Assessing HIV/AIDS Initiatives in China - Center for Strategic and ...

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priority policy for preventing the spread of HIV. This gap in potentially valuable services
could be filled by international charities with expertise in delivering similar services.
Access to Antiretroviral Therapy
Access to effective, affordable antiretroviral therapy has been shown to help HIVprevention
efforts by encouraging otherwise reluctant HIV-positive and at-risk
individuals to identify themselves and engage in HIV-education, awareness, and
prevention activities. China’s national treatment program remains at an early stage and
faces a number of challenges, but if properly expanded, it could serve as a critical
component of the national HIV/AIDS-prevention and control strategy.
The national HIV-treatment program is welcome and has made encouraging progress,
but much more needs to be done. Now that the program is moving from an “emergency
response” to a more standard treatment program, it will need to be more fully integrated
into the spectrum of patient management and linked closely with other components of a
successful strategy, including prevention education and awareness, harm reduction,
testing, and other social services. This will require an even greater commitment of
political will and financial resources to solidify and build on the gains achieved thus far.
Recommendations: Comprehensively Meeting the Needs of At-risk
Populations
Given the HIV/AIDS situation in China, the persistent challenges that confront the fight
against the disease, and the emergent best practices in the country, the following broad
recommendations point to a promising way forward.
• GIVE PRIMARY FOCUS TO KEY MARGINALIZED AND AT-RISK POPULATIONS.
Thus far, much of China’s government response to HIV/AIDS has focused on the
plight of the rural villages and farmers that were so hard-hit by HIV as a result of the
illicit blood donation schemes of the mid-1990s. Nevertheless, owing to stigma, official
obfuscation, and a lack of resources, it took many years for an effective response to take
shape to address those persons and families in central China who became afflicted with
HIV.
Looking ahead, the Chinese authorities and the international community will need to
increasingly focus their attention on HIV-infected and at-risk populations that are even
more difficult to access, inform, treat, and care for. By China’s official estimates, well
more than half of the country’s HIV-positive population comprises IDUs, CSWs, and
MSM, with the percentage perhaps as high as 60 to 75 percent. In addition, a large
proportion of these groups—especially within IDUs and CSWs—comprises ethnic
minorities. For a variety of reasons—political, cultural, legal, linguistic, and for practical
reasons of accessibility—Chinese authorities and international organizations have been
slow to focus HIV-prevention, control, and treatment efforts on these groups.
• WORK TOWARD A MORE COMPREHENSIVE, “FULL-SPECTRUM,” PATIENT-
MANAGEMENT APPROACH.
In bringing greater focus to these marginalized and at-risk groups, these efforts will
require a more comprehensive and “full-spectrum” approach that strategically and