Lancet Editorial Examines China’s Response to HIV/AIDS

Although the response to HIV/AIDS in China has evolved from "denial and inertia to pragmatic prevention and treatment programs," there still are "massive challenges" to addressing the disease in the country, a Lancet editorial says. Chinese health officials recently reported that in 2008, HIV/AIDS was the country's "leading killer among infectious diseases for the first time," the editorial says. It adds that although "[u]nder-reporting means that accurate figures on the country's epidemic are hard to come by," UNAIDS estimates that around 700,000 people are living with HIV in the country.

China has "committed resources and energy to tackle the epidemic, which deserve praise," according to the editorial. A nationwide program launched in 2003 provides no-cost testing; no-cost counseling and antiretroviral treatment for rural residents; no-cost medication for all HIV-positive pregnant women; no-cost education for AIDS orphans; and care for impoverished people living with the disease, the editorial says. In addition, the government recently launched awareness and safer-sex campaigns focusing on the heterosexual transmission of HIV -- which has become the main mode of transmission in the country -- according to the editorial. However, "the size of the country and its population and the decentralized system of government make universal access to testing, treatment and prevention, and the communication of public health messages, extremely difficult," the editorial says. It notes that additional challenges in communicating the risks of HIV/AIDS include "[c]ultural sensitivities to discussing sex and the stigma attached to homosexuality," as well as human rights, which remain "a problem." The editorial concludes that the "success of China's HIV control efforts will depend on how the country's response continues to evolve to meet these challenges" (Lancet, 2/28).