HIV testing

One of the main barriers to effective HIV prevention is that the majority of people infected with HIV in China are not aware of their positive status. HIV testing is important so that those found to be infected with the virus can seek treatment and take measures to prevent transmission to others. Little over a quarter of those questioned in a 2008 survey knew where they could get tested.⁷⁴

Until recently people in China were only tested for HIV through voluntary counselling and testing (VCT) schemes. Although these VCT sites still exist, in 2004 the government launched a national programme of ‘active testing’ to seek out certain high-risk groups. Under the new policy, community health leaders initiate outreach schemes to invite members of the targeted groups to be tested. The new policy was launched in Yunnan province in 2004 and found that of the 424,000 people targeted, only 1.3% refused the test. 13,486 people (3.2%) were found to be HIV positive.

Although the Chinese government consider outreach ‘active testing’ to be successful for the increased number of people identified as HIV positive (in Yunnan the number of people found to have HIV was equivalent to the total number identified through voluntary testing in the previous 18 years) some experts have voiced concern over the human rights of those being tested. There is unease that ‘active testing’ may be placing community protection over individual rights. The tests may not be entirely voluntary due to the significant social pressure to be tested. Additionally social marketing campaigns promoting HIV awareness and addressing misconceptions are often used in place of individual pre- and post test counselling⁷⁵.

Routine testing (whereby people are tested as part of an annual medical check up) has also been introduced in institutional settings such as prisons and government offices⁷⁶. This method of HIV testing has also provoked criticism as individuals consent to health examinations that include an HIV test, rather than directly agreeing to the test itself⁷⁷.

In the first seven months of 2008, China conducted random HIV tests on some 756,000 travellers at border crossings. HIV positive foreigners are generally barred from entering China, though it is expected that this ban may be lifted in 2009⁷⁸.