Treatment as prevention: Action in China

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Dr. Zunyou Wu, Director of the Chinese Center for Disease Control and Prevention (CDC), offered the audience at the 2nd International Treatment as Prevention Workshop in Vancouver new information about China’s response to new evidence on treatment as prevention. The first response in 2011 was to scale up testing and treatment. In 2011, more than 84 million Chinese received HIV testing and 74,517 individuals were identified as HIV infected. Of those individuals, 45,843 were enrolled in antiretroviral therapy (ART). Notably, of the individuals newly identified, 27.6 percent had late stage AIDS. The central government gave awards to the six provinces that were most successful in scaling up testing and treatment. The target for 2012 is to identify 77,500 HIV infected individuals and to newly enroll 46,000 individuals in ART. This year, the government has engaged non-governmental organizations in both testing and treatment.

The government is now financing a number of research initiatives to inform their response to treatment as prevention:

Initiative 1: Randomized controlled trial for discordant couples in 16 counties. Goal: increase ART coverage in these couples from 52 to 80 percent. Outcomes: ART coverage increase from 52 percent to 80 percent and reduction in HIV incidence.

Initiative 2: Randomized controlled trial for men who have sex with men (MSM) in 16 cities targeting 10,000 MSM. Test and treat. Outcomes: Reductions in community viral load and HIV incidence.

Initiative 3: Randomized controlled trial of female sex workers. Test and treat. Outcome: Reduction in viral load among sex workers.

Initiative 4: Community trial. Test and treat all infected individuals in four counties. Outcomes: reduced mortality and reduced community viral load.

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