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Because authorities think activists are abetting undesirables—drug addicts, homosexuals, prostitutes—AIDS workers must keep a low profile. That's antithetical to effective prevention programs, which work better when they are broadcast widely and loudly through the media. Activists instead conduct underground, door-to-door campaigns among high-risk groups, passing out condoms and safe-sex booklets like Avon ladies handing out lipstick samples in China's brothels, saunas, massage parlors and gay meeting places.
It's proselytizing at its grittiest, and it's easy to despair, says activist Chung To. A Hong Kong resident who was a financial adviser in New York City and San Francisco, Chung lost many friends when the virus scoured those cities in the 1980s. He now regularly visits the mainland to spread the gospel of prevention and operates a one-person office in Beijing for his Chi Heng Foundation. Chung says he was recently at a sauna in Beijing where the man next to him bragged that he had had sex with seven men the night before, all without a condom. "The more I see, the more problems I see," says Chung, shaking his head. "There's too much to do and too little time."
The story is much the same throughout Asia. Most countries, even the poorest, have AIDS awareness programs, but they tend to be underfunded and slow to react. AIDS workers cite a litany of other shortcomings. Medical blood supplies need closer surveillance. Condoms are too expensive for the poor. "There's a massive failure of prevention," says Beyrer from Johns Hopkins. "This is a human tragedy that doesn't have to happen."
Asians, too, can't shake the notion that AIDS victims deserve their misery because of their own misbehavior. Xiao Su, a Beijing AIDS patient in his early thirties, says he can no longer return to his home village in Yunnan. His parents, who are doctors, are shunned by their neighbors because of his illness. "When old friends pass them on the street, they look the other way," Xiao says. Ostracism makes it all the more difficult to arrest the epidemic's spread. Throughout the region, a depressing pattern emerges: people who find out they are HIV positive feel too panicked and guilty to confess to their partners that they are ill, so the disease festers secretly and is passed on to spouses and children.
In Burma, it is believed that the heat from an ordinary funeral pyre isn't fierce enough to kill the virus, and so the dead are cremated with burning tires. This way, even in death, the AIDS sufferer is stigmatized. "The cruelest part about AIDS is the rejection," says Alongkot Tikapanyo, a Buddhist monk who since 1992 has tended to more than 10,000 AIDS victims at the Wat Prabat Nam Poo temple north of Bangkok. Today, his hospice takes care not just of men and prostitutes but a growing number of infected housewives and children.
Inside the "Bone Museum" located on the temple grounds, Alongkot keeps the ashes of more than 1,000 dead, each in a gray, brick-size box—remains that families did not want. The collection has become a macabre local attraction. "AIDS tours" arrive daily at the temple. Some Thais come to pay homage to Alongkot, while others bring their sons and daughters to scare them into good behavior. After viewing the withered corpses of several AIDS victims floating in a cloudy formaldehyde pool, 11-year-old Kannika says with a shiver, "I'm afraid. Now that I know, I won't do anything bad."
Still, too few know. Meanwhile in U.S. and Japanese labs, researchers are playing catch-up with a virus that keeps mutating. In Xinjiang, it may be only a matter of months, they say, before the B/C strain melds with another strain carried over the Hindu Kush mountains by drug users from Pakistan and Afghanistan, evolving a new, invisible menace for which there is no vaccine and no cure. Says AIDS researcher Kitty Poundstone from Johns Hopkins School for Medicine and Public Health in Baltimore: "You've got to be faster than the virus. So far, we're not." Science, it seems, can't save this continent from AIDS. Asians will have to save themselves.