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By word of mouth
Audrey Swift

An estimated 10 million Chinese will be infected with HIV/AIDS over the next ten years. With the fight against the spread of the virus now a national priority, the Red Cross is expanding its prevention programme throughout the country.

China is facing the reality of the threat of AIDS increasing daily. The Red Cross Society must have a real sense of urgency and responsibility to respond," declared Peng Peiyun, president of the Red Cross Society of China. Madame Peng reflects the growing alarm among Chinese authorities and Red Cross officials about the rapid spread of the HIV/AIDS epidemic throughout the country. The government believes that if infection rates continue to rise by 30 per cent annually, 10 million people could be infected by 2010. Some international organizations put the figure much higher.

Currently, the authorities estimate that there are 850,000 people carrying the AIDS virus. Sharing needles among drug users is the most common means of transmission, particularly in the western provinces, although sexual and other routes are increasing rapidly. Recently, China launched a drive to curb the spread of HIV through tainted blood transfusions after thousands of peasants were cross-infected after they sold their blood.

This official alarm emerged as organizations like UNAIDS and the Chinese Red Cross launched initiatives to raise awareness of the HIV/AIDS problem in the country. UNAIDS declared 2001 the year of breaking the silence on AIDS in China. The Chinese Red Cross was one of the first national institutions to speak openly about the spread of the infection. In 1994, it initiated a youth peer education project, in collaboration with the Australian Red Cross. The programme targeted youth in Yunnan province and later in Xinjiang - the two provinces with the highest reported HIV caseloads.

Today, the AIDS progamme in Yunnan trains and provides care and support to people living with HIV/AIDS. The peer education project in Xinjiang province focuses on prevention work with youth, intravenous drug users and sex workers - those who are especially at risk. The success of these programmes had led to additional ones being implemented in Guangxi, Hainan, Fujian and Jilin provinces, with plans to expand HIV/AIDS prevention activities to the remaining provinces.

Freely speaking

"We need to do this, to protect our children from HIV," explains one peer educator. Another educator says: "My wife died of HIV last January. After the peer education training, I went to Myanmar to explain to her family about HIV and AIDS, but they did not believe me, did not believe that such a disease could exist…but now that my daughter has also died, they are beginning to understand."

These are the voices of some of the first people living with HIV/AIDS trained as peer educators in China. These educators, in the south-west of Yunnan province, take every opportunity to inform people about the disease. They participate in numerous social and work gatherings to talk to fellow villagers, drug users, youth, people from neighboring Myanmar, and others about HIV: how to prevent it and how to take care of people who are already infected.

The Yunnan and Australian Red Cross HIV Prevention and Care Project and the Ruili City Anti-Epidemic Station began at the request of two people living with HIV. After attending a self-care workshop, both wanted to help others in their communities to prevent infection or to take care of themselves if already infected. With the enthusiasm of these two individuals, the Red Cross developed a training curriculum, recruited others and launched the project. Two training workshops have been held for 12 volunteers in the Ruili area. Similar projects have received funding for implementation in Yuxi prefecture of Yunnan and in Xinjiang province (with Xinjiang Red Cross) in the north-west of China.

Unlike the Red Cross youth peer education projects, peer educators do not facilitate workshops or formal educational events. Rather, they host video parties, invite people out, attend weddings, funerals, and other social events… any venue is an opportunity to talk to people about HIV/AIDS prevention and care.

The Chinese Red Cross is leading a public awareness campaign as part of the national effort to stem the spread of the AIDS virus in the country.


One of them

Peer educators have several advantages: they are ethnic minorities (primarily Dai and Jingpo in Ruili) and can communicate in the local language, most are former intravenous drug users who can warn young people of the risks of drug use, and as people living with HIV/AIDS they can demonstrate to others that they are contributing members of the community like anyone else.

This is one of the first activities promoting the involvement of people living with HIV/AIDS in China, and despite concerns that peer education would lack credibility in their communities, their knowledge is eagerly accepted - and even sought - by neighbours and friends in Ruili and in nearby Myanmar. People's curiosity about "the training you went to in Ruili" or "why you went to Thailand (to attend the Home Care Conference)" or "what you did in Beijing (took part in the First National Conference on HIV/AIDS in China)" are openings for peer educators to share their knowledge and experience, and to help others to understand and to prevent the spread of HIV.

At a recent community meeting, people confirmed the success of the programme. Authorities and individuals reported that young people are more aware of the dangers of HIV and are taking steps to reduce their risk. Local women in particular asked that the Red Cross train more peer education volunteers and provide education and support, saying that they alone cannot prevent drug use and HIV in the mountainous border regions. One husband and wife peer education team are particularly adept - Mrs. Tu talks to women in the mornings and her husband, Mr. Le, to men in the afternoons. Together, they have educated nearly all of the villagers in their hamlet. Over the next several months, they plan to reinforce their prevention and care education at home and to travel to remote areas to inform others.

Youth peer education remains the Red Cross's flagship HIV prevention programme, developing beyond youth in school to entertainment workers, drug users and, now, to people living with HIV/AIDS. In ethnically and socially diverse China, peer education complements mass media education in providing relevant information and skills development to prevent HIV, to improve the ability of people living with HIV/AIDS and their families to care for themselves, and to reduce the stigma that is still associated with HIV infection. Peer education by and for people living with HIV/AIDS is a natural and necessary extension of the Red Cross peer education initiative. As one educator explains, "I hope that by educating others my children will remember me as someone who tried to help."

Audrey Swift
Audrey Swift is project manager of the Yunnan/Xinjiang/Australian Red Cross HIV Prevention and Care Project.

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