The first recorded case of HIV in China occurred in 1985.
Today, an estimated 780,000 Chinese citizens are living with HIV, according to the Joint Assessment of HIV/AIDS Prevention, Treatment and Care in China, published by China’s State Council AIDS Working Committee Office and the UN Theme Group on HIV/AIDS in China.
The China-MSD HIV/AIDS Partnership, or C-MAP is a program led by two conational directors and has project offices in Beijing, and in Sichuan Province’s Liangshan Prefecture. The program is focused on six goals:
- Raising awareness and reducing discrimination among target populations through training and education
- Deploying comprehensive, integrated risk-reduction approaches to reduce HIV transmission among at-risk populations
- Establishing a service network to provide continuous treatment, care and support to people living with HIV/AIDS
- Providing support to orphans and families affected by HIV to alleviate negative social and economic consequences of the disease
- Building capacity of healthcare workers and organizations
- Strengthening HIV surveillance, monitoring and evaluation systems, as well as data management and analysis, to track program implementation, assess program outcomes, and identify and apply best practices
C-MAP collaborates with approximately 11,500 people working in 1,600 implementing organizations, including departments within the Government of China, medical and health institutions, civil society, international organizations, grassroots healthcare workers and beneficiary groups. The Government of China, through its Ministry of Health, is providing staff, facilities and equipment. The Merck Company Foundation has committed $30 million to support C-MAP over seven years.
When the partnership was launched in 2005, C-MAP covered three counties in Liangshan Prefecture in Sichuan province. In 2008, C-MAP expanded to cover 62 counties/districts, targeting 21 million people out of a total population of 87.5 million in Sichuan province.
Key Indicators & Achievements
Strategy 1—Mass Education
Through a variety of HIV educational programs, nearly 8 million people received HIV information directly, and 14 million people were reached through a mass-media educational program. The target populations for HIV education included local government officials, migrant workers, Yi ethnic community members, and middle school students.
To reduce the infection rate among high-risk populations, more than 262,000 at-risk individuals, including injection-drug users, female sex workers, men who have sex with men, and STD clinic patients have undergone targeted HIV-prevention interventions to encourage prevention, HIV testing and counseling, and treatment.
Strategy 3—Testing and Treatment for Provider-Initiated HIV Testing and Counseling Initiatives
To increase the diagnosis of HIV/AIDS and to provide timely counseling and referral services, C-MAP supported the efforts of Liangshan's Center for Disease Control and Prevention (CDC) to establish 214 provider-initiated HIV-testing and counseling (PITC) sites in 17 counties, along with 186 testing and counseling sites for pregnant women in nine counties for the prevention of mother-to-child transmission (PMTCT) of HIV. Nearly 631,000 people, including more than 81,000 pregnant women, have received HIV-testing and counseling services through PITC and PMTCT sites.
Strategy 4—Care and Support
C-MAP worked with county CDCs to provide support and care to 4,181 people living with AIDS (PLWHAs), including orphans affected by the disease, and helped 23,500 HIV/AIDS patients and their families join the New Rural Cooperative Medical Scheme conducted by the Chinese government.
Strategy 5—Capacity Building
To improve healthcare capacity and the quality of care provided to people living with HIV/AIDS in China, C-MAP has trained more than 50,000 of that country’s healthcare workers. Moreover, 599 public health workers have been hired to supplement the staff shortage at local health facilities.
Strategy 6—Surveillance, Monitoring & Evaluation
To better understand the HIV epidemic and the behavior of targeted populations in Sichuan Province, C-MAP worked with province/prefecture CDCs and Sichuan University to conduct baseline surveys and HIV surveillance of nearly 187,000 participants from the targeted populations. In addition, with the support of the Sichuan Health Authority, C-MAP worked with the Liangshan CDC to conduct a mass HIV screening in the most critical county of Liangshan Prefecture, through which more than 133,000 county citizens were tested for HIV.
The first large-scale, international, public-private partnership focused on HIV/AIDS prevention and control in China, C-MAP received the China Charity Award—Most Influential Charity Program from China’s Ministry of Civil Affairs in 2011.
Through widespread HIV screening and comprehensive surveillance efforts, C-MAP helped to highlight the HIV epidemic in Liangshan, the attention of the central and provincial governments, and contributed to raising awareness among officials about the importance of HIV/AIDS prevention and control in Liangshan.
C-MAP has developed a series of successful, replicable and effective models for HIV prevention and control in ethnic-minority areas, such as Yi ethnic opera performances for HIV education; life-skills education among middle school students; prevention-education programs for rural women; methadone replacement/treatment branch sites at the township level; PMTCT programs; PITC, and rapid HIV testing.
C-MAP has supported and facilitated large-scale HIV testing, intensive follow-up for patients at the community level, and the establishment of comprehensive patient referral and management systems. These efforts have contributed to substantial achievements in providing treatment for people living with HIV/AIDS. For example, the number of patients on antiretroviral treatment (ART) in China increased from 76 in 2007 to 3,924 by end of 2011. The Merck Company Foundation has committed $30 milion to support C-MAP over seven years.