China has reported 18,543 new HIV infections in the first half of 2007, which is near the reported number from all of last year.  A figure that is certainly worrying and indicative of China's growing epidemic, but also a bit confusing.

The article starts out with the simple facts:

"China reported 18,543 new cases of HIV/AIDS in the first half of this year, state media said, near the number for the whole of 2006.

Drug abuse was the main cause of new infections, Xinhua news agency quoted Han Mengjie, an official with AIDS Control Work Committee of the State Council, as saying in a report on Saturday."

There is always a large discrepancy between the amount of reported cases and the amount of actual or estimated cases.  This stems from lack of surveillance as well as the fact that worldwide only around 10% of HIV positive people actually know they are positive.  If we take a conservative estimate for China and say that 20% of people who are HIV positive know their status we could estimate that 18,543 reported infections translates to 92,715 actual infections.

Further confusing is the fact that most infections are reported to be drug related despite the fact that the government recently came out with a press release with the info that sex just overtook needle sharing as the main means of HIV transmission in China .  

The article continues:

"Han also warned of the danger of the virus spreading to the general public through unsafe sex and the greater migration of the infected population.

China has become increasingly open about AIDS in recent years, facing up to an epidemic once stigmatized as a disease of the West."

The first point is incredibly important as once the virus embeds itself in the general population, it will be devastatingly difficult to fight its spread.  While China has become more open about AIDS in recent years and their has been some phenomenal leadership on the issue from the powers that be in Beijing, there is still a lot of work to do on the local levels in preparing the infrastructure to deal with the growing infection rates.

One of the main things that can be influenced in a cost effective and efficient manner is attitude towards the virus, which is what PTE is trying to change.  As long as HIV is viewed as a virus of outsiders that affects the dredges of society, no country stands a chance in fighting it back.  It's impossible to try and fix a problem when the people it afflicts remain oblivious or negligently under-informed about it.  As long as discrimination continues to flourish and HIV is stigmatized as something people get for misbehaving we have no hope of curbing its spread.  

AIDS education isn't about going into a classroom and telling kids the do's and don'ts of sex and drugs.  It has to do with helping people understand the disease, fighting back stigma and preparing society as a whole to accept it as a public health concern like obesity, heart disease and cancer.  One that is treatable, not limited to affecting "bad people" but most deadly if ignored.  

"The nation had 214,300 officially registered cases of HIV/AIDS by late July, Xinhua said, an increase of five percent over the figure for April.

The United Nations estimates the true number of the killer disease in the country to be around 650,000."

Ah the stats, everyone loves the stats.  I don't really get it in China.  There is one constant number 650,000, that was adjusted from around 840,000 by the  WHO, but never changes despite around 100,000 new infections every year…  I think what we can learn from all the misleading stats and contradictions in information is that no one really knows for sure.  China is so massive that to constantly rely on such a solid statistic seems a little silly.

Here is what we know: HIV infections are on the rise; knowledge about how it is transmitted is limited; discrimination against those it infects is rampant; awareness of places to get tested and available treatments that make HIV a chronic illness rather than a fatal is not widespread.  China is in a tough spot at the moment and what it needs is knowledge. Sure the health system should be prepared, doctors trained and AIDS patients cared for; but can we really hope to succeed in curbing rising infections with education so limited?

Since it first emerged in 1981 HIV has killed around 25 million people, around 5 million new people are infected every year.  The global community is spending billions of dollars to fight its spread and I still can't see one clear example of a well defined success. 

The news that China's reported infection rates are greatly increased over last year is troubling, but we shouldn't always wait for news like this to realize our efforts need to be scrutinized, new strategies implored and more innovation sought after.  Awareness alone will never be enough.