How do you show support for an illness that has become all but invisible?
That's the problem Tomoko Yoshida, 34, a PR consultant at health-care company Sunstar, sought to solve with her "Red Ribbons on Nails" campaign, which uses nail art to educate people about AIDS.
In Japan, 20,600 people have been diagnosed with HIV, the virus that causes AIDS, and the incidence of infection is on the rise. However, AIDS remains deeply misunderstood and shrouded in stigma. Advances in antiretroviral drugs that have improved the quality of life for people living with HIV are undoubtedly a good thing--but the increasing invisibility of the disease means that it's a case of "out of sight, out of mind" for many.
"People don't say 'AIDS.' They don't talk about it," says Yoshida, who was inspired to write her dissertation on the illness after seeing the musical "Rent" while at university. "Even those who are HIV-positive don't want to talk about it because they worry they'll be ostracized or discriminated against."
Frustrated that so many people harbored misconceptions about the disease, Yoshida struck upon the idea of using the red ribbon design--a symbol for the fight against AIDS--to paint on people's nails to raise awareness.
"Women won't normally boast about their hairstyles or their clothes, but they will hold out their hands and say, 'Look at this!' and show off their nails. That's good because it's an opportunity to talk about it," she says.
The five minutes it takes to paint the design also provides an opportunity for the nail artist to pass on information, and to correct the misunderstandings and incorrect assumptions people often have about the virus. Rather than a ribbon that can be taken off, constantly having the design on one's hands seems to be more effective at making people think about the disease.
"Painting something onto your body is a conscious act," says Yoshida. "Nails are part of your body, so it's more meaningful than a badge."
According to Yoshida, older generations tend to be less well-informed about the disease, partly because they left school before the epidemic exploded in the late 1980s, and have never been properly educated about it.
"The image of AIDS is emaciated, bed-bound people with horrible skin conditions, but now it's not like that. You might be standing right next to someone with AIDS and you wouldn't even know," says Yoshida, adding that modern medicines allow people to live almost exactly as they did before they were infected.
Rather than spreading information with passive posters, Yoshida hopes that the nail designs will spark discussions about AIDS that dispel rumors and make it a less taboo conversation topic.
"We thought that the message would be best spread by word of mouth, so that people can casually pass on information to other people," she says.
There is paltry coverage on the subject in school curriculums, meaning that the disease barely features on young people's radars. According to Yoshida, the government quietly scaled down its awareness campaign after 1996, when it was revealed that the Japanese health ministry was to blame for 1,439 hemophiliacs being infected with HIV-tainted blood in the 1980s.
The relatively low number of HIV-positive people in Japan--20,600 compared to an estimated 1 million in the United States--is one reason for the lack of awareness. Many associate AIDS with developing nations and do not consider the possibility that they may be infected themselves.
Yet while the incidence of infection is falling in the rest of the world, particularly in developed nations, it's on the increase in Japan. It's also likely that the real number is much higher than the official statistics, since few people voluntarily get tested.
For Yoshida, however, promoting understanding of the disease is just as important as educating people on prevention.
"Some think that if only four people a day are infected in Tokyo, a city of 10 million people, then it couldn't possibly happen to them," she says. "But it's not really about whether you're likely to get infected or not, it's more about supporting people if they are infected. We want to talk about individuals, not statistics. I think that's much easier for people to relate to or empathize with."
Yoshida hopes the campaign will grow so that HIV-positive people reluctant to talk about their condition can feel less isolated when they see someone with red ribbons on their nails.
"With painted nails you can show your support quietly to people around you. It's small--it's not like a string of posters--but people who see it will think, 'Oh, that person understands.' "
Dec 1 is World AIDS Day.
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