Most Chinese would refuse to work alongside a person infected with HIV/AIDS, an academic said Monday, citing a recent survey.

"A large number of Chinese are willing to discriminate in the workplace for health reasons," Cai Dingjian, director of the Constitutionalism Research Institute of China University of Politics and Law, told reporters.

In a survey conducted by Cai and his colleagues in 10 cities covering 3,500 people, 52 percent of the respondents said they would not work with an HIV/AIDS carrier, while 49 percent said the same of Hepatitis B carriers.

More than 55 percent of the repondents said they would not hire carriers of either disease.

The survey suggested other causes of discrimination at work include physical appearance.

It showed 70.1 percent of male respondents said good looks were important for women if they wanted to get ahead in the labour market.

Although China has laws opposing work-related discrimination and promoting equality at work, the laws are not rigorously enforced, Cai said.

A cross-sectional study of men who have sex with men (MSM) in Shanghai, China has found prevalence rates of 1.5% for HIV and 13.5% for markers of syphilis. Researchers from the Center for AIDS Prevention Studies at the University of California, San Francisco, say that prevention work in China needs to target and strengthen the social networks of men who have sex with men. The study was published in the May 1^st issue of the Journal of Acquired Immune Deficiency Syndromes.

The study found that men were at lower risk for syphilis if they had larger social contact networks or had steady female sexual partners. However, they were more likely to have unprotected intercourse if they had larger male sexual contact networks, were or had been married, or had steady sexual partners (male or female).

As of the end of 2005, there were a confirmed 141,000 and an estimated 650,000 HIV-positive persons in China. Most of the infections are in injection drug users; however, HIV prevalence among MSM has been found to range between 1% (in northeast areas) to 3.1% (in Beijing). HIV among Chinese MSM has been understudied overall.

In this study, researchers from the Center for AIDS Prevention Studies at the University of California, San Francisco investigated MSM in China’s largest city, Shanghai. The study focused on the men’s social and sexual networks and how these influenced HIV and sexually transmitted infection (STI) rates.

Participants were recruited between September 2004 and June 2005. An initial 52 participants recruited from MSM venues including bars, clubs and restaurants led to an overall “snowball” sample of 515 men screened. Of these, 477 participated in the study: all were men who self-reported as having sex with men (57% “homosexual”, 38% “bisexual” by self-report), 18 years or older (mean age 28), and residents of Shanghai. Most (78%) were never married; 73% had no college education.

Most of the men were knowledgeable about HIV transmission (mean 6.9 correct responses to a set of eight questions) but felt themselves to be at low (52%) or no risk (38%) for HIV. Yet 57% reported unprotected anal sex with men in the past six months, 63% had unprotected intercourse with men or women, and 13% had unprotected sex with both men and women. Of the 475 who provided blood samples, 7 (1.47%) tested positive for HIV, 64 (13.47%) had markers for syphilis, and two (0.42%) were co-infected with both.

Men with stronger social networks were at lower risk of syphilis infection. Multivariate analysis found that syphilis was less likely in those with three to five (vs. six or more) sexual partners, meeting other MSM at the gym or through the Internet rather than other venues, having a steady female partner, and having social and sexual networks that overlapped more strongly (i.e., having more partners who were also social rather than purely sexual contacts).

Men were more likely to have unprotected anal and/or vaginal sex if they: were married, were more knowledgeable about HIV, had more lifetime male sex partners (six or more vs. three to five), and were part of larger male sexual networks.

The study did find that sexual and social networks tended to overlap strongly – more than half of the sample had male social contacts as sexual partners, and 22% had a sex partner (male or female) in their social contact network. The researchers believe “[t]hese data suggest that HIV prevention programs should target the social and sexual networks of Chinese MSM”, and suggest that such programs could aim to strengthen social networks for MSM, and to promote safer sex among such networks.

Reference
Choi K-H et al. The influence of social and sexual networks in the spread of HIV and syphilis among men who have sex with men in Shanghai, China. J Acquir Immune Defic Syndr 45: 77-84, 2007.

Failure to tackle HIV/AIDS among drug users is hampering the global battle against the disease, the United Nations agency that coordinates the world body's fight against the disease warned Monday.

To be effective, programmes targeting the HIV virus, which precedes AIDS, need to reach around 80 percent of people who inject drugs, said UNAIDS.

However, only eight percent of the estimated 13 million intravenous drug users worldwide, around half of whom live in Asia, have access to any kind of HIV prevention or treatment programme.

The shortfall has deadly consequences, because fighting the virus among drug users is a key to stemming its spread in the wider population, said UNAIDS.

"About 10 percent of all new HIV infections worldwide are attributable to injecting drug use. If you exclude Africa, that figure rises to 30 percent," Prasada Rao, UNAIDS' regional director for Asia and the Pacific, told a conference in Warsaw.

"Evidence shows that HIV prevention programmes are particularly effective among people who inject drugs, but they are regularly denied access to information and services," he said.

UNAIDS also said that access to antiretroviral therapy, which is used to keep the disease under control in infected individuals, was "unacceptably low" among injecting drug users.

