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Following is a question by the Hon Frederick Fung and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (November 30):
Question:
Regarding promoting the prevention of AIDS and sex education, will the Government inform this Council:
(a) given that promoting the use of condoms has always been an integral part of the Department of Health's HIV prevention activities, but some overseas researches have nevertheless indicated that the use of condoms can only reduce the risk of AIDS infection by about 69%, whether the authorities have assessed if the Department of Health's promotional strategy is effective or has misled the public into believing that the use of condoms is 100% effective in preventing AIDS infection; if they have, of the assessment results; and whether the authorities will consider adopting other strategies in promoting AIDS prevention;
(b) as it has been reported that the HIV infection rate in Uganda has dropped from 18% in the early 1990s to 6% at present, indicating that its AIDS prevention strategies have been more effective vis-a-vis those adopted by other countries, and the Government of Uganda has controlled the spread of HIV by emphasizing the importance of changing individual behaviour (especially among the young people), advocating a healthy life style and high moral integrity, encouraging young people to abstain from pre-marital sex and be faithful to one's spouse after marriage, promoting the proper use of condoms, etc, whether the authorities will consider following the practice of Uganda in the promotion of AIDS prevention and sex education, as well as promoting the relevant concepts and ideas, so as to tie in with the notion advocated by the Chief Executive in his policy address delivered in October that cherishing the family forms a core value of the community of Hong Kong; if not, the reasons for that; and
(c) whether the authorities have collected statistics on HIV infections through pre-marital sex, extra-marital affairs and having sex without the use of condoms; if not, whether they will collect the relevant information in order to know more about the living styles and patterns of HIV-infected people in the territory, for the purpose of formulating corresponding measures?
Reply:
Madam President,
Condom promotion remains an important international priority in the fight against AIDS as demonstrated by the Joint Position Statement of three leading international agencies, namely World Health Organization, Joint United Nations Programme on HIV/AIDS and United Nations Fund for Population Activities, in the fight against HIV/AIDS. In 2004, their joint position statement declared that "......condom is the single, most efficient, available technology to reduce the sexual transmission of HIV and other sexually transmitted infections (STI)." Similarly, the United States Centres for Disease Control and Prevention supported this view and stated that "Latex condoms, when used consistently and correctly, are highly effective in preventing heterosexual sexual transmission of HIV, the virus that causes AIDS."
Since 1980's, the Department of Health (DH) has been implementing education and publicity programmes to raise public awareness on HIV/AIDS and promote acceptance of people living with the disease, mainly through Announcement of Public Interest and distributing flyers and pamphlets to target groups. With sexual contact being the most common route of transmission locally, the practice of safer sex and the proper use of condom has always been a major theme of HIV prevention education.
(a) According to a meta-analysis commissioned by UNAIDS, condom use is 90% effective in preventing transmission, and condom use has been a key element in reductions in HIV prevalence in many countries. In Hong Kong, given the rising number of HIV infections and the fact that most of the people are infected through unprotected sex, it is important to remind the public to use condoms to reduce the risk of contracting HIV. DH launched a "Safer Sex Campaign" in September 2005 with the primary objective of promoting the practice of safer sex and removing the taboo on the use of condom in the community. DH has commissioned an academic institution to evaluate the effectiveness of the Campaign, with a view to making reference to the outcome in refining its HIV prevention strategy.
(b) The HIV situations in Hong Kong and Uganda are very different. The estimated HIV prevalence in Hong Kong is less than 0.1% in the general population while the rate is around 5% in Uganda. We understand that the significant fall in HIV prevalence in Uganda is multi-factorial with the "ABC" approach (Abstinence, Be faithful to partner, and Condom use) being one of the several reasons accounting for the drop. The different cultural, societal and demographical background as well as epidemiological situations of the two places account for the different approaches adopted in respect of HIV/AIDS prevention strategies.
Our HIV/AIDS prevention and control strategies are premised on the principle that AIDS education should be non-judgemental, and should aim to reduce stigma and discrimination. This approach is in line with international practice, and is also highlighted in UNAIDS policy position paper 2005 "Intensifying HIV Prevention" prepared by the Joint United Nations Program on HIV/AIDS. Our public education therefore focuses on teaching what the dangers are and how they can be avoided - without passing moral judgement on those who engage in infection-related behaviours, whether they do so safely or not. By labelling people diagnosed with the disease as leading an immoral lifestyle would discourage people from seeking testing for HIV and appropriate care.
Promotion of healthy living and lifestyle, as well as a positive attitude towards love, sex and family are covered under DH's other educational efforts including the Adolescent Health and Men's Health programmes. Pre-marital sex and marriage harmony are some of the issues addressed in these programmes.
(c) DH has not conducted any study on the extra-marital or pre-marital behaviour of those contracted with the disease. Instead, DH and local academic institutions have been collecting data concerning risk behaviours in various at-risk populations, like the sexually-active groups and drug users. Findings of these studies enable DH to monitor the trend of risk behaviours, and hence the epidemiological development of the disease. It also helps inform the preventive and education strategy. Risk behaviours tracked in the study include number of sex partners, condom usage with regular partners and non-regular partners, and whether heterosexuals or homosexual activities are engaged. Since 2001, a registry has been in place at the Integrated Treatment Centre, DH to collect in-depth epidemiological data of HIV/AIDS patients. A variety of information pertaining to each infection is covered, including the likely place of HIV contact, the likely source of infection, and their perceived risk of HIV infection before the diagnosis.
Ends/Wednesday, November 30, 2005
Issued at HKT 12:57
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