HIV/AIDS in China

HIV/AIDS in China        —by Jinny Batterson

Today is World AIDS Day.  Estimates of the number of HIV/AIDS sufferers in China vary widely, from about 600,000 to an order of magnitude larger than that. Though the infection rate in China as a whole remains relatively low, the sheer size of China’s population (about 1.4 billion) makes it important that any outbreak there be contained.

It’s thought that the first AIDS fatality in China was that of an infected tourist during the 1980’s. By the 1990’s, AIDS had gained a foothold in local populations, primarily among intravenous drug users in southern provinces adjacent to the “Golden Triangle,” Southeast Asia’s prime poppy-growing region. Then, in a scheme in which some levels of the Chinese government played an indirect but culpable role, peasants in several rural interior provinces were infected through unsafe blood donation procedures. China had stopped accepting blood components internationally during the 1980’s (ostensibly to avoid HIV contamination of the blood supply). Local entrepreneurs began to fill the supply gaps by recruiting rural donors to sell their blood for money. These “bloodhead” recruiters promised to minimize the impact of the loss of blood by extracting only plasma and returning donors’ red blood cells to them at the close of the donation process.  In some areas, safe blood handling practices were not followed—equipment was unsanitary, blood was pooled among donors before being returned. Soon whole villages were  afflicted with the “nameless fever.”  It took over a decade before the problem was acknowledged. It is estimated that 3-5% of current HIV/AIDS infections in China originated through unsafe donations—by 2010, Chinese government sources claimed that unsafe donation centers had been shut down and that all blood products were being tested for the virus before use.

A turning point in China’s official posture toward the AIDS epidemic may have come in 2003, when large parts of the country were essentially locked down during efforts to control a more short-term but also potentially lethal virus-caused infection, SARS (sudden acute respiratory syndrome). As the global reaction to SARS slowed international travel and domestic tourism in China to a trickle and seriously disrupted Chinese commerce, Chinese officials realized that having a large population of HIV-infected citizens could become an economic and human rights disaster.

My exposure to the AIDS epidemic and to efforts to contain it in China was extremely limited: the only time I saw any AIDS-related publicity was once during a 2006-2007 teaching assignment in rural Xinjiang—at the far end of the college campus, tucked away behind a line of trees, was a billboard cautioning of the dangers of unsafe sex, listing a telephone number someone could call for additional HIV/AIDS information.  A few of my Chinese teaching colleagues had heard vague stories of a young woman student who had become infected, subsequently forced out of school and shunned by her family. China’s infected population continues to grow, fueled by intravenous drug use and men having sex with men, but increasingly through unprotected heterosexual sex among sex workers and migrant laborers. The Chinese government has started promoting condom use as a safeguard against transmission, but the effectiveness of condom campaigns varies widely from region to region, and results are hard to verify. Among officially recognized victims of the disease, about a third are receiving antiretroviral drugs.

The year 2010 was the first in which AIDS was the leading cause of death from communicable diseases in China, passing tuberculosis and rabies, the former record holders. That year, over 7,700 Chinese died of AIDS. HIV/AIDS cases have been confirmed in all of China’s provinces, independent cities, and autonomous regions. As is the case in much of the rest of the world, China’s efforts to contain and reduce the HIV/AIDS epidemic can be spotty and inconsistent. Local customs, stigmatization of those infected, misinformation, some local governments’ reluctance to admit there is a problem, and the huge proportion of migrant, mostly male, laborers in the country, make developing effective overall strategies difficult.

One of the most visible spokespeople for HIV/AIDS awareness in China is James Chau, a young British-born journalist who has lived for the past decade in China. Chau became a U.N. AIDS goodwill ambassador in China in 2009. Since then, he has attended numerous international conferences on the disease, and has worked within China to educate the public about the disease and to reduce the stigma experienced by those infected with the virus.

If you have contacts in the HIV/AIDS community in China, perhaps you can use today as a reminder to provide monetary and moral support for ongoing efforts there to contain the disease and to treat its victims. Regardless of where any of us live or who we know, each can each contribute a small part to the multitude of solutions that will be needed to reduce the toll of this dreadful disease worldwide. Check the World AIDS Day website ( for ideas, or find your own way to contribute within your community.

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