The HIV/AIDS confusion and circumcision

babycondom1130.jpgWe've had a hard time making sense of the conflicting reports on China's HIV/AIDS situation that kept appearing on our RSS this morning. First, there was an AFP report that China says estimated HIV/AIDS cases rise to 700,000, and then AP came out with a conflicting report entitled China HIV/AIDS figures down.

In the AP report:

China has 223,501 people infected with HIV, the official Xinhua News Agency said Thursday, a sharp drop in previously reported figures.

The brief dispatch from Xinhua did not give any more details.

In 2004, China scaled back the estimated number of people infected with HIV, the virus that causes AIDS, from nearly 1 million people to 840,000, and then further lowered the estimate to 650,000 in 2005.

Even though all the various reports appear to have come out from the same press conference given by China's Health Minister Chen Zhu yesterday, newswires all had their own twist on the story. We found that AP's story was very sloppy in comparing the 223,501 HIV cases this year with the 650,000 in 2005. Allow us to clarify the key points of what the health minister said:

  • There were 223,501 officially reported cases of HIV/AIDS.
  • The total number of people estimated to be living with HIV/AIDS in 2005 was 650,000.
  • An estimated 50,000 people will contract the disease this year, bringing the total number of people living with HIV/AIDS to 700,000.

In China, as in many other countries, there is a disparity between the number of officially reported cases of HIV/AIDS and the number of people thought to be living with the disease. Of course, in China's case, the disparity is very large. But that disparity is being slowly reduced with the encouragement of (anonymous) testing, better data collection methods, and greater openness in information dissemination, among other reasons.

China's latest figures appear to come with the stamp of approval of international organisations such as United Nations and the World Health Organisation, although independent Chinese AIDS activists such as Wan Yanhai have begged to differ. Just last week, we told you that UNAIDS was busy fighting allegations that it had inflated its estimates in many countries worldwide for years in an alarmist effort to raise funds. The worldwide total of people infected with HIV, estimated one year ago at nearly 40 million and rising, is now reported as 33 million, and one of the reasons for the disparity cited is an improved data collection methodology. Yet, other AIDS activists are ringing new alarm bells, and the controversy continues.

Back in China, Ben Blanchard of Reuters reports:

Of the new infections, 44.7 percent will come from heterosexual transmission, 12.2 percent from men having sex with men, and 42 percent from intravenous drug use, the report said.

This apparently is the very first time sex (both heterosexual and homosexual contact) has been cited as being the main cause of HIV transmission instead of intravenous drug use. Nevertheless, at 42 percent, drug abuse still remains a key driver in the spread of the disease, a relatively unique Chinese situation, it would seem.

We were also surprised to read from the Reuters report that Chinese authorities were mulling over the plan to push for a circumcision campaign to combat AIDS:

"This is a technical question. I think our experts will evaluate it," Chen later told Reuters. "Even before the AIDS era some children in China were already being circumcised."

Circumcision rates are low in China compared to Asian countries like South Korea or Japan, where the foreskin is often removed at birth for hygiene reasons, or Muslim countries like Indonesia which practice it for religious reasons.

China's Muslim minority, concentrated in the far western region of Xinjiang, likewise circumcise their male children, normally as they reach puberty.

Chen said that were the government to decide to promote circumcision among the wider population, he did not think it would run into much opposition or cultural problems.

"As long as there is evidence it is effective, I don't think it would be an issue," he said.

The report also added that while the WHO has recommended circumcision as one of the ways to fight AIDS in Africa and even though circumcision has been shown to reduce the risk of HIV transmission by up to 60 percent, it does not offer total protection.

We are somewhat sceptical about the effectiveness of a circumcision campaign to fight against AIDS and think it could lull circumcised men into a false sense of security that they are immune to the disease. And then, we read this report by a Christian commentator that HIV/AIDS prevalance in Africa is highest in those countries where Protestants and other non-Catholic Christians predominate, and lowest in Muslim-dominated countries — a very interesting situation which leads us to ask more questions if the report is to be believed.

Yet one thing remains certain. If public education on sexual and health matters is not improved in China, a circumcision campaign will not help.

In other related news: China will launch a three-month campaign to wipe out illegal advertisements of sexual medicine and venereal disease treatments.

Related links
Reuters: China AIDS rate slows, main transmission now sex
SCMP: Heterosexual contact top cause of new HIV/Aids cases [Subscription]
AP: China HIV/AIDS Figures Down
ABC: China reports sharp drop in number of people infected with HIV/AIDS
AP: Sex Now the Main Cause of HIV in China
AFP: China says estimated HIV/AIDS cases rise to 700,000
People's Daily: China to wipe out illegal ads of sexual medicine

Picture of baby boy in front of a condom machine by Nick Lui: Will circumcising this baby boy keep him safe from AIDS?

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Posted Nov 29 2007, 10:00 PM by Shanghaiist
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