For Zhou Lu, a 13-year-old student who has been listening to talks on HIV/AIDS prevention, the potential horrors of an AIDS-related death are her worst adolescent fears.

“The scariest thing about having HIV/AIDS is not that you will die, but that you will look like a leper before you die,” she said with a grimace. “I’m not really afraid of death, because everybody dies. What I cannot stand is to die looking ugly.”

Zhou, with a porcelain doll face, has never seen an AIDS patient, just photographs of victims that are displayed at her school, Mianyang No. 4 High School, 91 km north of the provincial capital, Chengdu. “The disease is horrible. These are just pictures, I don’t want to die like that,” she exclaimed.

The photo exhibition is part of a program aimed at improving AIDS prevention awareness among high school teenagers. The photos graphically illustrate the physical consequences of HIV/AIDS, and present harsh truths to young people - although some argue it is not necessary to confront them quite so powerfully.

But Mianyang Education Commission Director Hou Xun argued that “the reality of AIDS is not pleasant.”

“If we don’t teach students the things they ought to know about HIV/AIDS, the consequences could be worse,” he said.

HIV is spreading at an annual growth rate of 30 percent in China. “That means the number of HIV carriers will be 500,000 by the end of this year if we don’t get the situation under control,” said Liu Kangmai, director of the National Center for AIDS Prevention and Control in Beijing.

What worries Liu most is that “youngsters could be plagued by HIV/AIDS some day soon. On the whole, young people today are sexually active one or two years earlier than preceding generations, yet they are almost ignorant of safe sex practices.”

Sexual activity among Chinese adolescents is not uncommon.

“A dozen teenage girls were hospitalized last summer to be treated for sexually transmitted diseases (STDs), and three came for abortions,” said a nurse from Chengdu No. 3 Hospital.

“The figure is just the tip of iceberg. More and more young people who have contracted STDs do not go to see doctors because of shame or embarrassment.”

In a move to control the possibility of HIV/AIDS spreading among high school students, the Mianyang municipal government, with funding from the United Nations Children’s Foundation, is waging an education campaign called “1+N Project.” The “1” signifies one student, while “N” stands for numerous parents and relatives.

“It’s an experimental way to mobilize social forces and make the campaign accessible to mainstream Chinese,” Hou Xun said.

The domino-theory program intends that a student learning the facts of HIV/AIDS in the classroom then passes on the information to his or her parents.

“Schools also write parents a letter inviting them to give their opinions about the campaign,” he noted. “Most parents believe it’s a good idea to have such special education courses in high school.”

The project integrates AIDS-prevention education into standard curriculum courses such as Chinese, English, geography, mathematics and fine arts.

Students at Huayuanlu Junior High School of Jiangyou County, Mianyang, say the pictures of AIDS patients displayed at school are very disturbing “because they don’t look like human beings any more. They look like ghosts.”

Xu Tao, a teacher at the school, said the ultimate goal of the program was “not to scare the children but to prevent teenagers from dying of ignorance. And to alert them to the fact that no one is immune from the disease.”

Aged 27, he has an infant son. “We must help students realize that there are so many beautiful things in life. But ignorance of HIV/AIDS can jeopardize their lives, thus limiting their chances of enjoying these beautiful things.”

Xu’s words were echoed by Duan Fei, a student at Mianyang No. 4 Middle School. Duan said the campaign against AIDS had prompted him to look at life in a different, more contemplative way. “The AIDS prevention campaign at school is to improve our ability to live in a safe and happy environment. I appreciate life more now since I know AIDS has claimed so many lives, including some young people,” he said.

The “1+N project” has been carried out in 120 high schools, reaching 50,000 students. Mianyang education director Hou said, “This suggests that at least 100,000 parents have been reached thanks to their children, who approach them with some essential and key concepts, like what HIV/AIDS is. They tell their parents about preventative ways to control the disease.”

Duan Xizhong, a controller at a local insulation materials manufacturing plant, admitted that before his 13-year-old son Duan Fei had passed on his knowledge about AIDS, he “barely understood what it really was, other than that it’s contagious.”

Duan Fei said he and his father used to have a phobia about HIV/AIDS. “I used to think the virus would get into my body just by shaking hands with an HIV carrier, and that I would die immediately,” he said.

His 40-year-old father is grateful that the school provides his son with reliable and detailed information. “Because of his training, I know now that AIDS is not a disease exclusively for homosexuals,” he said. “It is a disease anyone can get, but it is preventable.”

Some rural parents still frown on HIV/AIDS education in school, disliking any form of sex education for their children. It is still an absolute taboo for farmers to openly talk about sex or anything sex-related; the notion of their own children discussing the matter at home is inconceivable.

Miles away from Mianyang and farther down the economic scale, farmers gave 14-year-old Xiao Long, a member of the AIDS Prevention Team at Huagai High School, of Anxian County, a hard time.

“As soon as I told them unsafe sex was the most common way to get HIV, they interrogated me, asking if I knew where I came from and how my parents make love,” Xiao recalled.

The public confrontation infuriated Xiao’s parents, who are also farmers. “My parents had reservations about me participating in the campaign to begin with. They are ashamed when they see me talking about HIV/AIDS. They believe the disease only affects immoral people. They are afraid of what the other villagers will think of my family,” said Xiao, who has composed rap songs with pointed lyrics about the dangers of the disease and the ways to prevent it.

Although his performances met with laughter from his farmer audiences, his parents still believe the issue is “for adults only.”

Controlling the spread of HIV/AIDS ought to be the whole nation’s responsibility, “not just teachers, or authorities in public health,” said Liu Kangmai.

He estimates that HIV/AIDS will cost China between 460 billion (US$55 billion) to 770 billion yuan (US$93 billion) a year if the population of HIV carriers reaches 600,000 to 1 million.

Despite the high school campaign against HIV/AIDS, sufferers of the disease still face social discrimination.

“The great majority of the public still look frightened just by hearing the terms HIV/AIDS,” said Li Jiangqian, director of the Anxian Education Commission. “Some people even suggest the government should segregate HIV/AIDS patients.”

Li said the current HIV/AIDS education program in local schools is “timely,” adding that “we cannot wait until the epidemic has spread among our environment before we take any action.”

(China Daily 12/15/2000)