Visit to an IVDU Detention Center

The spread of HIV/AIDS in China is extremely different from other countries. Besides the normal methods of transmission - intravenous drug use (IVDU), tainted blood transfusions and unprotected sex - many poor villagers contracted HIV in the 90s by selling blood. This occurred in the Central China region (which includes Anhui province). In Central China, the infection rates have stabilized since selling blood is now banned. However, in the IVDU regions, the disease is spreading due to the sharing of tainted needles.

Yunnan Province in southern China, which shares a border with Myanmar, is a region where IVDU is a serious problem. Much of the border is completely porous - no guards, fences or anything. Just walk across the street. As a result, a lot of drugs flow into China from Myanmar. Once in Yunnan, the drug travels to Guangxi Province next door and into rest of country. On average, 50% of the IVDU drug users in Yunnan are HIV+, a staggering figure.

We flew to Lincang, a small town high up in the mountains yesterday morning, and did some patient consultations at the local hospital. The infection rate among intravenous drug users here is approximately 70%. Unlike our other sites, where we only saw Pediatric patients, here, we saw adult patients too, many of whom contracted the virus from unsafe needle use. Today, we visited an IVDU Detention Center where drug users were incarcerated to provide patient consultations. 90+% of the inmates here are HIV+. It was a truly depressing experience. Inmates live 15 to a cell. The thin mattresses they slept on were lined up one next to another on the ground. There were no beds. The cells are located around an outdoor courtyard and the metal bars on the door provide no protection against the elements. They put up a cover of some sort over the bars in the winter. Food is passed to them through a small window on the outside door. It is such a sad existence.

We took a tour of the detention center. We walked on a platform above the cells and looked down into them. One of the inmates saw us and said - "welcome to the zoo." And he is not far off. That was exactly how it felt. These people were locked up behind bars and we were observing them from afar. It felt rather voyeuristic. The inmates are there for a year and then released, but many of them end up back there again. Only 2-3 inmates out of a hundred stay off drugs for any meaningful length of time. It just shows you how strong drug addictions can be. The fear of returning to a place that is so dehumanizing does not seem to trouble most of these people.

The staff at the hospital visit the detention center and provide care to the patients several times a week. All patients who need ARV receives it for free. I'm glad the Chinese government is trying to treat them. They've even opened up methodone clinics. The consequences of ignoring the problem is too great since this is the major cause of the spread of HIV in China today. Figuring out how to help these people will be key to limiting the spread of the disease in the future.