Contact: csssm@aol.com
U.S. Embassy Beijing April 1997 First of seven reports
Summary. Embassy Beijing has prepared a series of reports on the AIDS
situation in China. HIV estimates for China vary between 100,000 and
300,000. HIV prevalence estimates are unreliable since they neglect
important high risk groups. The spread of HIV among some high risk
groups -- drug addicts, people suffering from sexually transmitted
diseases and male homosexuals -- is not being adequately addressed
largely because of the reluctance of the Communist Party to confront
the
reality of the rapid growth of these groups which are at high risk
for
HIV/AIDS. The Chinese Ministry of Health expects, despite recent
strenuous efforts to raise blood collection standards, that HIV/AIDS
will continue to enter the Chinese blood supply for some time to come.
China cooperates closely with the European Union, Australia, and UN
agencies on combating AIDS. This cable presents an overview of the
series. End summary.
HIV Just 100,000-PLUS Among One Billion But Rapid Rise
Estimates of the incidence of HIV and AIDS in China, which continues
to
rise among China's high risk groups of drug addicts, prostitutes, male
homosexuals, and persons with sexually transmitted diseases (STDs)range
between 100,000 and 300,000 persons. Although the numbers of HIV
infected people are small for a country of 1.2 billion people, the
rapid
increase in the numbers of people in these high risk groups indicate
a
serious and rapidly deteriorating situation.
Poor Data Collection, Denial of High Risk Groups
Poor statistical data collection and reporting methods along with an
unwillingness on the part of local officials to report bad news to
the
central government makes good policy making difficult. According to
a
Chinese public health official, the CPC and the Chinese government
are
reluctant to admit to the reappearance and rapid growth of drug
addiction, prostitution, and numbers of homosexuals -- the elimination
of which the Communist Party of China views as some of the proudest
achievements of the early years of the PRC. Although China has now
gone
beyond the denial stage (seen in many societies) in its handling of
HIV/AIDS overall, its denial of the rapid growth of some high risk
groups makes attacking the HIV/AIDS challenge much more difficult.
Very
rapid social and economic changes have brought with them changing sexual
mores among China's young people which make them vulnerable to STDs
and
HIV.
HIV Concentrated in Yunnan, But Already Spread Nationwide
HIV/AIDS cases first appeared in large numbers in rural villages along
China's southern border in Yunnan Province where in some areas 30 to
70
percent of intravenous drug users have HIV. A flourishing sex trade
in
the Reili area of southern Yunnan, the very area where HIV rates among
drug addicts are highest, makes HIV transmission to heterosexuals likely
there. Moreover, the Chinese police arrested 15 HIV infected prostitutes
in Yunnan Province during the first three months of 1996. Now HIV/AIDS
has spread throughout China including the far northwest region of
Xinjiang where an unpublished official report estimates that 50,000
drug
addicts are HIV-positive.
Venereal Disease Increase Makes Faster HIV Spread Likely
Sexually transmitted diseases (STDs), which greatly increase the
likelihood of AIDS transmission, have risen at a 20 percent annual
rate
since 1991. The rapid increase in STDs, already common in the southern
provinces of Jiangsu, Guangdong and Hainan, make it likely, Chinese
public health officials believe, that the breakout of AIDS into large
numbers of STD-infected heterosexuals will occur soon in South China.
100 Million Migrant Workers Could Spread HIV Nationwide
China's 100 million migrant workers are potential carriers of HIV to
cities and villages throughout China. In Embassy's view this is the
most
serious HIV/AIDS challenge that China faces and the most difficult
to
address because of the array of push and pull social and economic
factors that make migration necessary and attractive and poor public
health conditions within migrant communities. Deep-rooted traditions
bring migrant workers back to their townships and villages once a year
thus placing at risk those left behind in impoverished, overpopulated
areas which are least able to deal with this public health menace.
Contaminated Blood Products Remain A Serious Problem
Contaminated blood products and contaminated needles which infect blood
donors and rural clinic patrons also spread the HIV virus. Health
Minister Chen Minzhang told the October 1996 Chinese HIV/AIDS Conference
that HIV contamination of blood products is a serious problem that
cannot be solved soon.
Structural Problems: Poverty, Poor Training, Low Standards
Deep structural difficulties underlie the Chinese blood supply
contamination problem. Among these are the severe financial difficulties
of many local governments and hospitals, poorly trained laboratory
technicians and medical personnel, and the general lack of collegiality
among medical units that would foster adherence to established
procedures and raise medical standards generally.
HIV-Contaminated Blood Infects Dozens in Mid-1996 Incident
According to two Chinese health officials, HIV contaminated blood
infected at least several dozen people at a hospital in the Beijing
suburb of Langfang in mid-1996. One of the officials said that the
incident shocked the central government since the Langfang hospital
supplies blood for some Beijing hospitals used by the official elite.
As
a result of this incident, which was never reported in the Chinese
press, a high Ministry of Health official was nearly fired.
HIV/AIDS Denial Appears Over: HIV/AIDS Now High Priority
In China, the HIV/AIDS denial phase ['AIDS is a foreign problem']
through which many societies afflicted by HIV/AIDS pass appears over,
at
least at the ministerial level. Public health experts tell ESTOFF that
the Chinese government has given HIV/AIDS a much higher priority over
the past two years. Important new government initiatives against
HIV/AIDS include new legislation, education about HIV through the mass
media and schools, and efforts to help people in marginalized high
risk
groups through government-sponsored NGOs. For example, Vice Ministry
of
Health Zhang Wenkang at the October 1996 Chinese national HIV/AIDS
conference called for a reconsideration of legal impediments to giving
out clean needles to addicts and providing prostitutes with free medical
examinations and condoms.
Opportunities for Sino-American Cooperation
China participates in many bilateral and multilateral AIDS programs
including an AIDS education program with Australia, the UN Mekong River
Region States Anti-AIDS plan. The European Community, UNDP, UNAIDS,
and
UNESCO assist China in the fight against AIDS. There are also
opportunities for Sino-American cooperation in the fields of HIV/AIDS
research as well as drug addiction research and treatment with Chinese
partners in the Ministry of Health and Ministry of Public Security
among
others, and in AIDS education as will likely open up if the level of
trust between the U.S. and China increases.
A Series on AIDS
This first report summarizes a seven part series on HIV/AIDS in China
from Embassy Beijing. The second report examines Chinese official
estimates of the seriousness of HIV/AIDS in China and the weakness
of
the data upon which official estimates are based. The third report
summarizes Chinese Minister of Health Chen Minzhang's views on the
HIV/AIDS in China and how China should respond to the challenge of
HIV/AIDS. The fourth report discusses the effect of the rapid increase
in the numbers of intravenous drug users and in cases of sexually
transmitted diseases on the spread of HIV/AIDS in China. The fifth
report discusses AIDS and homosexuality in China. The sixth report
examines the spread of HIV through the contamination of the Chinese
blood supply. The seventh report looks at the Chinese government's
response to HIV/AIDS including efforts to clean up the blood supply,
education about HIV and STDs, mobilization of Chinese NGOs and Chinese
cooperation with other countries in HIV/AIDS prevention education and
research.
