Discrimination Against People with HIV/AIDS in China

Discrimination against People with HIV/AIDS in China

Wan Yanhai, Hu Ran, Guo Ran, Linda Arnade1

In many ways the spread of HIV/AIDS in - China follows a familiar pattern to that in 2 many other countries. For example, there is of high infection among specific sub-popula increased HIV risk and transmission among tions and in some localities.” vulnerable groups such as drug users, sex four haemophiliacs from Zhejiang province workers, men who have sex with men, and discoveredFollowing the that first they HIV/AIDS were infected case in 1986, with migrant workers. However, the increas- HIV/AIDS due to contaminated blood in an ing rate of heterosexual HIV transmission, imported blood coagulation factor from a especially among minority groups and the foreign blood supply. In 1989, the Yunnan - Ministry of Health found that 147 men at the nated blood transfusions in the mid 1990s border of Burma and China were HIV posi- havepresence made of the“AIDS Chinese villages” HIV/AIDS due to contami situation tive. By 2004, the number of reported HIV 3 unique. cases was approximately 107,000. From 1995 onwards, the growth of “AIDS In this article, we aim to outline how the his- - tory of HIV/AIDS in China has led to the cre- nated blood supplies, caused the HIV/AIDS ation of HIV/AIDS prevention programmes epidemicvillages”, whichto increase developed over large due areas to contami of rural - central China.4 Consequently, many farmers, women and children already living in poverty for “targeted” populations. We will also dis risk of HIV face stigma and discrimination on became infected with HIV/AIDS. The source cuss how different groups living with or at multiple levels. Lastly, we will provide a brief of women’s infection was primarily medical overview of some relevant advocacy and le- operations, for example during gynaecologi- gal rights work undertaken by civil society to cal operations or during childbirth, and their combat such stigma and discrimination. husbands who sold blood in blood stations or received blood in hospitals. Children fre- 1. The History of HIV/AIDS in China quently became infected through their par- ents and mortality due to infection was ini-

HIV/AIDS patient appeared in China. Since which family members realised that they had then,It has Chinesebeen almost people thirty have years fought since to thecontrol first tially high. This was often the first point at the HIV/AIDS epidemic. However, to this - day, HIV/AIDS infection rates continue to in- been affected by HIV/AIDS. The effects of a crease in China, even though according to the becameparent suffering orphans andfrom experienced HIV/AIDS compound increased most recent China UNAIDS reports: povertyed the suffering and hardship. of their children who often

“China’s HIV epidemic remains one Recent trends indicate that the spread of of low prevalence overall, but with pockets the HIV infection is more prevalent through

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heterosexual and same sex sexual activity. lack basic education, have limited Chinese

