More than 20,000 new HIV positive cases have been officially reported in China since 2002, but estimates of a far greater number of still unknown carriers present a huge challenge in quelling the epidemic.

The number of officially reported HIV positive cases in China has now climbed to 89,067 including 20,786 AIDS patients, according to a Ministry of Health report released yesterday in Beijing.

The new numbers, which are through September of this year, may vastly understate the extent of China's AIDS and HIV problem, however. Both China and the United Nations estimated last year that as many as 840,000 HIV carriers exist in the country.

That figure is based on estimates that .07 per cent of the population is likely infected, with the disease spreading rapidly. Yet the true extent of the problem is still unknown.

A major reason for the sharp increase in reported cases since 2002 is enhanced HIV screening among commercial blood and plasma donors in Central China's Henan Province and among intravenous drug abusers in Yunnan Province, Southwest China.

Henan finished a review this year among 280,000 commercial blood donors from the early 1990s, and 25,000 HIV/AIDS carriers were discovered.

Since the increase only refers to the reported infections from the 1990s, it cannot be a basis upon which to judge the ongoing expansion of the epidemic in the country, said Qi Xiaoqiu, director of the Disease Control Department of the Ministry of Health.

The exact expansion rate of the deadly disease is still unknown, he told China Daily when the report was released, but experts say the expansion rate is likely more than 30 per cent annually.

The assessment was completed by a special working committee on HIV/AIDS control under the State Council and the UN Theme Group on HIV/AIDS.

The ministry says that it does not know how many of the individuals who are registered HIV positive cases are still alive.

The ministry and related departments have been working to strengthen various control measures, such as offering free treatment, and fighting against sources of infection, including illicit drugs and illegal blood collections.

There is great urgency, since the epidemic is spreading quickly in the country, Wang Longde, vice health minister, said at the conference.

In some regions and provinces, such as Henan and Yunnan, the expansion rate has reached quite a high level, this year's report said.

There is lots of evidence showing the virus is spreading from high-risk people to common residents, especially through unsafe sex. More and more women are suffering from infection through that means.

According to Ministry of Health surveillance, the prevalence of HIV among intravenous drug abusers is from 5 to 8 per cent.

In the Ili area of Xinjiang Uygur Autonomous Region, the rate has reached to 89 per cent, the report says.

The prevalence rate of HIV among prostitutes, on average, is 0.5 to 1 per cent.

And a survey done last year shows that about 20.5 per cent of sampled prostitutes say they have never used condoms at all.

Up to September 2004, except for the Tibet Autonomous Region, all 30 provinces, municipalities and autonomous regions in China were found to have people infected with the virus through commercial blood donations.

In Henan, about 40 per cent of people who have sold blood from 1992 to 1996 have been infected with the virus and half of the carriers have become patients now.

Yet, alarmingly, the reports show that only about 10 per cent HIV/AIDS sufferers have been registered in China.

Where are they?

"The reality is that we still do not know where the 90 per cent are, which bring us great difficulty in controlling the disease," said Hao Yang, vice-director of the Disease Control Department.

Up to now, there has not been a nationwide survey on HIV infections, but only in special groups of people.

Another problem is that people hesitate to take HIV tests, even though they are free in many places, Hao noted.

Meanwhile, an effective and nationwide surveillance and reporting network in China is still under construction.

More than 1,000 surveillance spots have been set up in the country in the past year.

Many regions began placing condoms in entertainment venues earlier this year.

China has built 34 clinics and 50 spots to provide Methadone and clean syringes for drug users.

More than 10,000 AIDS patients have been given free anti-retroviral therapy, a kind of anti-virus treatment, this year.

The total central government investment on HIV/AIDS amounted to about 390 million yuan (US$47 million) in 2003.

The budget for 2004 was 810 million yuan (US$98 million), while budgeted international support reached to 421 million (US$51 million) in 2004.

Source: China Daily