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BBC World Radio Interview, November 30, 2001

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Good morning, this is 5-live, 909 and 693 and FM on BBC Radio Scotland and your BBC local radio station. This is Richard Evans with Up All Night coming up before four -- the doctor who has been walking around the world to spread the word about AIDS. Dr. John Chittick joins us live from Boston and you can join in as well if you like. Drop us an e-mail here at the program .

We've talked to Dr. Chittick several times over the years on Up All Night from 1999 until earlier this year [2001]. We've received regular updates from him on his global AIDS walk; a mission to 40 different countries to spread awareness among teenagers of HIV and AIDS. It is of course World AIDS Day [December 1] on Saturday and Dr. John is marking the occasion by going off on his second Global Walk and this time he's not going alone. He joins me now from Boston.

RE: Good morning, John.

JC: Good morning, Richard, how are you doing?

RE: Good thanks. How is it going to be this time? It's going to be a bit different?

JC: Yes it is, because what I want to do this time is bring along small teams of young people to travel with me. Not to every country, not the entire two years, but to come for two to three weeks stints where they will be trained and then they will train their peers in different locales. When they go home, other young people will join me along the road and this will continue around the world. It also means that I'll be taking young people from other countries with me to other countries to also train peers.

RE: Do you plan a route beforehand or does it sort of evolve organically?

JC: Well, it does evolve organically but it also depends a lot on where people are asking me to come. I do get requests formally from health ministries, from governments, but a lot of times it's directly from young people in each country. I just got one from a young man in Nigeria who said, "I've heard about your walks, will you please come and take me?" I want to go to Nigeria anyway but I will definitely make sure he joins me at least for a few days along the Walk.

RE: For you listeners, perhaps you can tell us how you got involved in this campaign and a bit about the organization, TeenAIDS.

JC: I was trained at Harvard University and received my doctorate in 1994. I wrote a major thesis, a book on the subject, where I said that it was just a matter of time, probably five to ten years, before teenagers and adolescents were going to be the new wave of HIV/AIDS. It was a little hard for people to believe that in the '90s because they believed the stereotypes of gays, Africans and heroin addicts were the only ones who basically (they thought) got HIV/AIDS. We know from the United Nations' AIDS umbrella organization, which I consult with, that 50 percent of all new cases of HIV in the world is occurring among 24 year olds and this is almost unbelievable. Ten years ago that figure would have been one to two percent.

So this is part of my impetus -- I decided I shouldn't be sitting in a classroom, I shouldn't be sitting behind a computer but I should be getting out directly on the street going right up to teenagers and starting to say to them, "look, give me five minutes. I want to tell you a little bit about AIDS because this information could save a friend's life."

RE: I'm surprised that the message isn't getting through. I mean, are we talking about the developing world largely cause there's so much publicity about it nowadays?
JC: Well, that's one thing that actually bothers me, Richard. We have so much emphasis on the third world that I think people are ignoring what is actually happening in Europe and in America. Now, I am starting my world walk on Sunday and I'm starting in the American heartland of the states of Utah and Idaho. I picked those two states because they're perhaps the two most conservative states anywhere in the country. They have very little AIDS education in their public schools and I want to go out there and really let the young know that they've got to know this information even if the adults don't want to give it to them. So I'm actually doing some work here in the United States as well as overseas. I'm not just picking third world countries.

RE: There are states where there isn't proper HIV education in the schools...

JC: Where there is no HIV/AIDS education.

RE: Why is that?

JC: Uh, I mean there's religious issues, there's conservative issues and a lot of parents feel that if you talk about a problem like this, then the kids are going to go out and do these things. What we've found -- and this is backed up by all types of research -- is actually that young people are willing to hear the facts if they're medical facts. They don't want to just hear morally, sort of biased view points. And so I always tell young people the pure medical facts. I say, this is the answer to your question. I also tell young people, "Look, you don't have to have sex. Theirs is no reason to start sex early. You can wait. You can postpone sex." But I tell them that if they or their friends are having sex, they've got to know about the facts and use protection -- but at least tell their friends what's going on.

