Fighting Stigma and Discrimination of HIV/AIDS in China: Media Art and Social Policy
Cosponsored by Asia Society and Shanghai Academy of Social Sciences

Wang Longde
Vice Minister, Ministry of Health, People’s Republic of China

Shanghai, June 13, 2005

Guests, Ladies, Gentlemen, and Friends, I am pleased to participate in this important symposium and to briefly introduce current activities in eliminating HIV/AIDS-related stigma in China. Since the first case of HIV/AIDS was diagnosed, stigma has been associated with HIV/AIDS. This stigma seriously affects the lives of people living with HIV/AIDS and their families. Stigmatization has also been a barrier to our efforts to fight the spread of this disease. HIV/AIDS-related stigma is a global issue, and China is no exception. Through many years of effort, China has made significant progress to improve this situation. However, stigmatization still remains an important issue in the response to HIV/AIDS.

I would like to use the time that I have been granted today to talk to you about the four strategies and methods that the Chinese government has used to fight against HIV/AIDS-related stigma. These four aspects are political commitment, law enforcement, government policy, and social marketing and community mobilization.

A steadfast political commitment is essential to the fight against HIV/AIDS. The pictures that everyone sees on the screen show that President Hu Jintao visited HIV/AIDS patients in Youan Hospital. He emphasized that the whole society should be full of love for HIV/AIDS patients. Chinese people should have the determination to eliminate stigma and discrimination and should initiate many kinds of care programs to help those infected by this disease. China’s highest political leader visited and talked with the HIV/AIDS patients at Youan Hospital. By doing so, he demonstrated to the Chinese populace that HIV is not transmitted by daily contact. Public demonstrations of this kind can have a profound effect on reducing HIV/AIDS-related stigma in China.

These pictures show that on the eve of the Spring Festival, Premier Wen Jiaobao went to the epidemic region in Henan to examine the work of prevention and treatment programs. He also visited HIV/AIDS patients and their families to celebrate the Spring Festival and took photos with AIDS orphans as well as elders. In 2004, before the World AIDS Conference in Thailand, Premier Wen published his paper, “Multi-Sector Strategies to Prevent and Control HIV/AIDS.” In this paper, he emphasized the importance of extensive education and social marketing, treatment and care of HIV/AIDS patients, and protection of HIV-positive people’s legal rights in the fight against HIV/AIDS.

Vice Premier Wu Yi who is in charge of sanitation-related work, underlines her care and support for the HIV/AIDS patients. At the National HIV/AIDS Prevention and Treatment Conference in June 2004, she emphasized that all relevant government departments should fully and carefully implement the “Four Frees and One Care” policy.

Revised in 2004, the "Law on Prophylaxis and Treatment of Communicable Diseases in People's Republic of China” is the first law in China to eliminate social discrimination against people with infectious diseases. The law requires no discrimination against people who have infectious diseases or those who are carriers. It reflects the respectful attitude of the Chinese government and protects the legal rights of patients with infectious diseases. The law also requires that, in fulfilling their obligations, organizations that work towards disease prevention and control are not permitted to disclose confidential information about individuals. At the same time, the law requires that if this article is violated, organizations and/or individuals in disease control agencies will be punished at different levels.

The government is currently drafting the first HIV/AIDS Act. In the HIV/AIDS Act it is clearly stated that the rights of HIV-infected people and their family members should be protected. This means that they should not suffer any discrimination as a result of being HIV-positive. The Ministry of Health presented a draft of the Act to the State Council last month, and it is expected that the Act will be approved and implemented within the year. The Chinese government established the “Four Frees and One Care” policy to emphasize HIV/AIDS prevention and control to fight against its related stigma.

The “Four Frees and One Care” policy reduces the HIV/AIDS related stigma. The policy includes 1) Free Voluntary Counseling and Testing (VCT); 2) Free ARV drugs to AIDS patients who are rural residents or people with financial difficulties living in urban areas; 3) Free ARV drugs to HIV infected pregnant women to prevent mother-to-child transmission, and HIV testing of newborn babies; 4) Free schooling for children orphaned by AIDS; 5) Care and economic assistance to the households of people living with HIV/AIDS. According to the policy, HIV/AIDS affected people are given necessary economic assistance, and those who can still be productive are encouraged to continue working to increase their income.

