Drug users in China tested for HIV without consent

People with HIV infection and AIDS in China experience discrimination, and many have little or no access to health care, warned a report published last week.

People with HIV infection and AIDS in China experience discrimination, and many have little or no access to health care, warned a report published last week. The report found discrimination in national and local government policies. National laws were discriminating, and some local laws banned people from certain activities, such as working in food services. The findings came from field observations and interviews by researchers from Human Rights Watch (an independent, non-governmental organisation working to protect human rights) in three areas of China – Yunnan, Beijing, and Hong Kong-over periods of five and a half weeks in 2002 and 2003. They conducted more than 30 interviews with people with HIV and AIDS, police officers, drug users, and AIDS outreach workers. The researchers found a range of problems likely to increase the spread of HIV. People interviewed in the study reported being refused admission to Chinese hospitals or clinics because of their HIV status. In some cases, the discrimination began after they had tested positive for HIV without knowing they had been tested and without being officially notified of the result. Observations showed that some hospitals, including one in Dehong, which has a particularly high rate of HIV and AIDS related to drug use, had locked their HIV/AIDS wards and barred all people with HIV or AIDS from admission to hospital. Practices that risked HIV transmission, including unsafe injections with unsterilised syringes and recycling of medical waste, were common in many hospitals, particularly in rural areas ( Human Rights Watch 2003 ;15:No 7(C)). Brad Adams, executive director of Human Rights Watch’s Asia division, said: “Discrimination is forcing many people with HIV/AIDS to live as outcasts, and the Chinese government tolerates it instead of combating it. That is sure to make the AIDS crisis worse.” He added: “SARS [severe acute respiratory syndrome] showed the importance of national leadership and a strong public health system in fighting an epidemic. It is time for Beijing to show the same resolve in helping people with HIV/AIDS.” UNAIDS (the joint United Nations programme on HIV and AIDS) estimates that at least 1.5 million people in China have HIV or AIDS, although the actual number is probably much higher because local authorities have minimised the numbers involved. Government documents obtained by Humans Rights Watch showed HIV prevalence rates of 4-40% across seven provinces with a total population of 420 million. The report argued that China had the capacity to deal with AIDS. “Despite a severely damaged national public health system and discriminatory hospital practices, some individual doctors and nurses have made extraordinary efforts to care for people with HIV,” the authors reported. Some senior policy makers are already pressing the government in Beijing to take a more progressive approach to HIV and AIDS. (Source: BMJ 2003;327:579 (13 September))