----------------------------------------------------------------------------------------------------
HIV/AIDS IN CHINA: A WORLD OF CONTRADICTIONS
U.S. Embassy Beijing April 1997 Second of seven reports
Summary. Estimates of the incidence of HIV and AIDS in China, which
continues to rise among China's high risk groups of drug addicts,
prostitutes, male homosexuals, and persons with sexually transmitted
diseases (STDs) range between 100,000 and 300,000 persons. The numbers
of HIV infected people are small for a country of 1.2 billion people
but
the rapid increase in the numbers of people in these high risk groups
indicate a serious and rapidly deteriorating situation. Poor statistical
data collection and reporting methods along with an unwillingness on
the
part of local officials to report bad news to the central government
makes good policy making difficult. According to a public health
official, the CPC and the Chinese government are reluctant to admit
to
the reappearance and rapid growth of drug addiction, prostitution,
and
numbers of homosexuals -- the elimination of which the CPC views as
some
of the proudest achievements of the early years of the PRC. End summary.
No One Knows How Many Chinese Have HIV: Guesses in 100,000 - 300,000
Range
Estimates by public health authorities that the number of people
infected with the HIV virus in China today range from 100,000 to 300,000
people. Many of the HIV infected people today are drug addicts in
southern China although the numbers of people infected through
heterosexual and homosexual contacts are increasing rapidly. As of
early
1996, seventy percent of the Chinese with full-blown AIDS were drug
addicts living in Yunnan Province on China's southern border. Now most
Chinese with AIDS are members of high risk groups such as drug users,
prostitutes, people infected with sexually transmitted diseases or
men
who have sex with men. Contradiction: Members of these groups often
avoid contact with public health authorities since they are often
considered to be criminals or a public disgrace. This makes getting
reliable statistics very difficult.
Much HIV Data Not Reliable; Good Data Not Shared
The public health disease reporting system in China is fragmented and
weak: few officials understand the methodology of systematic statistical
data and fewer want to send bad news to the central government. Sharing
of information among contending bureaucracies is poor. For example,
the
China Health Annual 1996 [Zhongguo Weisheng Nianjian] published by
the
Ministry of Health has little to say about HIV/AIDS and STDs other
than
noting a number of incidents of HIV spreading through contaminated
blood
supplies as well as efforts to improve procedures so that people who
sell or receive blood are safe from HIV, hepatitis and other blood-borne
diseases. Contradiction: Far more detailed information about HIV/AIDS
is
available from the Nanjing-based National Expert Advisory Committee
on
AIDS and Sexually Transmitted Diseases and from the semi-monthly Chinese
Journal of Prevention and Control of STD and AIDS. But this information
did not find its way into the Ministry of Health Yearbook.
At Risk Groups -- Drug Addicts, Prostitutes, Homosexuals Neglected by
Health Authorities, HIV/AIDS Educators
Important high risk groups are not closely followed. A Chinese public
health official told ESTOFF that the Communist Party of China and
Chinese government consider the elimination of prostitution, drug
addiction and homosexuality some of the major achievements of the early
years of the PRC. The re-emergence of these problems is very hard for
the CPC to accept. Contradiction: A public health official told U.S.
Embassy Environment, Science and Technology section officer (ESTOFF)
that the government "allows us to do health work with homosexuals who
have HIV but the government does not want us to report back what we
are
doing." The official also told ESTOFF that most Chinese homosexuals
do
not know that some homosexual behaviors (anal sex, large numbers of
sex
partners) put them at high risk for HIV/AIDS. Some Chinese government
agencies have created government-sponsored NGOs which can work with
marginalized groups more easily than can a government agency.
HIV Findings Often Artifact of Which Group Studied Where
Studies of HIV high risk groups neglect important populations since
not
all risk groups are studied -- ESTOFF noted at the December 1, 1996
AIDS
display about the Chinese AIDS reporting system that forms the basis
of
official HIV estimates does not include drug addicts in the large cities
of Beijing and Shanghai nor men who have sex with men, a marginal and
rarely acknowledged group. As a result, the central government does
not
have good information on the extent and nature of the HIV/AIDS epidemic.
The "appearance" of HIV in a high risk group in a certain area can
depend as much upon which groups are studied where as upon the actual
situation. Contradiction: One public health expert told ESTOFF that
Ministry of Public Health officials told her how they chose the figure
of 100,000 people infected by HIV in China the Ministry announced on
December 1, 1995. The Ministry of Health officials, realizing that
the
problem was getting serious, guessed at the 100,000 figure.
AIDS Series
This is the second in a series of seven reports from Embassy Beijing
on
HIV/AIDS in China. The first report summarized the series. This second
report examines Chinese official estimates of HIV/AIDS in China and
weaknesses in the data upon which official estimates are based. The
third report summarizes Chinese Minister of Health Chen Minzhang's
views
on the HIV/AIDS in China and China's strategy for responding to the
challenge of HIV/AIDS. The fourth report discusses what Chinese experts
say about the effect of the rapid increase in the numbers of intravenous
drug users and in cases of sexually transmitted diseases on the spread
of HIV/AIDS in China. The fifth report discusses AIDS and homosexuality
in China. The sixth report examines the spread of HIV through the
contamination of the Chinese blood supply. The seventh report looks
at
the Chinese government's response to HIV/AIDS including efforts to
clean
up the blood supply, education about HIV and STDs, mobilization of
Chinese NGOs and increased Chinese cooperation with Australia, the
European Union and UN agencies in HIV/AIDS prevention, education and
research.
--------------------------------------------------------------------------------------------------
AIDS IN CHINA: A VIEW FROM THE MINISTRY OF PUBLIC HEALTH
U.S. Embassy Beijing April 1997 Third of seven reports
Summary. Ten years ago the same type of HIV virus common in the U.S.
predominated in China. By 1996, however, an HIV virus type common in
Thailand accounted for 90 percent of all HIV cases in Yunnan, the most
severely affected Chinese province. The European Community and the
United Nations assist China in fighting HIV/AIDS. Health Minister Chen
Minzhang told the October 1996 Chinese HIV/AIDS conference that many
people throughout Chinese society don't want to admit the severity
of
China's HIV/AIDS problem for a variety of economic and social reasons.
Many medical workers are afraid to care for HIV patients. Chinese laws
should be changed to protect HIV patients and their families and to
facilitate HIV education and health work among marginalized groups
such
as prostitutes and drug addicts. Many health clinics do not sterilize
and reuse their needles. Blood contamination problems will take a long
time to solve. Many HIV/AIDS high risk groups do not know how to protect
themselves, said Health Minister Chen. End summary.