are key targets in HIV/AIDS prevention pro- employment in their hometowns. In some Consequently,grammes in China. sex workers Furthermore, and LGBT HIV/AIDS people cases,language migration capabilities, is driven and are by unable their involve to find- prevention policies are poorly developed in ment in illegal activities in their home towns respect to migrant populations and research - indicates that presently China is facing the ties and barriers for access to HIV prevention challenge of the HIV prevalence in this sub- schemes.and regions9 which in turn presents difficul group.5 Sex workers, in particular female sex work- 2. HIV/AIDS-affected Regions and Target Populations spread of HIV/AIDS due to the expansion ofers, the have sex increasingly work industry been in affected urban centres by the Those who have been infected with HIV and the large scale migration which has oc- through blood transfusions include resi- curred within China as a result of economic dents in rural areas of central China (Henan development. At the same time, infections province is the most well-known area due to among men who have sex with men (MSM) wide-ranging media reporting) and haemo- and risky homosexual practices, such as un- philiacs in east China who received unsafe protected anal sex, continue to increase new blood products. The Chinese government has HIV infections.10 - minal care for these groups; however, many 3. Official HIV/AIDS Statistics began to coordinate efforts to provide ter contaminated blood transfusions spend their wholefamilies lives infected struggling and affected to obtain bysupport, HIV due jus to- prevalence in China remains relatively low, tice, and compensation from the local gov- atAccording an estimated to official 0.05% UNAIDS (0.04 to statistics,0.07%) of HIVthe ernments, hospitals and companies that sold total population. However, infection rates them contaminated blood products.6 some localities are extremely high.11 Intravenous drug users (IDUs) with HIV/ among some specific sub-populations and in AIDS are another target population, especial- By the end of 2009, an estimated 740,00012 adults and children were living with HIV, as Yunnan, Xinjiang, and along the border of Vietnam.ly in the drug Most trafficking IDUs are jobless,areas of andChina, may such be Health Education believes the true number the victims of drug circles. Eventually, many toalthough be higher, the sinceBeijing many AIZHIXING Chinese Institutepeople are of become infected with HIV. In Xinjiang, the reluctant to be tested due to fear, stigma and region with the fourth largest population of HIV infection in China, drug users make up infected through heterosexual transmission, - 16.0%discrimination. through Of homosexual the 740,000, transmission, 43% were ers.7 Migrant IDUs in urban centres, such as 32% through IDU, 8% through commercial theBeijing, highest Shanghai, proportion Chengdu, of HIV-positive and Wuhan suffer con- plasma donation and transfusion of infected - blood and blood products, and approximate- ed population, some of whom are also from ly 1% through mother-to-child transmission ethnicstitute minorities.a significant8 Many proportion of these of individualsthis affect (MTCT).13 Approximately, 91,000 or 12.3 %

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of people living with HIV/AIDS were infected through sexual contact between HIV positive discriminatory against migrants. As a pre- persons and their regular partners. HIV sufferers, it nonetheless is inherently must have a household or city registration permit,requisite documentation for benefitting which from themigrants policy, have one were transmitted through heterosexual contact,Of the 33% 48,000 through new homosexual infections in contact, 2009, 24%42% discriminatory in its application and further through IDU, and 1% through MTCT.14 marginalisesdifficulty accessing. migrants This who policy live with is indirectly HIV.

4. Some General Policies prevention in China, the law enforcement The “Regulations on AIDS Prevention and systemFor NGOs and working the lack in of thecooperation field of HIV/AIDS from the Ministry of Health are the two principal bar- - - edTreatment” in China towhich respond came to into the spreadforce in of March HIV/ tive and palliative treatment for everyone. AIDS.2006 Thewere regulations the first special provide legislation the fundamen draft- Practicalriers to ensuring and institutional effective barriersHIV/AIDS are preven cre- tal rights of people living with HIV/AIDS. For example, Article 3 states: - cultated to by promote both law safe enforcement sex through condom and official use “… No institute or individual shall amonghealth organisations;high risk populations, for example, since itcondoms is diffi discriminate against people living with HIV, are considered evidence of the sex trade. 15 Similarly, to obtain Methadone Maintenance Treatment (MMT), the main treatment for AIDS patients and their relatives.” heroin drug users16 of the most important HIV/AIDS prevention required from the police – which imposes so- andThe “Fourcontrol Frees regulations and One currently Care” policy operating is one cial and legal obstacles, specific for IDUs documents who may are be at an increased risk for HIV transmission due -positive persons to access treatment and to unsafe sharing of needles. In accordance medicinesin China. In through effect, four this basic policy provisions. enables It HIV with the provisions of new Chinese drug leg- provides people living with HIV/AIDS access islation adopted on 1 June 2008, police can to: (1) free anti-retroviral therapy (ART) test a drug user’s urine at any time17. If the medicine and treatment for rural and city result is positive, the person is liable to a residents who live in poverty; (2) free HIV prison sentence of at least two years. These consultations and HIV-antibody screenings, provisions create serious barriers in IDU’s which have been designated by medical in- access to healthcare not only due to the stig- stitutions; (3) free health counselling and matisation that many drug users experience prenatal guidance and delivery services; and but also as a consequence of the strict drug (4) free as well as timely perinatal mother testing policies. Many IDUs are reluctant to to child transmission (PMTCT) drugs and go to the police to acquire the necessary doc- infant testing reagents for HIV-infected umentation, without which access to MMT is pregnant women. The "one care" refers to impossible.18 subsidies for people living with HIV/ AIDS and patients who are in poverty. In spite of the broad benefits the policy bestows on

