In this section, four chapters address the topic of sexual health in the region with particular emphases on HIV prevention and treatment, reproductive health and sexual health in relation to ageing. Kazuya Kawaguchi provides an overview of regional responses to the HIV-AIDS epidemic. Asia is the region with the second highest rate of HIV infection after Africa, and the epicentre of HIV-AIDS infection has shifted from North America and Europe to Africa, Latin America and Asia. Prominent routes of infection are the contact of men with female prostitutes, and among intravenous drug users. There are also cases of transmission between men who have sex with men (MSM). The main characteristic of the HIV/AIDS issue in East Asia is the relatively low HIV infection rates as a percentage of the population. However, in many Asian countries the population scale is so large that the actual numbers may be quite substantial. The numbers of people infected with HIV continues to increase. Other chapters in this section focus more closely on local situations.
Tine Gammeltoft and Nguyen Thu Hu’o’ng survey sexual health in contemporary Vietnam. They note that the World Health Organisation (WHO) defines sexual health as encompassing ‘the integration of the somatic, emotional, intellectual and social aspects of sexual being in ways that are positively enriching and that enhance personality, communication and love’ (WHO 1975). Besides HIV/AIDS, prevalent sexual health problems include other sexually transmitted infections (STIs) (and their consequences such as infertility and genital cancers), reproductive tract infections, sexual dysfunction, the physical and psychological consequences of sexual violence, and discrimination on the basis of sexual orientation. In Vietnam, they argue, present-day political ideologies tap into revitalised Confucian moralities which emphasise social duty, sexual loyalty, and orderly family relations, thereby intertwining late socialist rule with long-standing moral values and orientations. This ideological emphasis on the family as the cornerstone of society, they argue, has sexual health consequences. By ignoring or condemning sexual practices that do not fit political ideals of sexuality as institutionalised procreative heterosexuality, social authorities unwittingly end up contributing to the country’s burden of sexual ill-health.
Johanna Hood looks at the situation around HIV-AIDS in the People’s Republic of China. She provides an overview of China’s uneven socioeconomic landscape which facilitated the spread of HIV, the biological transmission paths of the virus, major milestones and key dates and policies, and the latest trends in infections. Hood surveys the changing representations of and dominant attitudes to HIV in the media. She also considers the industrial aspects of responses to HIV by local and global health bodies and industrial corporate social responsibility (CSR) platforms, for HIV/AIDS programs are a major recipient of donor dollars and social and political attention in China. The chapter provides an understanding of the political, economic, social, cultural and global health issues that have shaped how the virus is spread, managed, engaged by sick and advocacy groups, and perceived by the general public.
Katrina Moore addresses the question of how sexual identities and practices are transformed through aging. Several societies in East Asia are facing the aging of the population, so that sexual expression for older people is an issue which needs to be addressed, not only by the medical profession but as an integral aspect of thinking about human welfare in society. The design of domestic housing and of elderly care institutions would have to be rethought if there were to be a recognition that elderly people are also sexual beings. As people age, those formerly in heterosexual marriages might see their lives transformed as they outlive their partners. There is also a long way to go in dealing with the needs of gays, lesbians and transgendered persons as they age (see also Stickland, in press).