Chinese HIV Virus Types and AIDS Research in China
Chinese Minister of Health Chen Minzhang told the Chinese National
Conference on AIDS Prevention of October 16 - 17, 1996 in his speech
"Greatly Strengthen Anti AIDS Efforts" that AIDS research in China
began
with the 1985 discovery that four Zhejiang Province blood transfusion
patients had been infected with a blood product imported from the USA.
Origins, Type of HIV Have Changed Radically Over Decade
According to Minister Chen, over the last decade the type of HIV found
in China has changed radically. Genetic studies by the Chinese Academy
of Preventive Medicine on HIV virus infected drug users at China's
southern border with Cambodia at Yunnan Province showed that the virus
frequency changed from 90 percent European-American B in 1989 to 90
percent Thailand B by 1996. India type C HIV virus has also been
detected in Yunnan Province.
Cooperative research between the Yunnan Province Epidemiological station
and the Thai health authorities showed that Type E HIV virus spread
principally sexual contact also exists in Yunnan Province. T>
Chinese HIV/AIDS Research and International Cooperation
The Chinese Academy of Preventive Medicine and the Yunnan Province
Epidemiological Station developing a second stage candidate AIDS vaccine
based on the protein coats of the HIV virus types found in Yunnan
Province. The Chinese Academy of Traditional Chinese Medicine, the
Chinese Academy of Preventive Medicine are assessing the immunological
action against HIV of a number of drugs including some types of Chinese
traditional medicine. China participates in many bilateral and
multilateral AIDS programs including and AIDS education program with
Australia, the UN Mekong River Region States Anti-AIDS plan. The UNDP,
the European Community, and UNESCO assist China in the fight against
AIDS, noted Minister Chen in his speech.
PRC Health Minister Chen Minzhang on Chinese HIV/AIDS Strategy
Our understanding of the AIDS epidemic in China is very inadequate,
says
Chinese Health Minister Chen Minzhang. Many people don't want to
acknowledge the seriousness of the situation or are afraid that
admitting that the situation is serious will affect tourism, investment,
economic development, and the overall social stability. Many medical
workers don't understand how to take care of AIDS patients and don't
want to have contact with them for fear of contagion.
Current Laws, Regulations Impede Public Health Work, Do Not Adequately
Protect Rights of People With HIV
Health Minister Chen noted that Chinese laws and regulations regarding
HIV/AIDS are incomplete. The responsibilities of various departments
for
the care of AIDS patients are poorly defined. Laws and regulations
have
not addressed the protection of the rights of HIV infected people and
their families as well as the school enrollment and employment of HIV
infected people. The laws against prostitution and drugs need to be
strictly implemented. However, laws and regulations should be adjusted
so that AIDS education and preventive measures do not come into conflict
with the law. [Vice Minister of Health Zhang Wenkang in a speech given
at the same conference pointed out conflicts between Chinese law and
anti-HIV/AIDS measures such as giving free needles to drug users and
providing free medical exams and condoms to prostitutes.]
Other important questions include the entry of HIV infected people into
China [Note: all Chinese overseas for three months or more must have
an
HIV test upon their return as do all foreigners who will reside in
China
over one year. End note], protecting the privacy of HIV infected people,
and protecting HIV infected people against discrimination, said Minister
Chen.
Minister Chen: Confronting AIDS Epidemic Risk Factors
Health Minister Chen noted these risk factors which favor the spread
of
the HIV epidemic in China:
a) the high density of the Chinese population and the 80 - 120 million
people in the floating population which moves throughout the country
in
search of work carry the HIV virus to China's population centers [Note:
As well as back to their home villages. End note].
b) the increase in drug addiction and the spread of sexually transmitted
diseases favors the spread of AIDS. [Comment: The spread of STD's among
the floating population also facilitates the spread of HIV. End Comment]
Experts estimate 3 million new cases of STDs each year.
c) Many rural clinics do not yet sterilize their needles. According
to a
1996 study, 5 percent of the 3066 clinics studied use the same needle
to
vaccinate more than one person.
d) The proportion of blood provided by professional blood donors is
high
in China. Management and inspection of local blood collection stations
is still weak. These problems cannot be solved soon, so the danger
of
HIV transmission through the blood supply will be with us for some
time
to come, said Minister Chen.
e) Poor understanding of HIV/AIDS among high risk groups. Surveys show
that in rural villages where AIDS is already a serious problem only
34
percent of the people knew about HIV/AIDS. In many rural towns and
villages there is no AIDS education at all, said Minister Chen.
AIDS Series
This is the third in a series of seven reports from Embassy Beijing
on
HIV/AIDS in China. The first report summarized the series. The second
report examines Chinese official estimates of HIV/AIDS in China and
weaknesses in the data upon which official estimates are based. This
third report summarizes Chinese Minister of Health Chen Minzhang's
views
on the HIV/AIDS in China and China's strategy for responding to the
challenge of HIV/AIDS. The fourth report discusses what Chinese experts
say about the effect of the rapid increase in the numbers of intravenous
drug users and in cases of sexually transmitted diseases on the spread
of HIV/AIDS in China. The fifth report discusses AIDS and homosexuality
in China. The sixth report examines the spread of HIV through the
contamination of the Chinese blood supply. The seventh report looks
at
the Chinese government's response to HIV/AIDS including efforts to
clean
up the blood supply, education about HIV and STDs, mobilization of
Chinese NGOs and increased Chinese cooperation with Australia, the
European Union and UN agencies in HIV/AIDS prevention, education and
research.
----------------------------------------------------------------------------------------------------
HIV/AIDS -- WHAT CHINESE EXPERTS SAY
U.S. Embassy Beijing April 1997 Fourth of seven reports
Summary. Rapidly rising numbers of intravenous drug users are the main
vector for the spread of HIV/AIDS in China. Twenty percent annual
increases in sexually transmitted diseases nationwide since 1991 (and
far higher increases in southern China) will probably soon make HIV
much
more common among heterosexuals, Chinese public health experts believe.
Many people can't afford treatment for STDs. Chinese NGOs and the
Chinese police are taking the lead in promoting education on HIV and
STDs and treatment for drug addicts. End summary.
The Three Stages of China's HIV Epidemic
A public health official told U.S. Embassy Environment Science and
Technology officer (ESTOFF) that the history of the HIV/AIDS epidemic
in
China thus far can be written in three chapters. During the first
chapter, from 1985 - 1989, there were only sporadic cases of AIDS from
foreign sources. From 1989 - 1994, HIV AIDS established a beachhead
in
southern Yunnan Province where in some communities 30 - 70 percent
of
the intravenous blood users now have HIV.
