"Impact of AIDS on the Military," Renmin Junyi 2 (Beijing) in Chinese 28 Feb 97, pp 64-65

China AIDS Survey
	What's New?
	Glossary
	Chronologies
	Documents and Statements
	Publications
	Links
	About China AIDS Survey (中文)

"Impact of AIDS on the Military"

Renmin Junyi (2) (People's Military Surgeon), 28 Feb 97, pp 64-65.

The issues of AIDS prevention and management of blood supplies to the military have been discussed in an article in a Chinese army medical journal. The journal said that soldiers had on average a high awareness of AIDS and risk prevention, but that the testing period no-show gap made it possible for HIV-positive recruits and blood samples to slip through. The journal noted that funds for AIDS treatment were limited: "There is the issue of the cost of treating AIDS patients, and particularly with the tight situation in our military health funds, the question of the funding of AIDS treatment is going to become more of an issue." The following is the text of the article by Wang Chicai, Zhang Xinsheng and Li Ying entitled: " Impact on and countermeasures against AIDS in the Chinese military" published in the Chinese journal 'Renmin Junyi' ('People's Military Surgeon'); subheadings as published:

Since the first case of AIDS was discovered in China in 1985 until the end of August in 1996, a total of 4,305 HIV (Human Immunodeficiency Virus)-positive cases have been discovered in the provinces, cities and autonomous regions throughout the country. At the 11th World Conference on AIDS held in Vancouver in July 1996, specialists estimated that by the end of the century Asia would be an AIDS hot spot. The number of HIV-positive people in countries surrounding China such as Thailand, Myanmar [Burma], India and Cambodia is rising dramatically, so the impact of AIDS on China cannot be ignored. The 30th International Conference on Military Medicine held in Germany in 1994 was the first conference to include " AIDS and the military" as a special conference topic, and at the 31st International Conference on Military Medicine held in Beijing in October 1996, military medical representatives from 18 countries exchanged nearly 30 papers on AIDS. Accordingly, viewed in the long term, the impact of AIDS on our military cannot be overlooked, and we should adopt focused measures early on by way of prevention.

1. Impact of AIDS on China's military

1.1 Impact on troops in infected areas. When, during the performance of their duties, troops are stationed in an AIDS epidemic area or come into contact with AIDS sufferers or HIV-positive individuals, it can very easily lead to the spread of AIDS. According to reports, a United Nations peacekeeping force of 230,000 soldiers was sent to Cambodia in 1992, and that year there was a 10-fold increase in HIV-positive individuals and the spread of AIDS in Cambodia. Many of the soldiers in the peacekeeping forces came from AIDS hot spots such as the area south of the Sahara in Africa and Southeast Asia, so it was extremely easy for the peacekeeping soldiers from other countries to become infected. China has sent engineering brigades to take part in the peacekeeping operations in Cambodia, and will have similar missions in the future. In addition, the epidemic is currently spreading in the various provinces, cities and autonomous regions in China. Therefore, in the case of those troops carrying out missions in AIDS epidemic areas or in key HIV monitoring regions in China, the problem of preventing HIV infection should be on the daily agenda.

1.2 Impact on the quality of new recruits. Owing to certain limitations, we still cannot conduct HIV antibody testing on a widespread scale among new recruits, and the period between when one becomes infected with the HIV virus and when HIV antibodies are detected in the blood can be a "window" of half-a-month to half-a-year or even longer. At present, military regulations stipulate a three-month limit for the physical observation period and the out-processing of recruits, so if a recruit who has already been infected with the HIV virus happens to be in this "window" period, he may superficially pass the HIV test and enter the unit as a healthy soldier, when in fact he is HIV positive and represents a hidden threat in the collective living environment of our military. These pose new problems for the quarantine of new recruits.

1.3 Impact on preventive inoculations and blood transfusions during wartime. During emergency combat preparation periods, the officers and men of a unit will get various vaccine inoculations and preventive medicines, and these may possibly increase the chances of HIV infection for the members of a unit, or the possibility of causing the obvious onset of the disease for an HIV positive person. Wartime medical treatment and evacuation take place under tense combat conditions, so how can one quickly determine whether or not a wounded person is HIV positive? How can we avoid HIV infections during first aid? Are special medical treatment instruments, regulations or systems required when stopping bleeding, applying bandages or carrying out surgery? The supply of fresh blood during wartime primarily comes from local blood donors in the war zone or nearby unit members, so how can we ensure the safety of the blood supply? All these [issues] must be dealt with seriously.

1.4 Impact on medical treatment. At present there still is no particularly good treatment or medicine for HIV positive individuals or AIDS patients, and hospitals that take in AIDS patients for treatment must have the appropriate equipment and facilities. Because there is no particularly good medicine or treatment at present, HIV positive individuals and AIDS patients often remain in the hospitals, creating a difficult problem for hospital management. In addition, there is the issue of the cost of treating AIDS patients, and particularly with the tight situation in our military health funds, the question of the funding of AIDS treatment is going to become more of an issue. All these issues must be studied and appropriate measures formulated at an early date.

