News (Updated January 17, 2010)

[Home]  [Previous news]

AIDS and the elderly in China : More elderly afflicted with HIV

The rise in infections among elderly men could even be much worse than doctors think. - China Daily/ANN

Tue, Jan 12, 2010
China Daily/Asia News Network

By Cao Li in Guangzhou and Shan Juan in Beijing

There is a worrying increase in the number of elderly people diagnosed with HIV and AIDS, with the highest infection rate among prostitutes and their clients, senior health officials have revealed.

Although no official figures are available, Hao Yang, deputy director of the Ministry of Health's disease prevention and control bureau, said cases involving men and women aged 60 and over have risen by several hundred since 2007, particularly in southern China .

In the southern metropolis of Guangzhou alone, infections among people aged 50 or older are up to more than 100 a year, officials said.

The revelation highlights a possible oversight in AIDS prevention policies, which for many years have focused on younger age groups and migrant workers, experts said.

Of the 320,000 HIV-infected people in the country, 70 percent are 20 to 49 years old, the health ministry said last October. However, Hao told China Daily: "Old people have not been a priority in HIV and AIDS prevention and control campaigns, but they should be paid more attention."

Given the country's limited capacity for epidemic monitoring and reporting, the rise in infections among elderly men could even be much worse than doctors think, he said.

Due to constantly improving conditions, the Chinese are living healthier and longer, which Hao explained means more seniors, particularly men, are staying sexually active longer.

"Some of them turn to prostitutes but they face a high risk of HIV/AIDS. A great number do not use condoms," he said.

Outside an AIDS support clinic in Guangzhou , 70-year-old Zhong Ping - not his real name - was seated with dozens of others waiting to see a doctor.

He was diagnosed as HIV-positive last year and told China Daily he thinks he was infected after sleeping with women at a "sauna" in 1999. "I didn't use any protection," he said.

Alongside him in the queue at Guangzhou No 8 People's Hospital, the only hospital in Guangdong with a special AIDS unit, were parents with babies and small children, a prisoner in shackles escorted by a police officer, a young pregnant woman, and a couple in their 70s.

Sex has overtaken intravenous drug abuse as the most common method of HIV transmission in China . Of the 48,000 new cases reported in 2009, about 70 percent were infected through heterosexual or homosexual sex, according to China National Radio.

Cai Weiping, director of the infectious disease department at No 8 People's Hospital, warned that the deadly virus is spreading fast among the country's elderly population.

"I am seeing more elderly patients year by year," he said, adding that seven of the 39 people hospitalized with HIV at his unit last year were aged 58 or above, with the oldest being 73.

"The oldest patient we have tracked is a 94-year-old man. Study of his development has found he was most likely infected by sex," said Xu Huifang, director of HIV and AIDS Control and Prevention under the Guangzhou Center for Disease Control.

The situation in the southern metropolis is being echoed in most other regions of the country, said Hao at the Ministry of Health. However, both Hao and Xu declined to reveal the exact size of the elderly HIV positive population.

Some experts have put the nationwide rise in cases down to the improved blood screening programs introduced since 2006, when hospitals began to give all patients blood tests before surgical procedures, such as cancer and heart operations.

"As older people are more prone to major diseases than youths, they are more likely to receive a HIV test, meaning they have a higher chance of testing positive," said Wang Ning, deputy director of the National Center for AIDS and Sexually Transmitted Disease (STD) Control and Prevention.

The fact that the majority of China's 740,000 HIV and AIDS patients are aged 20 to 49 shows they are "still the biggest hit groups, rather than the elderly", he said.

However, other experts disagree and instead blame the rise in infection among older people on abundant and cheap commercial sex, as well as an increasingly active gay community.

Campaigners have urged health officials to roll out more safe sex awareness programs targeting the elderly. Most programs and events currently only target young adults on college campuses or at nightclubs, they said.

"There is demand. People are getting richer and the price of a prostitute is getting cheaper," he said.

There are between 4 to 10 million female sex workers on the Chinese mainland catering regularly to more than 6 percent of the male population aged 20 to 64, according to a paper published in 2009 by Wan and Professor Joseph T.F. Lau, director of the Chinese University of Hong Kong 's center for epidemiology and biostatistics.

Some women charge as little as 20 to 50 yuan ($3 to $7) and usually attract elderly men and migrant workers, the paper said.