From 1995 HIV Spread to Xinjiang, Guangxi, Sichuan
Since 1995, HIV has spread from Yunnan throughout China, mostly by
intravenous drug users. After Yunnan Province the Xinjiang Autonomous
Region has by far the most serious problem. The incidence of HIV among
intravenous drug users according to surveys there doubled from 8 percent
to 17 percent between June and December 1996 so that now about 50,000
intravenous drug users in Xinjiang have HIV.
Far behind Xinjiang in the proportion of intravenous drug users with
HIV
come Guangxi and Sichuan, although some communities in those two areas
have many HIV-infected intravenous drug users. In Pingxiang City [22
degrees, 7 minutes North, 106 degrees 44 minutes East] on the border
of
Guangxi Province and Vietnam, 25 percent of the intravenous drug users
have HIV. In Sichuan Province, along the main road between Kunming
and
Chengdu that passes through the Liangshan Yi Minority Autonomous
Prefecture [27 degrees, 54 minutes North, 102 degrees 16 minutes East]
a
number of IV drug users with HIV were found very recently. The social
origins of these drug users are quite diverse. The Xinjiang A.R.
intravenous drug users are migrants, in Guangxi A.R. the infected IV
users are urban Han Chinese in Pingxiang City, and in Sichuan Province
the IV users are rural people who belong to the Yi minority group.
HIV Breakout to Heterosexuals Likely in Guangdong, Fujian
After Sichuan comes the provinces of Guangdong and Fujian where
heterosexually-transmitted HIV occurs sporadically. The enormous number
of cases of and rapid increase in sexually transmitted disease makes
these two provinces the prime candidates, according to some Chinese
health officials, for the spread of HIV to large numbers of people
by
heterosexual transmission.
Drug Addiction Spreads HIV Infection
Public health officials say that most of the Chinese infected with HIV
are intravenous drug users although increasing numbers of people get
HIV
from heterosexual and homosexual sex contacts. HIV has spread from
its
beachhead in several counties of Dehong Prefecture in Southern Yunnan
on
the Myanmar border where HIV infection rates among intravenous drug
users are in the 30 to 70 percent range. HIV spread from there on to
Kunming (10 percent of intravenous drug users infected as of mid 1996),
Sichuan Province and then on to the Xinjiang Autonomous Region in the
far northwest where about 50,000 drug addicts have HIV.
HIV Risk Boosting Needle Sharing Habit Spreads Rapidly
Drug addicts spread HIV by sharing needles. The proportion of all drug
users who are drug injectors, however, varies widely from region to
region. Semi-annual surveys of 250 - 400 drug users in each Province
and
Autonomous Region show that intravenous injection is the rule in
southern China, in central and northern China oral ingestion is common.
For example: the Fall 1995 survey showed that 74 percent and 88.3
percent of the drug abusers in Guangdong and Guangxi were intravenous
drug users while only 0.4 percent and 1.0 percent of the drug users
in
Shaanxi and Inner Mongolia were intravenous users. Fashions change
quickly: the proportion of intravenous users in Xinjiang rose from
37
percent to 60 percent between the Spring and Fall 1995 surveys. Studies
show that the proportion of intravenous users is rising rapidly owing
to
fashion and because intravenous ingestion is much more efficient (and
thus cheaper) than oral ingestion or nasal inhalation. Some drug users
share needles with blood remaining in them with others as a sort of
social ritual -- a ritual which facilitates transmission of the HIV
virus.
Fifty Thousand HIV-Infected Addicts in Xinjiang Province
The 1996 book 'Jin Du' [Ban Drugs] by the Xinjiang Public Security
Bureau notes that while the amount of drugs and smuggling across the
Chinese border with Kazakhstan has increased sharply since the breakup
of the Soviet Union, most drugs reaching the Xinjiang Autonomous Region
come from Yunnan Province and the Golden Triangle region. According
to
one unpublished official estimate, 50,000 or one-third of the 150,000
drug addicts in the Xinjiang Autonomous Region have HIV. Migrant
populations carry infections with them when they come to the city to
find work. In a 1996 sampling of just ten Xinjiang drug addicts now
living in Beijing four tested positive for the HIV virus.
Sharply Higher STD Rate Facilitates Spread of HIV Virus
People with syphilis are twenty times as likely to be infected by an
HIV
during unprotected sex as are healthy people. STDs, and especially
syphilis, weaken the body's defenses and increases inflammation and
bleeding in the genital area. Since 1991, STD incidence in China
nationwide has risen by 20 percent annually still faster in some rapidly
developing southern coastal provinces such as Jiangsu Province where
reported STD cases rose at a 60 percent annual rate during 1990 - 94.
As
in other areas of China, syphilis infections, although still a small
part of the STD picture, are rising far faster than STDs as a whole.
China's 100 million migrant workers are potential carriers of HIV and
STDs to cities and villages throughout China. The Chinese Academy of
Social Sciences estimates that most (80 percent) migrant workers are
under age 35 and two-thirds are men -- just the age group most
vulnerable to HIVs and STDs.
Migrant Workers Carry HIV Where Public Health Is Weakest
In Embassy's view this is the most serious HIV/AIDS challenge that China
faces and the most difficult to address because of the array of push
and
pull social and economic factors that make migration necessary and
attractive and poor public health conditions within migrant communities.
Deep-rooted traditions bring migrant workers back to their townships
and
villages once a year thus placing at risk those left behind in
impoverished, overpopulated areas that are the least able to cope with
this public health menace. For example, a Chinese public health official
at a recent Guangdong AIDS conference reported that when he found a
migrant from outside the Guangdong with HIV, the person was detained,
put on a plane home and the local authorities notified. This not only
does not help solve the problem, but it pushes the HIV/AIDS problem
onto
poor communities far in the countryside which are least able to meet
the
challenge of HIV/AIDS.
AIDS Expert Dr. Ye Ganyun: Poverty, Lack of Data Handicap Efforts
Against STDs, AIDS
Dr. Ye Ganyun, Chairman of the National Expert Advisory Committee on
AIDS based in Nanjing, told ESTOFF at the December 1, 1996 AIDS Day
Exhibit in Beijing that he estimates there are three million new cases
of STD infections in China each year or ten times the number of STD
cases reported to the Chinese health authorities. Dr. Ye said that
collecting reliable data on STD infections is difficult, since many
people go to private physicians since they are reluctant to admit to
the
authorities that they have an STD. Many private clinics do not make
the
required report to the public health authorities.
Curing an STD, says Dr. Ye, costs 300 RMB (a month's wages for many
people) a sum which many people can't afford to pay because many people
do not have health insurance. Another public health expert told ESTOFF
that the number of new STD cases treated at the public hospitals and
fifty STD clinics in the Hainan Provincial capital (and tourist center)
Haikou treating 200 people each week means that the number of people
treated actually exceeds the resort city's population of about 350,000
people.
