Fiona Ma doesn't mind being the poster child for a campaign against an infectious disease — if it means saving lives, and even if it means making Asian communities in The City slightly uncomfortable.

Ma, a San Francisco Democratic assemblywoman, learned she had hepatitis B at age 22 while trying to donate blood. She began speaking out against the disease several years ago and is now backing an edgy new advertising campaign that has raised eyebrows in the Asian community.

One advertisement released this month by the nonprofit San Francisco Hep B Free features an image of 10 beauty queens lined up side-by-side, with the aggressive question at the bottom:

"Which one deserves to die?"

The tone of the ad – part of the second phase of a campaign that began three years ago to eradicate the virus - is a far cry from the group's previous slogan, "B a Hero."

The time for softball pitches is over, Ma said.

"Nobody wants to talk about illness or depression or problem gambling," said Ma of the Chinese community. "Once you talk about it, it brings pity and shame."

Ignoring that hepatitis B has become a rampant public health hazard in The City is not going to make the killer disease go away, she said.

The virus, which attacks the liver, has made San Francisco the liver cancer capital of the United States. The Asian Liver Center at Stanford University estimates that 1 in 10 residents of Asian or Pacific Islander descent has the disease.

One in four people will die prematurely due to liver failure or cancer if they are not monitored and treated. The disease is a silent killer, often posing no symptoms until it is too late, and it can be transmitted from mother-to-child, from wound-to-wound contact or by sharing needles, razors or toothbrushes, experts said.

"It is seven times more contagious than HIV," said Dr. Lisa Tang, a Kaiser Permanente practitioner. "But the disease can be prevented and can be treated."

In fact, a hepatitis B vaccine has been available since 1982. The vaccine — a three-shot series given over six months — is "so effective at preventing" the disease that it is called "the first anti-cancer vaccine by the World Health Organization," the Asian Liver Center said.

"We could have wiped out 80 percent of liver cancer 30 years ago," said Ted Fang, co-founder of San Francisco Hep B Free.

Also, those who catch the virus early can live regular lives, he said.

"We have the nexus of drugs to treat this," Fang said.

That's why there's no reason not to break down the walls of cultural sensitivity on the topic of hepatitis B and get people tested, Ma said.

The assemblywoman, who inherited the virus from her mother, said she has no symptoms and pays regular visits to the doctor.

She said her 70-year-old mother had a piece of her liver removed last year due to the disease. Her brother, who is two years younger, is also a hepatitis B carrier. And her sister, who is 28 years old, is not a carrier because she was vaccinated at an early age, Ma said.

Ma said she can relate to Asian community members who neglect to get tested. She said it took her nearly 20 years after learning that she had hepatitis B before she did anything about it.

"I didn't know [about the dangers]," she said. "I'd say, 'I'm just a carrier. I'm fine.'"

At a news conference several years ago, a top Stanford physician warned Ma that her condition was chronic.

"That's where the panic started," Ma said.

That's when Ma decided to become active about her disease — and active about informing others.

"I thought, 'If I didn't know, I'm sure others don't know,' so that's when I started on the campaign to be kind of the poster child," Ma said. "And it's worked. A lot of people have stopped me on the street and thanked me because they got it checked."