China's Surprising Assault on HIV/AIDS—and a Cultural Taboo

Was an HIV-positive man -- who'd been denied other treatments because of his disease -- right to falsify his medical records? Beijing thinks so.

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A nurse prepares medicine at the HIV/AIDS ward of Beijing YouAn Hospital on December 1, 2011. (David Gray/Reuters)

In late October and early November, a 25-year-old man sought treatment for lung cancer at two hospitals in Beijing and the northeastern Chinese city of Tianjin. After a blood test, he was found to be HIV positive. Doctors at both hospitals refused to treat him and turned him away.

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This type of discrimination against AIDS patients may be common in China. but there is a twist to this story. The young man went to a third hospital in Tianjin, only this time he changed his own medical records to avoid a blood test, and concealed the fact that he has AIDS. He received the operation to treat his lung tumor in mid-November and is now reportedly recovering at home.

When this story circulated on Weibo, China's version of Twitter, it sparked intense debate. The tweet from Li Hu, an HIV carrier in Tianjin, that broke the story has attracted more than 6,100 retweets and 4,800 comments on Weibo. While some microbloggers demonstrated sympathy, using "in his shoes" arguments, a surprisingly large number were angry about the young man's concealment and concerned that his actions put others in danger.

@虎式坦克568 commented angrily, "The concealment is quite malicious. Can he endanger public safety just because his personal rights were trampled on? It's like those HIV-carriers who use needles with their blood to stab passers-by to infect them on purpose. The victims of this man's actions could be anyone who comes into contact with the hospital, and most likely other patients. Can he undermine our faith in society just because he is discriminated against? Can he put others' lives in danger just because he is discriminated against?"

Another microblogger, @羽曦最爱杰伦 wrote, "This guy is like a tumor, living at the hospital for ten days...His behavior was selfish and despicable. Where did he put the health and safety of others?"

Others were however more sympathetic, if in the minority and softer in their fury. @夜D百合 argued, "It's not like people want to have AIDS. I do not believe if you were in the situation you would not do the same thing?!"

One censored post from @爪机杀手天师露 that appears on Free Weibo, a new web tool that is able retrieve censored posts, revealed the user's anger toward the lack of transparency in hospitals, of the way the AIDS epidemic has been routinely covered up by the government: "It's not rare for surgeons to pierce their hands and becoming accidentally infected. Concealing the AIDS epidemic is tantamount to murder ... So only the doctor's and the patient's rights to know aren't human rights?"

The state-run CCTV, on the other hand, wrote a sympathetic synopsis of the story via their Weibo account, arguing that the young man acted out in desperation. They quoted a disease specialist as saying that occupational exposure from HIV is very rare, with only 500 to 700 reported cases each year.

The government, too, has expressed a different viewpoint from that of its netizens. Li Keqiang, China's second most-powerful man, who was a top official in Henan Province in late 1990's and early 2000's when one of the most serious AIDS outbreak in China took place, was quick to intervene in the Tianjin hospital case. By his request, China's Ministry of Health issued an emergency announcement that banned hospitals from turning away patients infected with HIV. Li also met with AIDS rights activists on November 28.

The incident occurred, however, days before International AIDs Day on December 1, making Li Keqiang's intervention and the Ministry of Health's announcement a preemptive response to curb international criticism.

What makes the government's move unusual is that, in the West, the government usually enters the AIDS conversation after a swell of public discourse. In the U.S., it wasn't until activists and writers like Randy Shilts debunked AIDS as a "gay man's cancer" that Ronald Reagan made his first public statement about the epidemic-a decade after it first broke.

Here in China, the government has moved first, while its people are still discussing whether the hospital should have treated the young man at all. In China, the discrimination is caused in part by poor educational campaigns about AIDS, as well as a lack of NGO culture that makes it difficult for nonprofits to dismantle myths about AIDS.

It is not clear which method will work best, and whether China's usual top-down approach will quell discrimination among its people and close the gap between government action and public discourse. However, without better educational campaigns and a stronger civil society, the government's new initiatives may be in name only.

This post also appears at Tea Leaf Nation, an Atlantic partner site.