This was once the topic I wrote about more often than any other, but I stopped following it so closely some months ago, when I got the impression that China was finally getting serious about the tragedy and cleaning up its act. And in some ways I know they have. But after Ellen of Crackpot Chronicles pointed me to this article, I’m forced to wonder whether all those stories I was reading about education programs for the rural workers really amount to anything.

Stigma and discrimination form the main barrier to China’s HIV/AIDS prevention, said a UNICEF health official here Saturday.

Overcoming stigma and discrimination is crucial to China winning the war against AIDS, said Koen Vanormelingen, chief of the Health and Nutrition Section of the United Nations Children’s Fund (UNICEF) Office for China.

In China and in the rest of Asia, social and cultural discrimination prevents people from wanting to know more about AIDS, and makes it especially hard to stop the spread of the disease.

A recent investigation by Horizon Market Research, a leading survey company in China, shows that nearly 19 percent of Chinese people have never heard of AIDS, almost the highest percentage in the world. In some regions of central China’s Henan Province, where unsanitary blood sales have caused a serious increase in HIVinfection, the local people do not even know the term AIDS, and just call it a “mysterious disease.”

In addition, for many people, HIV/AIDS is considered a disgraceful condition. Those infected with HIV are usually considered morally bad, and are therefore despised by others.

Stigma and discrimination are also very dangerous in that they may push the HIV-affected group to criminality and other behavior which destabilizes society, said Vanormelingen.

It’s a damned depressing piece. It sounds like we are right where we started when I wrote my first long post about this nightmare. Nineteen percent of the population has still never heard of AIDS? I would have believed that back in 2002, but now, after so many highly touted moves by the government to alert the at-risk population, could we really still be stuck on square one?

Ellen also alerted me to an article in the WaPo that says the AIDS problem is worsening and seeping from the drug users into the general population.

President Hu Jintao was shown on state television Tuesday shaking hands with AIDS patients for the first time, as a report warned that the disease is spreading in China from high-risk groups such as drug users to the general population.

The number of people contracting the AIDS virus in China is rising, according to a report by a U.N. agency and the Chinese Cabinet’s AIDS commission released on the eve of World AIDS Day….

“The party and the government are all concerned about you,” Hu added. “I hope you will have confidence in your treatment by cooperating with the hospital and trying to have an early recovery.”

It was the first time China’s president was shown meeting AIDS patients and part of a government campaign to show it cares. Premier Wen Jiabao set the new tone in December 2002, when he was photographed shaking hands with ordinary Chinese stricken with the disease.

The new joint U.N.-China report warned, however, that the epidemic is spreading to the general population.

I am glad that Hu did what he did, though I’m not happy that’s it’s taken two decades to happen. The key question is, as long as AIDS victims are stigmatized and marginalized and, in effect, punished for their bad fortune, how can China expect them to seek treatment? How can they expect to win? As we in America know, silence really does equal death when it comes to AIDS, and the more they try to push it down, sweep it under the rug, the worse it will get.

I was so optimistic after reading of Bill Clinton’s and Dr. David Ho’s efforts to de-stigmatize AIDS in China last summer, and it looked like it was working. Reading the latest reports, it’s hard to feel so sanguine.