HIV/AIDS, pay attention to the student population

The rapid spread of AIDS in China has shocked the world. At the 5th AIDS Academic Conference at the end of last month, experts revealed that in the second quarter of 2018 alone, 40,104 new HIV infections and AIDS cases were discovered in China, with sexual transmission accounting for 93.1%. Zhou Peng'an, a member of the Social Committee of the China Democratic League Central Committee, believes that the continued surge in HIV infections is mainly due to three factors: firstly, the lifting of restrictions on the entry of AIDS patients; secondly, the influx of a large number of African students; and thirdly, transmission through homosexual sexual behavior.

The new policy announced on April 27, 2010, removed restrictions on the entry of foreigners with AIDS. At that time, the head of the State Council Legislative Affairs Office stated: "The removal of entry restrictions on foreigners with AIDS and sexually transmitted diseases will not cause a high incidence and spread of these diseases within China."

However, according to relevant sources, the dozen or so regions with the highest HIV infection rates in the world are all in Africa. More than 70% of the world's AIDS patients and HIV carriers are concentrated in African countries.

Data shows that the number of newly diagnosed HIV/AIDS cases in recent years is as follows: 48,000 in 2009; 64,300 in 2010; 74,500 in 2011; 82,400 in 2012; 90,000 in 2013; 103,500 in 2014; 97,000 in 2015; 120,000 in 2016; 135,000 in 2017; and at least 160,000 in 2018, showing a rapid upward trend.

Chinese government health officials also disclosed at relevant HIV/AIDS prevention and control work conferences that as of June this year, more than 820,000 people have been diagnosed with HIV/AIDS or are HIV carriers. This number represents an increase of more than 100,000 compared to the same period last year.

Renowned commentator Zhou Peng'an also wrote an analysis stating that, assuming an increase of 40,000 HIV infections and AIDS cases per quarter, with 80,000 cases in the first half of this year alone, the total number of cases at the end of last year was 755,700, with approximately 238,000 reported deaths, totaling 993,700 cases. Even if we conservatively estimate the new cases at 80,000 for the last two quarters of this year, the combined figure by the end of the year would be 1.2337 million, a 24.15% increase compared to the same period last year, while China's GDP growth rate is less than 7%.

China discovered its first AIDS patient in 1985, and the virus subsequently spread rapidly among drug users. An expert told a reporter from *China Newsweek*, "Initially, we only marked a red dot on the map, then it became a whole red area, and now there are no blank spots on the national map. Large numbers of AIDS patients have died in some areas, and the spread has surpassed that of Africa."

Chinese universities have become "AIDS hotspots." In recent years, in the education sector, many universities have focused on international education and recruiting foreign students. The Ministry of Education plans to have 500,000 international students in primary and secondary schools and 150,000 international students in universities by 2020. However, this accelerated opening up of education has also brought many negative factors.

African students from countries such as Botswana, South Africa, Congo, Central African Republic, Zimbabwe, Rwanda, Lesotho, Zambia, Tanzania, Angola, Cameroon, and Mozambique have flocked to China. They are extremely sexually promiscuous but generally lack effective hygiene practices.

Since China is the largest market for these students, some are already infected with HIV before coming to China. China provides nearly 100,000 yuan in subsidies to each of these students annually. Besides daily expenses, these students often have surplus funds for prostitution or even "keeping" Chinese girls, which is likely one of the main reasons for the surge in newly discovered HIV infections and AIDS cases in China in recent years.

A university counselor revealed online that African students lead promiscuous lives. "Male Black international students on campus are like being in an emperor's harem; this is not an exaggeration. From my observation, one male Black international student in my class changes Chinese female university student girlfriends on average every month."

In 2015, two male Black university students at a university in Chongqing brought three female university students back to their dormitory at night. That night, the five engaged in inappropriate sexual activity. Because the noise was too loud, a Korean international student in the next dormitory reported them, causing a strong reaction on campus. However, considering the male students were from Africa, the university did not want to escalate the situation, and the matter was eventually dropped.

