A group of men sit in a community centre housed in an airy apartment overlooking Harbin's drizzly panorama of high rises and office blocks. They are talking about their daily pressures they face: health problems, social attitudes and financial worries; all part of daily life with HIV.
The community centre in Harbin offers them a support system many no longer have with their own families, and a place where people understand what it is like to be HIV positive in China.
"When I found out I was infected with HIV, I decided to keep it to myself because I didn't want my family to worry," says one of those in the apartment, a man in his late 20s.
These men are among the 700,000 people in China the government and U.N. estimates are currently living with HIV. Last year, 50,000 people were newly infected. But given the lack of widespread testing, the full extent of the epidemic is hard to gauge.
The community centre in Harbin is just one example of the work of the Red Cross Society of China (RCSC) against HIV. Under a three-year nationwide HIV programme, RCSC plans a significant increase in the volume of its work of prevention, anti-stigma and discrimination, peer education, and care for people living with HIV and their families, coordinated under the framework of the Red Cross and Red Crescent Global Alliance on HIV launched on 28 March, as part of the wider International Federation of Red Cross and Red Crescent Societies (International Federation) efforts to tackle HIV.
The virus is increasingly being spread in China through sex, so people's lack of sufficient awareness and knowledge of the virus is a big concern. In addition to care and support for those who are already HIV positive, like the men in the Harbin community centre, a key objective of the new programme is to stop more people from becoming infected.
The communities currently hardest hit are often the least accepted by mainstream society. Gaining acceptance in those groups is key, and something the RCSC does well.
"Our unique advantage is the trust that people have in us and the reach we have into communities that might be harder for the government to engage with," says Xusheng Yang, director of RCSC's programme management office and HIV office.
An afternoon spent with Red Cross volunteers in Heilongjiang proves his point. Dropping into two men who have sex with men (MSM) bath houses, a park where men go to seek sexual partners and a private club where sex workers operate, it's clear there's a relationship of trust with members of the community. Even more importantly, the volunteers make sure that those places where sexual activity goes on are kept supplied with condoms and those who run the establishments receive training to help make sure clients use them.
Nurturing this relationship of mutual trust is sometimes neither quick nor easy. Recalling her first contact with one of the key volunteers in outreach for the MSM community, Zhu Xiaoping, who heads the Red Cross' HIV project in Heilongjiang, says: "I had to invite him three times before he would agree to a meeting with me. His initial reaction was that we were just doing things for appearances' sake."
But whether it's MSM in Heilongjiang, sex workers in Sichuan or injecting drug users in Xinjiang, "to contain the spread of the HIV epidemic among the wider population, we can't lose any time in focusing on the key vulnerable groups right now," says Dr Mukesh Kapila, Special Representative of the Secretary General of the International Federation.
Under the new push on HIV work that launched this week, RCSC plans to reach 27 million people with messages on prevention and reducing stigma and discrimination, and more than 866,000 people, including key vulnerable populations, through peer education. In addition, the organization will assist 90,000 people living with HIV and their family members as well as orphans and vulnerable children.
But these services come with a steep price tag. Expanding the program to this extent will require 27,564,057 Swiss francs, which by 2010 represents a 3.6-fold increase in annual funding from present levels.
If achieved, PMO and HIV office director Xusheng Yang says the efforts will benefit the entire community. "We expect that this process will yield benefits not just in our HIV work but right across the whole spectrum [of the Red Cross’ work],” he said.
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A group of men living with HIV gather to tie red ribbons to help generate income for the community centre in Harbin, China. Amid their many pressures – health problems, money worries, social stigmatization, they gain mutual support at the centre; their need to preserve their anonymity makes them unwilling to have their faces seen on camera. The centre was set up with the help of the Netherlands Red Cross in Harbin. (p17424) (Francis Markus/IFRC)
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Red Cross volunteers handing condoms to a customer in a Harbin bar. The Red Cross Society of China distributed around 100,000 condoms in MSM venues in Heilongjiang last year and conducted some 80 MSM peer education trainings. (p17425) (Red Cross Society of China/Heilongjiang)
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