December 1 marks the 30th anniversary of World AIDS Day, a time to raise awareness for the deadly disease and rally around those affected by the HIV virus. In China, a rising infection rate, plus an increasing awareness and willingness to confront the problem, constitute a mixed bag for the future of the disease in the mainland.

Days ahead of this public health campaign, the Chinese Center for Disease Control and Prevention released a report revealing that the number of domestic HIV cases has jumped from 719,000 in 2012 to 1.2 million. Though China’s infection rate is low compared to other countries – every nine in 10,000 people – 30% of HIV carriers are still undetected, falling far from the 90% diagnosis goal set by global NGO UNAIDS.

This problem ties into the 2018 World AIDS Day theme: Know Your Status. The Chinese version is “Active Detection, Prevent AIDS, Enjoy Health” (主动检测，知艾防艾，共享健康), which isn’t as punchy but speaks to the progress the country has made in expanding and normalizing HIV testing. Between 2012 and 2017, the number of domestic testers doubled from 100 million to 200 million people.

However, with almost one in three infected individuals unaware that they carry the virus, stopping its spread remains a challenge.

One of the groups most at risk for contracting HIV is students. From 2011 to 2015, the number of 16 to 25-years-olds diagnosed with HIV grew by 35%. In 2017, over 3,000 college students tested positive, many of them (81.8%) acquiring the virus through same sex relations.

A survey conducted by the CDC found that while students have a high awareness of AIDS, few took the steps to protect themselves. Han Mengjie, a director at the Chinese CDC, pointed out that less than 40% of sexually active students use condoms.

To combat the spread of HIV, Chinese universities across the country have launched awareness campaigns, which include hanging a lot of red banners and handing out booklets on AIDS – some over 80 pages thick! – to students. That’s a big shift from just a few years ago, when HIV/AIDS were taboo subjects, rarely mentioned through official channels. The World AIDS Day hashtag on Weibo features pictures of HIV patients (or people playing patients) asking for hugs, medical staff making classroom visits, and young volunteers collecting saliva for testing. Some campuses have even started selling cheap HIV testing kits in vending machines.

Meanwhile, infection rates are also rising among elderly Chinese. In the male population over 60 years old, HIV/AIDS cases increased by 136% in five years, from 8,391 cases in 2012 to nearly 20,000 cases in 2017.

“The biggest reason is that the elderly people lack awareness of self-protection and do not know much about AIDS,” an expert from the Hangzhou Municipal CDC told The Paper. “They are not accustomed to using condoms, and refuse to seek medical treatment when they feel unwell.”

(If you’re wondering how the elderly population gets HIV, the answer is: old people are thirsty too. Hangzhou CDC statistics show that elderly men are mainly infected through extra-marital affairs and gay sex; elderly women are more likely to get it through their male partners.)

Because of late detection and treatment, this demographic has a greater risk of AIDS-related deaths.

Coincidentally, this is not the first time AIDS has made Chinese headlines this week. On Nov. 26, scientist He Jiankui sparked global controversy after he announced his team had successfully engineered the world’s first genetically-edited babies. Dubbed “China’s Frankenstein,” He altered the genes of twin girls born this month to make them HIV-resistant. His experiment was met with severe backlash as we’ve written about here:

As of now there is no cure for HIV or AIDS, and gene-editing seems to be off the table. The best way to prevent HIV is to stay safe and, per today’s theme, know your status.

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Article Nov 27, 2018