The [him] moderator is reminded of the Lennon/Oko collaboration Double Fantasy when he reads articles like this. There may be two or even three fallacies here.
The first is that Chinese sex workers are contributing to the problem by working in Burma and then returning home. Is this true? If so it is the first he has heard of it. Sex workers from other countries working inside China is the usual situation. Burmese, Vietnamese, North Korean, and Mongolian sex workers commonly work in China both near the border and further inside the Middle Kingdom.
The second is that drug resistance is somehow spread by patient's ignorance. The truth is that health workers and poorly designed programmes are mostly responsible for drug resistance.
The general population myth is hardly worth commenting on any more. Please look at David Wilson's latest presentation on the dynamics of HIV
epidemics in Asia: http://www.aids2008.org/Pag/ppt/SUSAT2811.ppt or this one from last spring http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2785.
Comments?
[him] moderator
******************************
HIV drug resistance spreading in China, researcher says
Published: Monday, 13-Oct-2008
Disease/Infection News
As HIV spreads beyond high-risk groups into China's general population, drug-resistant strains of the virus also are appearing in parts of the country, Chen Zhiwei of the AIDS Institute in Hong Kong said recently, Reuters reports.
According to Chen, the two trends are "alarming" and people living with HIV in China could face treatment obstacles because relatively few antiretroviral drugs are available in the country. "All these drug-resistant mutations are in China now, they are emerging in Chinese patients," he said, adding, "The major worry is whether the drug-resistant virus will spread. We are studying whether that is happening, but that will be the case if you don't provide proper treatment. If drug-resistant virus (strains) spread in China, we don't have enough selection of (drugs) that are made available."
According to Reuters, about seven of the more than 20 different antiretrovirals are available in China, meaning that HIV-positive people might be left with limited options if they develop resistance to certain drugs. In addition, treatment adherence can be low in rural parts of China because of a lack of knowledge among patients, low access to health care and inadequate numbers of health care workers to explain the importance of adherence.
Chen's comments follow a study published last week in the journal Nature that found how HIV cases are increasing among women and men who have sex with men in the country. "The virus is moving into the general population," Chen said, adding, "Signs are prevalent among women and" in mother-to-child transmission. Chen also said if "there is no good prevention, transmissions will suddenly explode." According to Chen, China's open southern border is a concern, and an HIV strain recorded in Yunnan province also has been detected in Thailand and Myanmar. He added that this could be explained by women working as commercial sex workers in other countries and returning to China. In addition, travelers crossing China's southern border could be contributing to the situation, Chen said (Ee Lyn, Reuters, 10/10).
http://www.news-medical.net/?id=41944
