AIDS-HIV IN CHINA: NUMBERS, HISTORY, DISCRIMINATION AND TAINTED BLOOD

AIDS-HIV IN CHINA

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Chinese AIDS sufferer
In November 2011, AP reported: China had about 780,000 people infected with the AIDS virus at the end of 2011, state media reported, with most having contracted it through heterosexual sex. Xinhua said a report from the Ministry of Health and the United Nations estimates there was about 48,000 new HIV infections in China in 2011. Xinhua quoted the report as saying the virus remains “mildly prevalent” in China. [Source: AP, November 30, 2011]

In 2008, AIDS ranked as China’s deadliest infectious disease for the first time, killing people at a rate of one an hour. The World Health Organization reported that 740,000 people were living with HIV/AIDS as of the end of 2009, and that 220,000 others had died of the disease.

The information coming out of China isn't always consistent with that coming from the WHO. In October 2009, the Chinese Health Ministry reported that number of people with HIV/AIDs reached 319,877, up from 264,302 the previous year. As of 2008, according to the Chinese government, 264,302 people had contacted the disease and 34,864 had died since the disease was first detected in the 1980s. The WHO estimates there were 700,00 cases n 2008, an increase of 8 percent from 2005.

A study by UNAIDS released in November 2009, reported that 40 percent of the new infection were acquired through heterosexual contact, 32 percent by homosexual contact, with most of the rest related to drug abuse. The data suggested that infection rate was increasing and shifting away from drug users and to people engaged in heterosexual contact and to a lesser degree homosexuals ex. The rate of new infections among heterosexuals tripled between 2005 and 2007 and doubled among homosexuals after 2007---an alarming trend that requires new strategies to deal with.

About 37 million men are estimated to be clients of female sex workers. Surveys indicate that about 60 percent do not regularly use condoms. This trend has led to a doubling in women’s share of HIV cases between 1999 and 2009. China’s policy of tolerating the sex industry while outlawing it has hampered efforts to promote education and testing among sex workers.

A survey conducted by the WHO and released in January 2006 estimates the number of HIV and AIDS cases in China is around 650,000, down from the 840,000 estimated in 2003. The decrease was due not to a reduction in cases but because of an overestimation of HIV and AIDS cases in the past when some scientists said there could be several million people carrying the HIV virus in China, with over 1 million people being infected in Henan province alone. Between 200,000 and 250,000 people have died of AIDS in China The Chinese government reported 70,000 new HIV-AIDS cases in 2005, bringing the total to 650,000. The WHO report said 75,000 have full-blown AIDS and 25,000 died in 2005.

HIV-AIDS data coming out of China is sketchy at best. One reason for the higher numbers of AIDS and HIV cases in the past was due an overestimation of the cases caused by blood transmissions in Henan Province. A 2003 study estimated that the number of people inflected by infected blood in Henan Province was around 50,000 to 200,000 not 1 million as had been estimated before. Drug users with HIV are thought to number around 288,000. The lower figures are also the result of the fact that many people with the virus have already died.

If the 650,000 figure is accurate---and even if it is 850,000 or more than 1 million---the number of AIDS and HIV cases in China is small for a nation with 1.3 billion people. In comparison Thailand, a nation with a much smaller population than China, has one million and India, a nation with almost as many people as China, has four million (2001). Currently the adult AIDS rate in China is 0.07 percent.

But health officials worry the AIDS situation could get much more serious in the future. The United Nations publically scolded China for not doing more on the HIV epidemic, specifically not offering adequate treatment or education, and warned of “an epidemic of proportions beyond belief.” Some think the number of AIDS patients could rise to 10 million or even 15 million by 2010.

Websites and Resources

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AIDS prevention poster
Good Websites and Sources on Disease in China: The Chinese Center for Disease Control and Prevention chinacdc.net ; Center for Disease Control on China CDC World Health Organization on China who.int/countries/chn ; Wikipedia article on Public Health in China Wikipedia ; Rare Diseases in China , Lancet Article thelancet.com ; Burden of Disease in China pdf file dcp2.org/file/53 ; AIDS-HIV: Article on AIDS in China avert.org ; WHO China Office Report on AIDS wpro.who.int ; China AIDS Info china-aids.org China AIDS Medica Project chinaaidsmedia.com ; SARS : CDC Paper on Origin of Sars www.cdc.gov ; SARS Map nationsonline.org ; SARS Book Stanford University ; Influenza and A/H1N1 Flu: Flu in China flu.org.cn ; Paper on Flu and Ducks ncbi.nlm.nih.gov ; Paper on effects of Flu Pandemic in China interscience.wiley.com ; Bird Flu: Avian Influenza Info avian-influenza.info ; WHO Avian Influenza Reports who.int/csr/disease/avian_influenza ; Flu in China flu.org.cn ; Bird Flu Center bird-flu-center.com; CDC on Bird Flu cdc.gov/flu/avian

