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    Foreigners Aren’t to Blame for the Spread of HIV/AIDS in China

    Clickbait smears are no replacement for scientific research.
    Nov 30, 2018#health#HIV

    Leading up to World AIDS Day on Dec. 1, the issue of HIV/AIDS in China has been thrust back into the media spotlight — most recently as a result of He Jiankui’s controversial gene-editing experiments. Even prior to He’s announcement, however, concerns over a recent “surge ” in new AIDS diagnoses had many on edge.

    This has been fueled in part by a viral article arguing that China’s at risk of becoming an “AIDS state.” The sensationalist and bigoted tirade, penned by the well-known commentator Zhou Pengan, assigns much of the blame for this supposed crisis on China’s visa policies and promiscuous foreigners — particularly international students from a number of African countries with relatively high rates of HIV/AIDS. Zhou claims that the country’s education officials are giving these students scholarships to come to China, where they then infect people with the disease.

    Even by nigh non-existent clickbait standards, the piece is offensive. It’s also entirely groundless. Although there has been a rise in new recorded AIDS cases in China over the past decade, there’s no evidence that this trend has anything to do with foreigners — regardless of their country of origin. Nor do the misleading numbers Zhou cites prove that China is on the verge of an epidemic.

    The tropes Zhou regurgitates in his article are not new. The author, who describes himself as someone with a degree in accounting and a passion for statistics, is just the latest in a long line of exploitative clickbait creators and rumormongers trying to peddle this story. By playing on racist stereotypes and fears — while mixing in just enough facts to give their arguments the veneer of credibility — these unscrupulous writers boost clicks and advertising revenue, even if it means stoking racial or social tensions.

    In the piece, Zhou begins by criticizing the State Council’s 2010 decision to allow foreigners diagnosed with AIDS into China. To try and prove that this decision was misguided, he cites statistics that he claims show an immediate increase in the number of new AIDS patients in the country after the change went into effect. His figures are deceptive, however, and do nothing to prove that reinstating the travel ban would be anything other than an ineffective and counterproductive step.

    In the years after AIDS was first formally identified, one of the primary international responses was panic. Armed with only a partial understanding of the disease and sometimes swayed more by homophobic and xenophobic attitudes than scientific evidence, many countries tried to keep AIDS out by instituting travel bans on those with the disease. In China, where many blamed the illness’ appearance on the growing influence of decadent Western lifestyles and values, the government passed two separate laws, one in 1986 and one in 1989 , banning any foreigner who tested positive for AIDS, STDs, or leprosy from entering the country.

    Of course, such bans quickly proved unfeasible. Since 1990, China has hosted several major international events, including the 1990 Asian Games, the United Nations’ Fourth World Conference on Women in 1995, and the 2008 Olympics. Each time, immigration authorities had to announce exceptions to the ban for attendees.

    In other words, 2010 was far from the first time the government allowed foreigners with HIV/AIDS into China. And in changing the law, the State Council made it clear that officials viewed the visa ban as ineffective.

    Meanwhile, Zhou’s statistics, which are mainly there to give his arguments some semblance of credibility, in fact do nothing of the sort. To start, this self-proclaimed statistics aficionado mislabels data related to HIV cases as being AIDS data. Even looking at the correct data, there’s little evidence for his claims. While figures from the National Health Commission do show that from 2011 — the first full year after the ban was lifted — to 2012, new AIDS diagnoses did indeed increase from roughly 20,000 to almost 42,000 cases, this jump was largely the result of changes in the way data was being collected and reported, not an actual increase in infection rates. Almost 18,000 of the “new” AIDS diagnoses that year weren’t new at all: Regulations implemented in 2011 required researchers and doctors to report cases in which patients progressed from HIV to AIDS as new AIDS cases, counting them together with those who had been diagnosed with AIDS from the start. This reclassification explains most of the surge that occurred immediately after the relaxation of the country’s visa policy.

    The number of HIV/AIDS patients in China has indeed continued to rise, but — sorry, conspiracy theorists — this has nothing to do with the country’s international student population. It’s not even necessarily a bad sign. This is because the increase of reported cases is primarily driven by the ongoing expansion of the country’s STD and HIV/AIDS screening programs.

    In the five years between 2012 and 2017, the number of Chinese screened for HIV/AIDS doubled from 100 million a year to roughly 200 million. More screening has naturally led to a rise in the number of HIV/AIDS diagnoses. This increase is, if anything, a good thing: By helping patients get necessary treatment, the country’s medical authorities can hopefully reduce the number of new cases in the future. HIV can remain asymptomatic for years, meaning it’s possible to transmit it without realizing you are infected. Currently, about 30 percent of Chinese with HIV/AIDS are undiagnosed. This group by far is one of the primary vectors from which the the disease spreads. And the percentage of those tested who actually test positive has declined over the past decade, from 12.5 per 10,000 people in 2008 to 6.8 per 10,000 in 2017.

    Ironically, improved screening and treatment methods can actually give the false impression that the HIV/AIDS problem is becoming more serious. As those living with the disease have longer life expectancies, and new cases are recorded, the overall number of people living with HIV/AIDS in a given country will naturally rise. This is not evidence of a looming crisis, however.

    It’s also worth noting that the number of foreigners in China living with HIV or AIDS is pretty small. And of the 2,154 new cases reported among the overall foreign community in 2017, the majority were from the country’s southwestern border region, where drug trafficking and abuse are serious problems. According to the Chinese Center for Disease Control and Prevention’s AIDS Prevention Center, just 100 international students — one of the groups Zhou blames for China’s supposed AIDS crisis — were diagnosed with AIDS in 2017. This out of a total foreign student population of more than 440,000.

    In short, Zhou’s claims, and others like his, are unfounded. China is not about to become an “AIDS state,” and foreigners are not responsible for an uptick of new AIDS cases in recent years.

    The world has made great progress in treating and preventing the spread of HIV/AIDS. This World AIDS Day, we should remember that these advances have been achieved not through impulsive travel bans or racist innuendo, but through an international effort to invest resources in scientifically proven methods and research. What China needs now isn’t a return to the days of fear or xenophobia: It needs to build public awareness of HIV/AIDS and prevention techniques and continue improving its screening methods. Blaming foreigners won’t help the country’s HIV-positive population. It will only cause panic.

    Translator: Matt Turner; editors: Lu Hua and Kilian O’Donnell.

    (Header image: A university volunteer signs a red ribbon commemorating World AIDS Day in Qingdao, Shandong province, Dec. 1, 2017. Yu Fangping/VCG)