1.5 Impact on the soldiers' psychology and social activities. When units are sent to AIDS infection areas to perform military duties, it is easy for them to panic regarding AIDS, which affects military morale. Once infected with HIV, it is difficult to gain the understanding of others, and can easily alter one's psychology and actions. Also, leaving the military and returning to one's original location often has an impact on securing employment and a normal life.

2. AIDS prevention countermeasures

2.1 Strengthen leadership and perfect the regulatory system. The prevention and control of AIDS is a systematic process involving many military, political, logistics and local departments, and relying on the public health departments alone will not be very effective. The " Temporary Regulations Regarding Venereal Disease in the Military" drafted by our military has established regulations for the leadership of AIDS prevention efforts, for preventive measures, treatment and control, the monitoring of epidemics, and rewards and punishments, requiring that all senior officers should strengthen their leadership of AIDS and venereal disease prevention work, with units at the regimental level and above designating one senior officer to be responsible for this and the various departments dividing up the work in keeping with their responsibilities, conducting close coordination and pulling together in the AIDS prevention effort.

2.2 Strengthen AIDS prevention and propaganda education. AIDS is an infectious disease that is closely related to social factors and personal actions. Accordingly, we must vigorously promote education on the correct outlook on life and on sexual morality, enabling the officers and men to resist conscientiously the influences of decadent ideology, respect discipline and observe the laws, and guard against immorality. We should launch AIDS prevention and health education programs, spreading basic knowledge about AIDS so that officers and men are familiar with and understand the basic information and methods to prevent venereal disease and AIDS. We must conduct regular AIDS prevention publicity and education for recruits after they join the military, briefing them on the situation and threat from HIV infection and the spread of AIDS, so that there is an ideological understanding of the enormous threat that HIV infection and AIDS outbreaks represent to mankind, thereby improving the effectiveness of the prevention efforts. We should conduct briefings on the primary methods by which AIDS is spread, energetically avoiding and eliminating actions that can spread the disease in the military, such as strengthening safe-sex measures, raising personal health awareness and health protection capabilities, avoiding close contact with those who are HIV-positive or suffering from AIDS, and not sharing toothbrushes and razors or other instruments that may have come into contact with contaminated blood. We should conduct vigorous anti-smoking campaigns. According to research, smoking affects the human immune system, and smokers are more susceptible than non-smokers to HIV infection. Smoking is one of the risk factors associated with HIV infection and the occurrence of AIDS.

2.3 Formulate an education and prevention plan. Military personnel come from the ranks of citizens, so we must improve the overall level of health education in society if we are to ensure the health of members of the military. In particular we should strengthen the health education and supervision of our young people and strengthen AIDS prevention efforts among the young, thereby improving the quality of the soldiers. The State Education Commission has already ordered the launching of comprehensive AIDS prevention education at universities and colleges and specialized secondary schools, including the issuance of "health education prescriptions" , establishing elective courses in AIDS, and watching AIDS prevention videotapes, etc, strengthening individual moral training and preventing the spread of AIDS. A health issues survey conducted among new recruits by a certain army division in 1995 showed that the recruits' understanding concerning the sexual transmission of AIDS was higher than their understanding of the ways in which hepatitis and dysentery are spread, which demonstrates that the AIDS prevention campaigns conducted in China over the past several years have been extremely effective.

2.4 Strengthen the detection and monitoring of AIDS. In 1987, our military established a network for monitoring and reporting venereal disease and AIDS, issuing the "Circular on Launching AIDS Prevention Research" , establishing AIDS detection, recognition and testing centers throughout the military, and establishing AIDS detection and screening laboratories in every hospital and blood bank. We have strengthened our efforts aimed at new recruits, new matriculates, and the hiring of personnel by military units, monitoring those personnel returning after living abroad or outside the country for three months or more to prevent HIV from getting into the ranks.

2.5 Increase investments and develop simple, effective, and sensitive reagents, vaccines and drugs. We should increase investments to develop speedy, effective, sensitive, and easily-stored detection reagents and specific drugs as quickly as possible. Because there is a "window" of half-a- month to half-a-year or longer between HIV infection and the appearance of the HIV antibody, HIV antigen testing of new recruits is an important way of stopping HIV infection from getting into the ranks. Therefore, it is critical that we develop fast, effective, sensitive and simple antigen testing reagents. In addition, we should also develop blood substitutes as quickly as possible, minimize or avoid the use of blood products and, when battlefield first aid requires the use of human blood, fast HIV testing should be conducted to ensure the safety of the blood supply. At the same time, we should strengthen research into specific treatment medicine and methods, bringing about the systematic research of AIDS testing reagents, diagnosis methods, preventive vaccines and treatment drugs.

Only through the adoption of the above comprehensive measures can we check the spread of AIDS in military units, ensure the health and improve the quality of the officers and men, and maintain the combat capabilities of our military units.

[Note: Translation provided by BBC 5 May 1997; n Lexis-Nexis Academic Universe, 5 May 1997, http://www.lexsnexis.com.]