China is making significant progress in addressing the HIV epidemic with a focus on key population groups. Following a successful scale up of interventions for people who inject drugs (PWID), access to community-based rapid voluntary testing and counselling for populations such as men who have sex with men (MSM) is critical.
China’s slogan for 2013 World AIDS day "Fighting AIDS together, Sharing Responsibilities, Sharing the Future" highlights the need for improved action to ensure universal access to prevention and treatment of HIV, Dr Bernhard Schwartländer, WHO Representative in China, said.
The Chinese government has demonstrated strong commitment and leadership in addressing the HIV epidemic. Prevention programmes for people who inject drugs (PWID) have been scaled up significantly since 2005. As of 2012, China has put more than 200,000 people who use injecting drugs on methadone maintenance therapy (MMT). This programme has greatly reduced HIV transmission among this group.
Scale up of community-based testing needed
However, key populations, in particular MSM, face stigma and discrimination, resulting in less access to testing and treatment services than other people. Recently, HIV infection rates have increased among MSM populations in large cities due to inconsistent condom use.
"In China, community-based rapid voluntary testing and counselling has been put in practice with good progress over the last years. However, far from all the people infected with HIV are aware of their status and more than a third of those eligible still do not receive treatment. Expansion of innovative community-based testing services for key populations and stronger partnership between public health services and communities are essential to an effective HIV response", Dr Nicole Seguy, HIV medical officer at the WHO in China, said.
Further ART scale up needed
Following testing, a strong public health response to address treatment and care for people living with HIV is essential. The 2013 WHO ART guidelines recommend commencing ART before people become sick. This will require considerable strengthening of service delivery systems, from testing to treatment, with greater emphasis on quality. "The use of fixed-dose combination (FDC, 1 pill a day) for ART is essential to simplify treatment and therefore ensure adherence to ART, in particular when treatment is started earlier", Dr Bernhard Schwartländer, emphasised.
As of September 2013, there were 206,000 PLHIV on ART in China. This achievement, along with innovative initiatives like the China-led "Test and Treat Implementation Research" conducted among key populations in China, will be critical to further decrease HIV incidence and reach universal access to ART.
"Scale up of innovative approaches combined with pragmatic leadership is the recipe for China to become the pathfinder not only to achieve the global goal of universal access to HIV treatment and prevention, but also to establish a concrete model for universal health coverage by 2020", the head of the WHO in China, concluded.
For more information, please contact
Helen Yu
Communications Officer, WHO in China
Tel: +86 10 65327191
E-mail: yuji@wpro.who.int