China

There are around 1.4 million people living with HIV in China and women make up around 23.7% of them, according to the latest data from Chinese health authorities. Among those living with HIV are pregnant women who are in a particularly vulnerable position due to the stigma surrounding the disease.

In order to counter such stigma and discrimination, women living with HIV and Hepatitis B came together at The Voice of Resilience event to tell their stories and to call for additional resources for community-based organizations (CBOs) working on the frontlines providing services for women living with and affected by HIV.

In 2023 alone, more than 5,000 pregnant women were diagnosed with HIV and over 400,000 with hepatitis B, and some of them were diagnosed at very late stage to be able to receive HIV services to prevent transmission to their children, according to China’s National Health Commission. Even though services are in place to prevent the transmission of HIV to their babies, discrimination, including denial of healthcare, obstructs women from accessing such services.

“I received a call from the doctor telling me that I couldn’t receive services from their hospital because I was HIV positive,” explained Xia Jing, one of the mothers, after she went to a general hospital in Beijing for a routine maternal exam. She still cannot hold her tears when she remembers her traumatic experience. She challenged back and told the doctor r that under the law they had no right to reject her.

She was eventually referred to Beijing’s You’an Hospital, a designated hospital for infectious diseases and people living with HIV where she delivered her baby. Now she is a happy mother of a four-year-old boy. Doctor Zhu Yunxia was the doctor who helped Jing deliver her baby. Dedicated to her job for more than 30 years, she is proud of having helped so many women deliver healthy babies. She calls for empathy with people facing discrimination and unfair treatment and urges all people to look at women living with HIV without prejudice.

“Stigma undermines public health objectives by creating barriers to accessing health and social services and can reduce the quality of the services that members of affected communities receive,” said Mark Vcislo, the First Secretary at Canadian Embassy to China, which has supported the work to tackle stigma. He called for breaking down “the prejudices that can prevent and deter marginalized communities, including persons living with HIV, from accessing the health and social services they need and deserve.”

Community-based organizations (CBO) are vital support for women living with HIV. Sister Xin, for instance, who herself received help from community volunteers when she was first diagnosed with HIV, created Firefly, a community-based organization that has help more than 20,000 women living with HIV in the last 20 years. Zhang Yu whose CBO supports women living with HIV in rural areas of China’s southwestern Yunnan Province, called for more resources for CBO’s work. “CBOs are struggling with their survival due to lack of resources,” she said. “I sincerely hope the government, the charity organizations and everybody can support us to continue our work.”

China has developed a strong and ambitious plan to significantly reduce the transmission rates of HIV, syphilis, and hepatitis B by 2025 outlined in China Women’s Development Plan and Healthy China 2030. China has achieved around 99 percent national screening rates among pregnant women living with HIV over the past five years. In 2023 alone, more than 9 million pregnant women have received HIV testing services. 

The Chinese government has partnered with UN agencies for the “last mile” by building a patient-centred and family-centred community service model to enable a holistic set of services and help break the barriers for both mothers and infants.

“Thanks to the combination of development of technology and social progress, women living with HIV can today give birth to healthy babies,” said Sister Xin.

Read the profile of the storytellers and more unsung community heroes committed to  helping mothers and babies: http://www.unaids.org.cn/page122?_l=en&article_id=1233.

BEIJING, 15 July 2024 – The Joint United Nations Programme on HIV/AIDS (UNAIDS) and China signed two new Memoranda of Understanding (MOU) to advance joint strategic efforts to end AIDS in China and globally.

The first agreement was signed on 10 July by Wang Hesheng, Vice Minister of the National Health Commission and Administrator of the National Disease Control and Prevention Administration (NDCPA) and Winnie Byanyima, Executive Director of UNAIDS, in Beijing. UNAIDS and China have agreed to deepen their collaboration to reach the 2030 Sustainable Development Goals, within the context of China’s Global Development Initiative (GDI) and the Belt and Road Initiative (BRI). The agreement acknowledges China’s commitment to take a leadership role in the global HIV response including mobilizing partners and supporting efforts to end AIDS in middle- and lower-income countries. 

Mr Wang thanked UNAIDS’ for technical support and guidance around China’s HIV response, particularly in formulating HIV response plans and strategies, monitoring and assessment, as well as UNAIDS’ data collection and analysis.

