In China, Meds, Treatment Denied AIDS Patients

Chinese HIV/AIDS patients are suffering from inadequate health care because doctors and other health care providers may be unwilling to treat them, a May 17 Reuters article said.

There is also a disparity in health care depending on how patients became infected, a May 19 Reuters article reported.

The International Labor Organization (ILO), which is affiliated with the United Nations, said in a study that healthcare workers seemed not to understand how the virus is spread. In one case, a surgeon refused to operate on a patient for fear of the disease, the Reuters reported.

China has over one and one third billion people. Less than one million are thought to be infected with the virus. The nation saw a spike in infections in the 1990s, when poor farmers sold their blood for money and were exposed to the virus, the article noted.

People who contracted the virus through the blood-selling scheme are getting better care than those who became infected through sexual activity or drug use, the May 19 article said.

"Treatment coverage for blood donor HIV patients is up to 80 percent and their mortality is 6.7 percent," said Fujie Zhang, of the National Centre for AIDS/STD Control and Prevention. "But for injecting drug users, treatment there is only 43 percent and mortality is much higher at 16 percent."

The disparity was reported in a paper published in the medical journal the Lancet, Reuters reported.

Zhang argued for broader and more comprehensive treatment efforts as a means to control the spread of the virus, for the sake of public health.

"Treating one person perfectly is meaningless, but treating many will bring transmission down," Shank noted. "So we must increase coverage and then treat early."

But the results of the ILO study, undertaken together with the National Center for STD and AIDS Prevention and Control, indicated that HIV+ patients were often not receiving quality health care--or, in some cases, any care at all.

"The doctor said at our hospital, many patients need surgery, and if other patients get infected, it will be a very bad thing," one HIV+ Chinese citizen told the media. "At the second hospital... the doctor told me: 'I sympathize with your suffering but because of your status, I dare not operate on you,' " added the unidentified man.

"I've visited many other hospitals and encountered similar denials and excuses such as a lack of equipment," he went on to say.

The disparity is not only the result of health care providers' unwillingness to treat HIV+ people. Those living with the disease are often reluctant to seek treatment because of social taboos and stigma, Reuters reported. A policy that relegates HIV+ patients to certain hospitals intensifies the stigma.

"We should eliminate these designated hospitals," opined Beijing You An Hospital's Zhang Ke, of the hospital's infectious disease department.

The stigma can mean that hospitals where HIV+ patients receive treatment might be shunned in rural communities, Reuters reported. One man relayed that hospital administrators "are worried about the impact on economic gains" that treating HIV+ patients might have.

Change is only made more difficult by policies that do not respond to attempts at creating social pressure. China's authoritarian government is hostile toward activists, Reuters noted.

"Hu Jia, an advocate of rural AIDS sufferers, was sentenced to three-and-a-half years in prison by a Chinese court in April 2008, for 'inciting subversion of state power,'" the May 17 article said. "Another AIDS activist, former health ministry official Wan Yanhai, has fled to the United States with his family, citing pressure from authorities, according to rights group Human Rights Watch."

AIDS activist Gao Yaojie claims that the impact of the blood selling scheme that infected many poor farmers has been underreported by the Chinese government, FairWarning reported on May 19. Yaojie figures for the epidemic in China put the number at fatalities and infections at 10 million.

HIV, the virus that causes AIDS by decimating the immune system, cannot be spread through casual contact. The most common ways for HIV to be transmitted is through unprotected sexual intercourse or the sharing of needles, activities that enable the virus to pass from one individual to another with little or no exposure to the external environment. The virus dies quickly once exposed to the elements outside the body.

The news for HIV/AIDS patients in China is not all grim, however. A May 19 New York Times article said that according to a report by scientists with the Chinese government, more people with the virus are now surviving longer.

"About 63 percent of all those needing AIDS drugs are getting them, up from virtually zero in 2002," the Times article said. "That has caused a 64 percent drop in mortality in 'person-years,' as China measures it, an estimate of how long someone would have lived without the disease."

The results stand as "a testimony to the young midlevel scientists who convinced the leadership that this was the right thing to do," according to the University of North Carolina's Dr. Myron Cohen, who himself has aided the Chinese deal with the AIDS crisis there.