AFP , DONGGUAN SOUTH VILLAGE, HENAN, CHINA

Workers check for possible flawed latex condoms on a production line at the Dalian Latex Factory, which produces 50 million condoms a month, in Dalian, yesterday. Some analysts estimate that China may have 2 million to 3 million people who are HIV positive and that the figure could reach epidemic proportions without a broad campaign to educate the public about contraceptives.
PHOTO: EPA

Years after being infected with HIV from selling blood, poor farmers are finally getting life-saving drugs from the government, but many are shunning the free medication.

Unendurable side effects and fears of stigmatization caused about 20 percent of the more than 5,000 people from nine provinces on the pilot program to stop taking the anti-retroviral medication.

"Many stopped after one to two weeks because the side effects were too strong," said Hu Jia, a Beijing-based AIDS activist.

In some villages, such as Dongguan in Henan Province, farmers skip days when they cannot bear the painful side effects, including headaches and vomiting.

Elsewhere, farmers afraid of discrimination do not collect the medicine, which was first offered in July.

"Some patients prefer to die at home rather than admit they're AIDS sufferers," said Zhang Fujie, head of the program run by the National Center for AIDS-STD Control and Prevention under China's Center for Disease Control.

"They said their daughter won't be able to marry and their son won't be able to find a wife," Zhang said.

"Some patients prefer to die at home rather than admit they're AIDS sufferers."

Zhang Fujie, head of the program run by the National Center for AIDS-STD Control and Prevention

International experts fear a low compliance rate due to lower quality drugs, and that the lack of qualified doctors to help patients stay on the medication will create dangerous, drug-resistant HIV.

"The advent of poorly monitored anti-retroviral drug treatment virtually guarantees the emergence of a drug-resistant HIV `superinfection' likely to spread to other parts of China, Asia and the rest of the world," wrote Andrew Thompson, a researcher at the Center for Strategic and International Studies in Washington.

By 2008, China hopes to provide the drugs to 40,000 people.

The program comes following years of appeals for help by plasma donors who contracted HIV since the mid-1980s from selling blood in unsanitary, government-approved stations.

But it is being launched when China still cannot provide the best medicine or care.

Unable to afford the latest cocktail therapy drugs, China is manufacturing and distributing older versions with expired patents. But these drugs have stronger side effects, sometimes worse than the disease's symptoms.

Patients are also not getting follow-up care from doctors to help them change the course of the drugs and keep taking them, the experts said. Fewer than 100 doctors in the country are qualified to administer AIDS drugs and few work in the countryside.

"If nobody is there to say, `They will save your life. The side effects will go away in a few days,' people are going to say I'm not going to keep taking [them]," said an international AIDS specialist familiar with the program.

The drugs are the best China can offer for now and are still effective, Zhang said.

The cost of treating one patient on the Chinese version of the cocktail drug is about US$400 a year. The cost of treatment with imported drugs is more than 10 times this amount.

But Zhang acknowledged the risks.

"If patients develop a resistance to the drugs, that's a big worry for us," Zhang said.

In spite of the shortcomings, China seems to have little choice but to continue the program.

"It's better to start now than wait too long until they can do it right. Those people dying from AIDS cannot wait," the AIDS specialist said.

Up to a million plasma donors and their loved ones could be infected with HIV in just the worst affected province, Henan, experts said.

But not all of the hundreds of villages suffering from HIV-AIDS will be getting the medicine.

Provinces have usually nominated villages to receive the drugs after they have been exposed by the media. Some officials are reluctant to nominate other deserving villages to avoid damaging their area's reputation, the specialist said.

In Dongguan village, Tang Suying, 48, is among 100 villagers receiving the AIDS drugs.

She stopped taking them when she became overwhelmed by the side effects, including constant coughing, but resumed later, remembering what happened to her husband, who died three years ago.

He and Tang sold blood for years to pay for their children's schooling and to build their home.

"My husband was one of the earliest victims in our village. We didn't know what he died of at the time," she said.

Most of the other villagers are sticking to the regime, having watched too many neighbors and relatives die from AIDS.

"We're the lucky ones," several of them said in unison.