Good Websites and Sources on Health in China: Center for Disease Control on China CDC World Health Organization on China who.int/countries/chn ; Wikipedia article on Public Health in China Wikipedia ; Short UNICEF Article on Health Issues in China unicef.org ; On Health Care in China: Health Care in China, an IBM pdf file ibm.com/de/healthcare ; Pape on Chinese Helat Care from the 1990s mtholyoke.edu ; Library of Congress Country Studies countrystudies.us Paper on Chinese Health Insurance allacademic.com ; Ex-Pat Report justlanded.com ; China Health Care Blog chinahealthcareblog.com Asia Health Care Blog asiahealthcareblog.com

Links in this Website: HEALTH IN CHINA Factsanddetails.com/China ; HEALTH CARE IN CHINA---DOCTORS, INSURANCE AND COSTS Factsanddetails.com/China ; HEALTH CARE IN CHINA--- TRANSPLANTS AND DRUGS Factsanddetails.com/China ; TRADITIONAL CHINESE MEDICINE Factsanddetails.com/China ; ACUPUNCTURE Factsanddetails.com/China ; QI GONG AND MOXIBUSTION Factsanddetails.com/China ; ANIMAL PARTS AND CHINESE MEDICINE Factsanddetails.com/China ; DISEASES IN CHINA Factsanddetails.com/China ; AIDS-HIV IN CHINA Factsanddetails.com/China ; SARS IN CHINA Factsanddetails.com/China ; INFLUENZA AND A/H1N1 FLU IN CHINA Factsanddetails.com/China ; BIRD FLU IN CHINA Factsanddetails.com/China

History and Spread of AIDS in China

HIV gained a foothold in China largely because of unsanitary blood plasma buying schemes and tainted transfusions in hospitals. Health authorities say heterosexual sex has now overtaken drug abuse as the main method of transmission. [Source: AP, November 30, 2011]

Scientists believe the disease entered China in the 1980s with drug traffickers from the Golden Triangle. In recent years it spread along drug-trafficking routes in Xinjiang. The first known AIDS victim died in 1985. The Number of HIV infected people increased tenfold between 1993 and 1995, from 10,000 to 100,000 people. In 1997, China had 5,300 AIDS cases and 400,000 HIV-infected people. The Communist government has blamed AIDS on the decadent capitalist West.

For many years AIDS was confined to a relatively small number of intravenous drug users that lived in the Yunnan Province---near the Golden Triangle in Laos, Burma and Thailand---where a great deal of heroin and opium was smuggled. From Yunnan the disease spread throughout China mainly by intravenous drug users. Most AIDS and HIV cases are still in Yunnan although HIV-infection rates are increasing in the major cities and along the prosperous eastern coast, where drug use and prostitution are on the rise.

It is estimated that number of AIDS and HIV cases are rising at a rate of 30 percent a year. The big worry now is that AIDS-HIV will spread widely into the non-drug-using, heterosexual population and spread with devastating thoroughness as it has in Africa. In 2007 unsafe sex overtook intravenous drug use as the primary means of transmitting HIV. Health officials worry that AIDS will be spread by the floating population of 120 million migrant workers who live away from the families and satisfy their urges with prostitutes and still have sex with their wives.

A law was passed in 1994 banned foreigners with HIV-AIDS, sexually-transmitted diseases and tuberculosis from entering China. An announcement was made in 2007 that the law was going to be relaxed.

In October 2008, it was revealed that HIV infections rates jumped eight fold in the past few years among gay and bisexual men and doubled among women of child-bearing age raising concerns that the disease was beginning to spread from high-risk groups to the general population.

A study released in October 2008 found the AIDS virus had spread to all provinces and that it was spreading beyond the original high risk groups---heroin addicts in southern China and blood sellers in rural central China---and was showing up more among gay men and female prostitutes. In Yunnan, the hardest hit province, the male to female infection are was 2 to 1 in 2006. In 1996 it was 13 to 1.

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scene from the AIDS-themed film Together by Zhao Liang

AIDS and HIV Victims in China

Most AIDS-HIV victims have contacted the virus through needle sharing but the number getting it through sexual transmission is rising. Method of HIV-virus transmission (2004): IV drug use, 44 percent, compared to 59 percent in 1997; blood transfusion, 4 percent, the same as 1997; heterosexual sex, 19 percent), compared to 17 percent in 1997); homosexual sex, 11 percent, compared to 5 percent in 1997). Before 1997 about 70 percent of the AIDS casea are believed to have been caused by intravenous drug use, 20 percent through tainted blood and other non-sexual causes. Only 10 percent were acquired from sexual contact.

About 82 percent of H.I.V.-infected people in China are male. Some 60 percent of all victims are between 20 and 29. There are not any reliable figures on the number of homosexuals and prostitutes with the virus. In one study in three cites the HIV infection rate among prostitutes rose from near zero in 1996 to 11 percent in 2001. According to another study 60 percent of the prostitutes with AIDS are over 35.

According to government statistics the break down of HIV cases in August 1996 was: drug users (16,655); homosexuals (7,921); foreigners (4,340); people in re-education camps (582); blood product users (562); returnees from abroad (508); prostitutes (110); prostitute clients (78); sailors (34); blood donors (2).

