Evolution of information-driven HIV/AIDS policies in China

Abstract

Background As China continues to commit to universal access to HIV/AIDS prevention, treatment and care services, its HIV/AIDS policies have become increasingly information driven. We review China’s key national-level HIV/AIDS policies and discuss policy gaps and challenges ahead.Methods We conducted a desk review of key national-level policies that have had a major impact on China’s HIV/AIDS epidemic, and examined recent epidemiological data relevant to China’s HIV response.Results National-level policies that have had a major impact on China’s HIV/AIDS response include: ‘Four Frees and One Care’; 5-year action plans; and HIV/AIDS regulation. These landmark policies have facilitated massive scaling up of services over the past decade. For example, the number of drug users provided with methadone maintenance treatment significantly increased from 8116 in 2005 to 241 975 in 2009; almost a 30-fold increase. The ‘Four Frees and One Care’ policy has increased the number of people living with AIDS on anti-retroviral treatment from some 100 patients in 2003 to over 80 000 in 2009. However, stigma and discrimination remains major obstacles for people living with HIV/AIDS trying to access services.Conclusions China’s current national policies are increasingly information driven and responsive to changes in the epidemic. However, gaps remain in policy implementation, and new policies are needed to meet emerging challenges.

Psychological well-being of people living with HIV/AIDS under the new epidemic characteristics in China and the risk factors: a population-based study

“…These two groups were therefore combined. With regard to antiretroviral therapy, the Four Free and One Care policy 9 in China provides free antiretroviral therapy to PLWHA if their CD4+ T lymphocyte level is lower than 350 cells/mm 3 . Therefore, this was assessed on the basis of the receipt of any type of antiviral treatment from the provincial CDC.…”

“…Studies conducted in foreign countries revealed that nearly half of PLWHA suffered from anxiety disorders and that 20-32% of PLWHA were affected by depressive disorders. [6][7][8] In China, policies such as the 5-Year Action Plans and Four Frees and One Care 9 have been implemented to improve HIV/AIDS prevention, treatment, and care services. These policies have mainly focused on physical health care and not on the psychological health of PLWHA.…”

Condom use around the globe: how can we fulfil the prevention potential of male condoms?

“…There also is encouraging evidence that condoms can be successfully incorporated into comprehensive STI prevention strategies that involve multiple prevention messages, as demonstrated by recent examples from Uganda, 85 Thailand 9 and China. 86 Although the emphasis continues to be placed on developing biomedical interventions (e.g. vaccines, microbicides, circumcision), the male latex condom remains the most effective, most widely available and by far the least expensive prevention method.…”

International Expansion of the Use of Pharmacotherapies for the Treatment of Opioid Dependence

“…Methadone: China has a current policy that supports methadone treatment for opioid dependence as a national approach to the HIV/ AIDS epidemic [104]. The national approach to HIV/AIDS is to develop pragmatic solutions to the changing epidemic based on sound scientific information.…”

“…China's initial response was via a police crackdown on drug use. Incarceration, rehabilitation units with labor or compulsory detoxification were used [104]. However, this strategy did not stop the spread of HIV.…”