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HIV Around the World - China

The World’s Oldest Civilization and How It’s Dealing with HIV and AIDS


Updated November 16, 2010

China is one of the oldest civilizations in the world. Their way of life is built upon tradition and Chinese culture. How does a culture dating back 6,000 years deal with an epidemic that emerged less than 30 years ago?

China - Demographics

Here are some facts about China:
  • located in Eastern Asia
  • geographically, it's one of the largest countries in the world, with an area of approximately 9.6 million square kilometers (slightly less than the United States)
  • population of approximately 1.3 billion people, which equals about 20 percent of the world's total population
  • comprised of hundreds of ethnic groups speaking dozens of dialects and languages
  • no government recognized religion but personal religion and religious organizations are allowed
  • primary religions are Buddhism, Taoism, and Confucian
  • deep-seated ancient traditions provide the foundation of Chinese culture

The Status of HIV in China

Here are some facts about HIV and AIDS in China:
  • as of January 2006, the "official" estimate is that approximately 650,000 people are living with HIV and 75,000 living with AIDS. Experts outside China believe the actual numbers are much higher than those endorsed by the Chinese government.
  • there are an estimated 70,000 new HIV cases and 25,000 AIDS deaths each year

The exact extent of the HIV epidemic is difficult to assess due to government road blocks. Local governments as well has national government entities are hesitant to place a hard number on the epidemic for fear of discrimination and stigma. Those citizens who know what HIV is are reluctant to come forward for testing for fear of retribution if they are found to be positive. Most people don't get tested because they know little or nothing about the existence of HIV. It's estimated that 17 percent of Chinese citizens don't know HIV exists.

The number of rural HIV cases is nearly impossible to quantify accurately. The shortage or absence of testing supplies and the very limited number of trained testing staff makes diagnosis very difficult. The rural areas of China are very poor with very limited education. Those who do know about HIV don't get tested because of the stigma associated with a positive diagnosis.

The History of HIV in China

In China, the HIV epidemic started slowly in the mid 1980's. A small number of HIV cases were diagnosed primarily in coastal communities. Chinese officials attributed the outbreak to foreign visitors and Chinese students returning from studying around the world. The Chinese government posted official warnings for Chinese women not to have sex with who the government called "foreign visitors" because they may be infected. Simply put, China felt that HIV was someone else's problem.

The official government stance on HIV was that the risk to China was very limited. HIV was thought to be a predominantly homosexual disease and the government felt that in China, homosexuality and "abnormal sex" was a limited problem.

Beginning in the late 80's and early 90's, HIV infection emerged as a growing problem among intravenous drug users. Still, the government felt that HIV was a "disease of the West," as was their emerging drug problem. HIV was labeled "a capitalism disease" and one that China was not part of.

But from the mid 90's to early 2000, HIV began to spread across all Chinese provinces. The culprit for such a widespread problem was determined to be an unsafe blood supply.

The Chinese government contracted commercial blood collection centers across China. While there were guidelines in place to assure quality, many of the private collection centers cut corners in order to increase their profits. Their collection techniques exposed thousands of people to HIV. Collection equipment was routinely used on multiple patients and blood collected from several donors was pooled. Officials separated the blood components they needed and then re-infused what was left of the pooled blood back into donors, thereby exposing donors to HIV, hepatitis C and other blood-borne illnesses.

By 2000, fueled primarily by the unsafe blood supply, the number of HIV cases ballooned, prompting the Chinese government to lift its unofficial policy of HIV silence and denial.

A Culture of Sexism

As mentioned, much of Chinese culture is based on ancient traditions. One such tradition is sexism and the discrimination against women. Sexism is present both institutionally and individually. The fair and equal treatment of women is contradictory to cultural and religious beliefs. Sexism is so entrenched that many teachings ask the rhetorical question, "are women fully human"? Many question if men and women have equal virtues.

Even in an economic sense, sexism is prevalent. Women are seen as competition for the male workforce. Sexism has even permeated the choice to have children. The practice of gender selective abortion is such a common practice that the ratio of male babies to female babies is widening. Sexism impacts the extent of the HIV epidemic by dictating how people are educated about HIV and who makes the decisions regarding safer sex practices.

Page two discusses who is infected, the state of HIV prevention, and what HIV care is available.

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