Pubdate: Wed, 3 Dec 2003 Source: New York Times (NY) Copyright: 2003 The New York Times Company Contact: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Jim Yardley Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) CHINA TELLS ITS PUBLIC OF ENORMITY OF AIDS TOLL BEIJING -- With China taking its first real steps toward a full-scale public awareness campaign about AIDS this week, the degree of ignorance caused by past government denial is evident in the dazed expression of Zhao Pingyuan. Pedaling his bicycle along a narrow alleyway in the graceful old Houhai neighborhood, Mr. Zhao, 33, stopped beside a new government AIDS poster. He had not noticed the poster, or AIDS, before. "I've never heard of it," he said. "I'm from Henan Province. We don't have it in Henan." Told that Henan is an epicenter of AIDS, with huge numbers of cases and deaths, Mr. Zhao shook his head. "There is nothing like that," he said. "It would have been on television if people had died of AIDS." This week, in a flurry of publicity coinciding with World AIDS Day, AIDS is finally all over television in China. New public service announcements promote awareness and even recommend condom use. The most dramatic moment came on Monday night when Prime Minister Wen Jiabao was shown comforting AIDS patients and pledging support, the first such public appearance by a top government leader. Mr. Wen also promised that the government would provide free AIDS drugs to all people who needed them. Elated AIDS advocates praised Mr. Wen's appearance as a pivotal moment that could reduce the stigma surrounding the disease and send an important signal to lower officials. Yet those same advocates also warned that symbolism was not enough, and that the government must dedicate major resources to curtailing the spread of AIDS and educating people like Mr. Zhao. "This was like breaking the ice," said Joel Rehnstrom, the coordinator in China for Unaids, a United Nations agency. "It's something that a lot of people working in the AIDS field inside China and outside have been hoping for and waiting for." China is thought to have slightly more than one million people who are infected with H.I.V., the virus that causes AIDS, or who have already died of AIDS. Experts say there could be 10 million cases by 2010. The disease was initially confined to intravenous drug users, sex-trade workers and farmers infected by a tainted blood-selling operation in central China, but it is now spreading into the general population. Part of the problem is a widespread lack of public awareness. A recent poll by Futures Group Europe and Horizon Market Research found that roughly 19.9 percent of those responding had never heard of AIDS, the state news media reported. Only 13.4 percent knew the three methods of transmission - through sex, blood and mother-to-child breast-feeding. Only 21.4 percent of people knew they could be infected with AIDS by having sex, and only 2.6 percent realized that condoms could prevent transmission. For years the government blocked Chinese media coverage of the country's AIDS problem. Even now, Chinese and foreign reporters are detained in Henan if they are caught interviewing AIDS patients. But AIDS advocates say the public relations push this week represents a significant shift in attitudes about basic awareness. "They were talking to the Chinese people," said Odilon Couzin, whose Hong Kong-based nonprofit group, China AIDS Info, disseminates information about the disease. "It's both symbolism and hopefully the beginning of real action." Building public awareness is one thing. The more difficult task, experts agree, is creating an adequate nationwide health system to confront the disease and fulfilling the promise to provide free antiretroviral drugs to poor AIDS patients. On Monday night a top health official, Gao Qiang, used a television talk show to publicly repeat an earlier pledge that a free drug program would be quickly expanded next year to cover all people who had tested positive for the disease. Of the estimated one million cases of H.I.V., Chinese officials say only about 80,000 people have tested positive for the virus. They have not provided any figures about how many have been tested. About 5,000 people are already getting antiretroviral drugs under a pilot program in more than 100 counties, though 20 percent have dropped out of the program because of harsh side effects. Many experts do not think that the program can possibly be expanded by next year to cover all of the 80,000 H.I.V.-positive people. Other tough issues also remain. The government is still weighing a needle exchange program to reduce risks of continued spread among drug users. Public condom dispensers are available on college campuses and outside some public bathrooms. But experts say condoms are not available in hotels because the police believe that they encourage prostitution. Prostitution, meanwhile, is growing quickly. - --- MAP posted-by: Beth Wehrman