RE: Do you get similar stories wherever you go in the world?

JC: Well, you know, it depends. In some countries, like in Cambodia, which has one of the worst teen AIDS epidemics right now, it's so tragic that young people there have this sort of fatalism: "Well gee, there's nothing we can do about it. All of our friends are dying, everybody is getting sick. We can't see it. We don't know if we're sleeping with somebody who has it." And they have this feeling like well let's just give up -- which is a very different feeling then when you go to some countries where they don't see much HIV/AIDS in young people so they're just more curious to hear the information.

I just came back from Russia and Eastern Europe and it's absolutely shocking to see the amount of young people there that are sharing needles while doing drugs. Which means that Russia and Eastern Europe right now have the highest increase of HIV due to needle sharing -- not to sex, but to needle sharing! So around the world, different regions, different countries have different problems with HIV.

RE: There was an interesting feature in one of the morning papers here yesterday on behalf of World AIDS day with the latest figures and a map of the world showing where it's on the increase and it's on the increase amongst different sorts of groups in different parts of the world as well.

JC: Right, but there's one thing I want to point out to your listeners. None of this information is accurate when it deals with teenagers. And the reason is that most teenagers have never ever been tested for HIV. I go around the world. I was just in a school in Massachusetts today, 30 kids, and I asked them, "Have any of you ever been tested for HIV?" Not one hand went up. So we're running blind on this. We can [see] older people who have HIV because they come to the hospital, they get help, their blood is tested. But young people, we absolutely have no accurate figure about this but we are seeing so many people at the age of 20 and 25 developing AIDS that we know that they got it as teenagers.

RE: Let's talk a bit about the first world trip, if we can, 1999 to earlier this year, wasn't it?

JC: Yes, it was to...

RE: Yeah, I mean you picked up a few good stories along the way.

JC: Well, it's, uh, whenever you travel around the world, you're going to meet all types of interesting people and I, uh, could I speak about one young woman I met?

RE: Yeah, okay, I'm inviting you to tell us a story, John.

JC: Okay, good. I think that in the stories of these young people, you really see why HIV is so insidious. I was in Bombay and I heard about a young woman named Sayeeda and she was 20 years old. She was a widow of 6 months. Her husband had passed away and when he died the hospital discovered he had HIV so they called her in and her three babies. Now, she's twenty years old and her oldest child is six, which meant -- I asked here, I said when did you get married? And she said, "Oh. twelve or thirteen." She wasn't sure. And she knew nothing about AIDS until the hospital said, "You have this disease and so do two of your children." I went to visit here because she was virtually a prisoner in her little village. She was a Muslim in a Hindu country and she was virtually a prisoner. They would not let her leave. They were afraid to have her and her children outside of her house.

It was just a very sad situation so I went there and I asked here, I said, "I know Muslim custom is that I'm not suppose to touch you," I said. "but could I touch you and your children so that your neighbors will see that I'm not afraid of you because you have AIDS?" And she immediately -- it took a translation -- and she immediately said, yes. And we did talk to her and I found out later that she would be willing to help me. I said, "Would you come with me Sayeeda? Don't stay here in this little place. Come with me and you can help me talk to other Muslim women and other Hindu women" -- about a problem that most men do not approach women on, in India. And for the next three days we got her a babysitter, her two male cousins came along as chaperones and she came with us as we did out AIDS outreach. And I will just tell you that she is one of those women who showed a lot of bravery. She came out to people that she had AIDS. She went on the streets. She talked to other young women. You would be amazed at how they were just spell bound that a woman like that would come forward and say she had AIDS and wanted to help other people. So she's one of my heroes in the world. That's Sayeeda in Bombay, India now called Mumbai. RE: I mean, there is so much fear about this disease in many parts of the world. Do you get a rough time from the authorities sometimes?