Many Remain Vulnerable to HIV When STDs Are Not Treated
The high cost of HIV testing -- 50 RMB or US $6 per person makes HIV
testing financially difficult. Many Chinese hospitals have no money,
said the official, so we cannot force them to use the more expensive
government-certified test kit. The official said that while many people
go to private VD clinics which are widely advertised on utility poles
throughout Beijing for treatment, they treatment they receive is
generally of poor quality. The people running these clinics are
untrained practitioners -- rural people who set themselves up in
business running an STD clinic, said the Chinese public health official.
More Liberal Attitudes Towards Sex, Increasing Prostitution Spreads
STDs, HIV Virus
Very rapid social and economic changes have brought with them changing
sexual mores among China's young people which makes them many more
young
Chinese vulnerable to STDs and HIV. Some Chinese health experts expect
that the rapid rise of STDs in China (increasing at a 20 percent annual
rate since 1991 according to official figures) will within the next
few
years cause a breakout of the HIV virus into the heterosexual
population. Han Qingzhang, Vice-Director of the State Security Bureau
(Gongan Ju) Third District and Vice Secretary General of the China
AIDS
Prevention Association, said in early 1995 that over the last several
years the Security Bureau has arrested 65 HIV-infected prostitutes
in
Yunnan Province alone, including 15 during the first five months of
1995. The spread of HIV to prostitutes (mostly IV drug users) make
it
likely that an ever higher number of people will be infected with the
HIV virus through heterosexual sexual contact.
Chinese Police Involved in Drug, HIV/AIDS, STD Education
AIDS and STD education are weak points in Chinese efforts against HIV
and areas where the Chinese police are determined to help. In Reili
City, Yunnan Province, police official and AIDS Prevention NGO
Secretary-General Han Qingzhang said, fully ten percent of the drug
addicts arrested by the police during 1994 were HIV-infected yet the
police also found that 94 percent of the drug addicts in that city
did
not know how to prevent HIV transmission. Han said that the Chinese
public security organization has long been involved in anti-drug
education and HIV/AIDS prevention at detention centers throughout China.
The Chinese police should work closely with the Ministry of Health,
Han
said, to promote monitoring of the HIV/AIDS situation, train detention
center officials in HIV and STD education, and participate in
international cooperative efforts to fight the spread of HIV/AIDS and
STDs. Some health experts have noted that the Chinese police with their
'random sample' of people in their detention centers to study, are
in a
good position to study the drug situation and to develop effective
drug
education programs. In Kunming, Yunnan Province, where drug use is
rampant, the police often send drug abusers directly to police operated
drug rehabilitation centers rather than to prison.
Rehabilitation Neglects Needle, Condom Knowledge
One public health official who has visited the model clinic run by the
Chinese police in Kunming criticized the education provided at these
centers from a public health perspective. He said that addicts are
not
taught that sharing needles is very dangerous and prostitutes are not
taught about the use of condoms. Addicts and prostitutes at the centers
badly need this knowledge: 80 percent of the addicts return to drugs
and
95 percent of the prostitutes return to prostitution.
AIDS Series
This is the fourth in a series of seven reports from Embassy Beijing
on
HIV/AIDS in China. The first report summarized the series. The second
report examines Chinese official estimates of HIV/AIDS in China and
weaknesses in the data upon which official estimates are based. The
third report summarizes Chinese Minister of Health Chen Minzhang's
views
on the HIV/AIDS in China and China's strategy for responding to the
challenge of HIV/AIDS. This fourth report discusses what Chinese experts
say about the effect of the rapid increase in the numbers of intravenous
drug users and in cases of sexually transmitted diseases on the spread
of HIV/AIDS in China. The fifth report discusses AIDS and homosexuality
in China. The sixth report examines the spread of HIV through the
contamination of the Chinese blood supply. The seventh report looks
at
the Chinese government's response to HIV/AIDS including efforts to
clean
up the blood supply, education about HIV and STDs, mobilization of
Chinese NGOs and increased Chinese cooperation with Australia, the
European Union and UN agencies in HIV/AIDS prevention, education and
research.
---------------------------------------------------------------------------------------------
AIDS AND HOMOSEXUALITY IN CHINA
U.S. Embassy Beijing April 1997 Fifth of seven reports
Summary: Homosexualty is as common in China as in other countries. Men
who have sex with men in China, depending upon their behavior, are
vulnerable to HIV/AIDS. Yet the vulnerability of men who have sex with
men to HIV/AIDS is absent from public discussions of HIV/AIDS in China.
The homosexual community is largely isolated and unaware of how to
protect itself from HIV/AIDS. As in many parts of the HIV/AIDS picture
in China, China is flying blind. Nearly nothing is known about the
prevalence of HIV vulnerability factors (anal intercourse, number of
sex
partners) in China so the vulnerability of Chinese homosexual community
as a whole to HIV/AIDS is hard to estimate. Although drug addiction
is
still far more important than homosexual transmission of HIV/AIDS in
China, the near complete absence of public information on homosexuality
and how to reduce the risk of HIV/AIDS infection among homosexuals
handicaps Chinese efforts to combat HIV/AIDS. End summary.
Men Who Have Sex With Men -- At High Risk, Ignored in Chinese HIV/AIDS
Debate
In China, just as in other countries, there are many men who have sex
with men. According to the most authoritative work on homosexuality
in
China, "Homosexuality" [Tongxing Ai] by Zhang Beichuan [Shandong Science
and Technology Press 1994], China has a similar proportion of
homosexuals in its population in the European or U.S. populations.
Professor Zhang noted that strong social pressure in Chinese society
may
make the proportion of active homosexuals somewhat lower than it is
in
the U.S. and Europe. However the pressure may be now easing somewhat
since recent years have seen the emergence of open or semi-open gay
gathering places in nearly every Chinese province and municipality.
Social conservatism, and even more importantly, the unwillingness of
the
Chinese Communist Party to acknowledge the widespread presence of
homosexual people in the Chinese population prevent a public
acknowledgment of the spread of HIV among men who have sex with men.
Men
who have sex with men face contempt from the public at large and
sporadic persecution from local police under anti-hooliganism laws.
Flying Blind on Vulnerability of Men Who Have Sex with Men to HIV
AIDS has emerged as a serious problem among homosexuals in Chinese
cities although the numbers of infected people is still small. Very
little is know about actual heterosexual and homosexual social behavior.
Since homosexual transmission of HIV is related to behaviors such as
anal intercourse and number of sex partners, as well as to the
prevalence of STDs, estimating the potential for an HIV epidemic among
male homosexuals is difficult.
Varying Behaviors, AIDS Risks: Little Known in China
Indeed, while people familiar with the U.S. experience of HIV/AIDS might
well expect to see HIV emerge among Chinese men who have sex with men,
another Chinese society -- Hong Kong -- has a much different HIV
picture. Dr. Emile Fox, director of the Beijing UNAIDS office, told
ESTOFF that a study presented at the November '96 First Hong Kong AIDS
Conference reported that HIV was low among Hong Kong gays because the
main HIV vulnerability factor (anal sex) was rare. Although much is
now
known about HIV risk factor behaviors among drug users, nearly nothing
is known about the prevalence in China of homosexual (as well as
heterosexual behaviors that make people especially vulnerable to
HIV/AIDS.
