Describing the Chinese HIV Surveillance System and the Influences of Political Structures and Social Stigma
Lei Zhang*, 1, Eric Pui Fung Chow1, Jun Zhang2, Jun Jing2, David P Wilson1
1 Kirby Institute, University of New South Wales, Sydney, Australia
2 Research Center for Public Health, Tsinghua University, Beijing, China
China’s public health surveillance system for HIV was established in late 1980s and has evolved significantly
during the past three decades. With the gradually changing mode of HIV transmission from sharing of intravenous
injecting equipment to sexual exposure and the rapid spread of HIV infection among Chinese homosexual men in recent
years, an efficient and comprehensive population-level surveillance system for describing epidemics trends and risk
behaviours associated with HIV acquisition are essential for effective public health interventions for HIV. The current
review describes the overall strength of the Chinese HIV surveillance system and its structural weaknesses from a political
and social perspective. The HIV surveillance system in China has undergone substantial revamping leading to a
comprehensive, timely and efficient reporting system. However, large data gaps and lack of quality control and sharing of
information obstruct the full performance of the system. This is largely due to fragmented authoritarianism brought about
by the underlying political structure. Social stigma and discrimination in health institutes are also key barriers for further
improvements of HIV diagnosis and surveillance in China.
Keywords: HIV surveillance, political structure, fragmented authoritarianism, social stigma, China..
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