The Chinese government has only recently taken steps to address the nation’s HIV/AIDS epidemic. Earlier efforts focused primarily on foreigners, because the government believed that HIV/AIDS only affected homosexuals and that homosexuality was limited in China. China’s inability to effectively address this problem is partly due to the suppression of community-based groups that seek to raise awareness, and partly due to deep-seated discrimination of at-risk communities.

During the 1990s the Chinese government resisted large-scale HIV/AIDS programs and was unwilling to address the growing epidemic. Although a few social groups and community-based organizations (CBOs) emphasized treatment and prevention in China, HIV/AIDS advocates were mostly unregistered networks of friends and families of disease victims. However, since China announced a reversal in its HIV/AIDS policy and launched China CARES (China Comprehensive AIDS Response) in 2003, the prevalence of CBOs concentrating on HIV/AIDS has dramatically increased.The Aizhixing Institute of Health Education (Aizhixing), a national NGO based in

NGO Column 3 Photo 1
Condem Dispenser in China, Photo by John Pasden

Beijing, has been at the forefront of the HIV/AIDS battle. Wan Yanhai, the president and founder of Aizhixing, estimates that just a handful of these CBOs existed in 2003, but that today there may be 300-500 throughout China.

Despite the change in official government policies, significant gaps remain. For example, while all HIV/AIDS treatment is now provided free of charge, rural Chinese must incur high costs to travel to larger cities to receive treatment. Also, education efforts have been largely unsuccessful. A recent survey indicated that 89 percent of female respondents did not believe they could be infected. In addition, UNAIDS found that over 48 percent of people believe they can become infected by mosquitoes and almost 32% believe that those infected deserve the disease because of their high-risk behaviors. CBOs seek to fill these gaps by providing transportation and housing to rural Chinese infected with HIV/AIDS, and developing education programs.

As one of the largest Chinese NGOs working on HIV/AIDS, Aizhixing focuses its efforts on marginalized populations such as the LGBT community, drug users, sex workers, ethnic minorities and migrant workers. These populations are at a higher risk for HIV/AIDS infection, are under-served by existing government programs, and face social stigmatization. Aizhixing also coordinates the activities of rural CBOs, implements new research policies, and provides legal assistance.

Aizhixing has a difficult relationship with the government. Wan Yanhai was detained in 2002 and 2006 for raising HIV/AIDS awareness and for pointing out deficiencies in government policies. Since then, Aizhixing has developed a more positive working relationship with the government, which is rare for NGOs in China as advocacy organizations are usually denied government registration altogether. Aizhixing’s policy reports, such as Sex Worker Laws and Rights and AIDS and Human Rights and the Law, are important resources for identifying weaknesses in government programs. The UNAIDS 2008 China Situation Sheet specifically addresses the need for more involvement by civil society organizations to improve China’s HIV/AIDS situation. Government partnership with NGOs and CBOs such as Aizhixing will be critical for China to continue making progress on battling HIV/AIDS.