitudes.

今天我会逐一讨论四个对艾滋的致命误区。我之所以称之为致命误区,是因为人们普遍相信在这四种状态下感染艾滋病的机率很高,而这些误区又和我们每个人以及我们的道德观息息相关。

Only prostitutes, drug users and homosexuals get AIDS

只有妓女,吸毒的人和同性恋才会得艾滋病

The first deadly belief about AIDS is that it touches only prostitutes, drug users and homosexuals. This belief is not only wrong, it is also extremely dangerous as it will allow the disease to spread more easily.  It is true that prostitutes, drug users and homosexuals are more likely to be HIV positive but they are not the only ones who catch the virus. There are always more clients than there are prostitutes. If prostitutes are infected so are their clients and these clients then spread the disease further to their families. Most prostitutes are also drug users and this heightens their risk of being infected by HIV. Many people think that taking drugs is fundamentally evil and should be punished. However, if we want to stop AIDS from spreading, punishment will not help. We have to accept drug users with their addiction and start helping there: we have to give them sterilized needles and syringes, create injection rooms under medical surveillance and develop rehabilitation programs on the basis of drug substitution rather than incarceration. China has started to do this in some provinces and the number of infections has dropped but we need to do it everywhere for all drug users.

第一个关于艾滋病的致命误区就是,它只会传染给妓女,吸毒的人和同性恋者。这种偏见不但是错误的,而且极端危险,因为它会助长爱滋的传播。没错,妓女,吸毒的人和同性恋比较容易染病,但他们不是唯一得病的人。嫖客的人数永远会大于妓女的人数,一但妓女成为带原者,那么她们的客人也会受到感染,接着这些客人的家人就成了下一波受感染者。许多妓女本身就有毒瘾,这的确提高她们被艾滋病感染的危险。许多人认为吸毒是一件天理不容的事,所以理應受到惩罚。但如果我们想要扼止艾滋病蔓延,惩罚无济于事。我们必须接受吸毒者以及他们的毒瘾,并以这为基础出发点去帮助他们:我们必须给他们消毒过的针头和针筒,在医疗处所开设注射室并且发展戒毒疗程,而不单单是监禁他们。在中国的一些省份已经有类似的行动,而且感染率已经下降,但我们必须把它推广到每一处,使所有的吸毒者都可以得到帮助。

Society can also take a lot of time debating whether homosexuality should be morally accepted or not, but again, if we talk about AIDS, this is actually not the problem at stake. Homosexuality does exist, and having changing sex partners is part of many homosexuals’ lifestyles. If we want to stop AIDS we cannot do so by lecturing these people on the immorality of their behavior. But we can inform them on the risks they are running and offer them medical care; this has reduced the infection rate everywhere in the world and it will do so too in China.

每个社会都可以对于同性恋在道德上是否容许做讨论,但同样的,如果我们要解决艾滋病的问题,这根本不是治本之道。同性恋确实存在,拥有不固定的性伴侣是许多同性恋者的生活方式。如果我们要扼止艾滋病,一味地对这些人说教不是办法,但我们可以告知他们这种生活方式的危险性并且提供他们医疗帮助,这种做法已经在世界每一处有效降低感染率,中国也不会例外。

HIV does not care about moral philistinism. We might not like the idea of prostitution, drug use or homosexuality but we must not forget that these people are amongst us. Prostitutes have clients, drug users have families, and homosexuals have often heterosexual contacts, even families, and this is how the disease spreads from these groups to others. Therefore we have to inform on the risks, we have to educate and we have to offer medical care wherever possible to stop the epidemic.

艾滋病毒是不着眼于道德取舍的,我们或许不喜欢性交易,吸毒或同性恋,但我们不应该忘记这些人就在我们身边。妓女有恩客,吸毒者有家人,而同性恋者也有异性恋的朋友,甚或家庭,这些就是艾滋病从这些族群散播到别的族群的途径。因此我们必须了解这些危险存在,我们必须教育群众,并且我们必须在任何必要的时候提供医疗帮助,去制止疾病的蔓延。

Aids is an African disease

艾滋病是一种非洲疾病

Some people believe that AIDS is and African disease and this is the second deadly belief. AIDS is a global disease. If there are more HIV infected people in Africa then this is due to the lack of prevention and of medicine, and the limited capacities of their governments to act on AIDS. Africa is a warning of what happens to societies who do not put all their financial, medical, social and educational forces to work to fight AIDS.

有些人相信艾滋病是一种非洲疾病,而这正是第二种致命的误区。艾滋病是一种全球性的疾病,即便在非洲感染艾滋病的人数较多,这也是因为当地预防措施不足,医药短缺以及政府的力量有限。相对的,非洲正是一个借镜,从这里我们可以看到如果一个社会不尽其财政,医药,社工以及教育力量去防制艾滋病,最后的下场便是如此。

Some think that AIDS is African because its origins lie in Africa. It is true that HIV has developed from an animal virus in Africa about 100 years ago but nobody really knows how exactly HIV has mutated to infect humans. We know, however, that viruses frequently mutate so that they migrate from animals to humans. In the past ten years alone we have seen the adaptation of the bird influenza virus to humans, of an animal coronavirus to SARS, and at this very moment we are witnessing the spread of an adaptation of swine influenza to humans in the form of H1N1. Just as AIDS, these three diseases have spread globally. AIDS is not an African disease just because its origins lie in Africa; it is a global disease which is a threat for everybody.