It blamed "lack of information, exclusion and widespread stigma and discrimination."

Key planks of programmes for drug users include giving them ready access to clean syringes -- reused needles are a key source of infection -- and providing less harmful substitutes, such as methadone for heroin, to help people break their drug habit under supervision.

Worldwide, HIV is predominantly spread by heterosexual sex.

Injecting drug use, however, is a major mode of HIV transmission in Southeast Asia, and the former communist bloc countries of Central Asia and Eastern Europe.

In addition, drug use is emerging as a new source of HIV infection in sub-Saharan Africa, particularly in Kenya, Nigeria, South Africa and Tanzania, UNAIDS noted.

HIV programmes for injecting drug users make a difference, said the agency, citing the example of Portugal, which scaled up programmes for drug users in 2001.

Four years later, HIV diagnoses among injecting drug users had been cut by almost a third, said UNAIDS.

"The allocation of financial resources must be used in more strategic and innovative ways to deliver more effective prevention programmes to people most at risk of HIV infection," said Rao.

Around 39.5 million people were living with HIV or AIDS at the end of last year, according to UN figures.

Sub-Saharan Africa remains by far the worst-affected region, being home to two-thirds of all people living with HIV.

US drug maker Abbott on Monday offered to sell new anti-AIDS medicine at a cut price in Thailand, a senior health official said, in a bid to resolve a stand-off with Thailand over generic drugs.

The government here has jolted the powerful pharmaceutical industry by allowing generic versions of anti-AIDS drugs Kaletra and Efavirenz and popular heart disease medicine Plavix.

But Abbott has offered to sell antiretroviral drug Aluvia at a lower price as long as Thailand does not allow copycat versions into the market, said Siriwat Thiptaradol, secretary general of the Food and Drug Administration.

"We have passed this proposal to the (health) minister to decide," he told reporters after talks with Abbott and another drug company.

In March, Abbott said it would stop selling new drugs to the kingdom in a protest against the health ministry's generic drug programme.

Despite announcing the generic drug scheme in January, the government has continued talks with Abbott and other foreign drug firms in a bid to secure cheaper prices for vital medicines.

In a previous round of negotiations, Abbott offered to reduce the price of 30 Kaletra tablets per person to 3,488.20 baht (100 dollars) per month, down 40 percent from its earlier proposal.

But activists said that the new price would only apply to an older version of Kaletra that it currently sells in Thailand, while many HIV/AIDS patients need newer versions such as Aluvia.

Siriwat said Abbott had on Monday offered to sell Aluvia at "the same price as Kaletra, for 1,000 dollars per person for a year", as long as no generic versions were allowed.

But Kannikar Kijtiwatchakul, a campaigner with health charity Medecins sans Frontieres, said this was still too expensive for Thailand's HIV/AIDS patients.

"I think Abbott should offer a better price without conditions," she told AFP. "We would suggest the Minister of Public Health to say no to this condition."

Siriwat also met with the makers of Plavix on Monday, and said negotiations were progressing, with another round of talks scheduled for June 1st.

A representative from Abbott who attended the meeting refused to comment.

 

Banning sex education on the grounds that it offends Indian sensibilities puts young lives at risk and jeopardizes the fight against AIDS, a senior health official said.

Six states in India, which has the most people living with HIV/AIDS in the world, have banned sex education for adolescents or refused to implement the curriculum, saying the course material was too explicit or that it was against Indian culture.

Some politicians accuse educators of encouraging permissiveness among young people.

"We are not giving ideas to young people," National AIDS Control Organization (NACO) chief Sujatha Rao said. "They are already there."

"Some people are in denial that young people experiment with sex. They need to get real," she told Reuters late on Wednesday.

Rao's comments came before the cabinet approved on Thursday a plan that envisages spending 116 billion rupees ($2.8 billion) over the next five years in its most ambitious anti-AIDS project yet.

The plan for 2007-12 will focus on prevention and increasing the number of people on first-line AIDS drugs. The government plans to provide 80 billion rupees and the rest will come from foreign donors like the World Bank.

India has the world's highest caseload for HIV/AIDS with 5.7 million HIV-positive people, according to the United Nations. But sex is not spoken about openly in most parts of the country.

An India Today magazine survey last year showed one in four Indian women aged between 18 and 30 in 11 cities had sex before marriage.

Yet over 40 percent of all Indian women have not heard of AIDS, creating a dangerous combination of lack of knowledge and greater sexual activity.

"There will be a huge negative impact if you don't provide sex education, given the vulnerability of young people to the virus," Rao said earlier, addressing MPs who are also doctors.

"Are you more concerned about culture than the lives of young people?" she said.

The states of Gujarat, Maharashtra, Madhya Pradesh, Chhattisgarh and Karnataka have banned or refused to implement sex education curriculum introduced last year.

The Hindu nationalist government in Madhya Pradesh said sex education had "no place in Indian culture" and plans to introduce yoga in schools instead.

India has 165,000 reported AIDS cases of which around 50,000 are in the age group of 15-29 years.

"We are worried about our young people," Rao said.