HIV/AIDS in China

Welcome to this installment of The AIDS Pandemic, a podcast hosted by Dr. David Wessner from the Department of Biology at Davidson College. This is Cara Maguire.

With a population of 1.3 billion people, many of them poor and in heavily concentrated cities, China appears to be a country ripe for the easy spread of HIV/AIDS. In 2000, the estimated HIV-positive population exceeded 500,000, with a growth rate that could peak at 10 million people by 2010. However, today in 2006, the current estimate is 650,000 infected. In comparison, the United States has approximately 1 billion fewer people overall, but has 850,000 infected. How has the Chinese government managed to maintain such low numbers and prevent a healthcare disaster?
Traditionally, China has avoided widespread STD epidemics because of strict policies and conservative morals towards prostitution. For China, the twentieth century was basically drug- and prostitution-free. A theory explaining the recent surge in venereal disease is China’s increasing acceptance of a free market. With the economic reforms instituted in the 1980s came a growing wealthy population and the money to support the drug and sex trades. Although estimates in 2000 put intravenous drug users as 72% of the HIV positive population, more recent numbers suggest this group only makes up 42% of infections. It is difficult to assess the percentage of infections due to the sex trade; however, the two trades are often linked due to women offering sex for drugs.
For many years, the Chinese government was slow to recognize the threat of AIDS. Although drug abuse remained illegal, the penalties were relaxed. These penalties involved a variety of rehabilitation programs ranging from voluntary 10-day treatments to up to three years in a reeducation through labor center. In recent years, the Chinese government has taken several steps to address the growing epidemic more decisively. In 2004, guidelines were published for methadone maintenance treatment and needle exchange programs. Exchange programs provide intravenous drug users with clean needles, while methadone, an oral drug, is used to replace the intravenous drugs altogether. Although these programs are socially liberal (and not condoned in the United States), they were primarily confined to large urban centers.
On March 1st, 2006, the most recent governmental guidelines went into effect. By specifying the responsibilities of all levels of government, the guidelines force local governments to take action against the spread of HIV/AIDS. Governments must now provide free anti-HIV/AIDS drugs for rural and underprivileged patients and free testing and information. In addition, the guidelines protect the rights of patients by forbidding the release of any personal information. Finally, local governments must provide free tuition and fee exemption to AIDS orphans.
Overall, the measures taken by the government have done a good job in helping victims and limiting the spread of HIV in this large country.