The AIDS-HIV infection rate among gay men is not known. By some estimates men that have sex with men make up 1.35 percent of the male population and the AIDS-HIV infection rate among them could be as high as 3 percent. Gay men are worrisome group because they routinely participate in unsafe sex and one survey found that 28 percent of the m have sex with both men and women and thus could spread the disease to the heterosexual population.

In 2006, a warning was issued that HIV-AIDS was spreading from high-risk groups such as drug users and prostitute to the general population. There is a particular concern about the disease spreading from prostitutes to their clients and then to wives. Some customers refuse to have sex with prostitutes if they have use condoms.

Discrimination Against People with HIV/AIDS in China

After ignoring or demonizing people with AIDS for much of the 1980s and 1990s, China’s authoritarian government has taken a more compassionate line on the disease and combating its spread in recent years. But people with AIDS still face difficulties in getting treatment and compensation, and authorities remain deeply suspicious of independent activists. [Source: AP, November 30, 2011]

A 2009 survey reported by UNAIDSs found that two-thirds of HIV-infected people in China haven’t sought treatment because of fear, discrimination and ignorance. According to the survey 40 percent of the respondents said they had experienced discrimination and one tenth said they has been refused medical treatment at least once. In the report AIDS activist Yu Xiuan told the story of a friend who was refused an urgent operation because she was HIV positive and ended up dying as a result.

As is true with many things in China, there are reasonably good laws on the books aimed at combating AIDS discrimination but following and enforcing these laws is another story. Sex workers and drug users are routinely rounded up as “undesirables.” NGOs that work to expand AIDS education and outreach are intimidated and censored.

In September 2010, the first suit alleging work discrimination because of HIV status was accepted in China, at a municipal court in Anhui Province. The plaintiff, whose name was withheld, says that he was denied a teaching job because he had tested positive for HIV.

In April 2010, China lifted its ban on foreigners with HIV/AIDS entering the country. The decades -old policy got some negative foreign media attention when an Australian writer was blocked from entering China after he declared he was HIV-positive. Before the changes China’s laws formally banned foreigners entering the country with “psychiatric illness, leprosy, AIDS, sexually-transmitted diseases, active pulmonary tuberculosis and other infectious diseases.”

Andrew Jacobs wrote in the New York Times, “People with AIDS have increasing access to medical treatment in China, but they are widely shunned and often barred from universities, state jobs and private corporations. The ostracism has serious implications: in a report last year, the United Nations said fear and ignorance kept many of the estimated 740,000 Chinese infected with H.I.V. from seeking treatment. The government has come a long way since the 1990s, when it went to great lengths to cover up a scandal in which thousands contracted the disease at state-run transfusion programs. These days, people with AIDS have access to free antiretroviral drugs, and China’s top leaders, Prime Minister Wen Jiabao and President Hu Jintao, make a show of consoling people with AIDS each World AIDS Day. The government earlier this year lifted a ban on H.I.V.-infected foreigners’ visiting China. [Source: Andrew Jacobs, New York Times, November 12, 2010]

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scene from the AIDS-themed film Together by Zhao Liang

Ostracized AIDS Victims in China

Many Chinese regard AIDS victims---particularly those who contacted the disease through drug use, prostitution and homosexuality---as deserving of their fate. The victims are ostracized and receive little sympathy. One HIV-infected man told the New York Time, "H.I.V. is like having leprosy in the 1930s.

Workers are often fired if is discovered they have HIV and Clinics inform employers of workers who tested positive for the disease. Children with AIDS are expelled from school and have stones thrown at them by other children. There are laws that prevent HIV-infected people from marrying freely and using swimming pools.

In some places AIDS sufferers are forced to keep moving because their neighbors inevitably find out they have the disease and drive them out. Many sufferers get thrown into this predicament after being forced out on ths streets by their family. One former drug user told the New York Times, “When I was on drugs they could still accept me and forgive me, but when I became sick with HIV they had nothing more to give.”

Some suffers are beat up. One HIV-infected man told the Washington Post he was surrounded by a men in military fatigues and knocked to the ground and beaten with a nightstick, “They beat me because I stepped outside,” he said.

After an AIDS victim dies, his body, clothes and even furniture he has touched are often burned. Often grave diggers and funeral services will not touch people who died of AIDS and families have to bury them themselves.

Chinese HIV Discrimination Law Fails in Court

Andrew Jacobs wrote in the New York Times “In a rare, public test of the nation’s law prohibiting discrimination against people with H.I.V., a Chinese court on Friday ruled against a man who said he was wrongly denied a teaching job after his prospective employer learned he had the virus that causes AIDS. The man who filed the lawsuit, a 22-year-old college graduate, had passed a battery of written tests and an interview when a mandatory blood test revealed his H.I.V. status, prompting the local education bureau in the eastern city of Anqing to reject his application.[Source: Andrew Jacobs, New York Times, November 12, 2010]