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5. Prejudice and Discriminatory Policies the result is that many students feel that they against People Living with HIV/AIDS in are being discriminated against rather than China protected.20

Many HIV-positive persons are unfairly or The employment experience for people with unjustly treated due to their HIV-positive sta- HIV is similar to the experience of students in tus and/or potential risk of infection, due to schools. It is not uncommon for a worker who prejudice, discrimination and stigmatisation. has tested positive for HIV to be persuaded to In 2008 a survey conducted by the China leave work. In some informal and small-scale HIV/AIDS Media Partnership (CHAMP) ex- privately-owned companies, people who are - HIV positive are often dismissed outright on ing that nearly 48% of respondents would the grounds that they have HIV.21 notposed like the to level have of dinner prejudice with that a person exists, living find with HIV/AIDS, and approximately 41% of At hospitals patients living with HIV/AIDS respondents would not like to have a co- often experience discriminatory treatment worker who is HIV-positive. In schooling, from doctors or nurses if their status is dis- about 30% of respondents thought that stu- closed or revealed. Although regulations ex- dents living with HIV/AIDS should not be ad- ist which require doctors to protect an HIV- mitted by the school to study with students positive person’s privacy and provide them who are not HIV-positive. When it comes to with the same medical treatment as other people infected with HIV/AIDS by drug in- patients, in practice privacy is widely denied. jection and/or sexual intercourse, about one Furthermore, doctors and surgeons often re- third of respondents think that HIV/AIDS is fuse to treat or operate on patients who are the punishment they deserve.19 HIV-positive. According to one study more than 12% of respondents had been refused medical care at least once since they tested social prejudice that people living with HIV/ positive for HIV. Consequently, many people AIDSLegal experienceand policy inmeasures much of oftenChinese reflect society. the living with HIV/AIDS are limited to health- Within the school system, for example, if a care treatment in designated healthcare de- student’s HIV-positive status is disclosed, partments which primarily fall outside the he/she will face a number of challenges. mainstream hospital system.22 For example, Schools often attempt to persuade the stu- in Beijing, there are only two hospitals which dent to move out of the shared dormitory. provide specialised medical treatment for This separation distinguishes HIV-positive people living with infectious diseases (in- students from others, discriminates against cluding HIV/AIDS). In is clear that the social them in access to education and increases prejudice and stigma fuel mistrust between their risk of harassment by other students patients and healthcare practitioners, and and teachers. In some cases, the school will they in turn fuel practices of non-disclosure likely put pressure on the HIV-positive stu- and hiding by patients of their HIV/AIDS sta- dent to study in isolation. The systematic dis- tus which invariably increases the risk for both patients and practitioners. is often borne out of a vision by educational providerscrimination that which they students are actually with HIV protecting suffer Discrimination is also prevalent in the Chi- students who are infected by HIV/AIDS. Yet, nese commercial insurance sector. People

