真相集中营

The Guardian - China-More people living longer with HIVAids in China figures show

November 7, 2023   3 min   544 words

这篇报道揭示了中国艾滋病/艾滋病病毒（HIV/AIDS）情况的重要趋势。随着更好的治疗和检测手段的出现，中国艾滋病/艾滋病病毒患者的存活率显著提高，过去20年来报告的病例数量激增了超过7000%。这反映出治疗和检测的改善，尽管同期艾滋病病死率也有所上升。 中国疾病预防控制中心的数据表明，自2002年至2021年，报告的艾滋病/艾滋病病例的患病率从每10万人口1.09增加到每10万人口79.62，增幅超过7000%。然而，自2002年至2018年，报告的病例的死亡率也从每10万人口0.07上升至2018年的每10万人口1.31，但从那时起有所下降，至2021年为每10万人口1.28。 虽然中国在HIV监测和治疗方面取得了显著进展，但报道还提到了一些挑战。研究表明，新冠大流行对HIV结果的影响比疾病控制中心的研究人员所述的更严重。新冠大流行期间，患者通过医院访问获得重要的抗HIV药物的途径受到了极大威胁，加剧了已有的HIV病例，并增加了死亡风险。 中国在HIV监测和治疗中取得的进展包括检测领域。自2008年至2018年，年度检测从4500万次增加到2亿次，以满足联合国设定的目标，即到2020年使90%的HIV感染者了解其感染状况。此外，中国的大规模电子商务行业的规模和效率也意味着自我检测工具在中国比许多其他国家更广泛可得。 然而，近年来，有人担忧北京对公民社会的打压，特别是对LGBT+团体的打压，妨碍了公共卫生工作者接触到最易感染病毒的群体。对HIV预防方法的访问，如暴露前预防（PrEP），在中国也非常有限。尽管PrEP可以将性传播HIV的风险降低约99%，但据信只有约6000人在中国使用这种药物，该药物于2020年获得批准。 这篇报道突出了中国在艾滋病/艾滋病病毒领域的取得的重要进展，但也强调了继续努力解决挑战的重要性，特别是在新冠大流行期间，以确保HIV感染者获得必要的医疗护理和预防方法。同时，公共卫生官员需要更多支持来帮助接触到最高风险的群体，以进一步减少HIV传播。

The prevalence of HIV/Aids in China has surged in the past 20 years, as improved treatment means people are living longer with the disease, according to official data.

Figures published in October by China’s Center for Disease Control and Prevention (CDC) showed that between 2002 and 2021, the prevalence rate of reported HIV/Aids cases rose from 1.09 per 100,000 people to 79.62, an increase of more than 7,000%. Improved treatment as well as better access to testing have contributed to the soaring prevalence rates, even as the mortality rate for HIV/Aids also increased for much of that period.

Between 2002 and 2018, the mortality rate for reported cases rose from 0.07 per 100,000 to 1.31 in 2018. Since then it has decreased slightly to 1.28 per 100,000 people in 2021.

More than a million people in China are living with HIV/Aids, which first emerged in China in the late 1980s. Analysing the latest data, the CDC researchers said that “China’s comprehensive HIV/Aids prevention and control strategy and its overlapping impact of pandemic control efforts” had helped drive down incidence and mortality rates.

But research suggests that the impact of the pandemic on HIV outcomes is worse than the CDC researchers suggest.

A study published earlier this year led by Lan Wang, Na Zhao and Yuliang Wang, researchers at Zhejiang University, Anhui Normal University and Nanjing Medical University, respectively, found that the average yearly mortality rate for HIV increased by about 14% in 2020-2022, compared with 2015-2019. “During the Covid-19 outbreak, access to essential, life-saving HIV drugs through hospital visits was severely compromised, exacerbating established HIV cases and increasing the risk of death,” the researchers concluded.

One area in which China has made striking progress in HIV surveillance and treatment is in testing. Annual testing increased from 45 million to 200 million between 2008 and 2018, as China tried to move towards the UN target of 90% of people with HIV knowing their status by 2020. And the scale and efficiency of China’s massive e-commerce industry means that self-testing kits are also more widely available in China than in many other comparable countries.

A study published in 2018 found that nearly 60% of men who have sex with men had never done an HIV test. But since then that share is thought to have fallen, because of the widespread availability of cheap, discreet at home tests.

However in recent years there has been growing concern that Beijing’s crackdown on civil society, particularly of LGBT+ groups, has hampered the ability of public health workers to reach groups most at risk of contracting the virus. Public health officials “cannot supplant the critical function of community organisers”, said Chuncheng Liu, a medical sociologist who studies HIV/Aids in China. “This isn’t merely because community members place greater trust in their peers, but also because maintaining a local community and conducting health outreach is a full-time commitment. It cannot merely be an added responsibility to the already packed schedules of public health officials.”

Access to HIV prevention methods, such as pre-exposure prophylaxis (PrEP), is also highly limited in China. PrEP reduces the risk of getting HIV from sex by about 99%, but only about 6,000 people in China are thought to be taking the drug, which was approved in 2020.