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Jailed with HIV -- a Struggle Against Despair
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Although he has been a prison warder for 18 years, Fan Zongyu remembers feeling nervous when he first fronted up to a row of HIV-positive inmates.

For two years, Fan and six of his colleagues have been running a special correctional division in Qingliu prison, where male inmates from all over the southeastern Fujian Province who have tested positive for HIV are held.

"Many people think the job is like 'skating on thin ice between life and death', but we have learnt to get used to it," Fan said with a laugh as he directed the inmates out of their cells for morning exercises.

Lined up three rows deep on a basketball field, they jump and go through an exercise routine at the guard's command, occasionally revealing their muscles beneath the blue-striped T shirts, the uniform of prisoners across the country.

After the exercises, some go to chat with guards and others just sit on the grass, enjoying the sunshine in front of a big blue sign on the ground that reads "cherish life, overcome illness."

"Though these inmates look and can live like ordinary people, we have nevertheless started up extra sport programs for them and we cook them nutrient-rich meals," Fan says, adding that the prison monitors the immune system of inmates living with HIV twice a year.

Fan says the only two inmates who developed AIDS symptoms so far were granted medical parole and admitted into the best hospital in the provincial capital of Fuzhou where they have access to better health facilities.

More faith less discrimination

Hidden deep among the lush low-lying mountains, Qingliu prison is the only grandiose, modern establishment in a sleepy ancient town called Linshe.

It is such an uneventful place that the locals still talk about Chairman Mao passing through in the 1930s as the head of a relatively weak Red Army. They say he composed a poem here to show his faith in Communist victory.

Some 75 years after Mao's stopover, Fan and his colleagues have embarked on their own Long March -- to rehabilitate prisoners who, as AIDS victims, face a double dose of discrimination.

Given how sensitive the issue is and the negative social stigma attached to HIV/AIDS in China, Fan's task, in a sense, is no less arduous than Mao's revolution.

"The key to success is to give them (HIV-positive inmates) enormous faith and zero discrimination," says Fan, recalling a failure soon after the division was formed in 2005.

Keen to protect their staff, the prison authorities ordered the guards to wear head-to-toe protective clothing and had a glass shield set up in the conversation room.

"But we found it extremely hard to talk to inmates when we appeared behind a glass wall dressed like medics during the SARS crisis," Fan says.

"I remember howls of despair and defiance echoing up and down the cells all day and the inmates openly challenged us," says Wu Yongchun, a colleague of Fan's in his 20s, adding that the situation wasn't resolved until prison guards cast off the protective clothing and their unnecessary fears.

He says that when mutual respect was restored, guards and inmates were finally able to talk face to face in a casual manner.

"Deep down, they have very low self-esteem and are desperately in need of care and concern," says Fan, hinting that these people are genuine outcasts, both as prisoners and as AIDS victims.

According to UNAIDS, the levels of HIV infection among prisoners worldwide are much higher than in the population at large.

Though data on HIV infection in Chinese prisons and other correctional facilities is not accessible, Joel Rehnstrome, UNAIDS country coordinator in China, says it is very important to implement HIV prevention programs in prisons and other closed settings since many drug users and sex workers are among the incarcerated population.

"The majority of all new HIV infections in China are related to injecting drugs and commercial sex," he says.

The full range of HIV prevention, treatment and care services should be provided in prisons. This includes information about HIV -- the importance of clean needles and syringes and condoms to prevent the spread of HIV -- and offering HIV tests and counseling, he adds.

China only began to offer HIV testing in most of its 670 prisons in 2004. To prevent HIV transmission among prisoners, many provinces transferred those who tested positive to separate wards -- anonymously so as to prevent discrimination inside prison.

In Qingliu, HIV-positive inmates are entitled to free medication and better housing conditions. Rooms in the two-story dorm building have four single wooden beds side by side, with electric fans, a color television and a spacious window that opens onto a big stretch of grass with rolling green mountains in the distance.

In addition to all these, faith, Fan says, is something that HIV-affected inmates badly need.

An inmate surnamed Huang was only 19 years old when he was sent to Qingliu, with a sentence of more than 19 years for robbery and theft. He had contracted HIV through unprotected sex.

On receiving his HIV test results, Huang was "thunderstruck and felt his fate was sealed", Wu says, adding that the young man often lamented "my life won't last as long as the prison term."

"As guards, we believe that the day is not far off when there will finally be a cure for AIDS, and most of the HIV-affected inmates will be able to walk out of the prison," Fan says. "We try our best to convince the inmates to believe what we believe."

Harsh Conditions Outside

It is the hope of re-entering society that boosts the spirits of guards and inmates alike but none of them know whether the outside world is ready to accept them.

China's first AIDS case was identified in a dying foreign tourist in 1985, but the number has ballooned over the past two decades. The Health Ministry estimates that today there are 650,000 people living with HIV/AIDS across China, including 75,000 with full blown AIDS.

Despite repeated campaigns by the government and NGOs, prejudice and discrimination are still rife among the general population.

A recent survey conducted in 12 universities in Beijing, considered to be some of the most enlightened in the country, showed that nearly a quarter of students object to having HIV positive classmates, and 4 percent say that HIV carriers should not even be allowed to have a job.

The survey shows China's university students still consider it a "challenge" to shake hands with or embrace a HIV carrier. Once they finally do it, they regard it as a "breakthrough" in life.

Attitudes in the outside world hurt the HIV-affected inmates in Qingliu prison.

Fan recalls a China Central Television news program about the life of China's AIDS victims. The inmates were deeply depressed when they saw AIDS patients being disowned by their families and their possessions -- like clothes and bed covers -- being burnt.

"Many inmates tossed and turned in bed late into the night but just could not sleep." Fan said it was not until days later that most of them began to recover.

"They feared that what they saw on TV would be what happened to them," says Fan, adding that less than half the HIV-positive inmates agree to reveal the health test results to their family. For others, it is a secret only known to other inmates and certain guards.

Fan says that the letters of ex-inmates who wrote back after being released -- and confronted with the prevalence of with social prejudice -- were often distressed and confused.

"The rehabilitation of an inmate will certainly suffer if he or she encounters discrimination, whether it is inside prison or outside," says Jing Jun, an HIV policy professor at Tsinghua University. "We need to carry on the campaign to fight discrimination both in prison and in the general public."

Wu Zunyou, a top HIV/AIDS prevention specialist at the Chinese Center for Disease Control and Prevention, says a lack of continuity of care and medical support will harm progress made in HIV/AIDS prevention in prison and might lead to new cases of transmission.

"People living with HIV/AIDS need regular counseling, or at least have somebody who cares about them and who they can talk to, " he says.

Huang Yiquan, head of Qingliu prison, says prejudice and ignorance about AIDS are so strong that he had to postpone an expansion plan for the prison ward for infected inmates.

"The present ward is almost full and badly need to be expanded to accommodate newcomers, but the problem is almost all the construction teams cried off the moment they were told HIV carriers once lived here," he says.

The rural construction workers probably thought the virus could continue to exist in the empty wards, even weeks after all the inmates had been moved out, Huang says with a wry smile.

Anti-AIDS prejudice also explains why Fan prefers to keep a low profile. He insisted reporters not take close-up photos of his face and requested he be identified only by his surname Fan if the story is printed in Chinese.

"Except for my wife, I haven't told any of my family or friends outside Qingliu Prison about what kind of inmates I look after," Fan speaks in a low voice, his eyes closed and his head down. "Even my parents don't know. If they did know, they would probably worry obsessively."

(Xinhua News Agency July 10, 2007)

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