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Plenary Remarks were given by Yang Xiaodu, Vice Mayor of the Shanghai Municipal People's Government. Mr. Yang spoke about the government's solemn commitment to the issue of HIV/AIDS through initiatives such as the "Four Frees and One Care" policy. He stressed the importance of interaction between the government and the community as well as social science researchers and the medical field to make improvements in the social environment surrounding people living with HIV/AIDS.
The honorable Wang Longde, Vice Minister of Health, the People's Republic of China delivered the keynote address. Vice Minister Wang discussed the four strategies employed by the Chinese government to fight HIV/AIDS-related stigma: political commitment, law enforcement, government policy, and social marketing and community mobilization. The government is in the process of developing the country's first HIV/AIDS Act; the Act aims to protect the rights of HIV-positive people and their families, making discrimination against HIV/AIDS illegal. Vice Minister Wang also spoke at length about China's "Four Frees and One Care" policy which works to reduce stigma and discrimination through government support for HIV-positive people. He also cited evidence from a study performed throughout China in 2004 that demonstrates the lack of knowledge on basic aspects of HIV/AIDS among the general Chinese population. However, he stated that the situation has improved over the past year due to social marketing initiatives.
The keynote address was followed by the first panel discussion, "New Approaches: Leadership and Collaborations." Kevin Frost, Vice President for Global Initiatives and Director of TREAT Asia, American Foundation for AIDS Research (amfAR), acted as moderator for the first session. Panel speakers included Marina Mahathir, President of the Malaysian AIDS Council, Thomas, President and Founder of AIDS Care China, and Jing Jun, Director of the Social Policy Research Institute in the School of Public Policy at Tsinghua University. The discussion began with a consideration of stigma and discrimination specifically as it relates to young people. Speakers stressed the importance of providing nonjudgmental education on sex and HIV/AIDS to young people in Asia while simultaneously promoting gender equality. In places such as Malaysia, girls are brought up to believe that they have no rights; withholding this proper education allows these young girls to be infected by HIV/AIDS. The promotion of peer education is particularly important. The Malaysian AIDS Council has found that allowing youth to use fun, innovative methods to educate their peers on HIV/AIDS is a very effective method of communicating this essential information. Often, discrimination is directed specifically toward young people; important reproductive health information is withheld from those who are unmarried.
Panelists discussed their experiences with stigmatization through work with groups such as AIDS Care China, emphasizing the effect that ordinary citizens can have on the lives of HIV-positive people. Simply visiting with them and giving support can give them the gift of hope; discrimination can be very psychologically damaging to those living with the disease.
The panel also acknowledged the tremendous impact of discrimination in HIV/AIDS testing in China. The break through point in HIV/AIDS prevention in China may very well come when the final 90% of HIV-positive people become aware that they are in fact positive. However, the primary impediment to testing is stigma and discrimination. The discussion distinguished between two classifications of discrimination, direct and indirect discrimination. Direct discrimination is characterized by interference in the person's daily needs such as loss of a job, refusal of medical treatment, denial of schooling, or eviction from the community due to local regulations regarding HIV-positive people. In contrast, indirect discrimination refers to less invasive adversity such as stereotyping, exclusion, and hostility from the community. Often, the discrimination most damaging to people living with HIV comes from the family and the medical community. Among China's general population, discrimination is primarily due to people's moral judgment, not fear. Panelists suggested that one way to break down discrimination in China and encourage people to be tested is through Recommended Counseling and Testing (RCT). RCT uses the media and community programs to promote HIV testing. National leaders, famous and respected individuals, as well as other influential people can act as models for accepting the HIV test. Before this can occur, however, RCT must first fight against the stigma.
The second panel discussion, "New Tools: Media and Arts," was moderated by Li Xiguang, Academic Dean of the School of Journalism and Communication at Tsinghua University. Speakers on this panel included Bob Meyers, President of the National Press Foundation as well as Kevin Ryan, Director of Positive Lives. This session opened with comments on the way that "bad" journalism has contributed to discrimination, stigma, and contempt for people living with HIV; public understanding of HIV/AIDS relies heavily on journalism.