JC: Well, I think part of the problem is that as an American, I'm going to have some problems anyway with authorities or governments that don't like Americans. What I find though is that most people appreciate anybody from any country if you're there to help them. In Cuba, I was arrested and jailed and my teen volunteer, Jickler, was also arrested and he was beaten up. It was because they said we were "sabotaging the state economy." Really what it was, is that I was speaking about AIDS on the streets and this was during the Elian Gonzalez times. I never talk politics. I avoid politics. I just want to talk about AIDS but unfortunately we got involved in that.

In mainland China when I was there earlier this year, we were shadowed by the police. We had problems when going up to people on the street. They didn't want to talk to us when they knew the police were around but as soon as the police where gone, they would flock around and wanted to hear all the information.

And, Richard, I should explain that everywhere I go we pass out business cards, a regular business card. But on the back, translated into every indigenous language, is the information about AIDS. So it's something that a young person can put into their pocket that's inconspicuous, that they can pass onto a friend and has the basic facts about HIV/AIDS in every language.

RE: I was going to say, I mean the language must be a problem for you?

JC: Well, I'm not the smartest guy in the world so what I do is as ask...

RE: You have degrees...

JC: But, okay, when it comes to language, I try my best to learn at least 10 or 20 phrases in each language. Such as, "How are you? I'm Dr. John." "I'm joking" -- that's a favorite phrase of mine with young people, But where I can, at least, [I talk simply] about AIDS. I always ask young people to be translators for me and I volunteer all my time. I'm not paid and I ask all the young people to also volunteer their time. It's my philosophy and I tell them, you're doing this for your friends as much as for yourself and I want you to help me and they do translate. They are very good about it.

RE: How do you deliver the message? Do you have to have a different approach depending what country you're in? JC: Well, have you ever seen a picture of me?

RE: I have, yes, looking at it on the web today. You're a larger than life character.

JC: "Larger than life" is generous, I think. Thank you very much. I am a very fat man. I have white hair. I wear Hawaiian shirts. Coming down the street in any country, people obviously are going to take a second look at me. And I use that --I mean that's me, but I take advantage of this to actually go right up to people. I smile a lot, I joke with them, "Oh, you find my shirt interesting?" or I'll say something like that and we start talking. I try to get them laughing and then I turn the message to more of a serious nature. But my approach with young people is that, I say, "If you love a friend, it is your responsibility to save that friend's life." The only way you can do that is to learn the medical facts so you can give them honest advance.

And my second phrase that I like to use is "Shy = Die." I say, "If you're too shy to talk to a partner or friend about sex and AIDS and sharing needles, then a friend is going to die. And I think that has impact on young people... I never say to them, "Save yourself." I always say to save a friend. And I've found that psychologically that works better because every young person has somebody they love that they don't want to see die. And of course, if they're going to tell a friend to be careful and safe, then they're not going to be hypocritical themselves.

RE: What sort of response do you get generally?

JC: Well, the first one is a little bit of a surprise. You'll see young people just sort of look. Some of them are laughing and the first reaction is well, "Who is this guy coming up to us?" And then when I give them the card and card says that I [was educated at] Harvard University and from America; that's something that most young people around, if they know Oxford and Cambridge, they also know Harvard, that type of thing, so that I think opens or establishes some credibility and then I say, "Please listen to me," and I think they, well, you have to ask young people, but I think young people respond very warmly to me. I have an ability to be able to go virtually anywhere in the world and talk to young people. And I'm not shy and I tell them don't be shy with me.

RE: And it's probably -- your mission is very much getting young people involved.

JC: Well, my feeling is they are the best messengers for carrying information about intimate, personal details that adolescents all share and hate to talk with parents about or with adults. No young person really loves to talk about their sexual experiences or what they are thinking sexually with an older person. They might on rare occasions but most of them don't want to. But this is information that they're sharing every day at school, every day at work, every day at a sports venue and so if they're sharing this type of information, then they should be the ones carrying the message to their friends and that's what I try to do. I try to empower them to say "You can go out and save a life."
RE: What can people do to help you? I mean, how are these events funded and... ?

