China's rural migrants are new front in AIDS fight

BEIJING (Reuters) - The new face of AIDS in China is a shy man with a heavy provincial accent, a weathered face and the rough hands of a manual worker.

Zhang Xiaohu, a character in an educational film for migrant workers, is part of a trend that worries Chinese officials: the potential for AIDS to spread among the estimated 200 million rural migrants driving the country's rapid economic expansion.

AIDS in China has, to date, mostly been limited to drug users, gay men, prostitutes and the victims of reckless blood-buying schemes in the 1990s.

By the end of 2007, China had about 700,000 people with HIV/AIDS -- 0.05 percent of the total population -- health officials said on Sunday, ahead of World Aids Day the next day.

"The epidemic is lowly prevalent in general but it is highly prevalent among specific groups such as migrant workers, and in some regions particularly remote areas and the countryside," said Wang Weizhen, deputy director of HIV/AIDS prevention and treatment at the Ministry of Health, according to state media.

Higher rates of sexually transmitted diseases and other risk factors among male migrants have spurred an intensified effort to reach them before HIV spreads faster among them, and into the broader population.

"Other at-risk groups are rather small, but this one is huge," said Sun Xinhua, head of an office to combat AIDS that reports directly to the State Council, China's cabinet.

China's construction workers, miners and casual laborers have all the ingredients for HIV to spread. Often far from home, bored, and with some spare cash in their pockets, few of them use condoms when they visit prostitutes as rootless as themselves.

"You must stay away from these women and keep yourself out of trouble, especially when you are working away from home," said Liu Guilin, 38, at a dusty construction site in eastern Beijing.

"There are many dark corners now in Beijing. There are always women coming up to you and trying to drag you away."

Sexually transmitted diseases are more common among the migrants than the general population, but they have less access to healthcare and information than permanent city dwellers.

Their fear of rejection from co-workers and of losing jobs make many reluctant to test for HIV, which if not held back by drugs, leads to full-blown AIDS and usually death.

"I heard that you are doomed if you get AIDS. So if we found out anyone had it, we would stay well away from him," said Zhang Shiliang, 35, a slight cement layer who has left his family behind in Sichuan for six years while he forages for work.

Zhang, who said he was not clear on how AIDS spread, doubted that any of the hundreds of workers sharing his makeshift dormitory could have contracted the disease.

BARRIERS

The stigma and fear surrounding AIDS and embarrassment about talking about sex compound the difficulty of reaching the migrant population, who often lack access to information and deeply distrust officialdom.

Chinese Premier Wen Jiabao told AIDS workers and doctors on Sunday that more should be done to "strengthen prevention work in key areas and key populations," state radio news reported on Sunday. Wen also vowed more money for AIDS medicine, which has fallen short of needs.

The Ministry of Human Resources and Social Security and the International Labour Organization hope "Hometown Fellows," a short film with a Charlie Chaplin-like feel, will help break down barriers when it is shown at workplaces and mines.

In the film, shot partially in black and white, Chinese film star Wang Baoqiang, himself a former construction worker, shares toil, sweat and daily life with Zhang Xiaohu, a fellow worker ostracized because he has HIV.

Zhang is played by Wang Zhenting, a man who contracted HIV in 2002, and who knows what that rejection feels like.

"Some other workers had a lot of prejudice against us. But the government is working to raise awareness," he told reporters at the launch of the film.

"Now, some people are OK with me, but some are still not."

(Additional reporting by Phyllis Xu; Editing by Valerie Lee)