SOME mornings I get up feeling almost perfectly well. As I slip on my flak-jacket and prepare for another tour of duty in the trenches of the AIDS Foundation it's very easy to forget that on that list of known HIV-carriers in Hongkong there appears but onename - mine. This isn't as daunting and isolating as might first appear. My work, as Education Officer in the foundation, brings me regularly into contact with other carriers - expat and Chinese. I am daily confronted with reports which have obviously exhausted the superlatives of many a journalist - mind-boggling facts and figures relating to others in my situation. Through my involvement in support groups and other social activities I am acutely conscious that I am not alone. I recently had dinner with a group of friends and we were all highly amused just speculating on how the management of the very traditional Chinese restaurant we were in would react if they knew that they were entertaining eight HIV-positive customers. An important part of my job brief with the foundation is educating and raising the awareness of the general public, and I am only too aware of the language and cultural divide which separates me from the bulk of the local population. I am constantly trying to get some Chinese HIV-carriers to go public and help give the disease a human face - an Oriental face. Shadowy silhouettes of Mr X and the deluge of mind-numbing statistics seem to merely perpetuate myths, misconceptions and the notion that this really isn't a problem affecting Chinese people. As yet, there is no queue of volunteers willing to do this. Concern about family reaction is the main reason given for the desire to remain anonymous and certainly, judging from the experience of the HIV-infected hemophiliacs, the renowned Chinese extended family network does not appear to be effective in respectof HIV-disease. Work is the other most cited worry and one must accept that, given current attitudes and the prevailing social climate, disclosure of HIV-positive status would almost certainly lead to termination of employment in any field. What is it about this illness - this relatively-hard-to-catch viral infection - that produces such extreme reactions? What are the particular characteristics which can stir up such an incredible range and intensity of responses at the individual, community and, indeed, national level. Human beings are creatures of habit when it comes to patterns of thinking and behaviour. We love to run and rest in well-worn, comfortable ruts. The HIV-epidemic confronts us all with many unpalatable aspects of existence which most are quite reluctant to address - disease, sexuality, death. Only when the bodies are starting to pile up and the problem is battering on the door, demanding attention, do we finally and reluctantly make some response. Possibly the most alarming feature of the HIV-infection and AIDS is that it is, effectively, incurable. Today, in the latter part of the 20th century, we have become habituated to the idea that ''they'' can and will come up with a cure for every human ailment - that the miracles of modern science and technology have eradicated all health problems. OK we still have some cancer but even that is coming under control. You can still find heart disease and congenital disorders but they aren't affecting healthy young people. This AIDS business is different. More than 10 years down the line - billions of dollars spent, thousands of man-hours of research being thrown at the problem - and there is still no sign of a cure or vaccine. The best that ''they'' can come up with is - ''Wear a condom''. Reminders of the essentially fragile and uncertain nature of life have never been welcome. Within the medical profession itself, this challenge, to the self-appointed omnipotent status of many practitioners, has frequently provoked hostile reactions and a refusal to treat carriers or indeed have anything at all to do with the disease. A whole range of spurious excuses have been manufactured to justify this unethical, immoral and unprofessional stance. Currently within Hongkong, most private hospitals would refuse to admit an HIV-positive patient for any form of treatment on the grounds that they are not ''equipped to deal with the problem''. Government hospitals make no such distinction and treat HIV-carriers in regular wards. Most private doctors' and dentists' offices would similarly refuse to treat those who admit to being HIV-positive. More than one person in Hongkong has had the experience of going to his doctor for an AIDS test, returning for the result and being told that he had tested positive and was no longer welcome on the premises. Such irrational and irresponsible behaviour is reprehensible from any source. Coming from medical professionals this does grave damage to levels of knowledge and understanding within the community. HIV is spread predominantly through unprotected sexual contact. I recently came across the daunting statistic that there is estimated to be a total of 15 million acts of sexual intercourse occurring daily on a worldwide basis. Since the vast majority of these acts are quite unprotected, this theoretically amounts to an annual total of 18 billion opportunities for the virus to spread. Sexuality stirs up many powerful emotions and opinions, and throughout history sexually transmitted disease has had an enormous amount of stigma, blame and condemnation attached. In the 16th century, the world experienced an epidemic of syphilis which resulted in a characteristic outburst of name-calling at the national level. To the French this was the ''English Disease'', to the English the ''French Pox''. To the Japanese - the ''Chinese Disease''. With HIV we also have the indelible association with homosexuality, prostitution and drug addiction. This provides for many an irresistible opportunity to feel superior and cast judgement from a pinnacle of moral rectitude. Hideous violations of human rights can be perpetrated under the guise of public interest. There is no doubting the fact that AIDS