“We expect to continue and further our cooperation with UNAIDS with this MOU,” he said. “The first steps will be to boost communication and coordination, and actively participate in global health governance.”

According to the agreement, NDCPA will make an annual contribution of USD$1 million to UNAIDS from 2025 to 2029, totaling USD$5 million, which includes increased core funding.

The other agreement signed in Beijing on 13 July with the China International Development Cooperation Agency (CIDCA) addresses critical global development issues to achieve the Sustainable Development Goals (SDGs), which includes promoting health and ending AIDS globally, especially in other developing countries in Africa and Asia Pacific.

Luo Zhaohui, Chairman of the CIDCA recognizes UNAIDS’ leadership in the global HIV response and encouraged UNAIDS to apply for more Global Development and South-South Cooperation Fund (GDF) to address the HIV epidemic.

“Let’s work together to improve people’s health especially after the COVID-19 pandemic.” he said. "HIV is a new area for CIDCA but UNAIDS has a lot of experience so there is huge prospect to have more cooperation.”

As part of this agreement, UNAIDS and CIDCA will fund projects in developing partner countries through policy coordination, community engagement, capacity building and technical insight.

Since its founding in 2019, the CIDCA has provided steady financial support to UN agencies and developing member states. As highlighted at the annual Steering Committee of UNSDCF, 13 UN agencies mobilized more than US$ 100 million in South-South funding, predominantly from CIDCA, which assisted 85 partner countries in the areas of COVID response and resilience, social inclusion, agriculture, climate and energy efforts. Earlier this year, UNAIDS received the first GDF to support Iran’s upscaling of rapid HIV testing. UNAIDS is the second UN entity to sign a MOU with the CIDCA.

UNAIDS looks forward to deepening cooperation with China especially in South-South Cooperation and China-Africa cooperation in the areas of local drug production as well as supporting partner countries.

Ms Byanyima said, “Global South solidarity is the bedrock of the HIV response. It is only by standing together that we can end AIDS by 2030 and I welcome steps towards a deeper partnership building China and African countries.”

UNAIDS will also closely work with the African Union, the African Center for Disease Control and Prevention and the African Medicine Agency.   

Ms Byanyima’s week-long mission to China is her first to the country since she became Executive Director of UNAIDS.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The collaboration between UNAIDS and China was the focus of a consultation that took place on the sidelines of the 53 meeting of the UNAIDS Programme Coordinating Board.

The consultation brought together members of UNAIDS senior leadership, representatives from WHO and the Global Fund, and Chinese health authorities, to develop a bilateral strategic action framework and a memorandum of understanding (MoU) to expand and quicken the pace of the HIV response in China and globally. 

“We are at a critical time in the HIV response, and we have a great opportunity that the Chinese delegation is here for our Programme Coordinating Board meeting”, said Rosemary Museminali, UNAIDS Director of the Office of Multilateral Systems, in her introductions.

Building on China’s long-standing international cooperation on health, participants acknowledged the potential to engage China more prominently in global efforts to end AIDS, especially under the South-South Cooperation framework and in line with China’s development schemes including Belt and Road Initiative and Global Development Initiative which aim at promoting global development and helping other developing countries to achieve the Sustainable Development Goals.

UNAIDS pointed out that China has a pivotal role to play in promoting local production of medicines and health commodities. At the same time, there is a need to build and expand relationships with other government departments to leverage all available resources to implement international best practices, promote access to quality services and support civil society’s engagement in HIV response.

Ren Minghui, Director of Global Health Institute of Peking University Health Science Center, is helping UNAIDS develop the framework and MoU. He outlined some initial key points in positioning HIV in the overall health strategy and broader development agenda. He also highlighted China’s specific context, including its increased contributions to global health and the HIV response, China-led initiatives and South-South collaboration, as well as a special call from President Xi to build a community with a shared and healthy future for mankind.

“There are important elements for China and for the global AIDS response, but for these we need to address equality and have a multisectoral mechanism,” said Ren Minghui.

Participants shared ideas on how to facilitate the development process of the two documents, which will take place over the next six months.

Prior to the consultation meeting, UNAIDS Executive Director Winnie Byanyima met with the Chinese delegation for the PCB meeting. She congratulated China’s progress in HIV prevention and treatment and urged more efforts to be made to address challenges such as providing quality treatment for people living with HIV, increasing testing, improving HIV prevention and eliminating stigma and discrimination.