有些人认为艾滋病是一种非洲疾病仅仅因为艾滋病发源于非洲。没错,艾滋病毒是在一百年前在非洲由一种动物病毒所衍生出来的,但致今没有人知道到底艾滋病毒是如何开始影响人类的。但我们知道,病毒常有突变，突变之后它们就可以由动物感染人类。在过去十年之间,我们看到了禽流感的变种,非典,以及最近的新型流感。就像艾滋病一样,这三种疾病也在全球范围内流行。艾滋不应因为它发源于非洲而被视为非洲疾病,它是一种全球的疾病,而且威胁着每一个人。

Marriage is the best protection

婚姻是最佳保障

The third lethal belief is that marriage is a protection against AIDS. But no. More and more people become infected by their partners. Remember the clients of prostitutes? Most of these men are married and they pass on the disease to their wives. Do their wives know that their husbands are seeing prostitutes? Sometimes, but most often they do not. They believe to have true loving husbands. And so they believe that they are not at risk. But they are.

第三个致命误区认为婚姻可以保护你不受艾滋病威胁。但这是错的。愈来愈多的人被自己的伴侣所感染,记得我们提过妓女的恩客吗?这些男人大部分已婚,而他们把病传染给他们的妻子。这些人的妻子知道她们的丈夫去嫖妓吗?或许,但大部分时候她们是被蒙在鼓里的。她们以为自己拥有忠实的丈夫,所以她们不受艾滋病威胁,但她们错了。

And then…. even if they know about the “accidents” of their husbands many wives prefer to think that they will not be infected as it is not “their” disease. They are not aware that everybody can get infected. HIV is transmitted through blood or sperm. Every person who is having sex is a person at risk and is a risk for others. HIV does not care whose immune system it is destroying. Marriage is no protection. Condoms are.

很多妻子即便知道了丈夫有了外遇,也自愿选择相信她们不会受到感染,因为她们认为这不是属于她们的病,但她们不明白每个人都可能被感染。艾滋病毒经由血液或精液传播,任何有性行为的人不但都有受染的危险,也都是对别人潜在的威胁。艾滋病毒才不管它摧毁的是谁的免疫系统,婚姻无法提供你任何保障,但保险套可以。

AIDS can be treated and does not kill anymore

艾滋病是可治愈的而且不再致命

The naivety about AIDS can be explained maybe through this last deadly belief, namely that AIDS can nowadays be easily treated and does not have to lead to death anymore. It is true that antiretroviral therapy has saved many lives. Yet, drugs just treat the symptoms. But they do not cure and they certainly do not stop the contagion of HIV. They are not a vaccine. Furthermore, these drugs are expensive and not accessible to large parts of the world’s population. They also have heavy side effects which are comparable to those of cancer therapies. Patients under antiretroviral treatment cannot work anymore and are dependent on their families and state assistance. So, yes, there are less people dying of AIDS in 2009 than there were in 2004 but AIDS still destroys lives, and it does so thoroughly.

对于艾滋病的无知或许可以藉这最后一个误区窥见,也就是在今天艾滋病是可以轻易治愈的,而且不再致人于死。没错,现在的抗逆转录酶病毒疗法已经救活很多病患,但是药物只能抑制症状,并不能治愈艾滋病,更不能阻断病毒的传染力。这些药物也不是疫苗,更重要的是,这种药十分昂贵,对于世界上大多数人口来说,根本无力负担。它们还有可与癌症疗程相比拟的严重副作用,进行这种疗法的病人无法工作,只能依赖其家人与国家的救济。所以,没错,与2004年相比,在2009时因艾滋病而死的人数确实减少,但艾滋病仍然可以摧毁一个人的生活,而且是彻彻底底地摧毁。

These four deadly beliefs can be summarized in one naïve sentence: “AIDS only happens to others”. But this is not true. AIDS can happen to everyone. It is only through information and education, and through attentive medical care and prevention that we can avoid the epidemic. But if we inform and educate we have to talk about things of which we think that they are inappropriate to discuss for instance with young people: sex, prostitution, homosexuality, drugs, marriage and fidelity and so on. When I see young people like in our university I know that many of them do not know much about these things; they often do not even know where babies come from. This is where we have to start to educate. We cannot leave sexual education to pirate copies of “Sex and the City” but we need to be honest and clear with our youth. We need to talk about all these uncomfortable topics. Ignorance is the ground of those four deadly beliefs and if we need to fight these if we want to fight AIDS.

这四个致命的误区其实可以用一句话总结:艾滋病只会找上别人。但这并不是真的,任何人都有可能感染艾滋病。只有经由信息的传递与教育,还有积极的治疗与预防,我们才能阻止疾病蔓延。但若我们要传递信息和教育,我们就必须和年轻的一代讨论一些我们觉得他们不适合讨论的话题:性,性交易,同性恋,毒品,婚姻与忠实等等。当我看到像校园里的这些年轻一代时,我知道他们其中很多人对这些事情所知不多,有些人甚至不知道小孩是怎么来的,但这正是爱滋教育该开始的地方,我们不能把性教育留给盗版的欲望城市影集,我们必须诚实地面对我们的年轻一代,我们必须和他们讨论这些令人不甚舒服的话题,无知是这四个致命误区的症结,也是我们对抗艾滋病的症结所在。