is a public health concern and not simply a matter for purely individual consideration; this is not like cigarette smoking or the adoption of more sensible eating habits. The disease is infectious. A carrier can remain apparently perfectly healthy and unaware of his status for many years while, at the same time being capable - under certain circumstances - of passing on the disease to others. There is no cure or vaccine. The rate of fatality is very high and death often comes only after a hideous and protracted period of deterioration. Over the last 10 years I have been able to experience HIV-disease from many different perspectives - initially as a casually interested bystander reading about some weird new disease which was affecting the American homosexual community. Gradually, I took more notice as information began to reach me both as a health-care worker and as a sexually-active man. A few years of propaganda and I had substantially modified my behaviour and was having to acknowledge that, in view of my lifestyle and history, I hadbeen seriously at risk. I later had the experience of acquaintances dying and, after suffering some worrying health symptoms myself, decided to be tested. I know what it feels like to wait for that result and then having been told the worst, cling to the hope that a mistake had been made. A few more days passing before confirmation arrives and then even more shattering news as further tests reveal an immune system already largely destroyed. There followed interminable visits to hospital - reading statistics which predicted a life expectancy of not too many years - if I was lucky. Trying out different medications - no doctor would ever mention cure, merely demonstrate declining curves of varying shape which promised a few more months - possibly. Learning to live with side effects - nausea, the shakes - or was that just the disease progressing. More tests and the vital numbers falling ever lower. And, worse than any physical symptom, the dreadful fear and isolation. What about my job - bad enough in any line of business - but a dentist? What happens when I get really sick? What do I tell my colleagues, my family, my friends? Always checking - is that the beginning of skin cancer, that cough a fatal pneumonia, that memory lapse a slide into dementia? It became routine to lie awake in the cold light of dawn, to shake with fear, to dread the passing of each new day. Salvation came in the unlikeliest guise as circumstances conspired to make my situation public knowledge. This brought a whole host of newexperiences. Colleagues from work wept down the telephone line claiming that I had ruined their lives - that their wives and children would starve, their workplace irrevocably tainted by my presence. Well-meaning friends threw airline tickets and money at me and told me in no uncertain terms that I would be a dead man if I stepped out on the street with my identity known. I was treated to dire predictions of being pelted with excrement and hounded out of the territory. Several days were spent surrounded and immersed in panic and hysteria. Fortunately, in the midst of this madness I was granted a moment's respite. Professionally destroyed and with virtually no immune system left, I frankly did not have too many career options. One choice, and a very tempting one, was to pack my bags and run. Instead, I decided that I would stay. I would quite consciously and deliberately shed all feelings of guilt, fear and shame and, as far as possible, become open and honest about who and what I am. The results of this have been astonishing. Hongkong has been revealed to me as a far more liberal, compassionate and understanding society than I had ever suspected. I have been deluged with an abundance of human goodness - the many telephone calls, cards and letters offering support, encouragement and practical assistance. Strangers in the street would shake my hand and offer words of comfort. I very quickly found myself in a new and rewarding career where I am in daily contact with examples of caring, selfless behaviour: My colleagues and co-workers at the foundation not only talk tolerance and understanding but practice this on a regular basis as they treat me and other HIV-positive people in a normal and relaxed way. The foundation volunteers are prepared to do whatever has to be done to ensure that no one need be alone or neglected or suffer unnecessarily because of his disease. The other HIV-carriers I meet in our support groups and elsewhere never fail to impress me with their quiet dignity and good humour. And the staff of the Government Health Services, who carry on their demanding work in such a committed, professional and humane manner. The World Health Organisation and medical associations worldwide state emphatically that informed, voluntary testing and the provision of education and support services is the only morally acceptable and indeed practical and effective method of combatting the spread of HIV-infection. I would further contend that such preventive measures will succeed only if we also strive to eradicate irrationality and fear, openly acknowledge the existence of the many thousands of carriers thought to be present in the territory, and create a social climate which encourages open, honest and responsible behaviour from those who are, or suspect that they might be, HIV-positive. A key element in the control of this disease is to be found in the fact that no one will ever become infected with HIV from the likes of myself or from any of those carriers with whom I am acquainted. I can make that bold assertion with no reservations. I know how the virus is transmitted and I am fully committed to taking those measures which are necessary to prevent such transmission occurring. I consider it not unreasonable that, in return, I be granted the rights and privileges of an ordinary person - that I be allowed to go to those places and do those things which pose no threat whatsoever to the people around me. I ask no more than this, but will settle for no less.