Chinese Homosexuality Rarely Mentioned, Poorly Understood
Homosexuality is almost entirely absent from government, media and even
academic discussions of AIDS in China. Here, as in many other areas
of
the AIDS problem, China is flying blind. A Chinese public health
official told ESTOFF that in northern Chinese cities such as Beijing
and
Shanghai, where the number of HIV infected people is low overall, many
of the HIV infected people that he sees are male homosexuals. Tianjin
journalist in his 1995 book 'AIDS Is Closing in On China' ['Aizhibing
Bijin Zhongguo'] reported the experience of several male homosexuals
in
Beijing who have HIV as well as the work of an AIDS telephone hotline
mostly concerned with providing HIV information to Beijing area men
who
have sex with men.
Low AIDS Awareness, Little Education
Drug addiction and heterosexual sex are the main modes of HIV
transmission in southern China, said the official. Homosexuals are
generally ignored by public health authorities and ignored in public
discussions of AIDS. The public health official told ESTOFF that most
men who have sex with men are not aware that many gay men in Beijing
and
Shanghai have HIV. As long as men who have sex with men are ignored,
effective education which can help them change high risk behaviors
(anal
sex, multiple sex partners) and sharply reduce their exposure to HIV
infection will not be possible.
AIDS Series
This is the fifth in a series of seven reports from Embassy Beijing
on
HIV/AIDS in China. The first report summarized the series. The second
report examines Chinese official estimates of HIV/AIDS in China and
weaknesses in the data upon which official estimates are based. The
third report summarizes Chinese Minister of Health Chen Minzhang's
views
on the HIV/AIDS in China and China's strategy for responding to the
challenge of HIV/AIDS. The fourth report discusses what Chinese experts
say about the effect of the rapid increase in the numbers of intravenous
drug users and in cases of sexually transmitted diseases on the spread
of HIV/AIDS in China. This fifth report discusses AIDS and homosexuality
in China. The sixth report examines the spread of HIV through the
contamination of the Chinese blood supply. The seventh report looks
at
the Chinese government's response to HIV/AIDS including efforts to
clean
up the blood supply, education about HIV and STDs, mobilization of
Chinese NGOs and increased Chinese cooperation with Australia, the
European Union and UN agencies such as UNAIDS in HIV/AIDS prevention,
education and research.
---------------------------------------------------------------------------------------------------
KEEPING CHINA'S BLOOD SUPPLY FREE OF HIV
U.S. Embassy Beijing April 1997 Sixth of seven reports
Summary. Contaminated blood has been an important route for the spread
of HIV and other blood-borne diseases in China. Inadequate laboratory
tests often results in the entry of contaminated blood sold by unhealthy
donors into the blood supply. The eighty percent of the blood test
kits
used in China do not meet Chinese Ministry of Health standards give
an
excessively high number of false negatives. As a result contaminated
blood is sometimes not detected. During the last two years, in many
areas blood donation centers have been inspected and some closed.
Several provinces now require physical examinations of all blood donors.
Chinese blood banks must often rely on blood sold by professional blood
donors and migrant workers in order to meet their needs. Truly voluntary
blood donation does not exist in China. Work unit inducements and new
legislation such as the Sichuan Provincial law that requires all
citizens to give blood once every five years, may, however increase
the
quality of the blood entering Chinese blood banks. End summary.
HIV Contaminated Blood Often From Poor Who Sell Blood
Incidents of HIV infections through blood given by HIV-infected donors
or HIV infection given to blood donors by unsterilized needles occur
throughout China. Cases of blood borne diseases spread by improper
practices at blood collection centers has brought considerable
government and public attention on the safety of the blood supply.
Truly
voluntary blood donation is unknown in China. Even where blood donation
is ostensibly voluntary, in practice blood donation is expected by
the
work unit and often rewarded with two or three weeks of paid leave.
Some
people who earn money by giving blood are in poor health. These blood
donors sometimes include drug addicts and prostitutes who may have
STDs
or other blood-borne diseases. Contaminated blood products, diseases
transmitted to blood donors by dirty needles and other poor medical
practices have spread the HIV virus and other illnesses.
Poor Laboratory Techniques, Inconsistent Attention to Standards
According to a Western physician with considerable experience in China,
blood is tested using Chinese-made blood test kits that are often of
poor quality. Pipettes used in lab work are washed and reused even
where
test accuracy and safety dictates that pipettes should be disposed.
Standard procedures are not followed. In some Beijing hospitals lab
technicians are afraid to test blood for HIV. Blood in the elite system
might be tested five times in this way to assure quality, but five
poor
quality tests do not equal one good test, the physician said.
Poor Quality HIV Test Kits, Poorly Medical Workers
A Chinese public health official told Embassy Environment, Science and
Technology section officer that only five Chinese made blood-testing
kits have been quality certified by the Chinese health authorities.
Recent studies done by Beijing Municipality public health officials
have
shown, said the official, that the Chinese government certified HIV
test
kits are comparable to imported kits in their low rate of false
negatives and false positives. These high quality blood testing kits,
however, comprise only 20 percent of the blood testing kits used in
Chinese hospitals and clinics, said the official. The approved kits
are
much more expensive than the unapproved Chinese-made blood testing
kits.
Clinics involved in blood transfusion are required to use the certified
kits but the uncertified kits are widely used in Chinese hospitals
and
clinics said the official.
Blood Center HIV Contamination in Beijing Suburb
One of the worst incidents took place in mid-1996 in the Beijing suburb
of Langfang where blood collected from poor people for payment contained
HIV which infected at least several dozen blood recipients. One official
said that this incident shocked the Chinese central leadership since
the
Langfang hospital supplies blood for some Beijing hospitals used by
the
official elite. As a result of this incident, which was never reported
in the Chinese press, a high Ministry of Health official was nearly
fired.
Paid Donors Forced Into Groups by Blood Pimps
According to a front page report in the March 21, 1997 Nanfang Zhoumou
weekly newspaper, in the Guangdong Province city of Xunde, groups
numbering about blood donors each are kept together in rented hotel
rooms by blood pimps [xuetou]. The 'donors' pay one-sixth of their
payment plus 10 RMB rent per day. To raise productivity, the blood
pimp
gives the blood donors medicines (which donors take up to three times
daily) to increase blood volume and disguise disqualifying medical
conditions. The professional blood donors told the journalist that
many
circulate among blood centers in Guangdong and Fujian provinces in
order
to give blood more frequently. The donors give 400 - 500 ml of blood
five or more times each month. The Chinese government Price Bureau
sets
the price of blood at 50 RMB (about US$6.50) per 100 milliliters so
after deductions for the blood pimp and rent, so a professional blood
donor giving blood five times monthly would clear RMB 500 (US$63) per
month.