“I hope China can play a bigger role to end AIDS at home and globally”, Winnie Byanyima told the delegation. 

Networks of key populations and community-based organizations in China have called for strengthened collaboration to improve and increase access to Internet-based HIV prevention services.

At the Seminar on Social Organization’s Involvement in Internet-Based HIV/AIDS Prevention, held in Chengdu, China, more than 60 representatives of 45 community-based organizations came together for two days to discuss how to utilize technology and innovations to support the HIV response. In particular, they explored how HIV prevention services can reach a wider range of people and how to encourage key populations to get tested for HIV and initiate treatment if needed.

With the Internet increasingly being used as a source of health information, its potential for delivering HIV prevention services is significant, especially given that services can be delivered anonymously and with minimal cost.

In 2018, according to the government there were 1.25 million people living with HIV in China: 69% of those were aware of their HIV status and 83% of those were accessing treatment. The HIV epidemic in China is concentrated among key populations, particularly among gay men and other men who have sex with men.

Yuan Jizheng, from the Chinese Foundation for Prevention of STD and AIDS, recognized the significant role that Internet companies play in HIV prevention, especially corporations that serve the lesbian, gay, bisexual, transgender and intersex community, such as Blued, the world’s largest gay dating app. “Companies should continue to advocate for protected sex and HIV prevention and testing, including counselling for key populations and care and support for people living with HIV,” she said.

With more than 8 million active monthly users, apps such as Blued play an important role in promoting HIV services on the Internet among gay men and other men who have sex with men. Such services provide information on HIV prevention through chat room outreach, online partner notifications, online test slips, banner ads, interactive targeted interventions and websites, focusing on populations at higher risk of HIV, including gay men and other men who have sex with men, adolescents and young adults.

Danlan Goodness, a community-based organization affiliated with Blued, launched the Internet + HIV Response initiative four years ago to provide online and offline HIV prevention and treatment services for gay men and other men who have sex with men. Since its inception, 150 community-based organizations from 90 cities in China have joined the platform to provide HIV prevention services through Blued’s new media channels.

The UNAIDS Country Office for China has been working closely with Danlan Goodness to conduct research on Internet-based HIV prevention service strategies for young people and key populations in order to understand better how online services can help to improve service delivery. The research looks at the benefits of Internet HIV prevention services, such as the low cost of delivering content, the ability to reach hidden populations, the potential to erase geographic and social barriers caused by stigma and marginalization and the relative anonymity it provides in seeking information and support online.

“The research findings will be shared with community-based organizations and other related partners to facilitate capacity-building and policymaking in this area,” said Liu Jie, the Community Mobilization Adviser for the UNAIDS Country Office for China.

“The importance of Internet HIV prevention interventions has been magnified during the COVID-19 pandemic, when conventional HIV testing and treatment services were disrupted,” said Kong Lingkun, the President of the Beijing Love without Borders Fund and Chairman of the U = U Anti-AIDS Network of China. “Community-based organizations are willing to work with the government and the private sector, tapping into the potential of Internet HIV prevention interventions to benefit more people,” he added.

At the seminar, community-based leaders and participants exchanged ideas about the challenges and advantages of Internet HIV prevention services, sharing views on overcoming specific difficulties such as data privacy and confidentiality, Internet inaccessibility and ways to enhance cooperation between community-based organizations and the government, international organizations and private corporations.

The forum was co-organized by the Chinese Foundation for Prevention of STD and AIDS, Danlan Goodness, Blued, the UNAIDS Country Office for China, the Chengdu Tongle Social Work Service Centre, the China AIDS Fund for Non-Governmental Organizations and the Sichuan Association of STD and AIDS Prevention and Control.

Wang Tang (not his real name) had never been to Nepal before, but at the end of March 2020 it was one of the few countries that had not closed its borders with China. Since he was desperate to get away from Beijing after having had to stay at home for months after the coronavirus outbreak spread throughout China, he bought a ticket.

But days after he arrived, while he was staying in Pokhara, the fourth stop on his trip, the local government announced that the city would be shut down. He heard that the lockdown would not last longer than a month.

As someone who is living with HIV, he had brought along enough HIV treatment to last for a month. However, he soon learned that the re-opening of the city was to be postponed, which meant that he was at risk of running out of the medicine he needed to take regularly in order to suppress his HIV viral load and stay healthy.