Meanwhile, the more casual sexual attitudes among Chinese students are also one of the driving forces behind the AIDS epidemic. Last April, an incident in Changsha's Yuelu District University Town in Hunan Province, where 106 university students were diagnosed with AIDS, sparked public concern. On May 26th of this year, anonymous AIDS testing kit vending machines were deployed in Shanghai universities. Tongji University's anonymous AIDS testing kits sold out in just six hours. Last year, 11 universities, including Tsinghua University, sold out within 24 hours.

Data from the National Health and Family Planning Commission in 2015 showed that the proportion of newly infected HIV-infected young students aged 15-24 in China had risen from 5.77% in 2008 to 16.58% in 2014. This figure has exceeded the international 10% threshold for designating an HIV-infected "high-risk area." According to the *China Youth Daily*, "From 2011 to 2015, the net annual growth rate of HIV infections among college and university students aged 15-24 in China reached 35%," and 65% of student infections occurred during their university years (ages 18-22).

The third leading cause of HIV transmission is homosexuality.

Three years ago, a report on the *Yangcheng Evening News* titled "Guangzhou's HIV-infected Students Increase by 46.37% Annually, Nearly 90% Male" stated that among HIV-infected students in Guangdong, 89% were male, while females accounted for only 11%. Regarding transmission routes, 69% were through homosexual contact, 26% through heterosexual contact, and 5% were through other or unknown means. The annual growth rate and the proportion of infections transmitted through homosexual contact are alarming.

However, the Fifth National AIDS Conference also conveyed some encouraging information. Wang Bin, Deputy Director of the National Health Commission, revealed that by the end of 2017, the proportion of eligible HIV-infected individuals and patients receiving antiretroviral therapy, the mother-to-child transmission rate of HIV, the spousal transmission rate in couples where one spouse is infected with HIV, and the annual new HIV infection rate among those undergoing maintenance treatment with drug addiction medication were 80.4%, 4.9%, 0.68%, and 0.03%, respectively. Furthermore, the number of reported HIV infections transmitted through blood transfusions in China has approached zero, which is encouraging and reassuring for active blood donors.

As a populous country, China's HIV infection rate remains low due to relatively conservative traditional sexual attitudes, coupled with effective government publicity and prevention measures. However, we must be prepared for potential dangers even in times of peace. While the current number of 820,000 living HIV-infected individuals and AIDS patients may not seem alarming, the growth rate, several times higher than GDP, gives the impression of an impending catastrophe. If more effective control measures are not implemented, China could become a veritable "AIDS superpower." At that point, addressing the problem will be far more difficult. (End)

Further Reading:
What is AIDS?

AIDS is a highly dangerous infectious disease caused by infection with the Human Immunodeficiency Virus (HIV). HIV is a virus that attacks the human immune system. It primarily targets and destroys CD4 T lymphocytes, the most important cells in the immune system, causing the body to lose its immune function. Therefore, the body is susceptible to various diseases and can develop malignant tumors, resulting in a high mortality rate. The average incubation period for HIV in the human body is 8-9 years. Before developing AIDS, one can live and work for many years without any symptoms.

Other Names:
Acquired Immunodeficiency Syndrome ;
English Name:
AIDS
; English Alias
: acquired immunodeficiency syndrome ;
Department:
Infectious Diseases Department;
Most Affected Group:
Young and Middle-aged Adults;
Common Causes:
Caused by HIV Infection;
Common Symptoms:

Symptoms include persistent fever, weakness, night sweats, and generalized lymphadenopathy. Transmission routes
include sexual contact, blood, and mother-to-child transmission. Etiology studies suggest that AIDS originated in Africa and was later brought to the United States by immigrants. On June 5, 1981, the U.S. Centers for Disease Control and Prevention (CDC) published a case report of five AIDS patients in the *Morbidity and Mortality Weekly Report*, marking the first official record of AIDS worldwide. In 1982, the disease was named "AIDS." Soon after, AIDS rapidly spread to all continents. In 1985, a foreign tourist visiting China fell ill and died shortly after being admitted to Peking Union Medical College Hospital; the death was later confirmed to be due to AIDS, marking the first reported case of AIDS in China. HIV-infected individuals may experience an incubation period of several years, even up to 10 years or longer, before developing AIDS. Due to a severely weakened immune system, they are susceptible to various infections, such as shingles, oral candidiasis, tuberculosis, enteritis, pneumonia, and encephalitis caused by specific pathogens, and severe infections caused by Candida, Pneumocystis, and other pathogens. In later stages, malignant tumors often develop, leading to prolonged wasting and ultimately death from systemic failure. Despite the immense efforts of numerous medical researchers worldwide, a cure for AIDS has not yet been developed, nor is an effective vaccine for prevention. AIDS is listed as a Class B notifiable infectious disease in China and is included in border health surveillance. Clinically, it primarily affects young adults, with 80% of cases occurring between the ages of 18 and 45, the most sexually active age group. After HIV infection, individuals often suffer from rare diseases such as Pneumocystis pneumonia, toxoplasmosis, and atypical mycobacterial and fungal infections. Initially, HIV infection may be asymptomatic for several years to over 10 years. Once AIDS develops, patients can exhibit a wide range of clinical manifestations. Initial symptoms are similar to those of a common cold or flu, including general fatigue, loss of appetite, and fever. As the illness progresses, symptoms increase, such as Candida albicans infection of the skin and mucous membranes, leading to herpes simplex, herpes zoster, purpura, blood blisters, and ecchymosis. Later, internal organs are gradually affected, resulting in unexplained persistent fever that can last 3-4 months. Other complications may include cough, shortness of breath, difficulty breathing, persistent diarrhea, bloody stools, hepatosplenomegaly, and even malignant tumors. Clinical symptoms are complex and varied, but not every patient will experience all of the above symptoms. Lung involvement often presents with difficulty breathing, chest pain, and cough; gastrointestinal involvement can cause persistent diarrhea, abdominal pain, weight loss, and weakness; and the nervous and cardiovascular systems can also be affected. 1. General symptoms include persistent fever, weakness, night sweats, and persistent widespread generalized lymphadenopathy, particularly noticeable in the neck, armpits, and groin. Lymph nodes are larger than 1 cm in diameter, firm, mobile, and painless. 1. Weight loss can reach over 10% within 3 months, and can be as high as 40%, with patients experiencing significant emaciation. 2. Respiratory symptoms include persistent cough, chest pain, difficulty breathing, and in severe cases, hemoptysis. 3. Digestive symptoms include decreased appetite, anorexia, nausea, vomiting, diarrhea, and in severe cases, hematochezia. Medications typically used to treat gastrointestinal infections are ineffective against this type of diarrhea. 4. Neurological symptoms include dizziness, headache, slowed reaction time, intellectual decline, mental abnormalities, seizures, hemiplegia, and dementia. 5. Skin and mucous membrane lesions include herpes simplex, herpes zoster, and inflammation and ulceration of the oral and pharyngeal mucosa. 6. Tumors can include various malignant tumors; Kaposi's sarcoma, located on the body surface, presents as red or purplish-red macules, papules, and infiltrative masses. Examination : 1. Examination of the body's immune function, mainly moderate to severe cellular immunodeficiency, including: depletion of CD4+ T lymphocytes, significant reduction in peripheral blood lymphocytes, CD4 < 200/μl, CD4/CD8 < 1.0 (normal range 1.25–2.1), negative delayed-type hypersensitivity skin test, and decreased mitogen stimulation response. Decreased NK cell activity. 