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excluded and marginalised by government programmes due to stigma, discrimination, spiteliving of with the factHIV/AIDS that commercial experience insurance significant to - coverdifficulties the costs in obtaining of medical a health treatment insurance. for peo In- tivities. This section provides an overview ple living with HIV/AIDS has been available ofor howthe “illegality” discrimination of their against behaviours marginalised or ac since 2005, the provisions granting access to groups can by compounded by their HIV/ such insurance are extremely restrictive and AIDS status. in reality exclude a great number of groups at high risk of HIV/AIDS. For example, peo- High-risk groups experience acute discrimi- ple who have been infected with HIV/AIDS nation on the basis that they are perceived to through injecting drugs or through blood be living with HIV/AIDS. Multiple discrimination is also frequently encountered by these from commercial insurance. groups as their HIV status intersects and transfusions are sometimes unable to benefit compounds other characteristics, such as The extent of discrimination and stigma suf- ethnicity, occupation and sexual identity and fered by people living with HIV/AIDS is de- increases the detriment they experience. Dis- pendent on how a person became infected. crimination is meted out to high-risk groups For people infected by blood transfusions, in many social areas including but not limited to access to housing, residency permits, of stigma experienced tends to be lower. medical treatment, and education. Addition- Thissexual is based violence, on the or perception “by accident”, that the they level are ally, as many individuals in China are not well aware of the ways in which HIV transmission can occur, discrimination and harassment in who“blameless” have become victims infected and their through HIV statusconsen is- all stages of employment is prevalent. “not their fault”. On the other hand, people sual sexual intercourse or drug use tend to MSM experience increased levels of stigma, harassment and discrimination as their actions In China, MSM are at a high risk of HIV/AIDS are viewed negatively and their HIV-positive because of both stigma and discrimination.23 status is perceived to be the result of a bad or Recent research has shown that HIV infec- inappropriate decision. tion among MSM has increased from 0.4% in 2005 to 3.3% in 2007.24 Many MSM in Chi- 6. Stigma and Discrimination among na are unable to be open about their sexual “High-risk Groups” orientation and as a result may take part in risky behaviours; for example, younger male As set out above, HIV/AIDS is an issue that particularly vulnerable. MSM are further Chinese society. These include men who have marginalisedsex workers in known China asdue “money to the social boys” and are sexhas with affected men (MSM), many sex marginalised workers, migrants groups in family pressures associated with passing on - the family name from father to son and the resulting pressure to marry. MSM and other dedicatedand drug users.to working The Beijingwith these AIZHIXING groups and In endingstitute of the Health discrimination Education and (AIZHIXING) stigmatisa is- from being able to marry, or donate blood, - andLGBT frequently individuals experience continue discrimination to be prohibited in tion is necessary as these groups are often employment.25 tion that they suffer. Strong civil society ac

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Transgender People Transfusion-infected Persons

- Those who have been infected due to con- crimination. In Beijing, for example, many taminated blood supplies and transfusions Transgendermale to female persons transgender face persons significant are only dis able to dress and act as their female per- particular, haemophiliacs are at a high risk sonas in discreet venues, such as hotels or ofare contracting another highly HIV through affected transfusion. population.31 In In Karaoke rooms. In a survey conducted by the mid-1990s, many people were infected in this manner, especially in Henan, Shanxi, - and Sichuan provinces,32 and continue to AIZHIXING from December 2008 to January be denied access to treatment and compen- transgender2009 among people fifty transgender had been arrested persons, and AI sation33 approximatelyZHIXING found 50% that had approximately been threatened 20% by of victims and activists to speak out and de- the police.26 Additionally, research has found mand justice.. This For has example, galvanised during the the efforts events of that transgendered persons who engage in around World AIDS Day 2009, a group of sexual services often face harassment and people from Henan province who were HIV- insults from their guests and clients. positive went to Beijing to demand greater equality of treatment and compensation, de- Sex Workers spite political oppression.

