Preventing HIV Transmission Among Injecting Drug Users (IDUs) and From IDUs to Noninjecting Sexual Partners in Sichuan, China

Abstract

May you live in interesting times is actually not a Chinese curse. However HIV/AIDS is clearly creating interesting times in China. The initial outbreak of HIV occurred among injecting drug users (IDUs) in Yunan province in 1989. HIV spread along the drug trafficking routes from the Golden Triangle through southern China and northern Vietnam toward export cities on the Pacific. HIV also spread throughout the country and by 2002 there were HIV seropositive IDUs in all 31 provinces and autonomous regions. There was also substantial transmission among plasma donors in Henan province. Initial attempts at controlling HIV in China were hampered by many factors including a weak public health infrastructure differences in development between the eastern and western regions the difficulties in working with the large floating of internal migrants as well as relatively severe stigmatization of the disease. The Severe Acute Respiratory Syndrome (SARS) epidemic however taught a severe and important lesson. Even if only a small percentage of the population is infected infectious diseases can be a threat to economic growth and national security. A new national policy of Four Frees and One Care (free treatment free voluntary counseling and testing free prevention of mother to child transmission and free schooling for AIDS orphans and provision of social relief for HIV patients) was announced on World AIDS Day 2003. In the most recent estimates there are 650000 people with HIV in China though the actual numbers may be considerably greater than the estimates. There are also high rates of syphilis and other sexually transmitted diseases that facilitate HIV transmission. (excerpt)