Feature: China's "born again" HIV positive patients

by Xinhua writer Cao Bin

BEIJING, Nov. 28 (Xinhua) -- Preparing for his new life at an American University, A'le gets up early, jogs for an hour, eats a big breakfast and heads to a nearby cafe for a day of study.

Meanwhile, Xiaojuan is busy cleaning her flower shop, preparing customer orders and putting fresh flowers in the window display.

Mingzai is stressed as his daughter has been coughing all night and needs to go to hospital, but they are stuck in traffic.

Though living in three different cities, with three very different lives, A'le, Xiaojuan and Mingzai have something in common: they are living with HIV.

MAKING PEACE WITH HIV

The day passes quickly for all of them, and they hardly feel any different to the people around them, until evening when their cellphone alarms ring to alert them.

A'le is just back from the gym. Xiaojuan is video-chatting her parents. They both pop three pills. Mingzai is having dinner with his clients, but makes an excuse to go outside, swallowing his pills with a bottle of water outside the restaurant.

They are all on antiretroviral therapy, a combination of three antiretroviral drugs that suppress the HIV virus, preventing transmission. China has been offering the drugs for free to people with HIV since 2003.

Due to these drugs, AIDS is no longer regarded a terminal disease, but a chronic one that can be controlled. Adherence to the drugs can keep the virus load in an HIV sufferer's blood at an extremely low rate, ultimately making it undetectable. A person's immune system can be rebuilt, and they can have healthy children and an unaffected life expectancy.

"After being diagnosed HIV positive, many people pay more attention to leading healthier lifestyles, adopt a more responsible attitude towards life and turn out to lead better lives," said Li Hui of the Shandong Provincial AIDS Prevention and Treatment Association.

Li opened a public WeChat account four years ago, posting useful information on HIV and treatment, the latest research on the disease, and upbeat messages and stories from the account's followers.

Over 70,000 people have subscribed, and every day Li receives over 1,000 inquiries from people recently diagnosed.

The account has proved an inspiration for A'le, allowing him to reach out, connect with others and get through tough times. In a recent post on the account, he wrote: "Sister Hui's WeChat walked me through the darkest period in my life. Now I have been taking 'candies' for a year, and live my life fully every day."

His HIV status was confirmed in a health check-up for his first job after graduating, and he quickly felt like he was "falling from paradise to hell."

Xiaojuan used to think she was a "lucky person." She got married to her first love, and they immediately set about having a baby. But during her first pre-pregnancy check-up she was diagnosed with HIV. It turned out husband had committed adultery, contracted HIV and passed it on to Xiaojuan.

After a good cry, Xiaojuan decided to leave her husband, and moved to a strange city to "start over."

Reflecting on his HIV, Mingzai said that he "had it coming." He was a drug addict when he was younger, and once even viciously beat up his parents when they tried to talk him out of his reckless life. It was only after he was seriously ill, narrowly surviving death after urgent anti-virus treatment that he began to change his ways.

China had 718,000 known cases of HIV/AIDS as of June.

"About 20 to 30 percent are undiscovered or unaware of their infection," said Han Mengjie, director of the Chinese Center for Disease Control and Prevention (CDC).

Under Chinese law, personal information of HIV carriers is confidential and must not be leaked to irrelevant parties. HIV sufferers can also receive free antiviral treatment, health checkups and interdiction of maternal-neonatal transmission. Those in poverty receive living assistance benefits.

LIVING WITH HIV

This Friday marks the 30th World AIDS Day. Michel Sidibe, executive director of UNAIDS, highlighted "the importance of the right to health and the challenges that people living with and affected by HIV face in fulfilling that right."

According to the ambitious 90-90-90 UN target, by 2020, 90 percent of all people with the disease will know their status, 90 percent of people diagnosed will receive sustained antiretroviral therapy, and 90 percent of people receiving antiretroviral therapy will suppress the virus.

Wu Zunyou, head of AIDS and HIV prevention in China's CDC, said the first 90 percent was the key to realizing the full target, as an accurate grasp of HIV infection rates would benefit follow-up treatment and virus control.

"Voluntary testing is the most ideal, but it depends on improved self-awareness," Wu said.

Due to the taboo surrounding AIDS, sufferers of HIV are likely to be discriminated in education, employment and when seeking healthcare, preventing people from taking tests, which leads to increased risks of the virus spreading and deaths.

In October, the United States CDC said that people with HIV whose virus load was undetectable and continued to receive antiretroviral therapy could not transmit HIV. This was a landmark moment confirming that once HIV levels became undetectable they also became untransmittable. It means having sex with or performing operations on such patients is safe.

Doctors say that almost all people with HIV/AIDS can have their virus load brought to an undetectable level within three to six months of effective antiretroviral therapy, and be "born again."

A'le remembers his hopelessness when he was first diagnosed. He lost his job, and thought he would never be able to study abroad.

But he met someone with a similar experience, who told him that his HIV status would not stand in the way of his application for a visa or college in the United States. "You can still do whatever you planned to do in your life," his friend sent in an e-mail.

A'le learned English and threw himself into physical exercise, before his application process. His most recent checkup shows he is perfectly healthy, and the regular workouts have made him much fitter.

He also contacted an HIV organization in the city of his university. They said a volunteer would guide him through insurance, health checkup and treatment when he arrives in the United States.

When Xiaojuan offered her hand for a blood test for pre-antiretroviral therapy checkup, she whispered to the nurse: "Please be careful, I have AIDS." The nurse was perfectly calm: "Thank you. But first, you must remember you are just a carrier and have a great chance of continuing to be so for the rest of your life with the help of the treatment. Second, I have been working here for over a decade and nothing has happened. Don't worry about me."

"My eyes filled with tears upon hearing this," Xiaojuan said. She has now become a volunteer at the local Center for Disease Control and Prevention and comforts and helps many newly-diagnosed young people.

Much to her surprise, a guy recently asked her out. "He is a good man in every way. But I guess I will say no. Maybe some years later, I will like to marry again," she said "I'm very satisfied with my life now. I am happy, truly."

Since he quit recreational drugs, Mingzai visits his parents every weekend and helps with the housework. His wife, who is HIV negative, did not leave him when he was in rehab. Years ago, the "positive-negative" couple had a healthy baby daughter.

"Now I have a firm goal for life, to make more money to create a better life for my family," Mingzai said.

A'le opened a Weibo account to post his "rebirth diaries" on the first day of his antiretroviral therapy. One day, he reposted a message from an HIV positive friend: "AIDS is like a mirror, reflecting who you are. When you did not know or want to know about it, you turned away -- this reflected your blindness; when you knew perfectly well it was a chronic disease you ignored it, burying your head in sorrow -- this reflected your cowardice; when you knew the disease was transmitted by accident, not moral failing, you were still full of discrimination -- this reflected how judgemental you were." Enditem