Rates of HIV/AIDS are rising rapidly in China’s general population, according to new figures released on Wednesday by the Chinese Center for Disease Control and Prevention (CDC), which reveals the largest increases in recent years to be among older people and college students, due to unsafe sexual intercourse.

According to the Chinese government’s official press agency Xinhua, the CDC figures show that the number of men aged 60 and over with HIV has soared from 483 in 2005 to 3,031 in 2010. In 2005 this group accounted for only 2.2% of total HIV infections, in 2010 it accounted for 8.9%.

The number of men aged 60 and over with AIDS also soared from 237 in 2005 to 2,546 in 2010. This group accounted for 11% of all cases in 2010, double the proportion in 2005.

The CDC figures also show a massive surge in the number of HIV/AIDS diagnoses among students this year. Between January and October, a total of 1,252 cases were recorded, accounting for 21% of all student cases, reports Xinhua, who cite the CDC as saying infection has been particularly prominent among male college students aged from 20 to 24.

The Director of the CDC HIV/AIDS prevention and control center, Wu Zunyou, told the media agency that due to improvements in health and living standards in the country, older people have remained sexually active, even well after retirement, and for various reasons, such as the “death of spouses or their lack of interest, some elderly have resorted to sex services”.

“Many tended to choose secluded and low-end venues and didn’t use condoms, which made them highly vulnerable to HIV infections,” said Wu.

Wu noted that HIV/AIDS is now scattered more widely in China than ever before, sorely challenging efforts to prevent and control the spread, and explained they were also seeing an unexpected rise in cases of infection found through hospital checks.

Chinese authorities are expecting the number of people living with HIV/AIDS in the country to reach 780,000 by the end of 2011, even though only 346,000 are registered HIV carriers or AIDS patients.

Wu said it is going to be an “extremely tough battle” for China to achieve its goal of reducing HIV/AIDS infections by 25% and deaths by 30% in 2015, from the 2010 level.

One example of how the fight against HIV/AIDS is being fought in China is the project run by international medical and humanitarian charity Médecins Sans Frontières (MSF) and the Chinese CDC in Nanning, the capital of the mountainous province of Guangxi in the far south of the country. After 7 years of providing HIV care, the MSF-CDC partnership handed over the project to local health authorities in 2010.

The project started in 2003, targeting high-risk groups such as injected drug users, sex workers and men who have sex with men. The Chinese authorities were at first sceptical, and doubted that drug users would adhere to antiretroviral (ARV) treatment.

Dr Wu Zunyou, director of the National Centre for AIDS/STD Control and Prevention, said in a statement published on MSF’s website to mark the handover:

“In the early stages, we had no experience in providing treatment to drug users and AIDS patients overall.”

But they found patients responded well to the treatment and were able to stick to it.

A key part of the project was targeting people living with HIV from marginalized populations. Teams went out into these communities and persuaded people to get tested and commit to treatment. Counselling, previously regarded with suspicion by the Chinese health authorities, became an essential part of the care patients received.

Another important part of the project was the training of local health workers. The project helped to establish over 40 antiretroviral treatment centres, giving over 1,700 patients free and confidential treatment and care.

Over 80% of the patients were continuing to follow treatment when the project was handed over. One of these is 28-year-old Cui (not the patient’s real name), who has been receiving treatment for HIV since May 2008.

Cui told MSF:

“When I arrived in the clinic I was very sick, and people gave me a lot of encouragement. Before, I didn’t know anything about treatment.”

Like many of those infected, Cui didn’t understand the importance of adhering to the treatment regime:

“However, the doctors and counsellors emphasized the importance of this and my health improved. It’s good to talk to the counsellors. Talking with them is the only way to relieve my burdens. Every time I talk with them I cry,” said Cui.

Written by Catharine Paddock PhD