Better tests key for earlier HIV detection

31 percent of HIV-positive cases are found after patients develop disease

Improvements must be made to China's speed and efficiency in detecting HIV, Chinese and international experts said.

More than 10,000 hospitals that provide HIV testing detected 56 percent of all new cases in 2011, according to official data.

"However, about 31.6 percent of those HIV-positive cases were only discovered after the patients' condition had developed into the disease," said Xiong Ran at the National Center for the Control and Prevention of AIDS and Sexually Transmitted Diseases.

Xiong, who collects data on the performance of China's HIV/AIDS programs, said at the UN Forum on AIDS on Oct 30 that hospitals above county level detect 38 percent of new cases too late, higher than smaller clinics.

"This means many people infected with HIV were not diagnosed by grassroots clinics," he said. "They went to larger hospitals only when their health worsened and they needed medical treatment."

The center issued a roadmap this year, detailing how they intend to expand HIV test coverage in all 31 provinces, municipalities and autonomous regions on the mainland.

"The plans were made according to the prevalence in each province," Xiong said. "In areas with a high rate of infection, we suggest hospitals offer tests to anyone who comes to the hospital for the first time.

"We also suggest more training for grassroots medical workers and stronger advocacy to encourage more people are tested voluntarily."

Chen Zhongdan, a national program officer for the Joint United Nations Programme on HIV/AIDS China Office, suggested that more community organizations, such as gay rights groups, should be involved in the efforts.

"Given about one-third of cases detected by hospitals were tested late, I think it's worth considering whether merely stepping up coverage of HIV testing in hospitals is efficient enough," he said.

Nicole Seguy, team leader for HIV, AIDS and Sexually transmitted infections at the World Health Organization, agreed.

"Experience in many other countries where there is a concentrated epidemic of HIV is that this (collaborating with NGOs) is the only way to get earlier testing," Seguy said.

"People testing at the voluntary counseling and testing sites are not necessarily familiar enough with the system of the Chinese Center for Disease Control and Prevention to get more care," she said. "But community-based organizations can facilitate, explain and counsel, and help get more people tested and support them to get access to treatment."

Statistics provided by Xiong show that China has detected more HIV infections over the past four years.

The number of Chinese people getting tested for HIV increased from about 45 million in 2008 to 84 million in 2011.

"In 2011, people tested for HIV accounted for 6.4 percent of the population," Xiong said.

The increase in people being tested is a result of the growing number of medical institutions that are able to provide quick testing for HIV infections, she said.

"In 2008, about 7,500 institutions provided such tests. In 2011, the number increased to more than 14,000," she said. "There were about 56,000 newly discovered HIV cases in 2008, while the number in 2011 was about 74,500."

wangqingyun@chinadaily.com.cn