“I’m heartbroken,” said the man, who used the alias Xiao Wu in legal papers to protect his identity. “I just wanted to find some justice for me and for others facing the same problem.” Lawyers for the man said they would appeal. In his ruling, the judge agreed with the education bureau’s contention that regulations barring H.I.V.-infected civil servants trumped a four-year-old law that was supposed to protect people with the virus from the prejudice of employers. That measure, passed by the State Council, the government’s chief administrative body, states that “no institution or individual shall discriminate against people living with H.I.V., AIDS patients and their relatives.” Li Fangping, a lawyer who argued Xiao Wu’s case during a three-hour trial last month, said the judge’s decision defied logic. “It’s an example of how the legal system enhances and expands discrimination against people who are H.I.V. positive,” he said.” [Ibid]

“In a way, the legal travails of Xiao Wu had been a bright spot for AIDS activists, who for years had seen a series of job-discrimination lawsuits rejected by Chinese courts before going to trial. Domestic media coverage of the case has been sympathetic, and given the central government’s laws against discrimination, legal advocates hoped a positive outcome would set a precedent. Last month, an H.I.V.-positive college graduate, who was encouraged by Xiao Wu, filed a similar case in Sichuan Province.” [Ibid]

“Now advocates worry that Friday’s ruling will have the opposite effect, providing legal cover for employers who do not want to hire people with H.I.V. “This is bad news, given that it was the first time an H.I.V.-positive person dared to stand up for his rights,” said Yu Fangqiang, an AIDS advocate whose organization, Beijing Yirenping, provided free representation to the defendant. “The entire H.I.V. community had high hopes, but now the door appears to be shutting for people who want to use the courts to fight against discrimination.” [Ibid]

AIDS and Drug Use in China

HIV spread quickly among communities of intravenous drug users. In the western region of Xinjiang the number of HIV-infected addicts rose from 10 percent to 40 percent between 1996 and 1997. The HIV infection rate among drug users in Kunming is also around 40 percent. One addict there told the New York Times, he shot up twice a day, often with shared needles. “Life was hard and my friends said it would help me relax a bit. I’d never heard of AIDS before today.”

Butuo is town of 10,000 on the main drug smuggling route between Kunming and Chengdu. It is home to a large number of intravenous drug users, many of whom carry the HIV virus. Each year about 20 people die of heroin overdoses and the number of people carrying HIV is estimated to be in the hundreds.

One doctor who works in Butuo told the New York Times, “The spread of HIV here is worse every year. When I first saw it in the mid to late 90s, it used to be just from drugs, now there’s sexual transmission as well.” Most of the addicts began by inhaling heroin but turned to needles because you get a bigger bang for the buck. Sharing needles is common and ths practice no doubt was a primary fact on the spreading HIV. “

Prevention efforts focus on drug addicts and prostitutes. A detoxification center has been set up. Many of the addicts are poor and became addicts after working as couriers. Most deal to support their habits which costs around 100 yuan ($12) a day. This is a lot of money in an area where the average yearly income is 800 yuan.

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Plasma making machines

People Who Contacted AIDS from Tainted Blood in China

Many people in China have gotten HIV from blood products that have not been screened for the virus. Blood products obtained from hospitals are usually screened for the AIDS virus but blood contaminated from blood brokers often is not. One reason for this is that testing blood is expensive and blood brokers want to make as much money as possible.

The HIV virus has been transmitted to tens of thousands of people through reckless blood collection methods in which blood was collected from many individuals and pooled together; plasma and other blood parts were extracted; and the serum with the remaining blood cells was re-injected into the donors so they could donate blood again in the near feature. Because the blood was pooled together and given back if one person carried the AIDS virus it was transmitted to all the other people in the group whose blood was pooled.

Barbara Demick wrote in the Los Angeles Times, “The roots of the scandal go back to the mid-1980s, even before there was a term in Chinese for Acquired Immune Deficiency Syndrome. Trying to protect its blood supply against what was considered a decadent Western disease, the Chinese government banned the import of blood products and, in the spirit of Deng Xiaoping's economic liberalization, decided to go into the blood business itself.” [Source: Barbara Demick, Los Angeles Times November 27, 2010]

By 1992, blood collection stations sprouted throughout the countryside. Poor farmers were encouraged to sell their blood to get rich quick. "Extend your arm. Expose a vein. Make a fist. And it's 50 yuan [$7.50]" was a popular slogan. The blood stations often extracted the valuable plasma---which could be sold abroad for medication---and then re-injected the donors with leftover blood so they'd be able to give blood again without becoming anemic. Before re-injection, the staff often mixed the blood of various donors without screening for disease. [Ibid]

See Blood Brokers, See Health Care

Drug addict's who have no other way to support their habit sometimes sell their blood for $50 in rural clinics. Some 400 people contracted AIDS from one clinic that accepted blood from a donor known to have the HIV virus and used the same instruments used to collect his blood on other patients.

Wan Yanhai, the former health official turned activist, said tainted blood might have been used for transfusions as late as 2004, and that well over 1 million people could have been infected. Official statistics, however, are lower.

Henan Blood and AIDS Tragedy

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Gao Yaojie, the person who
uncovered the Henan blood tragedy
In what has been described as the worst medically-caused HIV epidemic in the world, tens of thousands, perhaps hundreds of thousands or even a million, people in villages in Henan province were infected with the AIDS virus when they sold their blood for use in blood products. In some places where the blood selling was common the HIV rate was as high as 16 percent.

