HIV/AIDS and STIs

In August 2001 the Chinese government stated that there were at least 600,000 people infected with HIV. It seems that China is now in the early stages of an epidemic. The first case was reported in 1985. China’s United Nations HIV Theme Group, comprised of representatives of all UN agencies working on HIV issues in China, predicts that 20 million HIV infections will have occurred by the year 2010. The following risk activities relate to HIV transmission in China.

1 The spread of HIV by injection drug use, caused by needle-sharing practices, has been concentrated largely in the southern and western parts of China.

2 A lack of adequate screening of blood products and unsafe practices in taking blood has led to the transmission of HIV. Many (maybe as many as half a million) blood donors who sold their blood in the mid and late 1990s have been infected with HIV.

3 Non-sterile use of needles also has been a mode of spread in the practice of Western medicine. For example, an investigation in Hubei province in 1999 found that 88 per cent of injections made by village, district and epidemic prevention station medical workers were unsafe.

4 The heterosexual spread of HIV initially has been concentrated in the eastern coastal provinces of China but is now more widespread. There also has been a resurgence of other sexually transmitted infections (STIs), which renders individuals more susceptible to HIV. It was believed that STIs were virtually eradicated in China by the early 1970s, but with recent economic changes have come many social changes, including an increase in prostitution.

The majority of sex workers have unprotected intercourse (see sexuality and behaviour).

5 Homosexuality is not illegal in China, but neither is it socially acceptable; therefore it is hard to predict HIV prevalence within this group (see homosexuality and tongzhi culture).

The epidemiology of HIV and AIDs seem to relate largely to the primary mode of transmission. Cases in Hainan province and through southeast China are mainly due to heterosexual transmission; in central China, particularly Henan province, due to unsafe blood practices; and in southwest China from intravenous drug use following the overland trafficking routes from the borders with Laos and Myanmar. Clearly there is more than one mode of spread within each region. Moreover, the large numbers of migrant workers and those living in poverty and relative poverty are much more vulnerable to HIV infection.

The Ministry of Health has demonstrated a steadily increasing commitment to addressing HIV issues. China has produced an Action Plan for Reducing and Preventing the Spread of HIV/ AIDS (2001–5). This plan includes the closure of illegal blood and blood plasma collection stations and testing all clinical blood supplies for HIV; the training of all medical workers in HIV and STIs, including the prevention of HIV, and in treatment and management of HIV and HIV-related diseases; the provision of treatment and care in homes; the building of an HIV/AIDS and STI information network; and the provision of welfare assistance to people infected with HIV.

At present there is very little accurate information available as to the current extent of the disease, limited access to HIV testing, and a very limited knowledge among the general population and vulnerable groups as well as among many health workers. An HIV epidemic is likely to present a major challenge not only for those concerned with the health of the Chinese population, but also for those concerned with the financial situation of the country as a whole.

Further reading

Avert (2001) HIV in China. Available at http://www.avert.org/aidschina.htm

Seidman, Spencer (2001) HIV/AIDS in China and its Implications for Tibetans and Other Minorities. Available at http://itsa.ucsf.edu/HIV/AIDS and STIsseidman/HIVC2.html (viewed on 17 October 2001).

Settle, Edmund (2003). China AIDS Survey. Available at http://www.casy.org/pubpage.htm

State Council Office (2001). China’s Action Plan for Reducing and Preventing the Spread of HIV/AIDS (2001–5). Unofficial translation of State Council Office Document 2001–40, US Embassy-Beijing, environment, science and technology section, available at http://www.usembassy-china.org.cn/english/sandt/AIDS-actionplantranslation.htm

——(2001) Unsafe Injections: A Great Threat to China’s Health. Available at http://www.usembassychina.org.cn/english/sandt/hivartic.html

US Department of Health and Human Services (2001). Report of an HIV/AIDS Assessment in China (30 July–10 August 2001 and 28–30 August 2001). National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention.

MARION TORRANCE