Chinese HIV prevention with drug users undermined by police

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Chinese police and security forces are driving injecting drug users away from prevention services, undermining the country’s efforts to contain a growing epidemic among China’s drug users, according to a new report issued this week by Human Rights Watch.

“The government has expanded prevention and treatment programmes for drug users,” said Joe Amon, HIV/AIDS programme director at Human Rights Watch. “But at the same time, the police are detaining drug users trying to access these services, and putting drug users in so-called ‘drug rehabilitation centres’ where they are provided no drug-dependency treatment and no HIV prevention or treatment services.”

“The Chinese government claims that drug users are sent to these facilities for drug-dependency treatment,” Amon said. “But instead of treatment they are put in overcrowded cells, denied medical care, beaten and forced to do menial work. On top of it all, their families are forced to pay for the ‘therapy’ they receive.”

Glossary

community setting

In the language of healthcare, something that happens in a “community setting” or in “the community” occurs outside of a hospital.

China has between three and six million injecting drug users, and around half of all HIV infections in China have occurred among this group. The Chinese government has set up more than 500 clinics to provide methadone treatment to help heroin users stop injecting drugs, and also provides free antiretroviral treatment to drug users with HIV who need it.

China’s policies have been viewed as progressive in comparison to Russia, where opiate substitution therapy such as methadone is rejected by the government and public health system.

However, in a survey of key informants in Guangxi province, which borders Vietnam and has the third-highest rate of HIV infections in China, Human Rights Watch found that injecting drug users were avoiding services that supply clean needles and injecting equipment or methadone because of police surveillance. Injecting drug users feared being detained for up to three years at 're-education through labour' centres if they were identified as drug users, or compelled to stay at compulsory drug detoxification facilities.

The researchers also found that drug users were not routinely provided with medical care, immune-system monitoring or antiretroviral therapy when confined to these facilities, nor were they counselled on HIV risk reduction or given access to condoms and clean needles, despite the fact that unsafe sex and drug use were taking place, often involving guards and female inmates. Some people reported disrupted access to antiretroviral therapy while they were detained, with continuous supply of drugs largely dependent on the whims of individual guards.

The Human Rights Watch report calls on the Chinese government to close mandatory detoxification and RTL centres housing drug users and to expand voluntary community-based drug treatment and HIV prevention efforts.

Human Rights Watch also called upon UN agencies and international donors to support efforts to reform Chinese anti-narcotics laws and regulations, and to advocate for the rights to freedom of expression, information, assembly, and association for people living with HIV/AIDS and organisations acting on their behalf. China has repeatedly detained and intimidated AIDS activists trying to promote treatment and prevention efforts and speak out about government HIV policies.

“The failure of the Chinese government to ensure that drug users in detention receive effective treatment for drug dependency and have access to HIV prevention and treatment services violates their rights, contributes to their deaths, and jeopardises the success of China’s HIV goals,” Amon said.

Further information

The Human Rights Watch report can be donwloaded here