'Born Again' HIV Patients Look To Brighter Future

Ahead of World AIDS Day on Friday, three people explain how they are beating the once-deadly disease. Cao Bin reports for Xinhua Features.

As preparation for his new life at a university in the United States, A'le gets up early, jogs for an hour, eats a large breakfast and then heads to a nearby cafe to spend the day studying.

Meanwhile, Xiaojuan is busy cleaning her flower shop, preparing orders for customers and putting fresh blooms in the window display.

Mingzai is stressed because his daughter has been coughing all night and needs to go to the hospital, but they are stuck in traffic.

Though they live in three different cities and lead very different lives, A'le, Xiaojuan and Mingzai have something in common: they are all living with HIV.

The days pass quickly for all three, and they rarely feel different to the people around them until the evening, when their cellphone alarms begin to ring.

A'le is just back from the gym. Xiaojuan is video chatting her parents. They both pop three pills. Mingzai is having dinner with some clients, but makes an excuse to leave the restaurant briefly, swallow his pills and wash them down with a bottle of water.

All three are undergoing antiretroviral therapy, a combination of three antiretroviral drugs that suppress the HIV virus and prevent transmission. China has been offering the drugs for free to people with HIV since 2003.

Thanks to the drugs, AIDS is no longer regarded a terminal disease, but a chronic illness that can be controlled. Adherence to the drugs can keep the viral load in an HIV patient's blood at an extremely low level, ultimately making it undetectable. The patient's immune system can be rebuilt, and they can have healthy children and an unaffected life expectancy.

"After being diagnosed as HIV-positive, many people pay more attention to leading healthier lifestyles, adopt a more responsible attitude towards life and lead better lives," said Li Hui, a member of the Shandong Provincial AIDS Prevention and Treatment Association.

Inspiration

Four years ago, Li opened a public WeChat account to post useful information about HIV and treatment, the latest research on the disease, and upbeat messages and stories from the account's followers.

Above 70,000 people have subscribed, and every day Li receives more than 1,000 inquiries from people who have recently been diagnosed with the disease.

The account has proved an inspiration for A'le, allowing him to reach out, connect with others and get through tough times. In a recent post on the account, he wrote: "Sister Hui's WeChat walked me through the darkest period in my life. I have now been taking 'candies' for a year, and live my life fully every day."

His HIV status was confirmed in a health checkup for his first job after graduation. He quickly felt as though he was "falling from paradise to hell".

Xiaojuan used to think she was a "lucky person". She married her first love, and they immediately set about having a baby. However, during her first pre-pregnancy checkup she was diagnosed with HIV. It turned out that her husband had contracted the disease during an extramarital affair, and he passed it on to Xiaojuan.

She decided to leave her husband, and moved to a new city to "start over".

Reflecting on his HIV, Mingzai said that he "had it coming". He was a drug addict when he was younger, and once even viciously assaulted his parents when they tried to talk him out of his reckless lifestyle. It was only when he became seriously ill, narrowly cheating death after urgent treatment, that he began to change his ways.

Living with disease

As of June, 718,000 people in China had been diagnosed with HIV/AIDS.

"About 20 to 30 percent of infected people are undiagnosed or unaware of their condition," said Han Mengjie, director of the Chinese Center for Disease Control and Prevention.

Under Chinese law, personal information related to people with HIV is confidential and must not be leaked to unauthorized parties. Patients receive free antiretroviral treatment and health checks, and are unable to pass the virus onto children in the womb. Those in poverty are eligible for assistance benefits.

Friday marks the 30th World AIDS Day. Michel Sidibe, executive director of UNAIDS, highlighted "the importance of the right to health and the challenges that people living with and affected by HIV face in fulfilling that right".

The UN has also set an ambitious target called 90-90-90. It aims to ensure that by 2020, 90 percent of all people with the disease will know their status, 90 percent of diagnosed patients will receive sustained antiretroviral therapy, and 90 percent of people receiving antiretroviral therapy will suppress the virus.

Wu Zunyou, head of AIDS and HIV prevention at the Chinese CDC, said the first 90 percent is the key to realizing the full target, because an accurate grasp of HIV infection rates would benefit follow-up treatment and virus control.

"Voluntary testing is the most ideal method, but it depends on improved self-awareness," he said.

As a result of the taboo surrounding AIDS, people with HIV are likely to face discrimination in education, employment and when seeking healthcare, which deters them from taking tests and leads to an increased risk of the virus spreading and causing more deaths.

Last month, the United States CDC said people with HIV whose viral load was undetectable and continued to receive antiretroviral therapy cannot transmit the illness. It was a landmark moment because it confirmed that once HIV levels become undetectable the disease becomes untransmittable. That means it is safe to have sex with or perform surgery on such patients.

Physicians say that effective antiretroviral therapy means almost every person with HIV/AIDS can have their viral load reduced to an undetectable level within three to six months and be "born again".

Diagnosis and despair

A'le remembers how despondent he was when he was diagnosed. He lost his job, and thought he would never be able to study overseas.

However, he met someone with a similar experience, who told him that his HIV status would not stand in the way of applications for a visa or for college in the US. "You can still do whatever you planned to do in your life," his friend wrote in an e-mail.

Before beginning the application process, A'le studied English and threw himself into physical exercise. The regular workouts have made him much fitter, and his most-recent checkup showed that he is perfectly healthy.

He contacted an HIV organization in the city in which his university is located. They said a volunteer would guide him through the insurance procedures, health checkups and treatment when he arrives in the US.

When Xiaojuan offered her arm for a blood test for pre-antiretroviral therapy checkup, she whispered to the nurse, "Please be careful, I have AIDS."

The nurse remained perfectly calm: "Thank you. But first, you must remember you are just a carrier and have a great chance of continuing to be so for the rest of your life with the help of the treatment. Second, I have been working here for more than a decade and nothing has happened. Don't worry about me."

Xiaojuan was overcome. "My eyes filled with tears upon hearing those words," she said.

She has become a volunteer at the local center for disease control and prevention to provide comfort and help to young people who have recently been diagnosed with HIV.

Much to her surprise, she has recently been asked out on a date. "He is a good man in every way, but I guess I will say no. Maybe in a few years, I will feel like getting married again," she said. "I'm very satisfied with my life now. I am happy, truly."

Since he quit recreational drugs, Mingzai visits his parents every weekend and helps with the housework.

His wife, who does not have HIV, supported him when he was in rehab. A few years ago, the "positive-negative" couple had a healthy baby daughter.

"Now I have a firm life goal; to make more money and create a better life for my family," Mingzai said.

On the day he started antiretroviral therapy, A'le opened a Weibo account to post his "rebirth diaries".

One day, he reposted a message from a friend who is HIV-positive: "AIDS is like a mirror, reflecting who you are. When you did not know or want to know about it, you turned away - this reflected your blindness; when you knew perfectly well it was a chronic disease you ignored it, burying your head in sorrow - this reflected your cowardice; when you knew the disease was transmitted by accident, not a moral failing, you were still full of discrimination - this reflected how judgmental you were."