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China: Public Security Forces Undermine HIV Response

Harassment and Imprisonment of Drug Users Weaken Treatment Programs

(New York) - China's response to the HIV epidemic is being undermined by the police and public security forces, which are driving drug users away from community-based prevention services and denying them access to HIV treatment, Human Rights Watch said in a report released today.

Human Rights Watch released the 43-page report, "Unbreakable Cycle: Drug Dependency, Mandatory Confinement, and HIV/AIDS in China's Guangxi Province," alongside an article on the topic in the prestigious medical journal, PLoS Medicine ( ). Although China has received increasing praise for its aggressive response to the HIV/AIDS epidemic in recent years, Human Rights Watch was sharply critical of its treatment of drug users.

"The government has expanded prevention and treatment programs for drug users," said Joe Amon, HIV/AIDS program director at Human Rights Watch. "But at the same time, the police are detaining drug users trying to access these services, and putting drug users in so-called ‘drug rehabilitation centers' where they are provided no drug dependency treatment and no HIV prevention or treatment services."

According to official government reports, China has 3 million to 6 million drug users, and nearly half of all recent HIV transmission has been associated with drug use. Since 2000, the Chinese government has set up more than 500 methadone treatment clinics, with the capacity to treat 100,000 drug users. Simultaneously, however, the government has increasingly put drug users in mandatory rehabilitation centers, which provide no effective drug dependency treatment. As of 2007, approximately 700 mandatory drug detoxification and 165 "re-education through labor" (RTL) centers housed at least 340,000 drug users in China. Sentences to such facilities typically range from one to three years.

Human Rights Watch found that the detoxification and RTL centers subjected drug users to abusive, inhuman, and degrading treatment. The centers not only failed to provide HIV prevention and treatment to drug users, but also facilitated its spread.

"The Chinese government claims that drug users are sent to these facilities for drug dependency treatment," Amon said. "But instead of treatment they are put in overcrowded cells, denied medical care, beaten, and forced to do menial work. On top of it all, their families are forced to pay for the ‘therapy' they receive."

The report called on the Chinese government to close mandatory detoxification and RTL centers housing drug users and to expand voluntary community-based drug treatment and HIV prevention efforts.

Human Rights Watch also called upon United Nations agencies and international donors to support efforts to reform Chinese anti-narcotics laws and regulations, and to advocate for the rights to freedom of expression, information, assembly, and association for people living with HIV/AIDS and organizations acting on their behalf. China has repeatedly detained and intimidated AIDS activists trying to promote treatment and prevention efforts and speak out about government HIV policies.

"The failure of the Chinese government to ensure that drug users in detention receive effective treatment for drug dependency and have access to HIV prevention and treatment services violates their rights, contributes to their deaths, and jeopardizes the success of China's HIV goals," Amon said.


The Guangxi Zhuang Autonomous Region, in southern China, has a population of 49 million. Bordering on Vietnam and China's Yunnan province, Guangxi is a hot-spot for illicit drugs.

Guangxi has the third-highest rate of HIV/AIDS among provinces in China. An estimated 92 percent of all HIV infections in Guangxi can be attributed to injection drug use.

In China, illicit drug use is an administrative offense, and Chinese law dictates that drug users "must be rehabilitated." Chinese law requires that all patients in compulsory rehabilitation centers be provided with "medical and psychological treatment, legal education, and moral education."

In 2007, the Standing Committee of the National People's Congress passed a new drug law, put into effect in June 2008, which substantially restructures the detention system for individuals detained for administrative drug offenses, but has significant ambiguities. While eliminating the use of RTL centers to detain drug users, it allows up to six years of confinement for a single drug offense, with one to three years in "compulsory isolation detoxification" (qiangzhi geli jiedusuo), followed by up to three years of "community rehabilitation."

Under the new law, the local head of the detoxification center determines the specific length of sentence based upon a "diagnostic evaluation." A second evaluation at the end of this period determines the length of time a detainee must spend in community rehabilitation. "Pilot" community rehabilitation sites have recently been developed on the same sites as RTL and detoxification centers in response to the legislation, and appear to be run with few differences from those centers, but promise to provide detainees with paid work and greater opportunities to visit and live with family members, including spouses and children.

The legislation also increased police authority to conduct drug searches. An anti-narcotics campaign initiated in 2007, called "Wind and Thunder Sweeping Narcotics," provides monetary incentives to citizens to report drug use by neighbors, relatives, and community members.

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