Currently, sex work is illegal in China, yet a Intravenous Drug Users (IDUs) strong informal sex work economy contin- ues to thrive in urban capitals such as Bei- - jing, Kunming, and Shanghai.27 Sex workers, tised, victimised and discriminated against in particular female sex workers face a great dueA final to groupassociations which withhas been HIV ishighly intravenous stigma deal of discrimination and stigma from cli- drug users. In China, the government has ents, family, police, and the Chinese govern- long viewed drug addicts negatively as “drug ment.28 that the rate of violence towards sex workers is high and An AIZHIXINGmay decrease research condom report use byfound sex addictsabusers” have and becomelawbreakers. the victims The result of stigma of this- workers and their clients.29 The report also tisationofficial perception and general is discrimination. that millions of34 Drug drug found that consumption of drugs and alcohol addicts are disproportionally subjected to often leads to unsafe sexual practices among questioning, forced urine tests, and interro- sex workers. Through in-depth interviews, gation by police and authorities. the report documented that many sex workers also face insults and abuse from their A high incidence of drug use is a growing partners. Beyond the social barriers that problem among the Uyghurs, a Muslim eth- put sex workers in a particularly vulnerable nic group living mainly in Xinjiang province HIV-risk category, many female sex workers are apprehensive about being tested for HIV young people, women, and migrants.35 A re- because if they test positive, they face losing incent western survey China,in Beijing, and which affects sampled in particular more their jobs or income. They also fear the risk than 210 active drug users, found that ap- 30 proximately 50% were Uyghur. Additionally, a survey conducted by the think tank known of being identified as being a sex worker.

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as the Research Centre for Health Develop- in the process of receiving medical treatment on Injection Drug Users in Beijing ment; (2) in the process of applying for so- found that among 503 Han Chinese drug us- cial security; (3) through community-based ers, 23 were HIV-positive -- a prevalence of home interviews for medical and health care; approximately 4.57%. However, out of 583 Uyghur drug users, 303 were HIV-positive, a prevalence of approximately 51.97%.36 (4) identification by the local community; Theand (5)disclosure identification of one’s by HIV the status media. may occur As a result of restrictions faced by migrants during a hospital stay in the process of rou- in gaining Beijing residency, many Uyghurs tine medical tests. Compulsory HIV tests are are denied access to necessary healthcare quite common in medical settings, especially treatment such as MMT.37 Data collected before operations, and a person’s HIV status must be disclosed to doctors. However, the only 11.9% of Uyghur drug users were able circulation of this information across the tothrough get access an to AIZHIXING the MMT during survey the shows period that of hospital may result in the patient being de- 2007 to 2009.38 Unfortunately, since this sur- nied medical treatment.40 vey, thirteen HIV-infected Uyghur drug users have died. In some regions, the emergence of projects which deliver medical care to patients at As discrimination against IDUs increases, their home has increased the likelihood that law and policy responses must target social a person’s HIV status would be exposed. At security provision which is currently not the community level, a person’s HIV status, available to IDUs in some provinces. Policies their drug use or prostitution histories are currently distinguish starkly between catego- kept by the local police. However, no strict ries of poor people: subsistence allowance is regulations or appropriate safeguards are in granted to those who live under the minimal place to ensure a person’s right to privacy is cost of living but denied to those who experi- protected, and therefore information can be ence poverty due to drug use or gambling.39 easily disclosed or misused. This is not only Furthermore, in many other areas IDUs are potentially harmful for the person living with disproportionately targeted for detrimental - and discriminatory treatment. Most employ- bers and close relatives, including children. ers refuse to employ drug users or those who HIV/AIDS, but can also affect family mem have previous experience of using drugs. couples who have been found to be HIV- AIZHIXING has documented cases where and discrimination, and crimes in the work- education and schooling for their children. place,Those suchwho doas theft,find work are often often blamed face prejudice on for- Inpositive other facecases, difficulties if a student in securingis found toaccess have to a mer or current drug users. Similarly in the family member who is HIV-positive, he/she wider community drug users and those with may be forced to take an HIV test. unjustly targeted for criminal activity. While the media can play a positive role in a history of drug use are easily identified and educating and providing the general popula- 7. HIV Status and Privacy Protection tion with information about HIV/AIDS care and prevention, it can be a double-edged A person’s HIV status can be disclosed in a sword violating people’s right to privacy number of ways in China. These include: (1) -

through the publishing of confidential medi

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cal and personal details about persons living (for those who are infected with HIV/AIDS with HIV/AIDS. through blood transfusion); (9) inclusion of vulnerable groups; and (10) inclusion of 8. Advocacy for the Rights of People Liv- HIV/AIDS and high-risk groups within a hu- ing with HIV/AIDS man rights framework in China.

