Guangxi: HIV/AIDS Programs on the Vietnam Border

UNCLAS SECTION 01 OF 02 GUANGZHOU 000640 SIPDIS SIPDIS DOL FOR ILAB HHS FOR STEIGER AND BHAT NIH FOR FOGARTY CENTER (HOLT) NIH ALSO FOR NIAID (HOFF) STATE FOR USAID FOR ANE AND GH/HIV-AIDS STATE FOR S/GAC, OES, OES/PCI, OES/IHA, DRL/PHD, AND EAP/CM CDC FOR GLOBAL AIDS PROGRAM USDOC FOR ITA/MAC/AP/OCEA MCQUEEN BANGKOK FOR USAID (BRADSHAW) USPACOM FOR FPA E.O. 12958: N/A TAGS: KHIV TBIO EAID SOCI PGOV ECON CH SUBJECT: Guangxi: HIV/AIDS Programs on the Vietnam Border REF: A) 06 Guangzhou 13565; B) 06 Guangzhou 5479 THIS DOCUMENT IS SENSITIVE BUT UNCLASSIFIED. IT SHOULD NOT BE DISSEMINATED OUTSIDE OF U.S. GOVERNMENT CHANNELS OR IN ANY PUBLIC FORUM WITHOUT THE WRITTEN CONCURRENCE OF THE ORIGINATOR. IT SHOULD NOT BE POSTED ON THE INTERNET. ¶1. (U) SUMMARY: Consul General and USAID Bangkok Health officer visited the cities of Dongxing and Pingxiang in Guangxi to take a look at and support USG-assisted HIV/AIDS projects along the border between China and Vietnam. Although small in scale, the projects serve two purposes: to provide outreach to at-risk populations of Vietnamese and Chinese sex workers, migrant workers, and truck drivers; and to develop capacity among local officials. Compared to one year ago, local support for the projects is growing. In addition, local public security officials increasingly recognyze vha vHk3e!lmiog"wiux"hM/AILSvnQL>rv0uvfMaG{QQ"}qi%q 18Qu6`MGxl,6V\f0QIx'whQ7evQG(ub4hmfQ}tl"1a7oL GkQ,O -------------- ¶2. (U) Consul General, accompanied by USAID Bangkok Project officer Clifton Cortez, a USAID publicist, members of Congen Guangzhou and several USAID HIV/AIDS contractors, visited Guangxi in late May to take a close look at USAID's HIV/AIDS-supported projects along the border with Vietnam. Though USAID does not have a mission in China, it has gained access for HIV/AIDS outreach to Guangxi (Dongxing and Pingxiang cities) and Yunnan through the Mekong River Delta program. ¶3. (U) The USAID programs target HIV/AIDS areas of high-risk activity, focusing on sex workers and their clients as well as intravenous drug users (IDU) and their sex partners. Sex and intravenous drug use are the two main methods of HIV transmission; sexually-transmitted HIV has recently reached parity with IDU-transmitted HIV in China. The projects' primary outreach methods include drop-in centers and peer education for sex workers, public outreach and education, condom distribution via hotels and public outreach or subsidized sales to sex workers, cross-border outreach with sex worker training and client education, and mass media campaigns to encourage behavioral change. USAID programs also offer voluntary counseling and testing (VCT) to motivate people to know their HIV status in order to reduce infection rates. The HIV/AIDS project staff work closely with local and regional officials to improve their capacity to monitor and respond to infectious disease outbreaks. Dongxing and Pingxiang Strongly Supportive of Programs -------------- -------------- ¶4. (U) During a meeting with the delegation, Dongxing Vice Mayor Xian Shiyong and local health officials voiced strong support for the HIV/AIDS programs in the border town. This was in contrast with more tentative support on the part of the municipal government when the project first began and it had little experience working with international NGOs in early 2006 (i.e., the time of our earlier visit). Xian cited progress made by the Dongxing government in establishing an HIV/AIDS prevention committee and programs to encourage behavioral change. He praised USAID-funded NGOs for expanding outreach platforms, strengthening cross-border cooperation, and improving the quality of the city's health teams. The Vice Mayor urged expansion of the drop-in center for sex workers, improved cooperation with Vietnam, and increased training for the city's health officials. Xian noted that attempting to reduce the stigma of HIV/AIDs remains one of the biggest challenges of the outreach program. ¶5. (U) The Consul General expressed the USG's appreciation for Dongxing's cooperation with USAID's contracting partners and USAID's GUANGZHOU 00000640 002 OF 002 Cortez highlighted the President's Global AIDS Initiative and agreement with Beijing to develop best practices. The hope, he noted, is that Dongxing (and Pingxiang) will be in the forefront of China-wide efforts to serve as a model for outreach and treatment. The visit to Dongxing included a stop at the Sisterhood Health Home drop-in center where sex workers were being trained in the use of the female condom, and a stop at the border with Vietnam, where one of the projects was conducting outreach with dock workers, laborers, and migrants. According to officials, Dongxing has 300-400 sex workers, a figure which doubles during China's three "golden" vacation weeks and during the summer when migrant sex workers arrive from central China to work the beaches. ¶6. (U) Pingxiang Vice Mayor Pan Xiaofang, who is responsible for her city's pandemic disease programs, echoed Xian's praise for the projects, expressing her appreciation for USAID's assistance to Pingxiang's efforts to build a harmonious society. Due to Guangxi's role in developing better economic relations with ASEAN countries, in particular Vietnam - where the majority of China's ASEAN trade goes - she noted that the Pingxiang border has rapidly developed as a major transportation hub. Unlike Dongxing, which is in the process of constructing a new customs and immigration center, Pingxiang's new border crossing is fully operational, though it appeared, for now, primarily to be processing individuals crossing the border on foot. Truck traffic and sex workers congregate at the nearby Puzai free-zone and crossing, a gritty warren of cross-border trade and brothels. Puzai's sex worker population, aged between 16 and 35 years of age, was entirely Vietnamese, in contrast to Dongxing's predominantly Chinese sex workers. (Once a female sex worker reaches her mid-thirties, one of the few options available to her, short of returning to Vietnam, where she likely will not be welcomed by her family, is to marry a Chinese farmer.) ¶7. (U) A Vietnamese outreach worker at one of the USAID projects estimated that one-third of the sex workers had been trafficked. Trafficked women remained in Puzai for an average of six years, compared with only two to three years for women who came voluntarily. Outreach to trafficked women remained more difficult and depended on whether the trafficker allowed outreach workers access to the women. The small free zone contained 45 brothels with more than 200 sex workers. ¶8. ()U) During a visit to an HIV/AIDS counseling and testing center, which was co-located with the infectious disease hospital in Pingxiang, USAID's Cortez highlighted the importance of project outcomes in Guangxi and Yunnan, noting that one of the goals was to develop a model of HIV/AIDS prevention and treatment for all of China. He and the Consul General met with local outreach workers, many of whom are "people living with HIV/AIDS" (PLHA),and praised them and Pingxiang officials for their commitment to HIV/AIDS outreach and treatment. GOLDBERG