JC: Well, what I should say is, I do not take any government or any religious really, [or] foundation money. I want to be completely free to be able to deliver the message that I think is correct so what I do is I used up all my savings on the first year and a half of the trip. I then started asking a lot of friends, "Could you give me a little bit of money, could you give me a lot of money?" -- depending on their circumstances and a lot of people came forward, including a few of your listeners from different places that had heard me on BBC. We have -- I run a tax exempt, tax deductible organization, a charitable organization called "TeenAIDS-PeerCorps." The "TeenAIDS" refers to the epidemic that I'm talking about that's now occurring in the world. "PeerCorps" represents, like Marine Corps or Peace Corps, represents the facts that young people together can help fight this. So I do ask for contributions. If anybody -- I'm not here to ask for contributions from you guys, Richard, but if anyone wants to look at my website, they can and that has more information.

RE: This is: www.teenaids.org .

JC: And teenaids is one word.

RE: Yes, teenaids is one word. You're more or less devoting your life to this work, now, John.

JC: Well, I haven't in the past -- and I started seeing so many friends die. I even had Harvard students and Harvard faculty that were colleagues of mine that were dying of HIV/AIDS which shocked me because here are people supposedly so smart and yet they were so --I don't want to say stupid or dump -- but they were just ignorant of the facts and they got HIV accidentally, by mistake. So I started to realize that I can't sit around and watch this happen. I got very concerned when I started seeing some young people that I knew getting sick. And so, for the next five years, this is my mission. I will retire at some point and I hope other people will carry on but I believe we're going to leave behind an army of hundreds of thousands of young people carrying this message to their friends and that's what I'm excited about.

RE: You obviously believe one man can make a difference.

JC: One many, one woman, one youth, yes. I think that everybody who's listening can talk to at least one friend. You know, I'm in a position that I can do this for this period of time in my life. I've made this -- this is my decision. Most people have other jobs, families, they can't do this but everyone can speak to at least one friend. And when I say "speak," I don't mean you lecture somebody and you say, "No, no, no, no, no; don't do this; don't do that." But I mean, "Gee, do you know the facts, can I tell you anything, do you want me to get you some information? Is there anything that you want to know?"

Everybody can be doing that with one friend. Now Richard, I don't know your situation but you sound like a man about my age, maybe a little bit younger and I'll make a bet you maybe know some sons, or nephews, or nieces or somebody, or a friend of a family friend, that you could just mention to them, "Do you have the information? What are the kids saying? I can get you information." And I hope everybody will do that.

RE: Can you remember the moment that you decided, you knew, to embark on this mission? Was there one incident that sort of set you off?

JC: Yes. I don't know if any of you remember Dr. Jonathan Mann but he was one of the -- he was actually the United Nations' first, at the World Health Organization, he was the first man to start organizing the world against HIV in about 1982, 1983, 1984. He'd first been in Uganda. He was a mentor of mine at Harvard University and when I first told him that I was writing my book on the subject of teens being vulnerable [to HIV/AIDS], regular teens, heterosexual teens from all over the world, he said to me, "If you can prove it, I will support you and your work and I will endorse your book." And I was in contact with him for a long time. He helped me a lot on this subject.

About three years ago, in September or August of 1998, I was going to bed one night and CNN had (sorry, your competitor) a news item about a plane crash off the coast of Canada. And I thought to myself, you know, life is so short. We devote ourselves to so many things and then all of a sudden in a flash, your life is over and you know, have you done everything you wanted to do? And I went to bed and I couldn't sleep. I was tossing and turning all night and came up with the idea I had to do something where I was putting -- where I was really going to walk the talk. And when I got up in the morning I went downstairs and found that Dr. Mann and his wife had been on that plane and had died. And I just felt at the time that this was an auspicious moment for me in the sense that this sort of reinforced what my own thinking was during that night. And so I've dedicated the first Global Walk to Dr. Jonathan Mann's memory.

RE: Most people might have made a donation to a charity or something or perhaps even gone and done some volunteering but, but what you're doing is totally remarkable.