Discrimination against people living with Environment for the Development of - HIV/AIDS NGOs cal treatment, employment, schooling and socialHIV/AIDS security is still in severemainland in the China. fields Faced of medi with discrimination, people living with HIV/AIDS politically sensitive issue such as HIV/AIDS, are unable to utilise relevant laws or regu- As an NGO working on a controversial and- lations to protect their rights.41 Therefore, - advocacy is very important in combating dis- isterAIZHIXING and obtain faces a various legal status barriers in China and chal and crimination and ensuring equality for those lenges. First, it is difficult for an NGO to reg disadvantaged not only by HIV/AIDS itself but by the social prejudice that surrounds forcedwithout to this register an NGO as is anot company. protected43 Second,by law. - Most HIV/AIDS NGOs have therefore been ducted three advocacy programmes aimed at with corporate burdens such as a liability for providingthe condition. awareness Recently, raising, AIZHIXING advocacy has con and highas a registeredtaxation. Third, company there AIZHIXING are very few is fundsfaced policy development support to combat the from the Chinese government which support

HIV/AIDS. is a lack of government transparency in pub- inequality suffered by people who live with licNGOs information that work and on HIV/AIDS.law enforcement. Finally, Inthere or- AIDS and Human Rights der to circumvent these organisational bar-

In 2008, the Chinese government drafted a issuing public appeal letters and statements National Human Rights Action Plan, which is andriers, initiating AIZHIXING’s lawsuits advocacy to urge has greater focused trans on- aimed at developing the government’s role parency at governmental levels and a more in protecting vulnerable groups and improv- ing people’s lives. The Action Plan, however, to work.44 did not provide protection for the human equitable environment for HIV/AIDS NGOs rights of people living with HIV/AIDS. Thus, Difficulties Facing AIDS Activists during the Olympic Games for AIDS Human Rights we proposed ten key pointsin AIZHIXING’s relating to 2008 AIDS Chinese human Legalrights Reportwhich should have been included in the National Human Rights Action Plan.42 These points ofDuring HIV/AIDS the 2008 were Olympicsuppressed Games by the in ChineseBeijing, are: (1) eliminating HIV/AIDS discrimina- government.HIV/AIDS activists In Hubei and province, workers for in example,the field tion; (2) informed consent on HIV testing; (3) privacy protection; (4) access to drugs; people living with HIV/AIDS, in an attempt to (5) ensuring HIV-positive people’s rights in stoplocal thesepolice people confiscated from conductingthe identity petitions cards of employment and social security; (6) indi- in Beijing. Similarly, a woman who wanted vidual freedoms and security; (7) revision of compensation for HIV blood infection was detained, charged with blackmailing and im-

relevant laws; (8) financial aid for lawsuits

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prisoned for one year. Working to support funding multiple HIV/AIDS grassroots or-

- has helped decrease stigma and discrimina- these activists, AIZHIXING collaborated with tionganisations through the throughout establishment China, of centres AIZHIXING and theAIDS China treatment AIDS CBO and Network prevention to submit urging a let the support groups for the lesbian, gay, bisexual ter of appeal to the state council office for and transgender people, female sex workers, suppression of HIV/AIDS activists; (2) ad- and Uyghur communities, as well as through dressoffice tothe (1) cases conduct of people an investigation in Henan infectedinto the with HIV/AIDS through blood transfusions. Conclusionrelevant advocacy and policy efforts. - duced discrimination against people living Multiple levels of stigma and discrimination withAIZHIXING’s HIV/AIDS advocacy in China programs by helping have them re AIDS in China. The prevalence of HIV among rights. For example, victims of contaminated marginalisedaffect people sub-groups living with, further or at increasesrisk of HIV/ bloodknow transfusions and fight for or their forced legal drug and testing human are the discrimination against these groups. - There is a pressing need for further advo- fend their basic legal rights. Additionally, AI- cacy to protect the human rights of people able to call upon AIZHIXING lawyers to de in China, especially people living with HIV/ used other media outlets to raise awareness AIDS and other vulnerable populations, such ofZHIXING the rights has ofpublished people living multiple with letters HIV/AIDS and as sex workers, drug users, and migrants. as well as groups such as sex workers, mi- This is a challenge, given the political, social, grants, and drug users. Finally, by encourag- and cultural climate relating to social change ing a stronger network of community-based in China. A great deal of work remains to be HIV/AIDS organisations in China as well as done.45

