It’s hard to fight an epidemic when no one wants to talk about the cause. In
China, a country whose last decade has been defined by economic growth and
social opening, silence still enshrouds many aspects of the nations’ sex
life, and not, health experts say, without consequences. While most
industrialized nations have seen HIV/AIDS death rates steadily decline in the
past 10 years, China announced in February that the HIV virus took the lead
as the deadliest infectious disease in the nation in 2008, killing nearly
7,000 people in the first nine months of the year. “It’s very difficult to talk about sex in schools. It’s very
difficult to talk about sex in relationships. It’s very difficult to talk
about sex in the workplace,” says Bernhard Schwartlnder, coordinator of UNAIDS in China. “If they don’t know about it,
how can they protect themselves?”
The fact that HIV, now regarded in the medical community as a preventable
and treatable virus, is a significant and increasing cause of death in China
shows that government programs are not reaching enough people, says
Schwartlnder. In the same government report, released in February, China’s
Ministry of Health also listed 264,302 diagnosed HIV cases across the nation — nearly double
the number in 2005. A lot of that increase is likely due to increased reporting and testing, but UNAIDS still cautions that the
statistics reflect only a fraction of disease’s real impact. At the end of 2007,
the organization says some 700,000 people were still living with HIV in China. Of
those, roughly 85,000 are believed to have developed AIDS.
While that number isn’t staggering — UNAIDS estimates that 33 million people are living with HIV worldwide — the potential for things to get worse is alarming. As the world’s most populous nation, the upswing in the epidemic is of great concern, Schwartlnder says.
While HIV/AIDS became a visible public health issue in much of the developed world more than 20
years ago, China did not put real resouces into fighting the disease until 2003. Confronted by the UN’s so-called 2002
“Titanic” report, which said China faced an AIDS epidemic of
“proportions beyond belief” and compared the nation’s leaders to officers onboard the
doomed Titanic who refused to believe the ship was sinking until it was too
late, Beijing launched the first national care program the following year to provide free services to those infected with the virus. “For a long time China missed the opportunity to tackle AIDS head
on,” says Schwartlnder. “They tried to avoid it, and I think they really ignored the problem.”
As a result, the stigma AIDS carries today in China remains strong — and potentially dangerous. In a 2008 survey by
the China AIDS Media Partnership, of the more than 6000 people surveyed,
nearly 48% said they wouldn’t knowingly eat with an HIV positive
person. Thirty percent said HIV positive children should not be allowed to
study at the same schools as uninfected children, and 40% said they would
not willingly share workspace with a colleague they knew was HIV positive. The government has taken steps to improve these attitudes, including
implementing an anti-discrimination law in March 2006, but perceptions like these don’t help in the fight to educate people about their own risk of infection. “It’s not something that can change
overnight,” says Schwartlander. “People have to get their mind around it.”
In the meantime, other social stigmas may also be playing a part in the increasing cases. Together with the government, UNAIDS estimates there are anywhere
from 30 to 50 million people vulnerable to HIV in China today, with sex
workers, men who have sex with men and intravenous drug users — all
communities thought to have higher rates of infection than the
general population — facing the highest risk. After the new government
numbers were released in February, Zhang Beichuan, a researcher at Qingdao University, told the
state-run media that the high number of gay men entering into heterosexual
marriages is a contributing factor to the increasing spread of HIV.
Extra-martial, high-risk sex puts both those men and their wives at risk, according to a study Zhang conducted in 2006, and the enduring discrimination homosexuals face in China prevents many men from getting tested for HIV/AIDS or seeking treatment. Only with more understanding and
tolerance will efforts to curb the spread of HIV be effective, Zhang said.