The Chinese government developed a series of policies related to HIV/AIDS. These policies helped reduce HIV/AIDS-related stigma and discrimination and have provided support to people living with HIV/AIDS. To fully implement these polices, relevant governmental sectors also issued detailed implementation plans in response.

We should say that poor understanding of HIV/AIDS is the primary factor to cause fear and stigma. In April 2004, the Chinese government hired the Horizon Group to conduct a nation-wide research on the HIV/AIDS situation in China. Of course, the results of the investigation are from a year ago. During one year, the situation of HIV/AIDS prevention and treatment in China has changed immensely. However, these results still generally reflect the lack of HIV/AIDS-related knowledge in China.

At that time, HIV/AIDS knowledge was widely heard yet superficially learned. The Horizon Group study found that 40.8% of people who were interviewed could not distinguish the difference between HIV-positive people and AIDS patients. Only 40.2% of people knew that the HIV virus could be tested; 48.8% of people knew that holding hands would not transmit the HIV virus. Only 57.1% and 50.2% people knew that working and eating with an HIV-positive person would not spread the virus. As many as 59.8% of people were not willing to work with people who had HIV/AIDS. Only 17.1% of people knew that there were drugs to prevent mother-to-child transmission; 7.8% of people knew that one of the purposes of using a condom is to protect themselves from getting the disease. However, over 90% of people showed their support for the “Four Frees and One Care” policy. This situation has changed dramatically during the year. However, social marketing to improve HIV/AIDS-related knowledge remains the most important tool to fight HIV/AIDS.

The pictures on the screen show that we are conducting extensive social marketing programs. We have also hired many celebrities, taking advantage of their fame and popularity to raise people’s awareness about HIV/AIDS. We have invited HIV-positive people to join the team to educate the populace as well. Last year, we printed 4 million copies of AIDS posters for every village, school and community in China. We also organized teams to perform nationally to spread HIV/AIDS knowledge. These are (pictures) taken from Shanxi DaPengChe and Hebei Dachang. We invited some celebrities in literary, arts and sports circles such as Cunxin Pu, Wenli Jiang, Yao Ming, Magic Johnson etc. to be the public figures of HIV/AIDS awareness. This type of HIV campaign raised a great response among young people. Pengfei Song and Ziliang Liu who were infected by HIV were also invited to participate in social activities. Ziliang Liu set out from Beijing to cycle around the country on his own HIV campaign.

This series of related activities effectively fought against HIV/AIDS-related stigma. At the same time, time has demonstrated that the “Four Free and One Care” policy has dramatically reduced stigma and discrimination in the community. In China CARES sites, parents of children from families who are HIV-negative now allow their children to play with children from families with HIV/AIDS and AIDS orphans. A study carried out in Anhui Province by the China CDC in 2004 indicated that after the social marketing and education activities conducted since the end of 2003, people have more comprehensive and correct knowledge about HIV/AIDS. They are less afraid of people carrying HIV. This is a change perceived by a husband of an HIV-positive woman. He said that people were dared not to have contact with people living with HIV/AIDS. However, through the current, prevalent social marketing campaign, most people now understand this disease and dare to have daily contact with patients.

In Hubei, many villagers came to the tea shops that were opened by people with HIV/AIDS for chatting and drinking tea. This phenomenon reflects a great psychological change. Stigma and discrimination are still very much a problem in our society. Though we have developed some laws and regulations for protecting the rights and interests of HIV-positive people, it is essential to fully implement these laws and regulations and to further improve them operationally. In addition, education about HIV/AIDS should be strengthened so that the community is mobilized to act against discriminating behavior.

In the past two decades, the world community has gained a lot of experience in combating HIV-related stigma. We are eager to learn from different experiences. We hope that we can work together to reduce stigma and discrimination associated with HIV/AIDS and eventually defeat this devastating epidemic. Thank you.

More information on the Shanghai symposium and related photography display.