JC: Well, you're being generous, thank you.

RE: What is it about you that made you want to do so much more, you think?

JC: I've always thought that our future in the world has to be each new generation that comes along. I believe very strongly that humankind has to have some type of continuity from the past to the present to the future. When I think about that and I see the young I meet, I say to myself, if we're not out there really giving them all the tools they need to prevent HIV/AIDS to live healthy lives, then we're not doing our jobs as a adults. So that was part of my impetus. I should also say, and I want to add this, I hope you don't mind, but when people say to me that religion does not allow this type of talk in any country I go to (and I work in the Muslim countries), I always say to them, "There is no holy book in the world that says it is alright to deny young people the medical information to protect their lives." There's no holy book that says that. So I say to them, "We have a duty," and every religious leader really should be thinking in terms like that. We have to protect this younger generation and that's part of my impetus. I'm not saying it's the only reason but it's a good part of it.

RE: We're lucky to catch you at home cause -- where are you off again, next week?

JC: Well, yes, now December 2nd you know, I'm leaving for Utah and Idaho. Then I'm going south. I'll be doing Central America and the Caribbean. I'm very much concerned about the migration of young people around the world. That wherever young people migrate -- what's happening is they're falling in and out of love in all the wrong places with all the right and wrong people. So sex occurs and they're not paying attention to what they are doing. I'm concerned that Salt Lake City is going to have the Olympics and wherever you bring that many hundreds of thousands of young people together, it's going to help spread HIV in that western part of the country.

I'll be going to South America, to mostly Brazil, Uruguay, and Argentina this time but I will also be in Western and Southern Africa. I will also be going to the Middle East. We just heard that King Abdullah of Jordan has agreed to let myself and the young people come with us. That's opening up a lot of doors in the Middle East and I'll also be in Europe. I'm going to be doing Ireland -- Northern Ireland -- trying to bring Protestant and Catholic young people together on this message.

RE: When will you be in Northern Ireland?

JC: Well, I'm going to be there probably in April but I can let you know more when I get there and I'll be in Spain, in the Pyrenees area, around the Basque region, to try to bring Spanish, Basque and French youth together. My mission is to also try to bring young people from groups that don't get along to try to bring them together on this mission. I'll be in Kosovo, Bosnia, in that area and then traveling the rest of the way around the world.

RE: Is this going to be a year or longer this time?

JC: No, this will be 20 months. Do you think I can do it, Richard?

RE: Well, it depends how far you walk, I suppose, John.

JC: Well, it depends how good the food is.

RE: Well, it depends how good your shoes are. Good to talk to you, anyway, and I'm sure we'll be speaking to you again and hopefully when you come over, you'll get in touch then.

JC: I would love to. That would be great. Thank you BBC and Five-Live for doing this.

RE: Alright, thanks a lot.

JC: Bye, Richard.

RE: That's Dr. John Chittick. The charity is called TeenAIDS -- www. teenaids.org, if you want to know more about it.

This is Radio Five-Live at 3:29.



2) Note from the Executive Director:


TeenAIDS-PeerCorps began as a direct outgrowth of my doctoral thesis that found adolescents were increasingly becoming vulnerable to HIV/AIDS (“Adolescents and AIDS: The Third Wave,” Harvard University, 1994). At the beginning of the decade, few experts thought adolescents would be a risk. Now we know otherwise.

Old stereotypes placing “blame” on certain high risk groups no longer hold true as we enter this new millennium. After 20 years of HIV spreading globally through the adult population, the deadly virus is now taking root within the younger generation. As the teen pool becomes more contaminated, it’s becoming exceedingly difficult to stop HIV/AIDS from infecting "regular" teenagers who are sexually active or have shared needles (for drugs, body piercings, tattoos, etc.). Many youth, perhaps even family and close neighbors are being exposed to the deadly virus and are not aware of it -- through adolescent experimentation with activities considered "adult."

In the last three years of Walks, I have witnessed first-hand the future of AIDS.