A Blood Bank Director's Perspective
Wu Jianning, director of the blood bank at the First People's Hospital
in Xunde, Guangdong told the Nanfang Zhoumou journalist (who was
accompanied by Guangdong Province health officials), "Ever since we
set
up blood banks, the system has been organized by the blood pimps
(xuetou). The main reason is that we have no blood donors in this area
so we have to depend on people who come from other places -- workers
and
some professional blood donors. These donors have no fixed address
and
often move so it is very hard to keep track of them. Therefore we asked
for "a contact person" to manage them as a group and bring them and
to
bring them in to give blood."
The Nanfang Zhoumou journalist commented that the situation at the Xunde
blood bank, founded in 1988 and the first of three central blood banks
in Guangdong Province, is not unique to southern China but is a
nationwide phenomenon. According to the Guangdong provincial health
authorities, by far the greatest part of the 150 tons of blood used
clinically in Guangdong Province during 1996 came from paid blood
donors. The Guangdong provincial health authorities want to establish
21
blood collection centers independent of hospitals which will have paid
staff that will manage contacts with individual blood donors in order
to
eliminate the deleterious effect of blood pimps on the quality of the
blood supply, concluded the Nanfang Zhoumou article.
Many Unsafe Blood Centers Closed, Physicals for Donors
Increased openness about the HIV/AIDS challenges that China faces The
Ministry of Health closed down 579 blood collection centers and
corrected improper practices at 738 others during 1995. Henan Province
rejected one-third of its 790,000 paid blood donors after physical
examinations were instituted in 1995. The Province issued blood donation
permits to 550,000 people who passed the examination. Several provinces
now train blood donation center workers to ensure that the donated
blood
is safe and that people donating blood do not get infected. However,
according to a December '96 report in the newsweekly Nanfang Zhoumou,
hepatitis infection as a result of blood donation is common in some
rural areas of southern China.
Almost No Truly Voluntary Blood Donation in China
Encouraging blood donations is an important part of the Chinese strategy
to ensure blood supply safety. Yet these donations are not truly
voluntary. Many Chinese work units encourage voluntary blood donations
by giving employees one or two weeks of vacation, a bonus, or a higher
place on the housing waiting list if they give blood. New Chinese
provincial and national legislation strongly encourages blood donations.
A December '96 Sichuan Province law requires all adult Sichuan residents
under age 55 to give blood at least once every five years.
In this type of 'voluntary' blood donation system, where blood is
obtained by a legal requirement imposed upon citizens by law or by
work
unit inducements. This new system may be preferable to the current
one
which relies largely on poor people but it is still not a truly
voluntary system that would encourage people in poor health to
self-select out of the blood pool. While truly voluntary blood donation
in which there is no social or economic pressure to give blood and
people feel completely free to say 'no' does sometimes occur, this
is
far from typical. In general, there is very little truly voluntary
blood
donation in China.
AIDS Series
This is the sixth in a series of seven reports from Embassy Beijing
on
HIV/AIDS in China. The first report summarized the series. The second
report examines Chinese official estimates of HIV/AIDS in China and
weaknesses in the data upon which official estimates are based. The
third report summarizes Chinese Minister of Health Chen Minzhang's
views
on the HIV/AIDS in China and China's strategy for responding to the
challenge of HIV/AIDS. The fourth report discusses what Chinese experts
say about the effect of the rapid increase in the numbers of intravenous
drug users and in cases of sexually transmitted diseases on the spread
of HIV/AIDS in China. The fifth report discusses AIDS and homosexuality
in China. This sixth report examines the spread of HIV through the
contamination of the Chinese blood supply. The seventh report looks
at
the Chinese government's response to HIV/AIDS including efforts to
clean
up the blood supply, education about HIV and STDs, mobilization of
Chinese NGOs and increased Chinese cooperation with Australia, the
European Union and UN agencies such as UNAIDS in HIV/AIDS prevention,
education and research.
---------------------------------------------------------------------------------------------------
CHINA RESPONDS TO AIDS
U.S. Embassy Beijing April 1997 Seventh of seven parts
Summary. Increased media attention to HIV/AIDS, efforts to clean up
the
Chinese blood supply, education in Chinese schools on HIV and AIDS,
and
the mobilization to government sponsored NGOs testify to the high
priority the Chinese government now places on the fight against
HIV/AIDS. China works with Australia, the European Union and UN agencies
(especially UNAIDS) on AIDS related research and on combating the spread
of AIDS in China. Opportunities for Sino-American cooperation in the
fields of drug addiction research and treatment, and in AIDS
epidemiology and education will likely open up if the level of trust
between the U.S. and China in this politically sensitive area increases.
End summary.
HIV/AIDS Now High Priority -- Chinese Government
Several public health officials told ESTOFF that during 1995 the Chinese
government began to give HIV/AIDS far greater attention than previously.
The clearest signs of progress can be seen in cleaning up the blood
supply now that local blood collection stations personnel are now being
trained and more closely supervised, donors screened, and healthier
blood donors sought. Government guided NGOs enable the Ministry of
Health and other government agencies to work more closely with
prostitutes, drug addicts and men who have sex with men than would
be
politically possible for government agencies.
China's NGOs Mobilize
The first NGO Cooperative Conference on HIV/AIDS Prevention and Control
brought together 21 national and provincial level NGOs together with
government officials, including representatives from the Ministry of
Health and the Ministry of Public Security on November 8 - 10, 1995.
These government-sponsored NGOs support HIV/AIDS education and academic
publications and participate in AIDS research and education with foreign
governmental and non-governmental partners including organizations
of
the United Nations system (such as UNDP and UNAIDS), Australia, and
the
Ford Foundation.
Public Awareness of AIDS on the Rise
Although the incidence of AIDS is still low relative to China's 1.2
billion population except for a few high-risk groups, notably
intravenous drug users, the Chinese government has moved to establish
a
nationwide network of HIV monitoring stations and increase public
awareness of AIDS. Due to press articles such as Tu Weidong's long
running series in the mass circulation national weekly Nanfang Zhoumou
during the Fall of 1996 and books like popular writer Fang Gang's 1995
book 'AIDS Closes in On China' [Aizibing Bijin Zhongguo] more educated
urban Chinese realize that severity of the AIDS pandemic and how they
can protect themselves. Both Tu Weidong's article and Fang Gang's book
recount stories of Chinese people driven from their homes by neighbors
who learned that they had the AIDS virus.
'We Fight HIV/AIDS, Not People Infected with HIV', Chinese Press is
Told
Press guidance distributed to the Chinese broadcast media on the AIDS
day commemoration at the Great Hall of the People in Beijing on December
1, 1996 made the same points as public health authorities make in other
countries. The press guidance told the Chinese media that 'We must
remember that we are fighting against AIDS and not against people with
the HIV virus', 'Anyone can be infected by the AIDS virus so we must
change high risk behaviors in order to avoid catching or transmitting
the AIDS virus'.
