The brief background of AIDS / HIV in Guangxi, China

The WHO defined HIV (human immunodeficiency virus) as an infectious disease transmitted mainly via intercourse, blood, or mother to child transmission, which may result in AIDS (acquired immunodeficiency syndrome). Also, WHO stresses that AIDS/HIV continues to be a significant public health problem worldwide in recent years. However, the good news is that the Asia Pacific region shows a slight downward trend in HIV cases, especially in Cambodia, Myanmar, Thailand and Vietnam nowadays (UNAIDS,2020). Guangxi, situated on China’s southern border, is geographically near the Southeast Asian nations mentioned above and is a particular area of worry for HIV transmission. However, the statistics indicate that the number of newly reported HIV cases has declined steadily since 2011. It means that Guangxi’s measures in the fight against AIDS and HIV have achieved remarkable results. Nevertheless, Guangxi still has the second-highest recorded AIDS/HIV incidence rate in China, which means that Guangxi still faces many challenges in the fight against AIDS/HIV.

 

The main challenge in Guangxi, China, in the fight against AIDS/HIV

Late diagnosis is a significant obstacle in Guangxi’s battle against AIDS/HIV. The rate of diagnosis has to be increased. Hu. et al. (2019) highlighted that more than half of the patients (58.8%) newly diagnosed HIV between 2006 and 2012 had a late diagnosis. Furthermore, patients with late diagnoses had a poorer immune system at the time of diagnosis than those with early diagnoses, and they had to pay a higher treatment cost. Due to the province’s poor socioeconomic position, the people live with HIV (PLWH) in Guangxi obtained lower levels of education and were less likely to have secure employment. It implies a higher cost of treatment due to late diagnosis, which might impose a significant economic burden on PLWH in Guangxi. Additionally, Hu. et al. (2019) added that late presentation and severe HIV illness were widespread among newly diagnosed HIV patients in Guangxi, China. So, targeted initiatives are urgently needed in Guangxi to decrease HIV late diagnosis, particularly among male heterosexuals, drug users, and patients with characteristics such as elderly, poor education level, divorced or widowed status.

 

The main drivers of this late diagnosis of AIDS/HIV in Guangxi

Due to the stigma associated with AIDS, some PLWH may get a late diagnosis because many people are ignorant of how HIV spreads and frightened of the epidemic. They develop prejudices and negative attitudes toward that PLWH, especially toward female sex workers (FSWs) with HIV. Traditionally, FSWs are labelled “social evils” in these regions. Thus it is unlikely that locals can be expected to be genuinely sympathetic to FSWs with HIV. Indeed, many smuggled migrants are compelled to work as sex workers in low-grade venues in Guangxi, near the Vietnamese border, to make ends meet. Such deep-root stigmatization is unfair to these patients. It is more likely to result in them hiding their infection and being reluctant to seek diagnostic testing when they suspect they have the disease. Thus, this leads to late diagnosis, making it very difficult to halt the spread of HIV in Guangxi.

Furthermore, the government’s neglect of elderly males living alone in rural regions may result in late diagnosis. The government is more concerned with conventional AIDS patients such as drug users and youths rather than the village’s old men who live alone and have a sexual desire to seek out prostitutes. In this case, those old men are ignored, making them more susceptible to HIV infection. According to Hu. et al. (2019) examined that most HIV-positive individuals in Guangxi are older males living in rural regions. Indicating that government should not ignore those older males. In addition, sex trade venues are typically concealed and undetectable. Thus, it is easier for governments and HIV testing agencies to ignore HIV infections among older people living in rural regions. Consequently, it was too late for these individuals to be diagnosed with HIV, and the disease progressed more likely to advanced HIV.

 

Next steps

The following are some potential solutions to Guangxi’s late AIDS diagnosis problem: First and foremost, the government should do an outstanding job of popularizing information about HIV/AIDS so that people understand how the illness is transmitted and how to avoid the disease and, as a result, no longer dread AIDS. In this instance, PLWH is respected, and they take the initiative to be seen by a doctor. What is more, medical institutions should pay more attention to elderly people who live alone in the countryside and provide them with regular free HIV testing services. Finally, the government must intensify its efforts to combat illicit prostitution. These strategies may have the potential to assist Guangxi in tackling the problem of late HIV diagnosis even more effectively in the future if they are used.

 

Reference：

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Hu, X. et al. (2019) HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: A large-scale cross-sectional study. AIDS research and therapy. [Online] 16 (1), 6–6.

Sun, X. et al. (2020) Declining trend in HIV new infections in Guangxi, China: insights from linking reported HIV/AIDS cases with CD4-at-diagnosis data. BMC public health. [Online] 20 (1), 919–919.

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Oct 3, 2021