Mr Wang swallowed hard while counting the remaining tablets. He had no idea how to get more.

As the lockdown dragged on, it seemed that no end was in sight. Mr Wang started to take his medicine every other day so that his supply would last a little bit longer.

He contacted his friends back at home, hoping that they could send medicine to Nepal, but they couldn’t. The country was under lockdown—nothing could be imported.

Then, Mr Wang contacted his friend Mu-Mu, the head of Beijing Red Pomegranate, a nongovernmental organization providing volunteer services for people living with HIV. It was with Mu-Mu’s help that Mr Wang learned how to obtain HIV treatment after he was diagnosed as living with HIV. Having known each other for many years, Mu-Mu had the trust of his friend. Mu-Mu contacted the UNAIDS Country Office for China to see if it was possible to deliver medicines to Mr Wang. A UNAIDS staff member quickly got in touch with the UNAIDS Country Office for Nepal.

Everything happened so quickly that Mr Wang was shocked when he received a message from Priti Acharya, who works for AHF Nepal and had been contacted by the UNAIDS Nepal office, saying that she would bring the medicine to him.

The next day, Ms Acharya rode her motorbike for 15 km on a dusty road before reaching the place where she would meet Mr Wang. When he came down from the mountains to meet her, Ms Acharya, drenched in sweat, was waiting under the midday sun.

“I was so happy and thankful for her hard work. She gave me a sunny Nepalese smile in return, as well as detailed instructions on the medicine’s dosage,” said Mr Wang.

They took a photograph together, then Mr Wang watched Ms Acharya as she left on her motorbike. Her image, disappearing in the distance, is carved into his memory. To attend the five-minute meeting, Ms Acharya had to ride a round trip of more than 30 km.

“For half a month or so, I had been suffering from pain and anxiety almost every day due to the lack of medication and the loneliness of being in a foreign country on my own. I could not believe that I got the HIV medicine in such a short time,” said Mr Wang. After the trip, he wrote to thank Ms Acharya, explaining how important the medicine he now had in his hand was: “it’s life-saving.”

At the end of his stay in Nepal, Mr Wang wanted to do something for UNAIDS. As he is an experienced photographer, he volunteered to carry out a photo shoot for UNAIDS’ Nepal office.

The subject he chose was former soccer player Gopal Shrestha, the face of an HIV charity in Nepal and the first person living with HIV to reach the summit of Mount Everest. After his HIV diagnosis in 1994, Mr Shrestha launched the Step-Up Campaign and spent many years climbing mountains worldwide, hoping to give strength and hope to people living with HIV.

In 2019, Mr Shrestha reached the peak of the world’s highest mountain, Mount Everest, recording a historic breakthrough for people living with HIV. “If 28 000 people have already climbed Mount Everest, why can’t I?" he said. “By climbing the highest mountain in the world, I want to prove that we are no different from anyone else and that we can all make a difference.”

“The moment I saw him, I could tell he was a sophisticated man,” said Mr Wang. Without instructions, Mr Shrestha posed naturally in front of the camera. He displayed confidence and charm. His eyes, content and clear, reflected nature’s beauty. “The eyes surely are the window to the soul,” Mr Wang said.

Mr Wang is looking forward to his next trip to Nepal. After the pandemic, Pokhara’s lakeside will be flooded with tourists, and he looks forward to seeing the mountain town bustling with people like it used to.

“There were no such diseases back in the day! AIDS came into being only because of college kids like you messing around,” shouted an old man at a group of students who were speaking to people about HIV prevention at China’s West Lake beauty spot. “Behave yourselves! We don't need to listen to your rubbish!”

In 2020, almost three years later, Zhao Honghui, the group leader and a medical student in his third year at Zhejiang University, still remembers every word, but he knew he didn’t do anything wrong. “I wanted to tell the old man that actually new HIV infections among old people are also increasing,” he said. “And that hatred and denial are never the solution to HIV.”

Recently, Mr Zhao had the opportunity to say what he had wanted to say and speak about all the experiences, good and bad, he had as a HIV prevention volunteer, speaking to a live online audience of more than 71 000 people from across China.

