China AIDS Day ceremonies target stigma

Posted: Monday, December 01, 2008 2:00 PM
Filed Under: Beijing, China

BEIJING – With colorful kites, art exhibits and inspirational performances across Beijing from the Bird’s Nest Olympic stadium to the chic 798 Art District, Chinese and U.N. organizers marked World AIDS Day with a commitment to wage battle against the epidemic threatening the world's most populous nation.

The display of broad unity, with the attendance of some AIDS activists that have been targets of China's sporadic crackdowns in the past, was a touching tribute to this year's theme of "One Goal, One Dream – of a World without Stigma." 

"Stigma and discrimination are major obstacles in an effective response to AIDS," said Health Minister Chen Zhu at the launch of the campaign at the Bird's Nest Olympic stadium. "We need to engage all sectors of society in China to combat these issues and work to stop the disease."

Reuters

People walk past a giant red ribbon set up on the facade of the Bird's Nest during a World AIDS Day event in Beijing on Sunday.

The gravity of public misconceptions, persistent prejudice against AIDS victims, and new evidence showing that HIV/AIDS is quickly spreading from traditionally high-risk groups to the mainstream population are some of the forces compelling China to reassess how it deals with the epidemic.

In particular, the steady rise of unprotected intercourse with sex workers as a primary source of HIV/AIDS transmission is rekindling bold calls for the legalization of China's booming, but underground, commercial sex industry.

Same stigma, increasing numbers
China has an estimated 700,000 people who are HIV-positive, with about 85,000 people suffering from full-blown AIDS, according to estimates released by the Chinese government and U.N. health organizations. In comparison, just over 1.1 million Americans are estimated to be infected with HIV.

In the 1990s, drug use accounted for 60-70 percent of reported infections in China, followed by unsanitary blood transfusions.

But in September, the Chinese Ministry of Health announced that sexual transmission had overtaken intravenous drug use as the main cause of HIV infections in China. 

In Beijing, in particular, sexual transmissions have accounted for 55 percent of cases so far this year. And from 2004 to 2007, the percentage of sex-related transmissions has risen steadily, from 24.9 percent in 2004 to 41.5 percent in 2007, according to a recent city survey.

The increased number of heterosexual transmissions has put a spotlight on the stigma attached to the virus, as well as the lack of awareness about safe sex methods.

According to the latest nationwide survey conducted by UNAIDS, more than 48 percent of Chinese thought they could contract HIV from a mosquito bite, while 18 percent thought they could get infected if an HIV-positive person sneezed or coughed on them. 

Two- thirds of respondents to the UNAIDS survey said they would not want to live with an HIV-positive person, while nearly 48 percent would be unwilling to have meals with the infected person. In a further hint of stigma, about 41 percent said they would be unwilling to work or share tools with the person who was HIV-positive, and 12 percent would not even touch a family member or relative with the infection.

But, at the same time, only 19 percent of the survey respondents said they would use a condom with a new sex partner, while 30 percent did not know how to use a condom correctly. 

And in a separate report by Beijing's health director, more than half of the city’s prostitutes said they still shun the use of condoms despite the growing threat of HIV/AIDS transmission. The most recent survey of the city's prostitution industry shows that the nation's capital has some 90,000 commercial sex workers, of whom only 46.5 percent used condoms.

Eric Baculinao / NBC News

Dr. Wan Yanhai, left, with staff at an AIDS exhibit in Beijing on Nov. 30.

Legalizing commercial sex?
For Dr. Wan Yanhai, an outspoken AIDS campaigner, one way to avert the risk of a national health disaster is to involve the estimated millions of China's sex workers in the forefront of the fight against HIV/AIDS.

"But we must first legalize their profession," he said," so that we can regulate them and stop them from hiding, running from the police, or falling into the control of criminal syndicates."

Wan, formerly with China's Health Ministry, is the founding director of China's pioneering non-profit AIDS-awareness organization – the Beijing-based Aizhixing Institute of Health Education – which also established China's first HIV/AIDS hotline in 1994.

His frequent run-ins with authorities on gay rights and AIDS-related issues have landed him in detention three times in the past 12 years. In 2002, he was accused of leaking to the world a government report about the blood-buying scandal that caused large numbers of hapless poor farmers in central China to be infected with HIV/AIDS.

"We have to recognize the human rights of sex workers," he said as he explained his latest plan to hold a seminar to study the legalization issue. "We must establish their legal rights, before we can effectively organize them and conduct sex education and health education among them."

Other Chinese scholars have joined the calls for amending the government's laws and regulations in favor of a more "inter-disciplinary" approach. Among them is Academy of Social Sciences Professor Qiu Renzhong who told the Chinese magazine Caijing that "de-criminalizing" prostitution is needed to promote the use of condoms among sex workers and their clients.

Attempts to seek comment from Beijing's public security bureau on the issue were not successful, but it is public knowledge that the bureau has not joined other government bodies in endorsing the campaign to distribute more condoms in likely venues of prostitution in the past.

While Chinese leaders have definitely been more outspoken about confronting the disease in recent years and pledged to combat the stigmatization of the people infected ahead of World AIDS Day, it’s yet to be seen whether or not they will change their policy towards the world’s oldest profession and legalize prostitution in an effort to thwart the spread of the disease.

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