Blood stations opened in the early 1990s. Villagers typically sold their blood for $5 a bag. For many villagers the money was viewed as being heaven sent. They use it to fix their roofs, buy fertilizer, seeds or animals. It was not unusual for a single farmer to sell his blood 30 times. The blood was often collected with old needles using the pooling system described above. After the plasma and red cells were separated the serum was re-injected into the donor’s veins from a common vat

In the village of Wenlpu 40 percent of those who sold their blood before 1995 to blood brokers contacted the AIDS virus. In the village of Donghu, resident estimated that 80 percent of the adults carry the HIV virus.

What is particularly tragic is that authorities knew of the problem in 1995. Although they stopped the blood trade they did nothing to stop mass contamination. People who were at risk were not informed they were at risk. They spread the disease to family members. The disease spread more than it otherwise might have because of efforts to cover up the debacle and block of research, testing and education campaigns. Journalists who have attempted to investigate the tragedy were jailed.

Hebei’s blood problem was uncovered by AIDS activist and obstetrician Gao Yaoje in 1996 when she came across large number of HIV carriers who did not fit the normal high risk group and investigated further and found they all had given blood. She posted her findings on a friend’s blog and after that was followed by mysterious men and then placed under house arrest. Later she was released with the help of U.S. Senator Hillary Rodham Clinton.

In the end the numbers of AIDS-HIV cases caused by blood transmissions in Henan Province was grossly overestimated. A 2003 study estimated that the number of people inflected by infected blood in Henan Province was around 50,000 to 200,000 not 1 million as had been estimated before.

Villages in Henan Hit by the Blood and AIDS Tragedy

Villages struck by the AIDS tragedy in Henan were half empty. The people that remained had a desperate look in their eyes and were so thin it looked as if their clothes were going to fall off. Those who were the worst off had sores on their face, chronic diarrhea and hacking coughs.

Many AIDS victims figured they had no choice but to commit suicide because their treatment would force their families into a debt they could not emerge from. One AIDS sufferer told Reuters, “Given the choice between hanging myself or eating pesticides, I’d prefer to hang myself....Suicide is my only way. It might be a little sooner or a little later. But I’ll have to do it someday.”

The tragedy killed off many people around the same time and left villages filled with orphans. Many of the orphans had little education because what little money their parents had before they died was spent on medicines rather school fees. One orphan in Donghu told the New York Times in 2002, “Before, the children used to play soccer and other games, but you rarely see that this days. Lots of people are dying, and nobody’s in the mood for that sort of thing.”

The villagers received little help. Many sold their furniture to buy medicines and spent their last days lying on the dirt floors of their huts. Promises by the government to provide AIDS medication to affected villagers was largely unfulfilled until late 2003 when anti-AIDS cocktails began arriving.

In July 2003, police raided villages in Henan province, where people were protesting a lack of medical care. Villagers said the police ransacked, homes, beat up residents, arrested 13 and injured about a dozen. Afterwards the government promised to provide those who had HIV-AIDS or suspected they might have it with free effective drugs, free blood tests and free treatment.

As of 2005, the problem was still largely ignored and many victims were dying untreated. Even those who were given the cocktail stopped using the drugs because of their side effects. An effort was made to keep outsiders out so it was difficult to ascertain exactly what went down.

Cover Up of People in Henan Get HIV/AIDS Through Blood Transfusions

The companies that bought the blood were often run by local government agencies. When officials became aware of the extent of what they had done they tried to coverup the tragedy. Barbara Demick wrote in the Los Angeles Times, “In Zhoukou county, a doctor assigned to a blood station noticed a high rate of hepatitis among blood donors in 1994 and warned the Ministry of Health. Then, in 1995, the doctor examined a blood donor, who tested positive for HIV. "I was very worried. If just one person was infected, everybody was at risk," recalled the doctor, Wang Shuping. On her own initiative, she collected blood samples from 52 donors and had them tested for HIV. Thirteen were positive. "We've got to close the blood collection stations immediately and inform the donors. People are in big danger," Wang said she told her superiors. The response, she said, was thugs sent to vandalize her clinic.She fled China in 2002 and now lives in Utah.[Source: Barbara Demick, November 27, 2010]

Official silence turned mistakes into tragedies that begat more tragedies, as blood donors infected each other when their pooled blood was re-injected. They in turn infected spouses, children and blood recipients. Despite heavy government censorship, news reports about AIDS among blood donors began appearing in 2000. [Ibid]

Wan Yanhai, a former public health official and head of a nongovernmental organization who fled China and now lives in Washington, told the Los Angeles Times he believes the heightened sensitivity is because two out of the nine members of the Politburo Standing Committee, Li Changchun and Li Keqiang, served as Communist Party secretaries in Henan province, the epicenter of the scandal. "These are extremely powerful people who could be held responsible for the blood scandal," Wan said. "That's why so many of us have had to leave China."

