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You’re in: AIDS at 25 Coverage / 25 Years Later: Advocacy


One balmy night in late May, surrounded by gleaming skyscrapers, I joined a chic crowd gathered on the roof of the Shanghai Art Museum here in People’s Park. Breakdancers in baggy pants performed head spins; a transgendered jazz singer crooned. It was, in many respects, a typical upscale Shanghai party—except that it was the first of its kind in Shanghai thrown to raise money for AIDS. Not long ago, such a benefit simply could not have happened.

This woman would not show her face to the photographer, for fear of being identified as HIV+. The extent and intensity of the discrimination attached to the disease means that many people are afraid to maintain relationships with those who are infected. As a result, many HIV-infected people to live as outcasts.

Until as recently as the mid-1990s, the Chinese government maintained that AIDS wasn’t a domestic problem; foreigners were required to take HIV tests, while citizens were kept in the dark. In 1996, a doctor in Hen­an province discovered that, for nearly a decade, local officials had run a profitable but highly unsafe blood-selling operation that pooled blood from multiple “donors” (who were actually selling their blood) to skim the valuable plasma, then re-injected donors with the remaining blood cells. In some communities in Henan, as in many African communities devastated by AIDS, only grandparents and children are left behind. It is, arguably, the worst manmade public health crisis to occur here in recent history.

China’s small, well-educated band of AIDS activists have fought an uphill battle to promote prevention, and to get the central government to care for the hundreds of thousands of HIV carriers still living in Henan (many have already died). They recently won an important, if preliminary, victory in getting Beijing to acknowledge the gravity of China’s AIDS problem. “China is saying we can talk about it,” according to Kathleen Lau, the Chinese-American owner of Kathleen’s 5, the rooftop restaurant that hosted the benefit. “They recognize that they can’t do it alone.”

The very public mishandling of SARS in 2003 led the Chinese government to shift its approach regarding public health. Beijing launched an AIDS-awareness campaign in which President Hu Jintao shook hands with HIV patients, and the government doubled its expenditures on AIDS. Here in Shanghai, the Hospital for Infectious Diseases added a shining campus with an AIDS ward, and the city has pledged—though not publicized widely—free care for all AIDS patients. “After SARS, they realized that they cannot blindly pursue economic development while ignoring issues like public health,” said Chung To, founder of the Chi Heng Foundation, which promotes AIDS awareness and funds care for AIDS orphans. With the consent of the central government, Chi Heng workers go to villages in rural Henan, funding schooling and teaching life skills to the children
left behind.

But in China—one of four countries where HIV is on the rise, per UNAIDS’ 2006 report—AIDS policy is still tainted with a legacy of secrecy and repression. I spoke with Wan Yanhai, one of China’s leading AIDS campaigners, who insists that activists are still regularly being detained. The international aid now pouring into China doesn’t trickle down to legitimate AIDS organizations, he says. “Now the government receives more funding internationally,” he said, “but the government is not transparent. They don’t take responsibility for what they do, and we don’t know where the money goes.”

Even with governmental support, AIDS organizations face resistance from the general public, as the disease carries a strong stigma. Some villages in Henan reject the efforts of Chi Heng because they don’t want to be known as AIDS-stricken. “It’s like the early days of AIDS in the Western world,” said Lau. “Ignorance. That’s what we find is the real issue with AIDS here.” 

Homosexuality was declassified as a mental illness in China in 2001, and although there have been some advances (Chi Heng recently helped introduce a graduate-level public health course on homosexuality at Shanghai’s Fudan University), some doctors continue to diagnose it as such. Since March 1, Shanghai’s clinics are required to offer free condoms, but prevailing attitudes mean the service is under-utilized. “A lot of people aren’t willing to take them,” said Yu Tian, a Chi Heng activist. “They’re too embarrassed.”

On a recent Saturday night, I met up with Yu Tian at a park here that serves as a meeting place for gay men. As he passed out condoms and promoted a free hotline staffed by health professionals, he addressed a series of confusions about AIDS. “I saw a movie in which a sister doesn’t want to feed her brother because he has AIDS,” he told a circle of curious men. “That’s wrong. You can’t get AIDS by sharing bowls.” He told me later, “They are afraid, but they don’t know how AIDS is contracted.”

Mara Hvistendahl is Seed’s Shanghai correspondent.

Originally published August 11, 2006


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