He and five other young HIV volunteers joined an online dialogue on youth and HIV organized by UNAIDS and Tencent, a Chinese technology company, one of a series of youth dialogues organized by the United Nations in China and Tencent to mark International Youth Day and the United Nations’ 75th anniversary that enabled Chinese young people to speak their minds about the Sustainable Development Goals.

In China, according to government statistics, new HIV infections among young people aged 15–24 years have been on the rise over the past few years. By inviting young volunteers to share their stories, the UNAIDS dialogue aimed to raise awareness among young people about the risk of HIV infection, tell them how to protect themselves and other people and encourage more young people to engage in HIV prevention work.

Mei Junyan, a second-year student from the South China University of Technology, shared his experience as a peer educator on sexuality education and HIV prevention. Sun Yinghui, from Zhongshan University, told the audience how her medical research team had looked at COVID-19’s impact on people living with HIV and how to help them address the challenges. “I see hope because the dialogue made me realize that I’m not alone in this battle,” said Ms Sun. “It’s an inspirational dialogue for all of us who are devoted to HIV prevention,” said Mr Mei.

They also had good interactions with the guest speakers. UNAIDS China Goodwill Ambassador Huang Xiaoming, an actor, said it was not easy to be a volunteer. The Director of the Chinese Association of STD and AIDS Prevention and Control, Hao Yang, encouraged all the participants to continue what they are doing. He said peer education is complementary with school education and he encouraged students to do more volunteer work.   

One special guest was Andy Liu (not his real name). He contracted HIV five years ago, when he was 21 years old. Now he has an undetectable viral load after taking and adhering to antiretroviral therapy and has become a volunteer to help other people living with HIV. Unfortunately, however, he felt that had to turn his camera off to hide his identity, as stigma against people living with HIV is still prevalent in China. A touching moment came at the end of the dialogue when Mr Huang told Mr Liu that he hoped that one day he would not be afraid to show his face. He said he believes that day will come soon and he will continue to speak for people living with HIV and to advocate against stigma and discrimination.

Mr Zhao hopes the youth dialogue will become an annual event where young HIV volunteers can exchange ideas. “This dialogue is useful for us to know what other volunteers are doing and to learn from each other. I thank UNAIDS for providing this platform and I hope it can become a regular event,” he said.

Amakobe Sande, the UNAIDS Country Director for China, said that UNAIDS is committed to serving young people, together with the Chinese Government and community-based organization partners. “I hope the young people at today’s dialogue will inspire more people to join our efforts too. Together we can achieve an HIV-free generation. We can end AIDS as a public health threat.”

The winter of 2019/2020 in Wuhan, China, will remain with Xiao Yang for the rest of his life. During 60 days working in a makeshift hospital as an emergency nurse, he saw life and death, happiness and sorrow, tears and laughter.

Mr Xiao volunteered to go to Wuhan from his home town, Beijing, to save lives. “Saving life is the responsibility of every medical worker,” he said. This commitment is deeply rooted in his family—17 years ago, his father worked as a doctor on the frontline of the SARS epidemic.

Mr Xiao didn’t tell his boyfriend he was going to Wuhan until the last minute. “He didn’t want me to go, but he respected my decision,” he said.

On the night of their arrival in Wuhan, the volunteers were divided into two groups—intensive care and mild cases.

Mr Xiao was assigned to intensive care. For his protection, he was required to wear five gloves and two masks. However, most of the gloves were too small for him—wearing them for more than 20 minutes hurt. He also found it difficult to breathe. “It felt like someone was covering my mouth all the time,” he said.

Even worse for Mr Xiao is that he is asthmatic. If an asthma attack struck, he wouldn't have time to reach his medicine because of all the protective equipment he was wearing.

“All of us medical workers recorded final words for our families on our phones,” he said.

His boyfriend, Lin Feng, is a policeman. He too has become a lot busier because of the COVID-19 pandemic. When COVID-19 first broke out in Beijing, he was on duty for long hours, inspecting the freeways, streets and residential areas.

When the couple were far apart, instant messaging was the only way to communicate. Covered in snow after finishing his night shift, he received a text message from Mr Xiao reminding him to put on thicker clothes. His reply: “You take care of your patients. I’ll take care of you.”

Six days after his arrival in Wuhan, Mr Xiao realized that death could be near.

As he made his way around the ward, he saw a patient suffering from a drastic drop of blood oxygen level and shortness of breath. He rushed to intubate him—the quickest and most effective way to keep him alive. But he acted too forcefully, his protective suit tearing at his back—a colleague taped up the hole so he could continue to work.

