Growing cross-border population challenges AIDS prevention

Growing numbers of foreign AIDS patients in southwest China's Ruili City have come to Xiaohong (a pseudonym) for consultation this year, a trend that worries the thirtysomething woman, who is herself HIV-positive. Xiaohong distributes medicine to those in need as an employee at Red Ribbon Home, a non-government organization aimed at supporting people with HIV/AIDS -- a disease that will draw the world's focus on Dec. 1, which is recognized internationally as World AIDS Day. Ruili, a small city in Yunnan Province near China's border with Myanmar, has seen an increase in its cross-border population in recent years. The city is a key experimental area for China's opening-up to southeast Asia and for the Myanmar-China oil and gas pipeline's entrance to China. The area is likely to see even more cross-border migration, as China will allow border cities to implement special policies for personnel exchanges, processing and logistics, and tourism, according to a key reform plan adopted at the Third Plenary Session of the 18th Communist Party of China Central Committee on Nov. 12. The soaring cross-border population brought by the booming trade and a lack of medical resources have put tremendous pressure on the border city's AIDS prevention and control efforts, said Zhang Miaoyun, deputy head of the municipal health bureau. Ruili has a resident population of 120,000 and a floating population of 50,000 from overseas. About 20,000 people come in and out of Ruili every day, according to Zhang. Foreigners from neighboring countries often come to Ruili to work as migrant workers, do business, seek marriage or work in the entertainment service industry. Out of 700 newly-confirmed HIV cases since 2012, more than 60 percent were foreigners, mainly from Myanmar, she said. In Yunnan Province, 83,048 people had tested HIV-positive as of the end of October, including 6,970 foreigners. About 86 percent of the foreign HIV carriers were from Myanmar and 4 percent were from Vietnam, according to the provincial health department. Although the Chinese government has been providing free voluntary counseling and testing, free antiretroviral medications, and subsidies for HIV/AIDS patients for years, foreigners have been excluded as they have no household registration in China, said Zhang. "But they live in China and live with Chinese citizens. We cannot just ignore them," she said. Ruili, in a breakthrough move, has started to provide free antiretroviral medications for foreign HIV carriers, she said. A total of 271 HIV carriers from Myanmar have been receiving free antiretroviral medications in the Dai-Jingpo Autonomous Prefecture of Dehong, which governs Ruili, according to Xu Heping, head of the provincial AIDS prevention and control bureau. Many of the foreign HIV carriers are from the countryside and are between the ages of 18 to 40. They have little knowledge of AIDS prevention and can easily spread the virus through commercial sex, according to the latest survey from the provincial health department. Some foreign sex workers in Yunnan's border cities carry the HIV virus, which is likely to contribute to the spread of the disease, according to the survey. Some 86 percent of the 9,091 newly-confirmed HIV and AIDS patients diagnosed between January and October of this year in Yunnan were infected through sexual contact, according to Lu Lin, director of the provincial disease control and prevention center. Better health education for the cross-border population and effective interventions for prostitutes are urgently needed to contain the disease and prevent it from spreading in the province, said Lu. The provincial government is promoting the use of HIV rapid test cards and asking all service staff members in entertainment establishments, massage centers and hair salons to have an HIV test at least once every six months, he said. So far 50,000 such tests have been performed, he said. The departments of public security, civil affairs and health should work together to help them leave the sex trade with better care, treatment and persuasion, he said.