AID Education Pilot Programs in High Schools
Pilot AIDS education efforts now underway in middle schools of Yunnan
Province in Shanghai Municipality are expected to be extended to all
of
China over the next several years. As in other countries, including
the
United States, the reluctance of school administrators and teachers
to
discuss sexual behavior with students hamper educational efforts.
Another problem for AIDS education in China is that many students leave
school before or during the middle school years.
Flying Blind on Heterosexual, Homosexual Behaviors Which Affect Spread
of HIV/AIDS -- Epidemiological Work Needed
China is flying blind on HIV/AIDS. Little is known about the
demographics of the Chinese population that engages in the types of
heterosexual and homosexual behaviors (as a subset of all heterosexual
and homosexual behaviors) which makes them vulnerable to HIV/AIDS.
Although no confident predictions can be made about how serious a
problem HIV/AIDS will be for China in the years ahead, the very rapid
spread of sexually transmitted diseases in China which greatly
facilitate the spread of HIV/AIDS is a warning sign that China appears
to be heeding. Good epidemiological work is needed to provide the
Chinese government with better information that will assist
decisionmakers formulate more effective AIDS prevention policies and
strategies.
Even the high end estimate of 300,000 HIV-infected people is small
compared with the Chinese population of 1.2 billion. However, the rapid
growth of drug addiction and prostitution, combined with weakness in
educating both heterosexuals and homosexuals on the importance of safe
sex; systemic weaknesses in the impoverished health care system, and
the
widespread poverty which make safe sex expensive and AIDS treatment
with
expensive drugs impossible will likely make HIV/AIDS an increasingly
serious problem for China in the years ahead.
HIV AIDS Challenge Serious But Some Ground for Optimism
Chinese openness makes hidden, ugly problems appear. Thus, many problems
which have long afflicted the Chinese public health system have become
more apparent to local and foreign observers. Yet important progress
is
being made, especially in the cities where the most affluent, healthiest
and best educated fifth of China's population lives. Over the long
run,
however, the success of public health measures will be determined by
how
well the public health authorities can protect the health of rural
people.
In China, the HIV/AIDS denial phase which through which many societies
pass appears to be over. Chinese government during the last two years
has made important legislative and educational initiatives in the fight
against HIV/AIDS. Although this report notes the many challenges that
China faces in its fight against HIV/AIDS, progress that China is making
now that HIV/AIDS has become a high priority problem is now visible.
Opportunities for Sino-American Cooperation on HIV, STD Prevention --
If
Trust Can Be Built
Expert observers tell us that the Chinese government takes the AIDS
problem has given the HIV/AIDS problem a much higher priority during
the
last year. China participates in many bilateral and multilateral AIDS
programs including an AIDS education program with Australia, the UN
Mekong River Region States Anti-AIDS plan, the European Union, and
UN
agencies especially UNAIDS.
UNAIDS, partially funded by U.S. government contributions, serves as
a
bridge between China and the international HIV/AIDS research community.
Chinese officials regularly invite UNAIDS director Emile Fox to domestic
workshops on AIDS and discuss Chinese domestic and international
HIV/AIDS developments. Opportunities for Sino-American cooperation
in
the fields of drug addiction research and treatment, and in AIDS
epidemiology and education will likely open up if the level of trust
between the U.S. and China in this politically sensitive area increases.
AIDS Series
This is the seventh and final report from U.S. Embassy Beijing on
HIV/AIDS in China. The first report summarized the series. The second
report examines Chinese official estimates of HIV/AIDS in China and
weaknesses in the data upon which official estimates are based. The
third report summarizes Chinese Minister of Health Chen Minzhang's
views
on the HIV/AIDS in China and China's strategy for responding to the
challenge of HIV/AIDS. The fourth report discusses what Chinese experts
say about the effect of the rapid increase in the numbers of intravenous
drug users and in cases of sexually transmitted diseases on the spread
of HIV/AIDS in China. The fifth report discusses AIDS and homosexuality
in China. The sixth report examines the spread of HIV through the
contamination of the Chinese blood supply. This seventh report looks
at
the Chinese government's response to HIV/AIDS including efforts to
clean
up the blood supply, education about HIV and STDs, mobilization of
Chinese NGOs and increased Chinese cooperation with Australia, the
European Union and UN agencies such as UNAIDS in HIV/AIDS prevention,
education and research.
Appendix -- Notes on Text Sources
Text sources drawn upon from this report on HIV/AIDS in China include:
-- 'Chinese Journal of Prevention and Control of STD and AIDS' [Zhongguo
Xingbing Aizhibing Fangzhi Zazhi] published in Chinese every two months
by the Zhongguo Xingbing Aizhibing Fangzhi Zazhi Bianjibu, Nanwei Rd.
#27, Xuanwu District, Beijing 100050 and from the National Expert
Advisory Committee on STD in Nanjing. The October 1996 speech by Health
Minister Chen Minzhang summarized above appears in the 6/96 issue on
pp.
241 - 247. The article by Chinese police official Han Qingzhang is
in
the 3/95 issue on pp. 2-3, 37. The strengths and weaknesses of Chinese
governmental NGOs working in the HIV/AIDS prevention field are
introduced in 2/96, pp. 91 - 94.
-- 'Tongxing'ai - Homosexuality' by Zhang Beichuan, 1994, Shandong Kexue
Jishu Chubanshe [Shandong Science and Technology Publishers] is the
most
authoritative work on the medical, historical, psychological and social
aspects of homosexuality in China.
-- 'AIDS Closes in On China' [Aizibing Bijin Zhongguo] by social report
literature writer and Tianjin journalist Fang Gang, published by Jilin
Renmin Chubanshe in 1995, discusses the spread of HIV among the Beijing
male homosexual community and an AIDS hotline established to help
Beijing gays learn about HIV/AIDS.
-- 'Jin Du' [Banning Drugs] written by the Xinjiang Autonomous Region
Public Security Bureau and published by Xinjiang Renmin Chunbanshe
[Xinjiang People's Publishing House] in March 1995 discusses the spread
of drugs, drug smuggling and crime by drug addicts in the Xinjiang
Autonomous Region and throughout China.
-- 'No Pain, No Gain, Establishing the Kunming China Drug Rehabilitation
Center' in the 1/97 issue of the Journal of Drug Issues published in
the
United States describes a drug treatment program operated by the Chinese
police in Kunming, Yunnan Province.
-- 'On the Margins -- Men Having Sex with Men' by Neil McKenna [Panos,
1996] discusses the reluctance the Chinese share with other developing
countries in facing the AIDS pandemic. Like other developing countries,
China has difficulty acknowledging the presence of men having sex with
men in their society.