AIDS specialist Cai said his older patients often told him they paid for sex at cheap venues - usually disguised as saunas, hair salons and massage parlors - because their wives had died or lost their sex drive after the menopause.

"Traditionally, sex is a taboo subject in China . People do not talk openly about it, meaning men often feel ashamed at having to request sex with their wife if she has lost interest," he said.

Elderly widowers and divorcees also turn to prostitutes for sex because their children prevent them from remarrying, usually due to concerns about their inheritance, said Zhang Hongmei, a volunteer at China Red Ribbon, a non-government organization (NGO) advocating AIDS prevention in Guangzhou .

"The sexual needs of the elderly should be fully recognized and respected by society," added Pan Suiming, a professor at Renmin University 's institute of sexuality and gender in Beijing and well-known sexologist.

A Beijing man surnamed Huang, 74, who was diagnosed HIV positive in 2004, told China Daily he began paying for sex 10 years ago after the death of his wife. He never once used a condom, he said. "It felt better without it and I never thought HIV would happen to me. I wouldn't say I regret it, or that I am not afraid of dying, but my only concern is if others know about my condition it might lead to my children being discriminated against," he said.

A two-year survey by Wan Shaoping of more than 1,000 clients of female sex workers in three cities in Sichuan province found condom use was at about 40 percent for those offering the industry's "low-end services".

More than 95 percent of the men polled in 2005 and 2006, whose ages ranged from 17 to 80, admitted using a prostitute within six months of the survey. The average number of visits was 11, with the most 90. The average price paid for sex was 36 yuan.

The sex workers with the lowest fees are 30 to 60 years old, and are usually from poor rural areas or unemployed city women; they charge as little as 10 yuan, and more than 90 percent do not insist clients wear condoms, Wan's study discovered.

"They need the money and are the most likely to compromise their health to make it," said the professor, who estimates about 5 percent of low-cost prostitutes are infected with HIV. "The clients of female sex workers may get the virus and then transmit it to general female population."

Peng Xiamin - not his real name - was diagnosed as being in the serious stages of AIDS in early December and was immediately admitted to the Guangzhou No 8 People's Hospital for treatment.

The 59-year-old told China Daily he is still too ashamed to tell his wife about his condition.

"I have been losing weight since last year and now have a cold that cannot be cured. I had a thorough check-up and that's when I found out," he said as he slouched on his bed in the room he shares with two fellow patients. "I still need to tell my wife, tell her how I was infected. Then I must tell her she needs to have a HIV test, too."

Peng said that, in the early 2000s, he used to pick up prostitutes at entertainment venues and take them to hotels.

"I went there out of curiosity and found myself interested in the young women there. They were more sexually active. Sometimes I used a condom, sometimes I didn't. I remember sleeping with seven or eight girls, but I don't know who I caught the virus from," he said.

In heterosexual relationships, it is far more likely for a man to pass HIV to a woman than vice versa, said Cai, meaning the virus is often spread to wives and girlfriends, as well as other prostitutes.

Discrimination against people living with HIV and AIDS is still a major issue in China and experts warn this could be preventing high-risk groups - gay men, prostitutes and their clients - from accessing prevention and intervention services.

"People will not go to get help if they think they are going to be made ashamed, or even shunned by society," said Guangzhou AIDS control chief, Xu Huifang.

Of the 1,000-plus men surveyed in Sichuan by Wan Shaoping, only about 15 percent had received free condoms, 3 percent had received treatment for a STD and 20 percent had received AIDS awareness material. Just 3 percent had been tested for HIV.

When asked what they would do if they feared they had an STD, 52 percent of the men said they would visit a small private clinic, 28 percent would buy medicine from a pharmacy and 14 percent would go to a public hospital.

"It's no use telling people to stick to one sexual partner these days. More must be done to promote safe sex," said Doctor Cai.

More programs should also be directed at the "low-price" prostitutes, many of whom are also elderly, said Wan, who explained that the attention was currently on high- and middle-end sex workers.

Hao Yang with the Ministry of Health agreed and said: "More activities to spread anti-HIV knowledge will be held in neighborhood communities to show people, particularly the elderly how to protect."

Wan, along with a team of volunteers, has been running a safe sex awareness program targeting low-end prostitutes in Sichuan since 2005. The project is supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international financing project.

"We started by making friends with some of the women and encouraged them to spread the knowledge to their peers. Then we managed to talk to some clients, as well as owners of commercial sex venues," said Wan.

