China Must ‘Move Quickly’ To Control Spread of HIV Because ‘Situation Could Worsen Rapidly,’ NEJM Perspective Says
Health experts are optimistic that China can control the spread of HIV, but the country must "move quickly" because "the situation could worsen rapidly," Bates Gill of the Center for Strategic and International Studies and Susan Okie, a contributing editor of NEJM, write in a NEJM perspective piece. Among new HIV cases in China, 48.6% are caused through injection drug use, 49.8% through sexual contact and 1.6% through mother-to-child transmission, according to Connie Osborne, a Beijing-based senior adviser to the World Health Organization on HIV/AIDS care and treatment.
The country is undergoing rapid social and economic change -- including migration from rural to urban areas and increases in commercial sex work and drug use -- Gill and Okie write. They add, "Given China's enormous population, even a small increase in [HIV] prevalence could be devastating." Although China "has indeed made some tough choices" -- including supporting needle-exchange programs and establishing methadone-maintenance therapy sites for IDUs -- "other critical problems must still be addressed," Gill and Okie write.
Health experts "remain cautiously hopeful about China's chances of controlling its [HIV/AIDS] epidemic," the authors write, adding, "Success, however, will depend on how well the government handles challenges." China needs to overcome stigma associated with the disease; establish "aggressive outreach efforts" for people in high-risk groups; and mobilize "funding, expertise and commitment throughout the vast and diverse country to identify, counsel and care for people" who are HIV-positive, the authors conclude (Gill/Okie, NEJM, 5/3).