After the patient was stabilized, Mr Xiao could hardly breathe and he felt sharp pains in his hands, ears and face—he had worn masks, gloves and his protective suit for too long. When the pain subsided, fear came over him. That leak could easily have seen him become infected with the new coronavirus. The leak also reminded him of the risks he was facing every day. “I can only pray I will be fine,” he said. “I was prepared for the worst when I decided to come here.”

There are many people from the lesbian, gay, bisexual, transgender and intersex community, like Mr Xiao and Mr Lin, who worked hard to contain the virus and save lives during the pandemic. In the Wuhan Lesbian, Gay, Bisexual and Transgender Center, 26 volunteers worked around the clock to deliver medicine to people living with HIV. UNAIDS was proud to support their efforts by connecting the centre with local health authorities to facilitate the delivery of medicine, helping with the delivery of medicine for Chinese people living with HIV overseas and supporting the establishment of a hotline providing counselling services for people living with HIV. As a result, the centre was able to deliver medicine to more than 2600 people, and the hotline reached about 5500 people.

“It was planned that I would stay for one week, but then it was extended to three weeks and then longer,” Mr Xiao said, choking back his tears.

He finally left in early April, when the COVID-19 pandemic subsided in the city. He said he will remember everything, but he doesn’t want to relive it. Nobody should.

Now safely back with his boyfriend in Beijing, he remembered the captain’s words on his flight to Wuhan, “The flight is from Beijing to Beijing, with a stopover in Wuhan. When you have won the battle, we will take you back home.”

“You’re welcome!”

Sunny Dawson (not his real name) jumped with joy when he received his medicine from Bai Hua. “You're an angel sent by God,” he said to him.

Mr Dawson is an English teacher at a school in a small town in northern China. In January, he went on a vacation to his home country in south-east Asia, but his journey back to China turned out not to be as easy as his journey out. The coronavirus outbreak that started in December 2019 in Wuhan, Hubei Province, and quickly swept across China has posed big challenges to everybody’s life. But because he is living with HIV, the challenges for him were probably greater.

Rushing back to China

News about the outbreak in China hit the headlines in Mr Dawson’s home country during his vacation. “All my family objected to me going back to China,” he said. But he loves China and wanted to go back. “I needed to rush back before flights were stopped,” he said. His family conceded, his father giving him a big bag of face masks before his departure.

He thought he was fully prepared, but when his flight landed, he could feel that things were different. All the passengers had to have their temperature checked, one by one. Mr Dawson was wearing heavy clothes that day and was sweating a little—his temperature read 37.6 degrees Celsius. He and some other passengers were sent to a nearby hospital for further tests.

He tested negative for COVID-19, but soon after learned from the head teacher of his school that the small town he works in has been put under lockdown—he couldn’t go back to where he worked.

Since he is living with HIV, he needs to take antiretroviral medicine every day. He had only taken a one-week supply with him on his vacation, though, and it was running out.

BaiHuaLin alliance of people living with HIV comes in to help

Mr Dawson remembered Bai Hua , the founder of the BaiHuaLin alliance of people living with HIV, a community-based organization dedicated to supporting people living with HIV, including help with refills of medicine. BaiHuaLin was the organization that reached out to him when he was scared and lonely after being diagnosed with HIV a year before.

The coronavirus outbreak left many people like Mr Dawson at risk of running out of their medicine because they were stranded away from their usual HIV service provider. The BaiHuaLin alliance helps people in need of HIV medicine to get their refills by using an extensive network of volunteers that covers the whole country and extends globally. “Too many people need refills these days. We are terribly busy,” Bai Hua said.

When he received Mr Dawson’s call for help, he told him to come to his office immediately to pick up the seven-day refill he had requested. However, only a few days later he had to return for more because his stay in Beijing had been extended indefinitely. “My colleagues told me not to go back in the near future because the shops are closed under the lockdown,” he said. This time, Bai Hua gave him a month’s refill.

A strong partnership

The UNAIDS Country Office in China also felt the impact of the COVID-19 outbreak on people living with HIV. “We received messages on social media from people living with HIV, expressing their frustration and desolation and seeking help,” a UNAIDS staffer said.

