What’s happening with HIV in China?

Reporting from The Economist reveals that reported cases of HIV are rising rapidly in China, with one of the main drivers being improved rates of testing.

Current figures indicate the of the population in China, 0.09% are carrying the virus. This is comparatively low when compared to places like the UK (0.15%) or the US (0.34%). However, that picture is changing.

In November of 2018, China’s Centre for Disease Control reported that 850,000 people were known to be carrying the virus, a 12% increase in the numbers for 2017, and almost three times the number reported in 2010. The Economist reports that an official study found that new cases of HIV among students aged between 15 and 24 rose by more than one-third every year across the period 2011-1015, with sexual encounters between men being the primary source of transmission.

What the reporting highlights is that actual infection rates may not be rising as dramatically as the data suggests – it may just be that an increase in testing is giving us a more accurate picture of how infection rates are tracking in the world’s most populous country.

In 2016, China launched a five-year plan to combat HIV and AIDS. It increased funding to NGOs providing free self-testing kits to high-risk groups – with a particular focus on gay men and sex workers. 200m HIV tests were performed in 2017, up 38% from 2015. The initiative also gave NGOs money to provide free medication to people living with HIV. In 2015, nearly 70% of those diagnosed with HIV were receiving anti-retroviral drugs. In 2017, that figure had increased to just over 80% were. Research has demonstrated that treatment-as-prevention is one of the most effective ways to prevent the transmission of HIV.

However, the Chinese government estimates that around 400,000 people may have the virus but may be unaware of it because they have not yet been tested. Discrimination and prejudice remains one of the major barriers to testing – a recent survey people living with HIV found that because of their HIV status, 12% had been refused medical treatment and 15% had been denied work.

Health experts around the world advocate that a combination strategy of PrEP and Treatment-as-Prevention is the most effective way to minimise transmission rates of HIV.

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