Twenty-six-year-old Jiang visited a prostitute last July. Unexpectedly, he had a condom breakage during sex. He fell ill the next day. He believed that he had been infected with HIV. Another man, Zhang, went to a night club where he did not have sex but only allowed a prostitute to lick his chest. He ran a fever the next day and had a bad toothache. He suspected that he had been infected with HIV.
Both Jiang and Zhang were tested for HIV many times and the results were all negative.
Media interest in HIV has waned in recent years. But the stories of Jiang and Zhang have rekindled media interest. That rumor has triggered tens of thousands of blogs and microblogs in addition to heavy traditional media coverage.
Last week, a large number of people claimed to have been infected by the “HIV-Negative AIDS.” But there is no clinical, laboratory or epidemiological evidence that these people suffer any infective disease.
Even though medical scientists may laugh at journalists reporting this kind of rumors , the Chinese public urgently need a nationwide health education about prevention of HIV/AIDS.
Numerous studies have been conducted on the transmission risks associated with specific sexual acts. The odds of HIV transmission from a woman to a man during a single instance of unprotected vaginal intercourse is estimated at between one chance in 2,500 and one chance in 263.
HIV/AIDS in China is mostly transmitted through sex, particularly through sex workers.
By the end of August 2010, there were 361,599 people reported HIV positive in China. Among reported cases, the proportion due to heterosexual transmission rose to 53.8 percent from 30.6 percent in 2006, according to UNAIDS.
The Chinese government should take responsibility for preventing HIV transmission for sex workers living with HIV, particularly those who have not been tested as HIV-positive and work underground.
Since sex trade is a criminal offence, the government has no way to manage and control HIV/AIDS among the sex workers. Since last year’s nationwide crackdown, most sex workers have gone underground, making it more difficult for Chinese health workers to prevent HIV among the most-at-risk population.
Chinese women turn to the sex trade for many reasons, including unemployment, inadequate work skills, gender discrimination, failed marriage, domestic violence, financial troubles and the lack of protection of women’s rights. In a study of eight counties in a southwestern province, nearly a quarter of the female migrant workers studied had engaged in commercial sex.
Sex workers in China have many daily fears in their life such as unwanted pregnancy, abortion, venereal infections and sterility. But the biggest fear is not HIV, but about police attack. According to some experts’ estimation, there are as many as 10 million illegal full-time sex workers in China, who are constantly under attack from police.
Sex work is the oldest job in human history. Crackdowns are deemed too crude a tool to use in changing these behaviors. The jail terms and fines seem to be ill-suited to deal with HIV/AIDS.
According to many sociologists’ research, almost all sex workers started in the industry because of poverty or abduction.
But the prostitutes stayed there for earning and saving money for a better life, and acquiring social contacts for personal advancement in the future. A number of prostitutes spoke of gaining personal freedom.
Sex workers should be encouraged to be cautious about their clients’ possible HIV status and take appropriate protections.
New strategies for health education are needed, including communications strategies that use modern tools, such as online media, to reach high-risk people.
Last week, I led a delegation of Chinese lawyers, civil society activists and journalists attending a workshop at the University of New South Wales in Sydney, where we addressed the laws on sex work in the context of HIV prevention, treatment and care.
“The criminalization of sex workers is confusing. We find it so difficult to respect people who make a living in sex work,” a Chinese lawyer said.”We did not know that Chinese sex workers have poor health until we were allowed to learn about it.”
The author is a professor of journalism at Tsinghua University. firstname.lastname@example.org