AIDS Epidemic and Control in China Zeng Yi Chinese Foundation for Prevention of STD and AIDS

Estimated HIV/AIDS in the world 2003 New infected HIV 5.0 Million Death AIDS Cases 3.0 Million － 2003 Living HIV/AIDS 44.0 Million Death HIV/AIDS 30.8 Million Total HIV/AIDS 74.8 Million

HIV Epidemic in Asia Pacific Region 2002 New infected HIV 1.0 Million 2002 Death AIDS Cases 0.49 Million － 2002 Comulative Living HIV/AIDS 7.2 Million Living Young People with HIV(15-24) 2.1 Million Living Children with HIV Million

HIV Epidemic in China 1982 HIV in factor 8 transmitted into China st Chinese haemophiliac patient infected with HIV 1989 Drug users infected with HIV 1994 Blood donors infected with HIV

HIV Epidemic in China － Cumulative Reported HIV/AIDS Cases AIDS Cases 3532 Death AIDS Cases 1800 － Living HIV/AIDS AIDS Cases Death AIDS Cases － 2003 Estimated HIV/AIDS Cases ＞ 1 Million

HIV /AIDS Epidemic Trends in China

Geographic Distribution of Cumulative HIV Infections in China ( )

Risk Factors for Cumulative HIV Infections in China,

◆ Transmit in extensive scope, low transmission nationwide, high transmission endemic ◆ The nationwide AIDS transmission, symptom, and death have witnessed an distinct ascending trend ◆ Transmission pattern and route changed, the epidemic transfers from the high-risk population to the general population Characteristics of HIV/AIDS Epidemic in China

Factors Related with HIV/AIDS Epidemic in China

Migration Population Estimated that the total number of migrants, both temporary and permanent, may be as high as 120 million.

Injecting drug use (IDU) The drug users are estimated to be 3-5 million. The HIV infection rates among IDUs has reached 20-30%, and about 60-80% in a few provinces. HIV epidemic continues to spread among and from IDUs in China. Blood Transmission

Spread of HIV Infection in IDUs in China

Blood and blood products HIV infection rate among blood plasma donors ranged from % in some villages during

Prostitute The number of STD cases estimated is about 6 million. The HIV infection rate is 3-4% in STD outpatients clinic of some provinces, even up to 12% in one city. Sexual Transmission

Male Homosexual (MSM). The number of MSM estimated is 20 million. The HIV infection rate （ 1-5% ） : % % % Regularly use condom 9.0%

HIV sexual transmission will continue to increase and become the major mode of HIV transmission in future.

◆ Limited information is available about epidemic in mother-to-child transmission. This does not mean it is not a problem. ◆ Accompany with increased infection caused by heterosexual contact ， there will be more women being infected, therefore the mother-to-child transmission will increase in future. ◆ Mother-to-child transmission mainly occurred in epidemic center. Epidemics by mother-to-child mode

AIDS AWARENESS Serious lack of nation-wide education and intervention Use of mass media: small projects with limited scope and effect mainly in cities Because of low awareness of AIDS among the general public, discrimination against people with HIV/AIDS and their families is still a big problem in China.

There is no indication that the spread of HIV in China will be controlled or slowed down in the near future.

It is predicted that there will be about 10 millions HIV cases in China by the year 2010 if the government does not take appropriate and sufficient action to the AIDS epidemic.

Suggestions(2000) In order to effectively control the AIDS epidemic in China, We suggest the following: 1. The State Council takes a leading role in AIDS control. 2. Prevention should be first priority of the national strategies for controlling AIDS.

3. Policies need to be developed for adopting education and intervention strategies and measures that have been proved effective in controlling the AIDS epidemic worldwide.

4. The safety of blood and blood products needs to be improved by enhancing management, clarifying responsibilities, and protecting the human rights of patients.

5. More researches on AIDS control and prevention needs to be completed, including epidemiology, behavioral science, social science, dissemination science, pharmaceutics, and vaccine studies.

6.Funding for AIDS prevention, treatment and scientific research et al need to be increased to achieve the goals and objectives set in the “China Long/Medium Term Plan For AIDS Control ’’.

Actions Fighting against HIV/AIDS by Central Government in Recent Years Sex education has been approved by Ministry Education to begin in junior high school (2000). Methadone can be tried among drug users (2001). Top leaders of central government discussed and took strong actions in fighting against HIV/AIDS (2001). Increase budget for controlling HIV/AIDS to more than 2 billions for 10 years (2001). Combining treatment with prevention in 127 counties are being carried out (2002). National Committee for Prevention and Treatment of AIDS was established(2004.2).

1. Chinese government will strengthen government efforts to fulfill the responsibility. The Chinese government has considered HIV/AIDS prevention and treatment an important task. Chinese government will further clarify the targets, identify the responsibilities and improve evaluation, supervision and monitoring. Should there be any HIV/AIDS spread caused by ineffective work, the government will hold the person or department in charge accountable for the negligence. Gao Qiang Speeches

2. The Chinese government is committed to provide free treatment and medicines to HIV/AIDS patients who are in economic difficulties. 3. Chinese government will improve the laws and regulations and intensify the intervention on dangerous behaviors. Public awareness campaigns will be launched, educating the public and encouraging them to participate in the HIV/AIDS prevention and treatment effort.

4.Chinese government will protect the legitimate rights of HIV/AIDS patients and oppose social discrimination against them. In all the 124 counties where the Chinese “care” project will be established, integrated measures including antiretroviral treatment, care and life assistance will be adopted. 5. Chinese government will be more active in international cooperation. The HIV/AIDS prevention and treatment in China have received concern and support from the international community.

Two new studies reported that wider application of measures for HIV/AIDS education and intervention programs would prevent 29 million people in the world.

AIDS Education and intervention would prevent 70 percent of HIV infections in countries with rapidly growing epidemics (like Cameroon and China).

Thailand-existing epidemic vs. potential 6 million people with HIV infection prevented

HIV Prevalence in Thailand vs. South Africa The Impact of Early Intervention( ) Source: UNAIDS Thailand South Africa

If countries fail to adopt measures of education and intervention programs, about 46 million people, most in Sub-Suharan Africa, China and India, would become infected.

The costs of a aggressive program would be as ＄ 1,000 for each infection prevented, much less than the cost of treating people once they become ill.

It is critical to take strong action now, otherwise, this window of opportunity to control the AIDS epidemic in China will be lost. AIDS education and intervention are most important strategy for controlling AIDS epidemic.

According to our experience (in Weifang City): The costs of education and intervention program would be 2 yuan ( ＄ 25 cents) for each person in China, especially in the counties and rural areas.

The cost for carrying out education and intervention programs would be 2.6 billion yuan for whole China within 3-5 years. In that case, 6 million people infected with HIV would be prevented up to 2010.

Conquering AIDS requires combining prevention with treatment programs, a more aggressive effort to prevent the spread of AIDS would be far less expensive than treating those infected in an epidemic.

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