HIV/AIDS

HIV is a difficult subject to talk about, both because of how terrible the disease is, as well as the cultural stigma surrounding it. Nonetheless, it is an important health issue in all communities, and here I have gathered some resources that talk about HIV in relation to Uyghurs from medical and social perspectives.

Hayes, A., & Qarluq, A. (2011). Securitising HIV/AIDS in the Xinjiang Uyghur autonomous region. Australian Journal of International Affairs65(2), 203-219. [Link

For the People’s Republic of China, the localised HIV/AIDS epidemics in the Xinjiang Uyghur Autonomous Region are emerging as threats to those persons affected by the disease, but also to the stability of Xinjiang. This article examines the HIV/AIDS epidemic in Xinjiang and considers the impacts it may have on human and political security. The authors argue that due to its remote location and the religious, cultural and ethnic diversity of its population, and current political situation, Xinjiang poses difficult obstacles to effective programs in tackling HIV/AIDS, and the pandemic has disproportionately affected the minority nationalities in the region compared to their Han counterparts. If the HIV/AIDS pandemic among minority nationalities in Xinjiang continues to grow, it has the potential to further weaken social cohesion there, as well as Uyghur human security. Therefore, a HIV/AIDS pandemic in Xinjiang could tip the balance in terms of ethnic and regional stability.

Sun, Y., Hewan-Lowe, K., Wu, Q., Yu, J., Guo, Z., Han, Y., … & Hoshaerbai, M. (2011). HIV Screening and awareness Survey for pregnant women in a remote area in Xinjiang Uyghur Autonomous Region of China. The open AIDS journal5, 96. [Link

The Xinjiang Uyghur Autonomous Region is located in the north-western part of China. While only a little more than 1% of China’s population live in this region, it accounts for about 10% of estimated HIV cases of China. In 2006, the confirmed cases of HIV infection in Xinjiang reached 16,035, but the estimated number of people actually infected with HIV was around 60,000 [13]. After the first case of mother-to-child transmission in Xinjiang was identified in 1996, the prevalence of child HIV infection caused by mother-to-child transmission in Xinjiang exceeded 1% in 2004, and in some areas this number was as high as 5.3% [13]. Although significant efforts have been made for the prevention and treatment of HIV in Xinjiang, many remote areas need additional help to promote universal HIV testing in pregnant women. With the help of a humanitarian grant from the College of American Pathologist Foundation, free HIV screening was offered to pregnant women in Burqin County and Jeminay County in Xinjiang from July 2009 to June 2010. A survey for the knowledge about HIV infection and mother-to-child transmission of the pregnant women was also performed.

Hayes, A. (2012). HIV/AIDS in Xinjiang: a serious ‘‘Ill’’in an ‘‘Autonomous’’region. IJAPS8(1), 77-102. [Link

This paper investigates the sociographic history of HIV/AIDS in the Xinjiang Uyghur Autonomous Region in the People’s Republic of China (PRC). Xinjiang is China’s largest province and it is located in north-west China. It is home to a number of different minority nationalities as well as increasing numbers of Han Chinese migrants to the region. Xinjiang is also home to a serious HIV/AIDS epidemic and was one of the first areas to be significantly affected by HIV in China. The serious nature of the HIV/AIDS epidemic in Xinjiang, combined with growing concerns by Xinjiang locals that the Chinese government is not doing enough to combat HIV/AIDS among minority nationalities in the region, has the potential to increase regional tensions and provide further fuel to the tinder box that is ethnic relations in Xinjiang. While for the most part, tensions in the region have been focused around separatism and minority rights, HIV/AIDS poses an enormous threat to security within the region due to its ability to strip economic gains and reverse social developments made there over the past few decades and its potential to exact a huge toll in human life. Xinjiang is an important region for China due to both its wealth of natural resources and its strategic capacity as a buffer region between the PRC and Central Asian states. However, an everburgeoning HIV/AIDS pandemic in the region threatens to destabilise China’s grand plan for this north-western province if its HIV/AIDS epidemic continues to grow.

Ni, M. J., Fu, L. P., Chen, X. L., Hu, X. Y., & Wheeler, K. (2012). Net financial benefits of averting HIV infections among people who inject drugs in Urumqi, Xinjiang, Peoples Republic of China (2005–2010). BMC Public Health12(1), 572. [Link]

This paper explores the net financial benefit in Urumqi of providing harm reduction programmes in averting HIV infection as a consequence of injecting drug use as compared to the costs of providing HIV treatment and care. Urumqi was chosen as the site for this research based on completeness of records and readiness of access to staff. This study draws on available information about the incidence of HIV among PWID between 2000 and 2010 and specific studies to assess costs.