The team holds community lectures for elderly men and promise small gifts for those who come. Wan said they have so far been well attended.

"We tell them not go to prostitutes, but we also give them information on what to do to stay safe if they decide to go, and what they should do if they find a problem or need help," he said. "Men sometimes dial the hotlines for the local disease control offices during the lectures."

Prevention projects are not expensive, require few resources and pay large dividends, said Wan, who revealed that after just a year of lectures, condom use among clients of low-cost prostitutes rose to almost 70 percent.

The government should encourage more NGOs to get involved in helping to promote safe sex to prostitutes, urged Wang Min, director of the AIDS Study Institute affiliated with the First Hospital of Changsha, Hunan province.

"It is difficult for the authorities to help those in the illegal commercial sex at the same as trying to clamp down on them," she said. "The country's disease control departments, who lead most programs, are not able to handle such a huge task."

One solution could be involving neighborhood committees and local women's federations in the nation's war on AIDS.

"Raising awareness among female sex workers and their male clients should be part of their everyday activities," she said.

Beijing police cancel China 's first gay pageant

by Marianne Barriaux Marianne Barriaux Fri Jan 15, 2010

BEIJING (AFP) – Beijing police blocked China 's first gay pageant Friday shortly before it was to start, organisers said, stopping an event billed as heralding a new Chinese openness about homosexuality.

Organisers said police arrived at the upscale restaurant and club where the Mr Gay China contest was to be held and told them they did not have the proper licence.

The sudden cancellation came despite considerable pre-event media coverage this week, even in China 's state-run press, that had touted the pageant as a coming out for Chinese gays.

"Its a disaster. I'm full of disappointment. I thought the government was becoming more and more tolerant," said Jiang Bo, 29, a contestant from Sichuan province in southwestern China .

"They were making a big step. The whole world was thinking China was doing a very good thing. But now I think everybody will be disappointed."

Contestants in the pageant -- which was to have included an underwear segment -- were to vie for the right to represent China at the Worldwide Mr Gay pageant in Norway next month.

"Police said we didn't have the proper licence," said Ryan Dutcher, one of the organisers, who said they were still trying to negotiate with police late on Friday to let the event proceed.

"I'm very disappointed but I can't say I'm very surprised."

"(Police) came here just before the event. We didn't have any advance warning," he added.

Participants and organisers had hoped the contest would help underline what many have said are growing signs of acceptance of gay men and women in China , where homosexuality has long been viewed with shame.

Homosexuality was a crime in China until 1997 and it was officially considered a mental illness until 2001. Since then, however, an increasing number of visible gay and lesbian events has taken place.

The cancellation left about 150 attendees -- a large portion of whom were media covering the event -- milling about in confusion around a deserted stage with a runway as organisers dismantled sound systems and other equipment.

A man in plainclothes who said he worked for the government circulated among the crowd, asking people to provide their identification. He declined to further identify himself or to comment when asked why the event was halted.

But Wei Xiaogang, 33, a gay man who was to have acted as one of the judges, told AFP: "In my opinion, it had something to do with the issue of homosexuality."

"I feel very sad. I almost cried."

Dennis Sebastian, Asia representative for the Worldwide Mr Gay pageant and a Philippine citizen who flew in for the China competition, said that "even bad publicity is still publicity."

"( China ) might not be able to send a representative this year but I still think they'll find a way. You can't keep this underground for a long time," he said.

Although many gay people say the situation in China has improved over the past few years, especially in big cities, they typically say it remains difficult to come out to their friends and family.

One problem for China's gay community lies in the nation's one-child policy, which makes parents rely on their only child to marry and produce grandchildren.

According to Chinese experts cited in press reports, there are an estimated 30 million homosexuals in China , two-thirds of them men.

Still, there had been recent hopeful signs for the gay community.

Last June, China 's first gay pride festival was held in Shanghai , albeit discreetly and with some events cancelled at the last minute by authorities.

Last month, China 's first government-backed gay bar opened in the tourist town of Dali in southwestern Yunnan province, after a three-week delay sparked by intense media attention, in a bid to boost HIV/AIDS prevention efforts.

And on Wednesday, the state-run, English-language China Daily ran a front page story on what it called China 's first publicly "married" gay couple that included a photo of the two men arm-in-arm at the ceremony.

China postpones HIV-themed radio show

17 January 2010

THE debut broadcast of China 's first state-sponsored radio programme dedicated to HIV issues and featuring HIV-positive hosts was postponed, a day after police shut down a gay pageant in the capital.