Beginning in 1981 with the first report on the subject of HIV/AIDS by the U.S. Centers for Disease Control and Prevention, the first generation of AIDS coverage was extremely complex, containing dense medical and statistical information. This type of journalism removed the human aspect of the disease and provided information to the public in such a way that it was not easily absorbed. Stories were primarily sensational in nature, representing HIV-positive people as either victims or murderers. It was in this environment that the Positive Lives project began in London 12 years ago. The second generation of AIDS coverage moved beyond dry statistics to consider the human side of AIDS, utilizing powerful images of people living with HIV. Journalists became responsible for conveying the humanity of the person, focusing on their pain and suffering as well as the impact that this disease has on their family and friends. The initial goal of Positive Lives was to show the positive side of people living with HIV, to show the public that HIV-positive people were not a marginalized group, but rather they were members of the larger community. The Positive Lives Photographic Exhibition utilizes photographs from all over the world to show that this is not a disease localized to a particular community or region of the world; it is a global issue. Panelists called for cross-sector partnerships between the media, non-governmental organizations, as well as other organizations to work in tandem in order to effectively fight the battle against stigma and discrimination of HIV/AIDS.
The discussion framed the issue of HIV/AIDS as a battle on two fronts. The first fight is medical, searching for novel treatments and vaccines for the disease. The second fight is to capture the hearts and minds of the community in order to fight ignorance, stigma, and discrimination. If one does not win the second fight, one cannot have a successful containment policy in regard to HIV.
The third panel discussion, "New Direction: Policy and Strategy," was moderated by Ray Yip, Director of the U.S. CDC Global AIDS Program in China. Speakers included Ni Zheng, Deputy Director of the Shanghai Minhang Center for Disease Control and Prevention, Li Yifei, Managing Director of MTV Networks China, and Xia Guomei, Director of the Research Center for HIV/AIDS Public Policy at the Shanghai Academy of Social Sciences. The speakers began by discussing the unique position of China in the battle against HIV/AIDS. China is in a favorable situation because the government has pledged a high level of commitment to the issue when the prevalence of the disease is still in a mild, early stage. Other countries would have been lucky to face the issue when prevalence was as low as 1 per 1000. Panelists contended that the two major components to averting a crisis in China are to ensure that all HIV-positive people know their status and to teach prevention and curb discrimination within the general population. The low prevalence in China creates another problem in that most people do not have any personal experience with HIV, and therefore may foster fearful, discriminatory feelings toward people living with HIV. The media must be used to bring the Chinese public face to face with HIV-positive people.
The panel also discussed the success of the Room of Our Love and Care. This program gives people living with HIV a place to share their stories and feelings while protecting their privacy. The program works to show the patients that people care about them despite their disease. They also provide information to HIV-negative people in an effort to bridge the gap between the general population and people living with HIV. Other functions of the Room of Our Love and Care include a hotline for counseling, social activities, free HIV/AIDS testing, and HIV/AIDS-related conferences and seminars for special groups such as college students. Discrimination creates difficulty in attracting patients to utilize these services, making outreach and social marketing necessary to bring people into the program.
Discussion also focused on the role of media, MTV specifically, in influencing young people on matters such as HIV/AIDS. MTV's work to spread knowledge of HIV/AIDS throughout Asia's younger cohort has taken many forms, including the special program, "Staying Alive," documentary films, the Red Ribbon Award, an AIDS concert in India, branded condoms, and celebrity interviews. Statistics show that 6000 young people aged 15 to 24 are infected with the HIV virus every day around the world. In light of this fact, social marketing among young people becomes vital. Media forms such as MTV have great power to influence young people because they understand their target audience and use creative methods of relaying this important information.
HIV/AIDS-related stigma forces patients to defend their pride rather than committing their energy toward fighting their disease and seeking appropriate treatment. In order to create a positive environment through local or national laws, three issues must be considered. The first is that any law must emphasize the improvement of public health, especially in the area of sanitation. The second issue is that a law must create a healthy social environment for patients so that people do not become marginalized due to their disease. The third issue is that a law should ensure the reduction of obstacles to disease prevention and control. These three issues must be taken into account before successful legislation can be created to address HIV/AIDS.
The symposium concluded with closing remarks by Zuo Xuejin, Executive Vice President of the Shanghai Academy of Social Sciences. Mr. Zuo cited the participation of Vice Minister of the Ministry of Health, Wang Longde and Vice Mayor of the Shanghai Municipal People's Government, Yang Xiaodu as evidence of the Chinese government's commitment to HIV/AIDS prevention and control. In order for stigma and discrimination against HIV/AIDS to be reduced, cooperation between government, the medical community, and society as a whole must be achieved.
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