During the Forum on Population and Development held last week in Wuhan, China released its latest policy and budget commitments to combating AIDS. Even with these encouraging announcements, the overall success of China's AIDS control efforts will depend on Beijing's willingness to explore alternative channels of HIV/AIDS information distribution to effectively educate the general population.

Beijing has long recognized the need to increase public HIV/AIDS awareness through the centralized distribution of information. Centered on December 1, World AIDS Day, China's HIV/AIDS information response has primarily focused on short-run awareness campaigns that distributed posters and pamphlets, along with images of flag-waving university students to raise awareness among the public.

But these campaigns have limited long-term impact on behavioral change or reducing the number of infections, and are primarily centered in the country's urban areas, despite reports that up to 80 percent of HIV/AIDS cases are in rural areas.

China has an estimated 840,000 HIV/AIDS cases. As of late 2003, only 7.4 percent, or 62,159, had been tested and confirmed to be HIV-positive. China's national HIV prevalence rate remains low at 0.1 percent, while infections are increasing at an average annual rate of 30 percent.

Chinese officials now acknowledge the AIDS virus is moving from high-risk populations, such as injecting drug users and prostitutes, into the general population through sexual transmission.

If effective and sustained prevention measures are not implemented, China could have up to 15 million HIV/AIDS cases in six years.

General HIV/AIDS knowledge among the general public remains low regardless of government efforts to promote and disseminate HIV/AIDS related information.

A recent survey revealed that while 93 percent of Chinese have heard of AIDS, only 8.7 percent have sufficient knowledge about AIDS transmission and prevention.

For example, only 17 percent of urban residents realize condoms can prevent HIV transmission.

The stigma surrounding AIDS in China continues to be strong. Last month, some 40 Beijing-based schools and hotels turned away 72 children orphaned by AIDS because the schools were concerned that their regular students would feel distressed knowing that their dorms had been used by AIDS orphans, and hotels were nervous that the mere presence of the children would negatively affect other guests. Most Chinese believe people living with HIV/AIDS should be banned from the workplace.

To increase the general population's general knowledge of HIV/AIDS, China should include two additions to improve its current awareness campaigns and to further sustain the distribution of HIV/AIDS information.

First, television should be regularly used to promote condom use among the general population. Last December, China's first and only televised condom public service announcement (PSA) was not followed up with additional PSAs.

If HIV/AIDS awareness PSAs are not continuously aired throughout the year, they will fail to have any measurable impact.

Statistics show that most of China's 300 million TV households trust the HIV/AIDS messages on TV, but this important medium is rarely and ineffectively used.

Secondly, China should encourage group advocacy among independent HIV/AIDS non-governmental and grass-roots organizations.

The Chinese Government can increase the effectiveness and sustainability of its prevention and education programs by channeling resources to these groups and creating the social and legal space needed for them to operate as peer educators among high-risk groups, students and the general population.

Despite the fact the Chinese Government has increased its HIV/AIDS prevention and control budget, embraced progressive methods of HIV/AIDS control for high-risk groups and codified AIDS prevention into law, failure to effectively educate the general population through continuous education and prevention activities will limit the long-term success of China HIV/AIDS control efforts.

Successful information campaigns are more than a single event, but rather require varied and steady channels of information distribution in an effort to reach and influence a diverse number of people over a period of time.

(China Daily September 15, 2004)