Police: Woman lied about infecting others with HIV

By COREY WILLIAMS, Associated Press Writer Fri Jan 15, 2010

DETROIT – A Detroit woman who claimed in a video posted online that she infected more than 500 people with HIV has admitted it was a hoax, police said Friday.

On the video, the woman said she contracted HIV in 1998 and has been "pretty upset" about having to "suffer." She also said she has set out to "destroy the world" because a cure for the virus that causes AIDS has not been found.

Although she wore a bandanna over her face to hide her identity, police said they were still able to track her down. Police said the woman voluntarily submitted to an HIV test, which came back negative.

No charges have been filed against the woman, police spokesman John Roach said Friday.

"We don't see anything at this point under state law that would allow us to press charges, but we are researching," he said.

The woman identified herself to The Detroit News as 23-year-old Jackie Braxton and told the newspaper that she doesn't have AIDS. "I made the tape because I wanted to raise awareness about AIDS," she said.

The Associated Press tried several times to reach Braxton by phone Friday, but she did not answer and her voicemail box was full.

In 2008, a New York man was charged with sending threats in interstate commerce and falsely claiming to have tampered with a consumer product. He allegedly claimed in hoax Internet videos that he had poisoned millions of bottles of baby food, some with cyanide or rat poison, because he wanted to kill black and Hispanic children.

The gossip Web site mediatakeout.com was the first to report on the HIV hoax earlier and posted the 11-minute video of the woman on its site and on YouTube. The Detroit News and other local media outlets then picked up on the story.

Mediatakeout.com received the video via e-mail earlier this week, editor Fred Mwangaguhunga told the AP Friday.

"We looked at it, talked about it, and whether or not we thought it was a hoax and whether we should put it out," he said. "She was alleging a possible public health crisis. The hope was we would be able to find out more information on the woman. We uploaded it onto YouTube, and that's when we ran the story."

Mediatakeout.com also contacted Detroit police about the video.

Michael McElrath, a spokesman for the city's health department, said it appeared one positive did come from the hoax: The number of walk-ins for HIV testing more than doubled in Detroit on Friday. Because all information is confidential, people seeking testing were not required to say why.

District, NIH announce new initiative aimed at HIV/AIDS epidemic

By Darryl Fears
Washington Post Staff Writer
Tuesday, January 12, 2010

 The District government and the National Institutes of Health on Monday announced the launch of a $26.4 million initiative to attack the city's HIV/AIDS epidemic with expanded testing and treatment to reduce the level of the virus in its victims and hopefully decrease their chances of spreading the disease.

Mayor Adrian M. Fenty joined Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, a division of NIH, in making the announcement at an HIV/AIDS treatment clinic in Southeast Washington , home to one of the city's most at-risk populations.

The National Institute of Allergy and Infectious Diseases will work with the city Department of Health and the city's largest health care providers to evaluate the health of patients and measure the impact of testing and treatment. The effort will focus heavily on African Americans who represent 76 percent of the city's 15,000 HIV/AIDS cases. Two studies conducted by the George Washington University School of Public Health and Health Services will research the behaviors of the most at-risk groups, gay African American men, who comprise the largest group of cases, and heterosexual African American women, whose rate of new infections is rapidly growing.

"As the nation's capital and the national leader in the fight against HIV, the District of Columbia is excited," Fenty said in a statement. "This comprehensive collaboration will generate fresh ideas, new services and technical knowledge to assist the city . . . in preventing new infections and improve health care services for all residents living with HIV/AIDS."

The effort in the District and a similar effort in the Bronx has energized U.S. doctors and scientist who study AIDS because they are the first to approach aggressive treatment as a form of HIV prevention.

But the approach, based on a World Health Organization study, is so untested that Fauci said it's still hypothetical whether reducing the viral load in a city's infected population will reduce the transmission of the disease. A professor of medicine at the University of California at Los Angeles called its chances success unlikely "even under the best circumstances."

In recent months, the city's HIV/AIDS Administration has come under scrutiny for the way it has managed organizations that deliver services to victims and millions of dollars in grants that are provided to the groups. A Washington Post investigation revealed that one group received millions of dollars over several years while running a threadbare operation, and others provided fraudulent employee resumes and spent hundreds of thousands of dollars on executive travel.