Because of HIV-related stigma, when faced with the risk of the disruption of medicines, people living with HIV often choose to keep their anxiety to themselves, afraid to reveal their status. “Some people say they would rather die than disclose their HIV status,” Bai Hua said. “One person sneaked out of his village and walked 30 kilometres to get the medicine.”

The UNAIDS Country Office in China has been working to ensure that the rights of people living with HIV are fully protected. In addition to giving out information, UNAIDS also actively works with the government and community-based organizations in China in order to ensure that people living with HIV get medicine refills.

Special pick-ups and mail deliveries of HIV medicines arranged by UNAIDS have reached more than 6000 people living with HIV in Wuhan.

Best yet to come

Mr Dawson finally got back home to the small town in northern China after staying in Beijing for more than two weeks. Still under quarantine, he misses an old man in the park near his apartment. “He was my calligraphy teacher. He always goes to the park, writing Chinese calligraphy on the ground,” he said. He gave Mr Dawson a piece of calligraphy, beautifully framed, that is now hung on the wall of his sitting room.

“I look forward to the day when the virus is gone,” he said, “So I can visit my friends and learn calligraphy in the park.”

On the day of China’s Lantern Festival, 8 February, Shen Ming was making sweet dumplings, the traditional festival delicacy, at his home in Wuhan in China’s Hubei Province. From time to time, he would raise his head to watch the local news on the television to get the latest on the COVID-19 outbreak.

His paid particular attention to the new traffic restriction measures. Unlike most people in the city, who stayed indoors all day because of the lockdown, Shen Ming needed to go out almost every day—he is a volunteer who is driving people living with HIV to pick up their medicines from hospitals during the outbreak.

Shen Ming had planned to drive someone to Jinyintan Hospital in the afternoon. Just enough time to have the sweet dumplings, he thought. As the water began to boil, his phone rang. A colleague from the Wuhan Lesbian, Gay, Bisexual and Transgender Center asked him if he could drive another two people to get their medicine right away. He said yes. “You see,” he said. “It will save me a lot of time because I can drive three people to the hospital in one go.”

He switched off the hob and put on a protective suit and mask. “Never mind the sweet dumplings. I can cook them later,” he said. “Besides, I can have a video call with my parents while I’m having the dumplings in the evening.” 

A new year away from home

It was more than two weeks since Wuhan, the epicentre of the COVID-19 outbreak, was locked down. An uncomfortable silence hung over the city, which appeared deserted, in stark contrast to the energy of the city before the outbreak.

Shen Ming had had totally different new year plans. He had booked a flight to his home town in Zhejiang Province and had even bought some spicy local delicacies for his parents as new year gifts. “They are more accustomed to sweet food, but I want them to try something different,” he said.

Two days before his flight, Shen Ming got a text message from his boyfriend. “How are you?” the message read. “I got bad news: my father has been diagnosed with COVID-19. And my mother and I both have a high fever too. We are all on the way to the hospital and will stay there if there are beds for us.”

Shen Ming offered his condolescences to his boyfriend, and the next day went to see his doctor. He was relieved to be told that he was not infected, but was advised to stay in Wuhan for observation—he never thought that the coronavirus would be the reason for his first new year away from his family.

So, you are also HIV-positive, like us?

His first passenger was from Shanghai. Wuhan was put under lockdown just as he was about to leave. Soon, he found his HIV medicine running out. “If the medicine of people living with HIV is disrupted, their health will suffer. It might be inaccurate, but I can feel their fear, anxiety and dispair,” Shen Ming said.

Thanks to a directive from China’s National Center for AIDS/STD Control and Prevention, people living with HIV can receive medicine refills wherever they are. All they need is a letter from their service provider. However, they faced a challenge, as taxis and public transport services were stopped during the lockdown.

A survey jointly conducted by UNAIDS and the BaiHuaLin alliance of people living with HIV, a community-based organization in Beijing, shows that nearly 65% of the respondents in Hubei Province had difficulty getting their medicines during the lockdown. With most medical staff concentrating on COVID-19, community-based organization such as the Wuhan Lesbian, Gay, Bisexual and Transgender Center asked for volunteers like Shen Ming to transport people living with HIV to pick up their medicines.

