Fighting HIV+’s Negative Stigma

By Yuan Yuan

Misfortune never comes singly. It is especially true for Xiaofeng, a 25-year-old HIV-positive sufferer of lung cancer in north Chinas Tianjin. Worse still, his request for lung surgery was denied by a local cancer hospital because he was found to be HIV-positive. Xiaofengs only hope to receive treatment was to falsify his medical records.

Xiaofengs case was initially microblogged by Li Hu, head of Haihe Star, a Tianjin-based NGO that helps people with HIV/AIDS in local communities.

“I got to know Xiaofengs story on November 6 through a friend,” said Li, who has seen many such cases and deeply understood Xiaofengs situation.

After being denied by the Tianjin Tumor Hospital in early November, Xiaofeng went to Beijings Ditan Hospital, a facility that specializes in treating infectious diseases, including HIV/AIDS, but the hospital lacks a thoracic department, and thus couldnt perform surgery on Xiaofeng.

“If Xiaofeng had any other alternatives, he would not get the surgery done by concealing his medical records,” said Li, who was involved in planning the falsification strategy.“The cancer spread very fast. He had only two choices: Lie or die.”

It worked. Xiaofeng was admitted to surgery. His father was instructed to inform the head of the hospital of the truth only after the surgery concluded. The administrators furious reaction spoke volumes of the plight of HIV-positive individuals seeking treatment for other maladies.

Awkward situation

Vice Premier Li Keqiang, after learning of Xiaofengs case from the media, immediately made a phone call to the Ministry of Health, asking to guarantee the right to medical treat- ment of people with HIV/AIDS. He also emphasized that work should be done to guarantee the safety of doctors and nurses treating HIV-positive people as well.

The Tianjin Tumor Hospital was deemed negligent by the Tianjin Municipal Health Bureau on November 22. The bureau announced that it would penalize hospital staff found to be responsible for denying treatment according to the Regulations on the Prevention and Treatment of HIV/AIDS released in 2006, which forbid hospitals from refusing treatment unrelated to immune deficiency solely on the basis of the patients HIV-positive status.

Xiaofeng intends to sue, but he is not the only person with HIV facing medical obstacles in China.

“We have seen many cases where hospitals refused surgery for people with HIV/ AIDS. The root cause is that they are afraid that hospital staff might become infected with the virus,” said Xue Lei, who volunteers at Love Boat, a rights advocacy group for HIVpositive people in Beijing.

A car accident sent Xue to the emergency room in 2010. When HIV showed up in his blood tests after surgery, he was told he would have to go to an infectious disease hospital for post-surgical treatment. “Despite the regulations banning hospitals from turning away HIV/AIDS patients, there is no punishment for violation,” Xue said.

“HIV discrimination at hospitals is groundless and might cost lives. So far, no medical professionals have contracted the virus after performing treatment, including operations for people with HIV/AIDS,” said Wu Zunyou, Director of the National Center for AIDS and Sexually Transmitted Diseases Control and Prevention, an affiliate of the Chinese Center for Disease Control and Prevention (CCPCP).

“However, the ban has not been fully implemented, given that hospitals could cite other reasons to refuse treating them,” Wu said, calling on health authorities to punish violators.

On the other hand, there is no law guaranteeing compensation to medical practitioners infected with the virus in the course of treating people with HIV. Any hesitance by caregivers to render aid further aggravates the problems HIV-positive people face in seeking medical treatment.

According to a 2011 report jointly released by the China Alliance of People Living with HIV/AIDS and the International Labour Organization, apart from fear, clinically unnecessary HIV tests are another reason many people with HIV/AIDS get turned away by hospitals.

Meng Lin, an AIDS sufferer and coordinator with the alliance, said that most hospitals in China require patients to receive an HIV test before surgery so doctors can react in a timely and appropriate manner in case of an emergency during surgery. The safety of medical practitioners is deemed more important than HIV-positive patients rights to receive surgery.

Some hospitals have been designated to treat HIV/AIDS, which has also become an excuse for other hospitals to turn away HIVpositive patients, according to Meng.

Where to go?

According to a report released by the CCPCP, the estimated number of people with HIV reached 780,000 in China in 2011, but only 343,000 cases had been officially reported. The difference between the estimates and official figures is partly due to reluctance of HIV-positive people to come forward for treatment, the report said.

Sexual contact is the main vector for HIV transmission China. The CCPCP revealed that 46.5 percent of people with HIV in China contracted the virus through heterosexual contact and 17.4 percent through homosexual contact. In addition, infection via intravenous drug use and botched hospital blood transfusions stood at 28.4 percent and 6.6 percent, respectively.

More than 80 percent of HIV-positive people in China live in Yunnan, Guangdong, Sichuan and Guizhou provinces and Guangxi Zhuang and Xinjiang Uygur autonomous regions, according to the report. It also warned that there are still a large number of people with HIV/AIDS unaware of their infection.

“Now each prefectural-level city on the Chinese mainland has at least one designated hospital to carry out anti-retroviral and HIV/ AIDS-related treatment,” Wu said. “But patients are not willing to go due to the fear of alienation. Besides, the medical conditions in some of these hospitals do not meet the needs of the patients.”

“Many such hospitals, particularly those specializing in infectious diseases, are not competent in treating other diseases such as cancer,” said Zhao Yan, Wus deputy.

Meng with the China Alliance of People Living with HIV/AIDS suffered kidney problems as a side effect of anti-retroviral drugs in August.

“I first went to an infectious disease hospital, but it wasnt equipped to treat kidney disease at all,” Meng said, adding that he was rejected numerous times while seeking medical services at non-designated hospitals, even in non-surgical cases.

“The publics recognition of people with HIV/AIDS is still negative despite great efforts of related NGOs in spreading the basic knowledge of HIV/AIDS,” said Xiao Dong, head of Rainbow Clinic, a free clinic in Beijing offering medical and psychological help for people with HIV/AIDS. “As long as a person is diagnosed with AIDS, many people assume they will die, including family members. Patients like this are more inclined to commit suicide if not properly counseled.”

Speaking at a ceremony for a joint Chinese-Australian HIV/AIDS prevention program on November 23, Minister of Health Chen Zhu said that HIV-positive individuals now live much longer and need treatment for other medical conditions associated with immune deficiency. He admitted that hospitals designated to treat HIV/AIDS are not ready for the new environment.

“The Health Ministry will improve services at designated hospitals to better serve people with HIV/AIDS,” Chen said. “Well also improve safety conditions for medical workers.”n