Ignorance and Education About AIDS in China

A survey in 2002 found that three quarters of Chinese interviewed did not know that AIDS was caused by a virus and 17 percent had never even heard of AIDS. Even among those who were familiar with the disease, few understood how it was transmitted or how condom use could prevent people from catching it. One university student in Beijing told the Los Angeles Times, "I had a rather vague idea about it. I only knew it's incurable, but I was in the dark as to how it's transmitted. I'd imagined it to be more fearful than it actually is."

For decades AIDS was called a "foreigner's disease" and ignored by both the government and Chinese citizens. In a survey in 2000, about half of those asked believed the disease could by contacted from a sneeze or by touching utensils touched by an HIV-infected person and 59 percent said they would not work with an HIV-infected colleague. One doctor said he was notified seven times by a man who believed he contacted AIDS by touching the clothing of a foreigner.

Conservatives in the government still promote chastity and traditional values is the best ways to combat AIDS. One government spokesman said, "If you promote condoms among youth, it would lead to a great deal of sexual license and abandonment of sexual morality.” Many scientists blame these conservatives for preventing frank discussions about sex, drug addiction, condom use and AIDS. The government has spent only fraction of what Thailand has spent on AIDS prevention.

Slowly the government as begun to take action. AIDS-awareness classes are now required at some universities. Some classes show students how to sterilize hypodermic needles. Others pass condoms around and let students exam them and ask questions about them. For many to is the first they have ever seen one.

Television and poster campaigns have been launched, Rock stars have performed benefit concerts to raise money for AIDS-prevention efforts. Yao Ming and other stars in the NBA have made public service announcement on the disease. Proposals have been made for needle exchanges for drug addicts and making condoms available for young people. As part of World AIDS Day, Chinese security forces were given books about sex and AIDS.

Prevention, Openness and AIDS in China

China’s experience with the SARS outbreak in 2003 was a wake call that active measures need to be taken to fight all diseases. After the outbreak the government came to the realization that AIDS education was imperative and began taking a more active role in AIDS education and prevention.

Experts recommend urging sex workers to use condoms, providing clean needles and methadone for drug addicts and providing free anti-retroviral therapy. Women in the sex industry are beginning to insist that their customers use condoms even if they don’t want to. Government agencies and local groups are working together to train “peer educators” to contact people in the sex industry to urge them to use safe sex practices and distribute free condoms. Bars in the Santilun area of Beijing have been encouraged to put up anti-AIDS posters and distributed condoms.

In mid 2000s President Hu Jintao and Premier Wen Jibao appeared on television comforting AIDS patients; condoms were distributed for free to men by pretty girls in rallies; and a 20-part miniseries was broadcast about a girl who contacted HIV from a blood transfusion from her boyfriend. In September 2003, the first public wedding of an HIV-positive couple was given a lot of press in China.

In December 2004, the government released a series or articles that identified gay men as being at high risk for contracting and transmitting the AIDS virus. The move was significant in that up until that time gays been treated as virtual nonentities. Increased tolerance and openness about homosexuality has allowed the government and non-government groups to encourage gays to get tested for HIV, practice safe sex and take other preventive measures.

China still has a ways to go in its battle against AIDS. Needle sharing remains common among drug addicts. Condom distribution at university campus and late night discussions about AIDS and sex are discouraged by authorities on the ground that it encourage sex. According one study only nine percent of prostitutes regularly require their clients use condoms. Many prostitutes don’t want get to tested for AIDS because of they infected health officials are obliged to report to results to authorities. Most of the prevention and education are focused in urban areas. Rural areas such as Henan are still widely ignored.

The central government’s directives to be more open about AIDS and do more to combat the disease have been ignored to some extent on the local level. A number of nonprofit AIDS groups have sprung to fight for the rights of AIDS sufferers while courts have been ordered by the Communist Party not to take up any more AIDS cases.

AIDS Treatment in China

In some cases people with obvious HIV symptoms have been told they have minor problems and are given anti-inflammatory drugs and blister cream. Some hospitals and clinics not only don’t do HIV tests but the deliberately misdiagnose and cover up HIV cases to reduce hassles and make it appear that their area’s HIV-AIDS problem is not as bad as it.

Few HIV victims have access to or can afford the expensive "cocktail" of anti-AIDS drugs that are so affective in the West. Many take an Indian drug that controls the symptoms and is available on the black market for $60 a bottle. Billboards in Beijing advertise pseudo-medicines such as Love Solution which promises to protect sexually active people from AIDS.

In November 2003, the government began giving free HIV-AIDS drugs to the poor. The plan call for every poor person who had tested positive to the disease to be give free treatment by the end of 2004. It wasn’t exactly clear who qualified as poor in a country where many people still subsist on a few hundred dollars a year. The treatment was a cocktail of three of four drugs, all of which have patents that expired and thus can be produced cheap in China.

In many places, more than two thirds of the people who were given the free medicines abandoned them after several weeks, mainly because of the nasty side effects---which included vomiting and dizziness---were so severe. There was a lack of back up to make sure the patients were taking the drug This led to fears of drug resistant strains appearing. The programs has also been obstructed by doctors who prefer to prescribe expensive drugs that earn them money rather than free ones that earn them nothing. Some patients received the free drugs only after bribing doctors or hospital officials.