On his first drive, Shen Ming put on three face masks and rolled down the car window to reduce the possibility of getting infected. His trip was to the same hospital that looked after people affected by COVID-19. He was nervous when arriving at the hospital, but to his relief the HIV clinic and the COVID-19 clinic were far apart. The Wuhan Lesbian, Gay, Bisexual and Transgender Center gave him a protective suit after learning that he didn’t have adequate protective equipment, and he eventually became more relaxed.

He would walk to the clinic with his passengers and wait there until they got their medicine. Afterwards, they would have a chat. “So, you are also HIV-positive, like us?” almost all of them would ask Shen Ming. He isn’t. “It doesn’t matter,” he said. “AIDS is just a chronic disease. The care for people living with HIV goes beyond the community of people living with HIV.”

“I will probably stay here”

It was late when he got back home after driving the three people to the hospital on the day of the Lantern Festival. Hungry, he turned on the hob and cooked noodles. This is the first time that Shen Ming hadn’t had sweet dumplings on the Lantern Festival, but he was happy because he got to meet his boyfriend, albeit briefly.

“I will continue my volunteering work until they don’t need me. It would be best if I’m not needed,” he said with a smile on his face.“I will probably stay in this city. I’ll buy a house when the epidemic is over, and build a home here.”

GENEVA, 19 February 2020—A survey of people living with HIV has found that the current coronavirus disease outbreak, known as COVID-19, is having a major impact on the lives of people living with HIV in the country.

In the survey, nearly a third (32.6%) of people living with HIV reported that, because of the lockdowns and restrictions on movement in some places in China, they were at risk of running out of their HIV treatment in the coming days—of these, almost half (48.6%) said they didn’t know where to collect their next antiretroviral therapy refill from. However, a close partnership between the government and community partners is determined to ensure that access to life-saving HIV treatment is not interrupted as the country fights to get COVID-19 under control.

The Chinese National Center for AIDS/STD Control and Prevention has directed local authorities to ensure that non-resident people living with HIV can collect their medication wherever they are and has published and disseminated lists of antiretroviral therapy clinics. The UNAIDS China Country Office is working with the BaiHuaLin alliance of people living with HIV and other community partners to urgently reach those people living with HIV who are at risk of running out of their medicines in the next 10–14 days and will offer support as necessary. UNAIDS will also be donating personal protective equipment to civil society organizations serving people living with HIV, hospitals and others to help improve the quality of care for people in health facilities and to prevent coinfection of people living with HIV with COVID-19.

“People living with HIV must continue to get the HIV medicines they need to keep them alive,” said Winnie Byanyima, UNAIDS Executive Director. “I applaud the efforts of the Chinese National Center for AIDS/STD Control and Prevention to support people living with HIV affected by the lockdowns to get their medicines—we must ensure that everyone who needs HIV treatment gets it, no matter where they are.”

The COVID-19 outbreak in China has resulted in an unprecedented response, resulting in hospitals and health-care workers being overwhelmed as they look after COVID-19 patients. Lockdowns in cities have resulted in people living with HIV who had travelled away from their hometowns not being able to get back to where they live and access HIV services, including treatment, from their usual health-care providers.

While the vast majority of the respondents (82%) said that they had the information they need to assess personal risk and take preventive measures against COVID-19, almost 90% said that they wanted more information on specific protective measures for people living with HIV. Similar to the general population, many of the respondents (more than 60%) said that they didn’t have enough personal and household protective equipment, such as face masks, soap or disinfectant, medical alcohol or gloves. Nearly a third reported being anxious and needing psychosocial support during the COVID-19 outbreak.

“We need to know how many people living with HIV are contracting COVID-19, whether people living with HIV are at greater risk of contracting COVID-19 and, if they contract it, whether they are in greater danger from it—at this stage of the COVID-19 outbreak there are so many unknowns. We must fill in the gaps in our knowledge, and fill those gaps in rapidly,” added Ms Byanyima.

The survey was devised and launched jointly by UNAIDS and the BaiHuaLin alliance of people living with HIV, with the support of the Chinese National Center for AIDS/STD Control and Prevention. UNAIDS mobilized community support for the survey and promoted the survey online in order to maximize the responses to it—more than 1000 people living with HIV replied. Responses were collected from 5 to 10 February 2020. A follow-up in-depth survey is to be carried out in partnership with the School of Medicine at Zhongshan University, which will go beyond community needs and will look at health systems issues that have a direct impact on HIV services.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.