According to all reliable studies, teenagers are initiating their first sexual experience at younger ages (some in their first teen years) with more than one casual partner. In part, this trend is due to more liberal mores, economic independence and media hype -- and partly to stronger peer pressure to experiment with sex and drugs by “acting adult.” Perhaps the genie can be put back into the bottle, but just saying “no” has been tried and unfortunately, hasn’t worked.

Importantly, another crucial factor is having a profound impact. It is based in biology and physiology. Today, puberty is arriving at younger ages for both boys and girls and that is a function of nature -- not nurture. This earlier physical and sexual maturation is speeding the onset of adolescence. Any young teens are discovering they have sexual urges -- at earlier ages than previous generations.

The fact that children’s bodies are maturing sooner is hastening sexual experimentation. It’s difficult for most parents to acknowledge this unsettling development. But in the era of AIDS, a “head in the sand” mentality can be dangerous to the health of their children.

“Wait until you get married,” many parents advise, “Just abstain -- you can do it.” But this message has been roundly rejected (rightly or wrongly) by most teenagers who choose not to wait. Studies show the majority of teens in the USA, both boys and girls, have sex by age seventeen (other countries vary -- some start younger, some older).

Even when abstinence is the parents’ preferred course, adult societies and economic realities encourage youth to postpone marriage until they are older than previously happened (the average age for marriage is 27 for males in the U.S.). Is it realistic to expect teenagers and young adults will remain celibate during this entire time -- the peak years of their sexual drive? For adults who stress "no sex before marriage"-- are they helping their 20-something years olds by telling them to deny what affect nature is having on their bodies' normal development. And what message does music, TV, the movie industry, the media and advertising send about the "normality" of asexual young adults in the mid-twenties who don't want sex?

Other parents accept the inevitability of their teens’ sexual activity but don’t like to talk much about it. “ Be careful- use protection (condoms),” they suggest. But this message too is being ignored by many youth that believe that if they’re in a “steady” relationship, and are heterosexual, they cannot get HIV/AIDS. Because many teens enter into short-term relationships that they consider "monogamous" but which in reality, are a string of sexual encounters over a period of their young years that is referred to as "serial monogamy." Every unprotected sexual encounter is another opportunity for HIV to enter the body.

As a result, many unsuspecting youth are now at serious risk fir contracting HIV and in lieu of a medical cure, will die of AIDS.

Over the past ten years, I have developed a new model for stemming the further growth of HIV/AIDS among the youth. It is a simple but effective idea -- empower teens to tell their best friends about AIDS and how to avoid contracting HIV.

Each youth becomes the messenger of this life-saving advice, based on medically-sound information and proven, peer education techniques.

“If you love a friend,” we stress, “it’s up to you to talk about AIDS- or else your best friend could die.” I have found from my research at Harvard and working with teenagers around the world, that TeenAIDS’ approach is more effective than traditional prevention programs because PeerCorps volunteers truly feel motivated to tell their friends. It’s also more efficient because teens can replicate the training methods on their own. And it’s economical ---- even hard-to-reach youth in poor communities and developing nations can sustain the efforts with little or no expense. “Just tell your best friend!”

TeenAIDS-PeerCorps is the vehicle that trains teens to spread the message through direct, personal contact (local outreach and the Global Walks) as well as via our award-winning website. This innovative combination of high tech networking and low-maintenance walking shoes is a model for future health initiatives because it does save young lives.

My commitment to fighting teen HIV/AIDS began as a one-man crusade. The challenge for the last few years has been to expand this work into a collaborative effort involving many people and communities for the common good of the next generation. It cannot succeed globally as a solo operation or as a volunteer-run collective. In light of the magnitude of this problem, we are building a solid structure and adequate budget to keep our person-to-person interaction and internet programs growing.

The reality of the global HIV/AIDS pandemic in 2002 and beyond is that the virus could affect any teen who experiments with sex -- even one time. And that is the majority of teens in their high school years. Including teenagers you love and cherish. Thank you for your past support and continued interest.