Five Year Outcomes and Challenges of the China National Free Antiretroviral Treatment Program

To combat the HIV/AIDS epidemic in China, the National Center for AIDS/STD Control and Prevention established the Division of Treatment and Care in late 2001. The pilot for the National Free ART Program began in Henan Province in 2002, and the program fully launched in 2003. Initially, treatment efforts focused on patients infected through illicit blood and plasma donations in the mid-1990s, and subsequently expanded to include HIV-infected injection drug users, commercial sex workers, pregnant women, and children. The National Free ART Database was established in late 2004, and includes data on current patients and those who were treated before 2004. Over 60,000 adult and 1,000 pediatric patients have been treated thus far. In 2008, we initialed second line pilot study in Henan, Anhui and Hubei provinces. Challenges for the program include integration of drug treatment services with ART, an under-resourced health care system, co-infections, stigma, discrimination, drug resistance. The merging of national treatment and care, epidemiologic, and drug resistance databases will be critical for a better understanding of the epidemic, earlier identification of patients requiring ART, and improved patient follow-up. The Free ART Program has made considerable progress in providing the necessary care and treatment for HIV-infected people in China and has strong government support for continued improvement and expansion.