AIDS: China’s Growing Threat

Chinese officials have stated that HIV/AIDS was the leading cause of death last year, compared to other infectious diseases.

This is particularly remarkable because, at the beginning of the epidemic, Chinese authorities were reluctant to admit the extent of the problem.

According to recent estimates, 700,000 people in China are HIV carriers, 75,000 have tested positive for AIDS and over 39,000 are believed to have died of the disease. Experts believe that these numbers considerably underestimate the extent of the problem and warn that China could have as many as 10 million AIDS patients in 2010 if the efforts to curb the infection are not adequate.

During the 1990s, HIV/AIDS was considered a “foreign problem” in China, and most Chinese considered the infection totally removed from their daily lives. According to a survey carried out by the State Family Planning Commission, 70% of HIV-infected people in 2000 lived in the countryside. Among those, 23% had never heard of AIDS.

The Chinese government states that most infected people belong to three main groups: intravenous drug users, commercial sex workers and recipients of contaminated blood.

It is estimated that, in central Henan Province alone, more than one million people contracted HIV from selling their blood in unsanitary collection stations. Although Henan constitutes the best-known case, 22 other provinces — including SARS-affected Shanxi in the north, have also what is known as “AIDS villages” — where the infection is most widespread.

Although the Chinese government has adopted a much more combative attitude toward the infection, its efforts are still hindered by poor baseline data necessary for properly assessing the problem and allocating resources.

The problem is compounded by the fact that in traditional Chinese culture sex and sexuality are not openly spoken about. Many young people lack information on sexually transmitted diseases and on the modes of HIV transmission. According to the U.S. Centers for Disease Control, only 10% of Chinese who have HIV/AIDS know that they are infected.

Rapid economic growth has led to a dramatic increase in migration of workers from rural areas to the main cities, away from their families and communities. Migrant workers are much more likely to visit sex workers, thus increasing their possibility of becoming HIV infected.

As stated by UNAIDS, “Being mobile in and of itself is not a risk factor for HIV infection. It is the situations encountered and the behaviors possibly engaged in during mobility or migration that increase vulnerability and risk regarding HIV/AIDS.”

Many people are unaware of the need for condom use, particularly with commercial sex partners, to avoid getting infected.

To combat this, massive education campaigns are needed. Fortunately, the Chinese are particularly effective at creating these. For example, their literacy campaign in the 1950s was one of the most successful ever carried out.

In 2003, China began an ambitious program to raise awareness about the infection and to reduce the stigma provoked by it. Nevertheless, it was only in 2007 that China launched its first television campaign to promote condom use.

Campaigns should target not only students, but also high-risk groups such as drug users and sex workers.

The rapid spread of HIV in China is also having a devastating impact on the country’s children. This is due to the rapid rise in the AIDS orphan population.

The increase in AIDS orphans in China parallels the increasing number of AIDS orphans worldwide, and is one of the most serious consequences of the AIDS epidemic today.

In 2003, it was estimated that worldwide, more than 13 million children under 15 had lost one or both parents to AIDS.

Although Thailand has the largest number of AIDS orphans — usually defined as children under 15 who have lost their mother or both parents to AIDS — their number is increasing fast in other Asian countries. In Cambodia, Malaysia and India, AIDS orphans have increased by 400% from 1994 to 1997.

According to estimates of China’s Ministry of Health, there are at least 100,000 AIDS orphans in China. UNICEF’s China Office estimates that over the next five years, 150,000 to 250,000 additional children will be orphaned by AIDS.

In previous times, the remaining relatives used to take care of the children. Yet today, since many of those relatives are also affected by HIV/AIDS, they have become unable to provide basic support to children in their families.

Since 2003, UNICEF has worked with local health authorities, the Women’s Federation and communities to provide both psychological and social support to children affected by AIDS. It has also provided support to Summer Camps for Children Affected by AIDS, helping raise awareness about their needs.

Children orphaned because of their parents’ death by AIDS are likely to be malnourished and out of school, and are at a greater risk of becoming HIV-infected themselves. Because they are emotionally vulnerable, when they grow up they are more likely to engage in risky sexual behavior that may lead to a vicious cycle of abuse.

To help AIDS’ orphans in a more immediate and practical way, it is necessary to strengthen the capacity of extended families to protect and care for orphan children by providing them with financial aid administered by local councils or provincial governments.

Orphan children’s special needs should also be addressed through community-based responses and by increasing the capacity of local orphanages. Non-governmental organizations (NGOs) such as the China AIDS Orphan Fund are working to improve Chinese orphans’ health, education, and quality of life.

The stigma surrounding the HIV infection is damaging as well. Often times, children who have lost their parents to AIDS are assumed to also be infected with HIV, which further stigmatizes them.

Only education and a concerted push by the government can create an environment for respect and hope.