UNAIDS - September 19, 2008

The AIDS epidemic remains a formidable challenge and several factors in China are fuelling it, including shame, fear, stigma and discrimination associated with AIDS, low awareness of HIV, rural poverty, high mobility of workers, availability and affordability of commercial sex, and injecting drug use.

There is no doubt that China has dramatically improved its AIDS response in recent years and its government has demonstrated real political leadership and commitment to effectively tackle the epidemic. This commitment has been translated into new laws, policies, growing HIV prevention efforts and increased access to treatment. The challenge for Chinese society now is to move from the excellent policies developed centrally to reach out to people in the provinces and communities with the services they need.

HIV prevention remains a top priority for China's AIDS response. More than 30 million people are estimated to be practicing risky sexual and drug use behaviour. These include injecting drug users (IDUs), men who have sex with men, sex workers and their clients. For that reason, there has been an increase in programmes targeting those at higher risk, such as a methadone treatment for drug users, condom promotion among sex workers and clients as well as among men who have sex with men.

There have been improvements in HIV prevention programmes even though a full implementation of combination prevention is yet to be achieved. For example, methadone maintenance treatment, clean needles and syringe exchange for drug users has been introduced with the aim of establishing a total of 1500 methadone maintenance treatment clinics by the end of this year. These clinics represent an important milestone towards the implementation of a much needed comprehensive prevention approach for IDUs including needle exchange programmes and condom provision as well as treatment for sexually transmitted infections (STIs).

Treatment

HIV treatment, care and support has improved significantly over the last five years. Antiretroviral drugs are supplied to more than 34,600 individuals as part of the "Four Frees and One Care Policy". This is a major improvement considering that in 2003 there were 5,000 people on treatment. The increased access to treatment has also contributed to the implementation of pilot studies for the introduction of second line antiretroviral (ARV) drugs at the national level, with particular attention to availability of these drugs and monitoring of adherence.

Stigma and discrimination

Stigma and discrimination continue to be areas of concern both within the health care setting and with the population at large. A recent survey supported by UNAIDS and carried out in six major cities of China revealed that 41% would be unwilling to work in the same place with people living with HIV (PLHIV), 26% would not shake hands and 49% thought that they could get HIV through a mosquito bite.

In an attempt to address the situation, the banning of discrimination of people living with HIV has been outlined in the Law of Communicable Disease Prevention and Control and the 2006 Decree on AIDS.

Civil society

Civil society in China is still finding its feet. UNAIDS is investing significant resources in trying to bring together a diverse set of organizations and networks to get a stronger and more coherent contribution from civil society organizations as working with community groups can greatly increase the impact - and cost effectiveness - of AIDS strategies.

China has demonstrated a commendable leadership and commitment towards an effective AIDS response. The National five year plan to control AIDS (2006-2010) is currently being implemented and the coverage, quality and comprehensiveness of its implementation along with meaningful involvement of all stakeholders, will be the key to achieving the target of keeping HIV infected people below 1.5 million in 2010.

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