2. Examination for pathogens of various pathogenic infections, such as PCR detection of relevant pathogens, and histopathological examination of malignant tumors. 3. HIV antibody detection using enzyme-linked immunosorbent assay (ELISA), gelatin particle agglutination test, immunofluorescence assay, immunoblotting, and radioimmunoprecipitation. The first three are commonly used for screening tests, while the latter two are used for confirmatory tests. 4. PCR technology for detecting HIV virus. Diagnosis: 1. Diagnostic criteria for the acute phase : A recent epidemiological history and clinical manifestations, combined with a change in HIV antibody test from negative to positive, are sufficient for diagnosis, or only a change in HIV antibody test from negative to positive is sufficient for diagnosis. Approximately 80% of HIV-infected individuals show detectable antibodies in initial screening tests 6 weeks after infection, and almost 100% show detectable antibodies after 12 weeks. Only a very small number of patients test positive within 3 months or 6 months after infection. 2. Diagnostic criteria for the asymptomatic period : A diagnosis can be made based on an epidemiological history combined with a positive HIV antibody test, or a diagnosis can be made based solely on a positive HIV antibody test in a laboratory setting. 3. AIDS stage (1) Unexplained persistent irregular fever above 38°C for more than 1 month; (2) Chronic diarrhea more than 3 times/day for more than 1 month; (3) Weight loss of more than 10% within 6 months; (4) Recurrent oral candidiasis; (5) Recurrent herpes simplex virus infection or herpes zoster virus infection; (6) Pneumocystis pneumonia (PCP); (7) Recurrent bacterial pneumonia; (8) Active tuberculosis or nontuberculous mycobacterial disease; (9) Deep fungal infection; (10) Space-occupying lesions of the central nervous system; (11) Dementia in young and middle-aged people; (12) Active cytomegalovirus infection; (13) Toxoplasmosis encephalopathy; (14) Penicillium infection; (15) Recurrent sepsis; (16) Kaposi's sarcoma or lymphoma of the skin, mucous membranes or internal organs. Currently, there are no effective drugs to cure HIV infection worldwide. The current treatment goals are: to maximally and sustainably reduce viral load; to achieve and maintain immune function reconstruction; to improve quality of life; and to reduce HIV-related morbidity and mortality. Treatment emphasizes comprehensive therapy, including: general treatment, antiretroviral therapy, treatment to restore or improve immune function, and treatment of opportunistic infections and malignancies. 1. General Treatment: Isolation is not required for HIV-infected individuals or those with acquired immunodeficiency syndrome. Asymptomatic HIV-infected individuals can maintain normal work and life. Antiretroviral therapy should be administered according to the specific condition, and changes in the condition should be closely monitored. For patients in the pre-AIDS stage or those who have progressed to AIDS, rest and a high-calorie, multivitamin diet should be provided according to the condition. Those unable to eat should receive intravenous nutrition. Supportive therapy should be strengthened, including blood transfusions and nutritional support therapy, and maintaining fluid and electrolyte balance.

2. Antiviral Therapy:
Antiviral therapy is crucial for HIV treatment. With the application of highly effective antiretroviral therapy (HIV therapy), the efficacy of anti-HIV treatment has been greatly improved, significantly enhancing patients' quality of life and prognosis.

Prevention:
Currently, there is no effective vaccine for HIV/AIDS; therefore, prevention is paramount. These measures include:
1. Maintaining abstinence and avoiding prostitution, premarital and extramarital sexual activity.
2. Strictly prohibiting drug use and not sharing needles.
3. Not receiving blood transfusions or using blood products without medical supervision.
4. Not sharing personal items such as toothbrushes, razors, and shaving blades.
5. Using condoms is one of the most effective ways to prevent sexually transmitted infections (STIs) and HIV/AIDS during sexual activity.
6. Avoiding direct contact with the blood, semen, breast milk, and urine of HIV-positive individuals to cut off transmission routes.

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