Infected, but not isolated, in Hong Kong

10:07, May 05, 2010      

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Foreigners are turning to Hong Kong as an HIV haven, Guo Jiaxue reports from the SAR.

Unlike on the Chinese mainland where foreigners - or lao wai - still often attract stares, in Hong Kong they have become the unseen masses: Western businessmen rush between meetings in Central, Indian salesmen hawk suits on Nathan Road and Southeast Asian waitresses serve in Tsim Sha Tsui restaurants.

Yet behind this sea of faces lurks a disturbing statistic.

Although the number of foreigners who live and work in Hong Kong accounts for only 5 percent of its population, they make up one-third of the people infected with HIV or AIDS.

Of the 4,443 cases of HIV/AIDS reported by the end of last year, 1,489 involved non-Chinese residents, according to the department of health of the special administrative region.

"This figure deserves our attention," said Elijah Fung, manager of St John''s Cathedral HIV Education Center. "Government policies have been focusing on gay men and sex workers. Few care about this group (non-Chinese people)."

Fung''s center, which opened in 1995, organizes regular talks and workshops in community shelters to promote AIDS awareness and prevention. In recent years, her staff has focused on migrant workers from across Asia, one of the groups most at risk of infection.

"They don''t understand the risks," she said. "They know the basics, such as HIV can be transmitted by sexual contact. But if we ask further questions, like whether HIV can be transmitted by eating with someone, some of them just don''t know."

Fung explained that religion can also be a barrier to prevention. "Some of the migrant workers are Catholic, such as from Thailand. Their religion is opposed to using condoms," she said.

"I had no idea about this disease (before I came to Hong Kong), not to mention prevention," said a Thai woman in her 30s, who refused to give her name. She tested positive for HIV shortly after arriving in the city in 2004. "I lost my job at a restaurant shortly after."

A spokesman for an HIV and AIDS self-help organization, who did not want to be identified, attributed the high proportion of infections among non-Chinese to the fact they were "far from home".

"People living in a foreign lands tend to engage in more high-risk behavior. It is common around the world," he said.

However, not all the foreigners with HIV were infected while in Hong Kong, stressed Barry Lee, senior project officer for the Hong Kong AIDS Foundation.

"Some foreign people come to Hong Kong especially for HIV testing, because the test and reporting systems here are anonymous," he explained. "Moreover, many countries deport foreigners once they are found to be HIV positive."

A total of 59 countries, territories and regions across the globe have some form of entry restriction for HIV-infected visitors, while some countries in Asia - Singapore and Malaysia included - will deport foreigners who test positive, according to a 2009 report by the United Nation''s AIDS program, UNAIDS.

Last month, the Chinese mainland lifted its ban on HIV patients traveling to the country.

Living conditions

Vincent, an American who tested HIV positive five years ago, said he decided to move to Hong Kong in 2008 because "it is somewhere that I don''t feel threatened by AIDS-related laws".

The 30-year-old gay man, who declined to give his full name, was infected while working for a United States-based company in South Korea. After finding out his partner had been cheating on him, Vincent went through a period of having unprotected sex with random strangers.

"I took an HIV test and the results came out positive, meaning I lost my eligibility to stay in the country (South Korea only lifted its ban on HIV-infected foreigners in January this year)," he told China Daily.

For the next four years, he lived under the government''s radar and had to work illegally to survive. He had no visa and no medical support. Today, he has a steady job teaching English in a Hong Kong primary school, gets proper medical care to manage his condition and has joined a group of English speakers so he can talk with other people living with HIV.

"The doctors here are very supportive. People are also more open (than South Korea) about everything, including AIDS and gay issues. And my current partner has been my saving grace through it all," said Vincent.

The low cost of medical treatment is also attractive. "Hong Kong is the best deal," he added.

Hong Kong residents, either permanent or non-permanent (Vincent is a non-permanent resident with a working visa) enjoy medical benefits provided by the regional government. "It costs HK$60 ($8) for a consultation with a specialist and HK$10 per prescription," said Lee of the Hong Kong AIDS Foundation.

For those people without Hong Kong residency, medicine can cost about HK$10,000 a month and more than HK$2,000 for each specialist consultation.

Even in the US, medication to control HIV would cost Vincent about $2,000, "which is just a little less than my monthly salary, so it would effectively wipe me out", he said.

Although Hong Kong is more convenient for sufferers, life with HIV is still not easy, especially for those living alone in a strange land.

Vincent calls himself an "atypical American" and is fond of foreign cultures. He can speak French, German, Cantonese, and Korean. The only thing holding him back is stigma attached to his disease.

"I love Hong Kong but, deep down, it''s not so much that I love to live here. It is because I don''t have to worry about a visa or jobs here. I don''t like to isolate myself that way," he said. "I still want to travel all over the world. There are so many places I want to see."

Despite his condition, Vincent now pays more attention to his health than ever. He quit smoking, goes to the gym and is trying to give up alcohol. However, every slight twinge of his body or tiny rash still gives rise to anxiety that it may be related to HIV.

"I chose to live my life. I make my own efforts to keep healthy," he said. "Sometimes it is not your disease that kills you; your mind kills you. That''s why I always seek out positive life experiences that will help me deal with the cards I have been dealt."

He has also made good friends in Hong Kong, although he admits it was not easy at first. "Most of my friends know about my disease but there are still some people I don''t feel comfortable disclosing it to," he said.

To give something back to the society that is helping him, the American uses his spare time to do charity work. He helps blind students to learn English and takes part in fundraising activities for an NGO that supports people in need, including HIV-positive citizens in Asia and Africa.

Vincent also welcomed the news that China had lifted its travel ban for HIV sufferers.

"Now, I will be able to reach out to people who are affected by HIV on the mainland through the NGO," he said. "It would be even better if the government decided to allow foreigners to live there. I hope to maybe live in China one day."

In contrast, the 30-something Thai woman is having a difficult time adjusting to her situation.

Being HIV positive has changed her life completely. She got divorced, lost her restaurant job and has to take medicine and try to cope with serious side effects every day. One of her only friends is another Thai girl she met at an AIDS support service center. She is also HIV positive.

"Sometimes I wake up in the night in a fever, I feel everything is falling apart," she said. "All I want now is to be happy again."

Job concerns

Foreign domestic helpers, who test positive for HIV, are at a high risk of being dismissed by their employers as soon as their condition is disclosed.

"Although the Disability Discrimination Ordinance passed last year made discriminating against AIDS patients illegal, employers will find other excuses to fire them," said Fung at the St. John''s Cathedral HIV Education Center.

Vincent said he chose not to tell the school where he works he is HIV positive because of that reason.

"I want people, both those who live with HIV and those who don''t, to realize that it''s no longer a death sentence but perfectly manageable," he said. People fear HIV and AIDS based on irrelevant stereotypes, "ones that could easily be resolved through increased awareness and an overall elimination of the stigma attached to the disease".

"Medical technology has made a lot of progress," said the AIDS self-help organization spokesman who did not want to be identified. "With appropriate treatment, people with HIV can lead happy and healthy lives.

"What they need is full support - psychological and physical," he said. "More effort should be made to understand and care about these people. They are far away from their homes and living in this city with us," he said.

Vincent, 30, is an American who tested positive for HIV five years ago. He said he feels comfortable living in Hong Kong, where he moved to in 2008 after being forced to leave South Korea. Edmond Tang/China Daily

Source:China Daily
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