Wan Yanhai is the Director of the Beijing AIZHIXING Institute of Health Education. Hu Ran is Research Assistant at2 See the UNAIDS same Institute. China, Key Guo Data Ran, 2009,is Research available Program at: Officer, and Linda Arnade is Consultant at the same Institute. http://www.unaids.org.cn/en/index/page.asp?id=178&class=2&classname=Key+Data.

3 Cell Research, Vol. 15, No. 1, 2005, p. 825–832, available at: http://www.nature.com/cr/journal/v15/n11/full/7290354a.html. He, Na and Detels, R., “The HIV Epidemic in China: history, response, and challenge”, 4 Zunyou, W., Keming, R. and Detels, R., “Prevalence of HIV infection among former commercial plasma donors in Health Policy and Planning, Vol. 16, No. 1, p. 41–46, available at: http://heapol.oxfordjournals. org/cgi/reprint/16/1/41. rural eastern China”, 5 Sexually Transmitted Infections, Vol. 81, 2005, pp. 442-447. Qian, H. Z., Vermund, S. H., and Wang, N. N., “Risk of HIV/AIDS in China: Subpopulations of Special Importance”, 6 Reuters, Reuters Profiles “AIDS Village” in China’s Henan Province, 15 March 2004, available at: http://www.the- body.com/content/world/art10302.html.

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7 China and Eurasia Forum Quarterly, Vol. 4, No. 3, 2006, p. 35-50. Gates, B. and Gang, S., “HIV/AIDS in Xinjiang: A Growing Regional Challenge”, 8 Harm Reduc- tion Journal, Vol. 3, No. 4, 2006. Qian, H. Z., Schumacher, J. E., Chen, H. T. and Ruan Y. H., “Injection Drug Use and HIV/AIDS in China”, 9

10 Testimony provided to Beijing AIZHIXING Institute by M. Rayila, December 2009. AIDS Education and Prevention, Vol. 1, Issue Choi, 1, K.,2004, Gibson, p. 19-30. D., Han, L. and Guo, Y., “High Levels of Unprotected Sex with Men and Women among Men Who Have Sex with Men: A Potential Bridge of HIV Transmission in Beijing China”, 11 See above, note 2.

12 Ranging between 560,000 and 920,000 adults and children.

13 See above, note 2.

14 See above, note 2.

15 State Council of the People’s Republic of China, Regulations on AIDS Prevention and Treatment, 2006, p. 1, available at: http://www.ilo.org/public/english/protection/trav/aids/laws/china2.pdf.

16 See Drug Policy Alliance, 2010, available at: http://www.drugpolicy.org/library/research/methadone.cfm.

17 Forced Drug Testing in China: Public Humiliation and Disruption of Daily Life, November 2008. Beijing AIZHIXING Research Institute, 18 Report on the Status of Human Rights of Chinese Drug Users, August 2008.

19 BeijingChina HIV/AIDS AIZHIXING Media Research Partnership Institute, and Partners, AIDS Related Knowledge, Attitudes, Behavior, and Practices: A Survey of 6 Chinese Cities, 2008, available at: http://www.pte-china.org/what-we-do/background/.

