It’s worse in Jiegao, a few minutes outside town and right on the Burma border. Heroin use appears completely out of control there. Users sprawl in lanes just off the main drag, injecting themselves. Local police seem to have given up trying to stop them. According to one denizen of Jiegao’s alleys, as many as 10 addicts will share a needle before tossing it into the weeds–sometimes to be retrieved and used yet again by a desperate junkie. Aren’t they afraid of AIDS? “There is no AIDS problem in China,” insists the 38-year-old manager of a local massage parlor. “Or at least very few people with AIDS.”
He could hardly be more wrong. There’s no monument to commemorate the event–unless you count gravestones–but Ruili has earned a place in Chinese history. This is where the country’s first major HIV outbreak was discovered in 1989. Back then, public-health officials were horrified when blood tests revealed that nearly 150 local heroin users, most of them members of the Dai minority, were infected with the virus. U.N. epidemiologists now estimate that up to 80 percent of the city’s intravenous drug users are HIV-positive, along with many of the prostitutes working at karaoke and massage parlors. Meanwhile, the disease has been spread across China by dirty needles, tainted blood and unsafe sex to untold numbers of people.
The actual count is anybody’s guess. At a September 2002 press conference, the Beijing government upwardly revised the total from 850,000 to 1 million, but no one believes that figure. Publicly, the United Nations Theme Group on HIV/AIDS in China says that unless the government takes drastic steps to control the disease, it could infect as many as 10 million by 2010. But privately, some U.N. health officials concede that the country may have 6 million cases today, and that number could balloon to 20 million by 2010. The September press conference was perhaps the central government’s strongest admission to date that China faces a crisis. While calling on international organizations to provide needed assistance, a Chinese Health Ministry official also indicated the government would start manufacturing generic AIDS drugs if Western patentholders did not lower their prices by the end of the year. But Beijing’s attention still seems trained on the cities and hinterland, not on China’s far-flung regions that its minorities call home.
From the start, the border regions–and the ethnic minorities that are most numerous there–have been on the front lines. As of 2000, the most recent year for which figures are available, 51 percent of all known HIV cases in China were in Yunnan, where the epidemic first appeared-and where 52 of China’s 55 minority groups are represented. An additional 37 percent of the cases were on the Central Asian frontier in the Xinjiang Uighur autonomous region, where 62 percent of the population is non-Han. Some of Xinjiang’s heroin comes from Afghanistan instead of Burma, but a shared needle doesn’t care where the poppies grow. In both provinces, the epidemic has found perfect breeding conditions: an abundance of poverty, illiteracy, intravenous drugs and prostitution. China’s population is 91 percent Han, but according to UNAIDS, most HIV cases have been among the non-Han minorities, including the Uighurs of Xinjiang and the hill tribes of Yunnan.
It’s a topic that scares Chinese officials speechless. They’re unwilling to talk publicly about any connection between ethnic minorities and AIDS. More than 70,000 Chinese are currently in detention as drug suspects. Asked what percentage of them are non-Han, a Public Security Ministry spokesman says only, “Those statistics aren’t supposed to be public.” Since September 2001, NEWSWEEK has been seeking government permission to conduct interviews on the epidemic in Xinjiang; as this issue went to press, every request had been denied. The reticence is not surprising. The last thing China’s leaders want is to stir up more resentment among restive ethnic groups. “[There could be] race riots if people thought the virus was spreading through minority communities and the government wasn’t doing enough about it,” says one international NGO worker.
So far, many authorities clearly have not done enough. Some remote local governments have only begun to allow proper testing and publication of statistics on the disease. And Beijing has been painfully slow in applying its massive propaganda apparatus to the lifesaving job of AIDS education. “Millions of Chinese have never heard the word AIDS,” says the U.N. report. Even when materials on HIV/AIDS prevention are available, they are often written in Chinese, not in the minority languages that most people speak in the hardest-hit areas.
Still, human nature runs deeper than any public-service campaign. The highways and commercial centers of Xinjiang are crowded with Pakistani truckers, Russian toy buyers and Azerbaijani textile traders, most of them male, lonely and a long way from home. “In remote areas a truck stop is basically a gas station, a restaurant and a whorehouse,” says Dru Gladney of the University of Hawaii, author of “Muslim Chinese.” That’s practically the basis of some counties’ economies. At a nightspot in Urumqi, an attractive young Uighur talks about life there. She left her northern Xinjiang home a year ago. “If my parents knew what I was doing, they’d beat me,” she says. “They think I work in a clothing shop.” She and the other women at the club, most of them Han Chinese, earn at least $12 a night for a few hours of singing and coaxing patrons to buy drinks. For $45 and up, a hostess will chu tai, or “leave the perch”-go out of the club and have sex. The young woman says she knows about AIDS and always uses condoms. So is she carrying one this evening? She shrugs, smiling sheepishly. No.
Now the virus is breaking through to the Han majority. Fortunately, its emergence is bringing a new sense of compassion. Just outside Kunming in Yunnan province, sculptor Wei Kunhua, 54, has been working with county officials to set up a residence for HIV patients on the grounds of an old factory. He calls it the Sunflower Community. His daughter, Ping, and his son, Xiang, both got hooked on heroin in the mid-’90s. Both contracted the virus. Ping, 32, kicked the habit six years ago, and neither her husband nor their young son is infected. “Drugs are worse than HIV,” she says. “With HIV you can live a normal life. You can’t do that on drugs.” Xiang, 29, went missing in April 2002 after an argument with his father. Wei wonders if his son is still alive. Ping says her brother had begun to show symptoms of full-blown AIDS before he disappeared.
Even now, few non-Han HIV patients are willing to speak out. They bear a double burden of prejudice, attached to their ethnic identity and the virus. An AIDS activist and former addict in Urumqi, who is Han, says he endured years of discrimination after he learned he was HIV-positive in 1996. His family was so ostracized that he had to leave home. For their sake he doesn’t want to be quoted by name. Nevertheless, he says the public is starting to show more tolerance. He openly wears the red ribbon of the worldwide fight against AIDS, and he spent the summer of 2002 setting up an Urumqi office for Mangrove, a Beijing-based HIV support group. “Now officials will at least meet me and even shake my hand,” he says. “Considering what I’ve experienced, this is progress.”
Attitudes are evolving. Television stations in Urumqi recently aired an HIV/AIDS awareness program in both Chinese and Uighur. “Students learned a lot from the program,” says Zuo Shulan of Xinjiang’s Children’s Development Center, which wrote the script. Part of the hourlong broadcast was framed as a game show. (“Right! You can’t become infected from mosquito bites!”) Another segment featured two HIV patients calmly discussing the infection-and quietly driving home the lesson that people with HIV/AIDS are still people.
Beijing may finally be confronting the crisis in its minority communities. The central government ordered a crackdown on illicit blood vendors, is beginning needle-exchange programs and has authorized a Western-style drug-rehab center. The Futures Group, a British-based consultancy, predicts that as many as 12 million Chinese could die of AIDS by 2010–or as few as 2 million. The outcome depends entirely on whether the government acts quickly and firmly or whether the infection is allowed to go unchallenged. For now, everyone lives in Ruili.