The Washington Post described one hospital in Kunming that made a profit from treating HIV and AIDS patients by pressing them to pay for extra tests and treatments Those that asked for free anti-AIDS drugs were told they would given them only after taking certain costly tests. In one case described by the Washington Post a woman was given the drugs only after she shelled $1,400---triple her annual income, mostly money she borrowed---then was denied the drugs afer a couple of months because she couldn’t [ay more. She had contacted HIV from her husband who had cheated on her and took off with her kids after she found out.

A $95 million program funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria supplies 30,000 people a year with free anti-retro viral drugs.

China is conducting human testing on a locally developed AIDS vaccine and have promised to speed up the approval process for anti-AIDS drugs.

Chinese Policy and HIV/AIDS Activist Groups

China presents two faces with its AIDS-HIV policy. On one had it’s a generous benefactor for AIDS research and it has given generously to international AIDS-fighting organizations. But on the other hand is has locked up human right activists that campaigned for more rights for HIV sufferers and has discriminated against HIV-AIDS sufferers.

See Human Rights.

AIDS advocates say they face a wealth of restrictions that make it hard to carry out grass-roots activities. Wan Yanhai, the founder of the AIDS organization Aizhixing Institute, moved to the United States in May 2010, claiming government harassment had made it impossible to carry out his work.

In November 2010, Beijing Loving Source, a children’s AIDS charity founded by the jailed dissident Hu Jia, announced it was shutting down after repeated scrutiny by the tax authorities.

In November 2011, a handful of relatives of HIV or AIDS patients who contracted the virus through tainted transfusions planned to protest in front of the Ministry of Finance in Beijing but abandoned the plan because of the tight security there. Organizer Sun Ya said the group was demanding government compensation. Sun’s 15-year-old son contracted HIV from a tainted blood transfusion in 2002 at the Peking University Dental Hospital in Beijing. Sun said he and others have tried to use the legal system to fight for compensation but courts have declined to take their cases, so they have resorted to sporadic protests in the capital. [Source: AP, November 30, 2011]

Lack of Compensation for Those Given HIV/AIDS Through Blood Transfusions

Barbara Demick wrote in the Los Angeles Times, “Besides free retroviral drugs, victims have received almost no compensation. When they've tried to file lawsuits, courts have in most cases either rejected their claims or refused to accept the cases. As a result, victims usually petition officials---an archaic system dating back to imperial times in which the aggrieved would travel to the capital to implore the emperor for help. [Source: Barbara Demick, Los Angeles Times, November 27, 2010]

"It's the worst way of handling things," Li Xige, 42, a former post office employee from a town in Henan province, told the Los Angeles Times. She received tainted blood during a caesarean section in 1995. The girl she gave birth to died at age 8. She and a younger daughter are sick with AIDS. Li did get compensation eventually (she is prohibited from disclosing the amount), but only after repeated petitions to President Hu Jintao and Premier Wen Jiabao, a stint in prison, another under house arrest and suicide threats. "If you don't fight, you'll get nothing," Li said. "It would be better for the government to come up with a plan for all us who are sick or who lost children." [Ibid]

“China's handling of AIDS patients is a case study of a dysfunctional legal system, Demick wrote, “in which victims have no other recourse but to take the fight for justice into their own hands---a lonely, embittered struggle that often puts them and their defenders on the wrong side of Chinese law. If anything, the political space for AIDS activism has shrunk. Hu Jia, one the best-known AIDS activists, is serving a 3½-year sentence for "inciting subversion of state power." His wife announced this month that she was closing the charity he'd founded because of constant harassment by police and tax authorities. Several prominent AIDS activists have fled to the United States. [Ibid]

Wan Yanhai, the former health official turned activist, said blood recipients have gotten less compensation than blood donors. "The blood donors lived in the same villages. They got together and attacked government offices. They became powerful," Wan said. "The blood recipients are scattered all over the country. They are isolated and don't have a group identity." Even today, many transfusion recipients who might be HIV positive have not been tested and have not been notified that they are at risk. [Ibid]

Tian Xi HIV/AIDS Case

[Source: Barbara Demick, Los Angeles Times, November 27, 2010] In a closely watched case, Tian Xi, an AIDS activist who contracted H.I.V. through a blood transfusion, is awaiting sentencing in Henan Province on charges that his protests against the hospital responsible for his infection resulted in property damage. Tian is among 1 million Chinese infected by transfusions at government-run hospitals. One million more were infected donating blood. The government has yet to apologize or investigate the coverup.

Barbara Demick wrote in the Los Angeles Times, “It was just a small bump on the head, the result of one boy pushing another against a desk. It was such an unremarkable occurrence in a third-grade classroom that it should have been forgotten a day later, buried in the recesses of childhood memory. Who could have imagined that it would dictate the course of Tian Xi's life and of those around him?”