In September, the federal department of Housing and Urban Development threatened to withhold $12 million in AIDS housing funds from the District when the Department of Health and the Office of the Chief Financial Officer failed to submitted a timely audit of programs as required by law. A HUD assistant secretary ended the threat only after city officials worked around the clock to complete the audit and address other major federal concerns about its financial oversight.

The District has the nation's highest HIV/AIDS prevalence rate, 3 percent, touching nearly every ward in the city, according to its 2008 Epidemiology Update, released last year in March.

A heterosexual behavior study that accompanied the update found that majorities of black men and women in the highest risk communities thought their partners engaged in sex with others and said that they themselves engaged in sex with others, often without a condom. Few were aware of their HIV status.

Over the two-year funding period, NIH experts will work with District clinics to modernize their patient records. In addition, the NIH will attempt to help clinics improve their treatment of illnesses such as diabetes, cardiovascular disease and hepatitis that cause death in HIV-infected patients.

"The goals . . . are to enhance subspecialty medical care for underinsured HIV-infected patients . . . and provide those patients with the latest treatments available," said Henry Masur, chief of the Critical Care Medicine Department in the NIH Clinical Center .

Gates Foundation allocates $38M in banking grants

Motorbike banking, soap opera savings lessons: Gates Foundation grant winners get creative

By Donna Gordon Blankinship, Associated Press Writer , On Wednesday January 13, 2010.

SEATTLE (AP) -- From a TV soap opera advocating savings in the Dominican Republic to banking by motorbike in Ethiopia and India, the Bill & Melinda Gates Foundation's most recent grants to promote global development have a decidedly more creative bent.

But the ingenuity of the recipients of the $38 million in grants announced Wednesday did not result from a foundation request for new ideas. It was an unexpected bonus, said Joyce Bontrager Lehman, a program officer in the foundation's financial services for the poor initiative.

Lehman said the aim of a recent request for proposals was more basic: The Gates Foundation wants to work with microfinance networks around the world that have already made a successful transition to allow their customers to save money as well as take out loans.

The goal of the grants is to give more people a safe way to save their money. The foundation estimates these new initiatives could make savings accounts available to 11 million people across 12 countries in Africa, Asia and Latin America over the next five years.

"Our goal is to help them reach farther down into poorer markets and farther out into the more remote areas," Lehman said.

The impact could grow beyond the estimates, if the potential the foundation sees in these ideas is reached, she said, noting that these projects have an enormous potential for duplication in other organizations.

This is the foundation's second big collection of grants in its financial services initiative. Another $35 million in grants was announced in September to help facilitate agent banking services in Africa, Asia and South and Central America , through the use of mobile phones and kiosks in markets and post offices.

Mary Ellen Iskenderian, CEO of New York-based Women's World Banking, was happy to learn that the network of 40 microfinance providers and banks in 28 countries will be given $8.5 million for a variety of initiatives that aim to reach an estimated 3.5 million people.

Iskenderian also was delighted the Gates Foundation decided to wrap what she called a "crazy idea" into the mix. The foundation is going to pay to produce a new Dominican Republic soap opera, or "telenovela," with saving money as a recurring theme.

Of course, the soap opera, which is expected to begin airing in the second half of 2010, will also focus on more typical themes of the genre: relationships and family drama, said Iskenderian.

And some stories will combine both approaches, such as one about a woman saving money without letting her husband know she has an extra pot of cash, and the story of a mother who learns about savings from her teenage daughter who has become mom's go-to person at the end of the month when she runs out of money.

The idea of transmitting social messages through telenovelas is not new; birth control and HIV-AIDS prevention have been promoted through the same medium. The complicated part of this grant, however, is the Gates Foundation's need to see proof that a grant delivers on its promise, Iskenderian said.

Her organization will be closely monitoring banking activity throughout the country when the soap opera begins airing.

Most of the Women's World Banking ideas supported by the Gates Foundation are more along the line of the other grants announced this week:

-- Helping microfinance organizations figure out which software works best for remote banking.

-- Putting bank employees on motorbikes with handheld devices to reach people in remote African and Indian villages.

-- Installing automatic teller machines in the Philippines .

-- Researching why some people in rural areas are uncomfortable with using cell phones and other electronic devices for making savings deposits.

Iskenderian said her organization would continue to look for creative ways to increase access to savings and other banking services for the poor.

"Loans or credit were the model for the first 30 years of microfinance. Savings is the future," she said.

[Home]  [Previous news]