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In China, an About-Face on AIDS Prevention

Once-Reluctant Government Increasingly Promoting Efforts to Battle Spread of Disease

By Edward Cody
Washington Post Foreign Service
Wednesday, December 8, 2004; Page A26

GUANGAN, China -- Li Yi squirmed a little as she searched for the right words. Using condoms is important to staying healthy, she wanted to say, but pleasing men is also important if she wants to stay in business.

"You know what we do, right?" she asked with a wan smile, settling on a question as a way to make herself clear. "But now, we insist that our customers wear condoms, even when they don't want to."

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Li, 19, is one of more than 300 "peer educators" in the flourishing sex industry of Guangan, an agricultural hub of 200,000 people about 275 miles east of Chengdu in central Sichuan province. Picked and trained by AIDS activists working with local authorities, she has been converted to condoms and assigned to encourage other prostitutes to follow suit to reduce their risk of contracting and spreading the AIDS virus, HIV.

"This is a big thing for us," Li said to a visitor who stopped by a downtown "entertainment center" along with several Guangan health officials, who show up at least once a month to deliver free condoms and urge caution.

The status conferred on Li was one step in a broad anti-AIDS campaign in Sichuan and Yunnan provinces, carried out by Britain's Department for International Development and the Chinese Health Ministry. The open attack on AIDS here -- and elsewhere in China through foreign and domestic programs -- has departed markedly from earlier reluctance to face the danger presented by the disease to the country's 1.3 billion people.

Partly as a result of international prodding and partly as a result of last year's experience with SARS, or severe acute respiratory syndrome -- when sickness spread while officials dissembled -- the government increasingly has pushed AIDS prevention out of the closet.

President Hu Jintao dramatized the shift last week by visiting AIDS patients at Youan Hospital in Beijing accompanied by television cameras, matching a similar visit last year by Premier Wen Jiabao. Hu's gesture led the news on government-controlled television and in the press. Officials and newspapers discussed the disease at length in observation of World AIDS Day on Dec. 1, and authorities across the country used the occasion to announce measures to check the disease and detect those who carry the virus.

The Health Ministry said it had increased financing for AIDS prevention to $12 million, up from $1.8 million three years ago. In Beijing, where the known number of HIV carriers has risen by 40 percent a year since 1998, to more than 2,000, authorities hung anti-AIDS posters in the Sanlitun bar district and announced they would distribute free condoms. Shanghai authorities made a similar announcement, and an anti-AIDS spot featuring basketball stars Earvin "Magic" Johnson, who has HIV, and Yao Ming played on government television.

The effort to go public and intensify prevention is timely, Chinese and international specialists say.

As late as the 1990s, statistics showed the disease was largely confined to intravenous drug users and a group of peasants who became infected when they sold their blood. But the number of those known to be infected by HIV has climbed by 75 percent annually over the last four years, reaching an officially estimated 840,000 and, specialists say, probably many more.

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