Simayi, D., Yang, L., Li, F., Wang, Y. H., Amanguli, A., Zhang, W., … & Wang, W. (2013). Implementing a cervical cancer awareness program in low-income settings in Western China: a community-based locally affordable intervention for risk reduction. Asian Pacific Journal of Cancer Prevention14(12), 7459-7466. [Link]

Education intervention can significantly raise the awareness of cervical cancer in low-income women. Economic development and compulsory education are two important solutions in raising general disease awareness. We propose that implementing community-based awareness programs against cervical cancer is realistic, locally affordable and sustainable in low-income countries, which may save many lives over time and, importantly, will facilitate the integration of comprehensive programs when feasible. In this context, adopting this strategy may provide one good example of how to achieve “good health at low cost”.

Mijiti, P., Yuexin, Z., Min, L., Wubuli, M., Kejun, P., & Upur, H. (2015). Prevalence and predictors of anaemia in patients with HIV infection at the initiation of combined antiretroviral therapy in Xinjiang, China. International journal of STD & AIDS26(3), 156-164. [Link]

We retrospectively analysed routinely collected baseline data of 2252 patients with HIV infection registered in the National Free Antiretroviral Treatment Program in Xinjiang province, China, from 2006 to 2011 to estimate the prevalence and predictors of anaemia at the initiation of combined antiretroviral therapy. Anaemia was diagnosed using the criteria set forth by the World Health Organisation, and univariate and multivariate logistic regression analyses were performed to determine its predictors. The prevalences of mild, moderate, and severe anaemia at the initiation of combined antiretroviral therapy were 19.2%, 17.1%, and 2.6%, respectively. Overall, 38.9% of the patients were anaemic at the initiation of combined antiretroviral therapy. The multivariate logistic regression analysis indicated that Uyghur ethnicity, female gender, lower CD4 count, lower body mass index value, self-reported tuberculosis infection, and oral candidiasis were associated with a higher prevalence of anaemia, whereas higher serum alanine aminotransferase level was associated with a lower prevalence of anaemia. The results suggest that the overall prevalence of anaemia at the initiation of combined antiretroviral therapy in patients with HIV infection is high in Xinjiang, China, but severe anaemia is uncommon. Patients in China should be routinely checked for anaemia prior to combined antiretroviral therapy initiation, and healthcare providers should carefully select the appropriate first-line combined antiretroviral therapy regimens for anaemic patients.

Cappelletti, A. (2015). Developing the Land and the People: Social Development Issues in Xinjiang Uyghur Autonomous Region (1999–2009). East Asia32(2), 137-171.

I made a separate post about this paper.

Peierdun, M. J. T., Liu, W. X., Renaguli, A. Z. Z., Nurmuhammat, A., Li, X. C., Gulibaier, K. H. E., … & Halmurat, U. (2015). Clinical characteristics of abnormal savda syndrome type in human immunodeficiency virus infection and acquired immune deficiency syndrome patients: A cross-sectional investigation in Xinjiang, China. Chinese journal of integrative medicine21, 895-901. [Link]

Human immunodeficiency virus (HIV) infection rate was higher in Xinjiang compared to other regions in China, and a significant number of patients were seeking for treatment from Traditional Uyghur Medicine (TUM). However, TUM study on HIV infection and acquired immune deficiency syndrome (AIDS) was quite rare. In this study, we carried out an epidemiological investigation in order to explore the distribution of abnormal hilit syndromes among HIV/AIDS patients and describe the clinical characteristics of the abnormal savda syndrome.

Zhang, X. Y., Huang, T., Feng, Y. B., Meng, L. I., Chen, F. F., Li, Y. G., … & Lu, W. A. N. G. (2015). Characteristics of the HIV/AIDS Epidemic in Women Aged 15-49 Years from 2005 to 2012 in China. Biomedical and Environmental Sciences28(10), 701-708. [Link]

The objectives of this study were to describe the epidemic characteristics of reported HIV/AIDS cases among women aged 15-49 years, and to determine the source of heterosexual transmission. Furthermore, spatial analysis was used to reveal spatial distribution patterns of HIV/AIDS infection in women aged 15-49, to detect potential clusters, and to assess the epidemic by region.

Maimaiti, R., Zhang, Y., Pan, K., Mijiti, P., Wubili, M., Musa, M., & Andersson, R. (2017). High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China. BMC Infectious Diseases17(1), 15. [Link]

Tuberculosis and HIV co-epidemics are problems in many parts of the world. Xinjiang is a high tuberculosis and HIV prevalence area in China. We aimed to investigate the prevalence and cure rate of tuberculosis among HIV positive patients in Xinjiang. The prevalence of tuberculosis among HIV positive patients in Xinjiang was higher than in China taken as a whole, and HIV was diagnosed late, with underuse of isoniazid preventive therapy. The low cure rate and reduced survival can be due to late diagnosis of HIV and no testing for antibiotic resistance, together with insufficient control of adherence to the treatment regimens for tuberculosis and HIV.

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