United Press International - Friday, 1 December 2000
C. M. Wade, UPI Science News

That was more than a decade ago, during the mid-1980s, when the first few unofficial cases of the AIDS virus were starting to appear in China. For Qiao, life was good in those days. He was in his prime -- young and successful with lots of money to spend. Like many other young professionals in Shanghai, Qiao liked the nightlife. He spent his weekends roaming the bars, drinking and meeting women. And there were lots of women.

In July of this year, after he learned that one of his former lovers had tested HIV-positive, Qiao became concerned that he too might have the virus. Well-founded fears of damaging his social status -- an important element of the social fabric in Chinese culture -- kept him from going to a state-owned hospital. Instead, he took the test at one of the city's underground clinics.

Less than a week later, the results came back as HIV-positive.

"Until this point, I really thought the disease only affected people in other countries," he said. "No one told me about the threat here in China, so I never worried that I could get it. It was always very far away from here."

Qiao is just one of countless numbers of unreported HIV-positive cases in the country. According to a study conducted by the World Health Organization, released in July, less than 5 percent of the actual number of HIV-positive or AIDS cases in China are reported.

Even by modest government estimates, China has undergone a sharp increase in reported HIV/AIDS cases over the past three years. Figures released in November by the Ministry of Health indicate there are currently 20,000 confirmed AIDS cases, with more than 500,000 people registered as HIV-positive, an increase of more almost 40 percent from the previous year.

At this rate, health ministry officials warn that the number of HIV-infected people in China could reach 10 million by 2010.

In Shanghai, statistics from the Municipal AIDS Surveillance Center show that there are at least 300 cases of AIDS or HIV-positive people in the city. From January to October of this year, 85 people were found to be HIV-positive, 45 percent of whom are under the age of 29. Qiao, however, said he believes the actual number could be 10 times higher.

"Here in the city people can get tested by private physicians," he said, referring to unlicensed doctors providing underground medical services. "Nobody wants to get tested or get treatment at the hospitals, because we would have to register with the state, like the drug addicts."

According to public health officials, the taboo nature of HIV transmission is preventing many people from coming forward for testing. Given the fact that intravenous drug use and sex are the primary vehicles of transmission, most people shy away from hospitals and rarely discuss the matter in public.

"Chinese people are not comfortable talking about sex in public, and the issue is seldom even discussed with their physician," said Xue Yile, a doctor with the Shanghai AIDS Surveillance Center. "And because sexual contact is one of the main ways AIDS is transmitted, the disease is rarely discussed here."

Cooperating with local television stations, Xue said the city's public health bureau plans to air advertisements to broaden AIDS awareness. It has also established a Website devoted to spreading knowledge about the disease.

Armed with educational pamphlets and statistical material, Xue ventures out to shopping centers and public places every weekend, in an effort to inform the public about the threat of the epidemic. Her attempts to educate people, however, often fall on deaf ears.

"We handed out thousands of pamphlets with basic information on AIDS virus prevention at a shopping mall recently," Xue said. "But many people tossed the them away as soon as they saw the subject matter, possibly out of the belief that AIDS was not something that concerns them."

"That's the most dangerous thing," said Xue. "The mistaken belief that 'It can't happen to me."'

Along with education, the city government has also been promoting safe sexual practices -- such as installing condom dispensing machines in areas around the city -- and safe injections for intravenous drug users.

Still, others blame a lack of regulations for the spread of the virus. Since the first confirmed case of AIDS was diagnosed back in 1985, the roughly 3,000 member-strong National People's Congress has yet to discuss the epidemic. There are no reliable national systems for tracking the path of the virus and campaigns to distribute condoms are often short-lived.

"AIDS is a disastrous disease worldwide. But in China, we haven't realized the threat," said Sun Chao, a Shanghai-based attorney and legal adviser to the municipal government. "The whole country should pay attention to the disease. It isn't a question of morality. Only the law can ensure the issue is adequately addressed."

Sun said the NPC needs to break its continued silence on the matter before the epidemic becomes too widespread to control. He and a team of lawyers has taken on the cause, and is in the process of drafting regulations on prevention and treatment of the AIDS virus to present to the NPC when it reconvenes next March.

Meanwhile, Qiao waits in silence for the symptoms of the virus to take effect. He doesn't know how long it will be before this happens, because he refuses to seek consultation or treatment, much like the majority of those infected with the virus in the country.

"I just want the government to start confronting the problem, so that another generation of Chinese are not fooled by the denial," he said.
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