“After the incident, the 9-year-old was sent home from school to rest. That night he threw up, so his mother took him to Xincai People's Hospital No. 1, where a young doctor fresh out of medical school diagnosed a mild concussion and recommended a transfusion for a quicker recovery. His parents collected their savings, the equivalent of six months' salary, to buy four bags of blood. They didn't want their son, a top student who they were sure would be the first in their family to attend a university, to miss too much school.” [Ibid]

The incident occurred in April 1996 when few people in Henan province, where Tian and his family lived, had ever heard of HIV/AIDS. At the same time, hospitals were encouraging patients to get blood transfusions whether they needed them or not, offering doctors who sold blood commissions of $1 or $2 per bag. "So many people were selling blood, you needed somebody to buy it," said Tian Xi's mother, Chen Minggui, 48. "We think that's what happened with my son. When he bumped his head, he didn't lose one drop of blood, but in the hospital they gave him a transfusion of four bags."Tian spent seven days in the hospital recuperating and receiving well-wishers. He was a popular boy; even the mother of the boy who'd pushed him came to visit and offered to help Tian's family pay for the medical treatment. Tian's mother declined the offer. "Nah. Boys will be boys," she said she told the other mother. "Besides, Tian Xi is going to be fine." [Ibid]

“Within a few years, Tian's health deteriorated. He frequently got sore throats and unexplained fevers. He often missed school. He was once among the top 10 students in a class of 2,000, but his ranking fell to the top 300, respectable but not good enough for Tsinghua or Peking universities, the Chinese equivalent of Harvard and Yale, to which he aspired. He lost so much weight that his cheekbones jutted out of a skeletal head.” "Tian Xi is studying too hard. Make sure he eats more," his mother recalled the neighbors telling her. [Ibid]

Tian's parents didn't pay attention when the first cases of AIDS appeared in their area. They barely remembered their son's hospitalization. But, in 2004, they received notice from the hospital that everybody who'd had transfusions should get tested for HIV as a precaution. Tian got his results July 19, 2004. By a strange coincidence, it was the same day the results were released from the gaokao, the all-important test Chinese high schoolers take to apply to university. He'd done well enough to go to a decent, if not top tier, university in Beijing---and he had one of the most dreaded diseases. "He was crying all the time. He wanted to kill himself," his mother said. [Ibid]

“Against all odds, Tian did go to college, studying software engineering in Beijing. Henan authorities initially agreed to some aid---about $1,400 a year to subsidize his education. The university helped him rent a room in a basement off campus in Beijing because it didn't want him in the dormitories. But the assistance stopped in 2009 when he graduated.” [Ibid]

Tian Xi Seeks Justice for Contacting HIV/AIDS Through Tainted Blood

Tian turned 23 in 2010. At that time he weighed only 112 pounds---the result of the early stages of AIDS---and was confined to a detention center in Henan province. “He is charged with storming uninvited into the offices of the director of the hospital where he was infected with human immunodeficiency virus and sweeping everything off the top of the desk with his arm. A fax machine, computer and water cooler were broken in the Aug. 2 incident. He is to be sentenced soon.” [Source: Barbara Demick, Los Angeles Times, November 27, 2010]

“"He just wanted to sit down and talk about what happened to him because of a mistake made by the hospital," said his father, Tian Demin, 53, sitting on a squat metal stool in the single room where he and his wife live off a back alley---the rest of their house has been rented out to raise money for their ailing son. The room, with tile flooring and a ceiling fan, looks less like a home than a law office stuffed with legal papers, medical reports and many dog-eared petitions that their son has written imploring various government officials for help.” [Ibid]

“Unable to get a job with his poor health, and unable to afford expensive medications for hepatitis C, which he also contracted with the transfusion, he remained in Beijing, bringing his petitions to the Health Ministry, the Supreme Court and any government offices he could approach without being arrested. Tian's petitions were an irritant to Henan officials, who pressed him to stop his campaign and return home. Finally, on July 23 of this year, Tian received a text message from Xincai county's Communist Party secretary, Gu Gouyin, asking him to come home from Beijing to negotiate a settlement. “I will help you find a solution to your problems,” the message read. [Ibid]

“When Tian arrived for an appointment in Xincai, Gu had been called out of town for business. They rescheduled, and again Gu failed to show up. “He realized it was a trap. Tian Xi had been lured down here because he was embarrassing people by petitioning in Beijing,” said his father, who added that his son had only brought a month's supply of his retroviral drugs from Beijing and had initially gone to People's Hospital No. 1 to request medication, which the facility refused to supply. [Ibid]

“The family doesn't deny that Tian Xi behaved badly, not only knocking equipment off the director's desk but also showing up repeatedly at the hospital, trying to visit the director at home and vandalizing an office door. "Tian Xi's case is symbolic. There are so many patients who were just seeking compensation and got into the same kind of trouble because they ran out of legal options," said Liang Xiaojun, Tian's Beijing-based lawyer.”

AIDS Film with Zhang Ziyi and Aaron Kwok

See Film

Image Sources: Chinese Posters, Human Rights China, deGenerate Films

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, The Guardian, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

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© 2008 Jeffrey Hays

Last updated April 2012

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