About
780,000 people will be living with HIV/AIDS in China by the end of this year,
40,000 more than 2009, according to an estimate issued jointly by the Chinese
Ministry of Health and UNAIDS.
Nearly 370,000 sufferers have been detected,
including 154,000 with full-blown AIDS, the report said. Of the 200,000 who
need treatment according to World Health Organisation (WHO) standards, 130,000
are receiving it.
The estimated number of new infections this
year stands at 48,000. Nearly 82 per cent of infections resulted from sex,
including more than 29 per cent through homosexual acts.
"The epidemic is still on the rise in
China but at a slower rate than previous years," Wu Zunyou, director of
the National Centre for AIDS and Sexually Transmitted Diseases Control and
Prevention, said on Wednesday in an exclusive interview.
Wu said China had a low prevalence, meaning
infection rates as a percentage of the population. China's rate overall is 0.06
per cent. The WHO defines high prevalence as 1 per cent or more.
However, "sexual transmission is
increasing, particularly among men having sex with men, and the virus is
spreading into more diversified groups like the elderly and young students,
which makes intervention more complex and tougher," Wu said.
Of the cases reported so far this year,
roughly 20 per cent were in people 50 and older, up 10 per centage points from
2007, statistics from the ministry showed.
"Most of them got infected through
unprotected sex, because with improving health and their economic situation,
some kept sexually active and sought prostitution," Wu said.
Infections among students ages 20 to 24 also
increased, with 56 per cent contracting the virus via gay sex. Health coverage
at 70%
"AIDS deaths on the mainland appear to be
peaking, as a majority of the sufferers infected by contaminated blood during
the botched blood- and plasma-selling schemes in the 1990s became full-blown
patients," said Chen Zhongdan, UNAIDS national program officer.
By the end of October, 14,000 AIDS deaths were
reported this year. The figure compares with 6,596 in all of 2009, official
statistics showed.
Many rural people in Henan, Shanxi and Hubei
provinces were infected via contaminated blood in the '90s, but the exact
number has not been released officially.
To prevent or delay more deaths, Chen urged
government to further expand the coverage of treatment. On average, he said, 70
per cent of detected patients who need treatment are getting it.
"Coverage could reach 80 per cent among
those infected in the 1990s by contaminated blood," Chen said, but it is
only about 30 per cent for people who were drug users or men who had sex with
men.
Impact
of discrimination
Detection rates for those two groups are low
because of discrimination and "limited medical capacity, particularly at
the grassroots level". Interventions among those groups and sex workers
have to be enhanced, Chen said.
According to a 2009 survey conducted by UNAIDS
and China Central Party School, nearly 42 per cent of the 2,000-plus respondents
living with HIV/AIDS reported having faced some type of HIV-related
discrimination.
In addition, 26 per cent said they were not
satisfied with the privacy protection at HIV screening outlets run largely by
the semi-governmental Chinese centre for Disease Control and Prevention.
Xiao Dong, who heads a civic organisation in
Beijing working to curb the spread of HIV among men who have gay sex, said many
were reluctant to go for testing for fear their status would be exposed.
"That may cost them timely treatment or even the chance of surviving the
disease," he said.
China introduced free HIV/AIDS counseling and
testing services and free medication for AIDS patients in the early 2000s, and those
actions are credited with helping lower the mortality rate.
Meng Lin, an AIDS patient in Beijing, said
he'll never forget his desperation when learning in 1995 that he was
HIV-positive. "I just wanted to die while being told that the disease
couldn't be treated at all."
Wang Kerong, a nurse who works with AIDS
patients at Beijing Ditan Hospital, said some committed suicide in the early
years when they learned their status.
In 1996, AIDS researcher David Ho pioneered a
combination of antiretroviral drugs, widely known as cocktail therapy, that
could control HIV replication in patients and largely prolong their lives. The
AIDS death rate now is one-sixth what it was before the cocktail therapy.
Meng was invited that year to participate in a
treatment trial at Beijing You'an Hospital and he felt that he might survive.
"The situation today is much better, with
an established intervention mechanism including free testing and
medication," he said.
But he is concerned about side effects from
the drugs, and he urged the government to keep improving the therapy as
"medication could lower the viral load in patients, and thus better curb
secondary infections."
China will further expand testing and intervention
efforts, including education and drug coverage, said the country's 12th
Five-Year Plan (2011-15) for HIV/AIDS prevention and control.
UNAIDS' Chen said the anti-AIDS campaign in
China should be demand-driven more than supply-driven.
"The government has invested so much and
established a great network delivering services, so the key now is to attract
more people to use the resources."
To achieve that, Chen said, civil societies
must be involved in the anti-AIDS campaign led by the government. Wu agreed,
citing his own experience.
In 1996, Wu designed and implemented the
country's first pilot intervention program targeting sex workers at
entertainment venues.
The workers strongly rejected Wu and his
colleagues at first.
One time, he said, they spent two hours at an
entertainment parlor trying to talk to the workers about prevention, but no one
listened. "That only changed after we ate together with them and even
drank water from their cups."
More
effective outreach
Thomas Cai, who heads AIDS Care China, a
Guangzhou NGO that supports patients and their families, said civil societies
could help the government better reach out to patients and people at high risk
of HIV/AIDS.
Statistics from UNAIDS said China has hundreds
of such organisations now but most are not registered with civil affairs
authorities because policy requires that they affiliate with government units,
which often don't want the responsibility. Also, most of them work with money
from abroad, and have been called "Chinese children fed with foreign
milk".
"That situation will be changed and the
government will support such organisations on its own," ChineseMinister of
Health Chen Zhu vowed in June. He made the comment after Global Fund, a
Geneva-based international organisation that supports disease prevention and
control work worldwide, suspended grant money to China, citing poor government
support for NGOs and suspected abuse of grants.
To some degree, Chen said then, "The
process in China to fight AIDS has also brought in seeds for reforming social
management."
Sun Weilin, who heads the Chinese Civil
Affairs Ministry's social organisation registration bureau, said the ministry
was revising the law to make it easier for civil societies to register. The
revision had been promised to be ready a month ago.
In the latest development, civil affairs
authorities in southern China's Guangdong province said they would further
streamline the registration process in July.
Social organisations there would be able to
register at the local department of civil affairs without prior review and
approval by the administrative departments in charge of the relevant fields.
Shan Juan
China Daily
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