Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

Reuters NewMedia - Thursday November 30, 2000
Sarah Cheung

"There is no more time to wait. China does not have time to wait," Edwin Judd, the United Nations Children's Fund (UNICEF) representative in China, said just ahead of Friday's World AIDS day.

"China is on a fast track to having a big epidemic. The truth of the matter is that the 600,000 cases that exist now are just the beginning."

Officially reported cases are growing at more than 30 percent a year and hit 20,711 in September. Some 70 percent of these are intravenous drug users and the majority are males aged 20-29.

But experts reckon there are up to 600,000 cases of HIV/AIDS unreported because sufferers in the world's most populous nation carry the virus unknowingly or, fearing ostracism, don't dare to report it, Judd said.

The Health Ministry has begged the media to emphasize the urgency of the problem.

But many Chinese have very conservative attitudes toward sex and get squeamish talking about condoms, sexually transmitted diseases, or even the existence of China's estimated four million prostitutes.

Others think the problem is far away, in border regions such Yunnan next door to Myanmar, a major source of the opium from which heroin is derived.

"In Beijing, it's not a big problem," a taxi driver said.

In October, the official Beijing toll was 556.

But the real number was likely to be higher due to the city's large floating population, said Liu Ying of the Beijing Association of STD and AIDS Prevention and Control.

China's creaking bureaucracy and decentralized health service also made enforcement difficult, Judd said.

Guidelines on how to perform blood tests correctly are not followed, there is no national screening program and most hospitals simply lack the resources to deal with HIV/AIDS.

Ignorance compounds the problem. Many Chinese have no idea how AIDS is transmitted. A recent survey showed only 3.8 percent out of 3,824 people understood. More than half thought using the same chopsticks and bowls as a sufferer would infect them.

Bad Blood

Some discover they have HIV/AIDS in a routine visit to the hospital. For others, their trouble starts at the hospital.

A woman from the southwest province of Sichuan said her daughter had become infected through a blood transfusion after giving birth.

"China needs to test its blood! It can't just give people anybody's blood. My daughter's only in her thirties. She's too young to die," the mother told Reuters at the Beijing hospital to which she brought her daughter in a desperate bid to save her.

The Health Ministry has ordered each pint of blood to be tested for AIDS twice. "Blood used in hospitals and clinics should be provided by a central blood station. The hospital should not provide blood it has bought from individuals," said Shao Yiming, vice-director of the ministry's AIDS prevention and control center.

But in China's poor, central regions, transfusions with infected blood is the main reason for the spread of HIV.

"Blood heads" collect blood illegally from farmers eager for the cash, the Nanfang Daily said on Thursday. Not only do the collectors take too much blood, they use unsterilized equipment, pool the donated blood, extract the plasma then return red blood cells to the donors, it said.

Silent Killer

As China has reformed its once rigidly Communist economy, more and more people have left their rural homes illegally for the booming cities. Now there are an estimated 100 million of them and there is a danger homosexual sex could move HIV into their midst.

A recent Health News report said male laborers were beginning to sell sexual services. Ignorant of AIDS and keen to keep a low profile to prevent being sent home, many may unknowingly be HIV-positive, the newspaper said.

"This is a major population group at risk," said Judd. "We need to know about how we can reach these groups for education and surveillance."
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