21 TestimonyIbid. provided to Beijing AIZHIXING Institute by R. Hu, December 2009.

22 Institute of Social Development Research, The China Stigma Index Report, 2009, available at: http://www.unaids.

org.cn/uploadfiles/20091124085420.pdf.23

24 Testimony provided to Beijing AIZHIXING Institute by Y. Ling,, November 2009. Nature, 455, 2008, pp. 609 – 611. Lu, L., Jia, M., Ma, Y., Yang L., Chen, Z., Ho, D. D., Jiang, Y. and Zhang, L., “The Changing Face of HIV in China”, 25 China Daily, 28 August 2009, available at: http://www.chinadaily.com.cn/2009-07/28/content_8485672.htm. Matos, N., “Lesbian blood donors take action over being shunned”, 26 The Survey Report on the Status Quo of Beijing Transgender Sexual Service Providers, 2009. Beijing AIZHIXING Institute, 27 - Sexually Transmitted Diseases, Vol. 31, Issue Huang, 11, pp.Y., Henderson, 695 – 700, availableG. E., Pan, at: S. http://journals.lww.com/stdjournal/Abstract/2004/11000/HIV_AIDS_Risk_and Cohen, M. S., “HIV/AIDS Risk Among Brothel-Based Female Sex Work ersAmong_Brothel_Based_Female_Sex.11.aspx. in China: Assessing the Terms, Content, and Knowledge of Sex Work”, 28 Research Report on Behavior, Rights Protection, and Service Needs of FSW in 2008, 2008. Beijing AIZHIXING Institute, 29

30 Testimony provided to Beijing AIZHIXING Institute by Y. Huso, December 2009.

31 Testimony provided to BeijingReport AIZHIXING on the InstituteCurrent Situation by W. Rong of ChineseRong, December Haemophiliacs 2009., 2006.

Beijing AIZHIXING Institute,

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33 Some refer to this as the “Henan AIDS scandal”.China Internet Information Center, 30 June 2004, available at: http:// china.org.cn/english/2004/Jun/99851.htm. “Much to Be Done in Henan AIDS Villages,” 34 Report on the Status of Human Rights of Chinese Drug Users, August 2008.

35 BeijingMingjian, AIZHIXING N., Wheeler, Research K. M., Cheng, Institute, J., Yonghai, D., Chen, W., Fitzwarryne, C. and Wang, J., “HIV/AIDS Prevalence Harm Reduction Journal, Vol. 3, No. 7, 2006, available at: http://www.harmreductionjournal.com/content/pdf/1477-7517-3-7.pdf. and Behaviors in Drug Users and Pregnant Women in Kashgar Prefecture: Case Report”, 36 Research Center for Health Development on Injection Drug Users, PowerPoint presentation, December 2009, on file37 with the authors. Report on the Status of Human Rights of Chinese Drug Users, August 2008.

38 Beijing AIZHIXING Research Institute, Beijing AIZHIXING Research Institute, August 2009.

39 Guo, R., “Overview of the Urban Uyghur Floating Population”, Social Security in the People’s Republic of China, available at: http://www.undp-povertycentre.org/publications/cct/2chine.pdf. Testimony provided to Beijing AIZHIXING Institute by R. Hu, December 2009. See also 40 See above, note 22.

41 Suppression of Beijing Blood Safety Conference, Detention of Activist Wan Yanhai and Related Blood, Haemophilia, HIV/AIDS, and Human Rights Issues, Beijing AIZHIXING Institute, 2009, available at:: http://www.upr-info.org/IMG/ pdf/BAI_CHN_UPR_S4_2009_anx_Bloodissues_ENG.pdf.42 Chinese Legal Report for AIDS Human Rights, 2008.

43 Beijing AIZHIXING Institute,

44 Testimony provided to Beijing AIZHIXING Institute by R. Guo, October 2009.

For instance, on September 14, 2008 we collaborated with the China AIDS CBO Network to issue a public appeal letter,45 namely to call upon the government to strengthen the protection of AIDS NGOs. [email protected] or visit www.aizhi.net. For further information, please contact Mr. Wan Yanhai, Director of the Beijing AIZHIXING Institute, at:

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