HIV/AIDS in China Part 2

This month, I will be exploring the topic of HIV/AIDS in China. In my last article, I covered the basic history of the disease in China as well as the current situation. In this article, I will cover the three main routes of transmission that have historic and current importance: drug injections, blood donations/transfusions, and sex.

The major source for most HIV/AIDS epidemics in the 1990s and 2000s is attributed to drug injections. The first case of HIV/AIDS among injecting drug users (IDUs) was detected in 1989 in Hunan province. After its detection, HIV/AIDS quickly spread to the IDU community in various other parts of the country where drug trafficking was present, believed to span all provinces by 2002. Since HIV/AIDS was first attributed to this socially stigmatized group, government efforts at slowing transmission were relatively slow. There was a non-tolerance policy towards drug use at the time, and efforts focused on presenting negative health consequences of drug use instead of offering IDUs safer supplies. However, in the 2000s, the government began changing their attitude and offering needle exchange programs as well as methadone maintenance treatment programs. Both measures have been very effective in China, and the programs have been expanded to many other regions, a measure that has been heralded by the international agencies.

Another major route of transmission for HIV in China, especially in the 1990s, has been through unsafe blood donations and transfusions. China lacked a steady, safe blood donation and transfusion system, especially after it banned imported blood products in the 1980s. As a consequence, many smaller blood donation and transfusion centers sprang up, many illegally with little or no regulation from national authorities. Many centers removed plasma from the blood and injected the red blood cells back into the donor. This unsafe method, along with the reusing of needles throughout the process, may have infected hundreds of thousands of donors and people receiving blood transfusions. In the 2000s, the Chinese government has placed tighter restrictions on blood donation and transfusion centers. It maintains that all blood transfusions are now screened for HIV.

Sex is currently the major source of new transmissions. Homosexuals are a very high-risk group in China. In 2009, it was reported that 32.5% of new HIV/AIDS cases diagnosed were a result of homosexual activity. Compounding the problem is the heavy stigmatization of homosexuals. Many are young men who are married are hide their sexual orientation. This also places their wives at high risk for HIV/AIDS. Many are also unwilling to come forth and seek treatment due to public perception and stigmatization. Government efforts to reach the gay community have been hindered by fear, discrimination and stigma. Currently, heterosexual sex is the main source of new HIV transmission. Migrant workers and female sex workers are especially high-risk groups, mainly due to a lack of access to education, healthcare, and resources.

Unclean needles, unsafe blood donations and transfusions, and sex have played major roles in shaping the current HIV/AIDS situation in China. How the government and international community is responding will shape the future of this disease in China.

Joy Liu

Durham, North Carolina

Team 2: Servant Scholars

Freshman – Duke University

Sources:  HIV & AIDS in China, CHAIN Project