China is on the brink of an HIV/AIDS explosion. The increase in risk behaviour such as intravenous drug injecting and unsafe sexual practices is marked. Some women in the enormous migrant population, away from the traditional restrictions of family life, may resort to prostitution. Women are particularly vulnerable to HIV infection, not least because of gender/power dynamics in sexual relationships in China where a woman may not be able to insist on protective measures. Adolescents are growing up with many traditional role models absent and changing social and cultural systems surrounding them.
The risk of a serious AIDS epidemic is compounded by the fact that not only is there a vulnerable population, it is also an unprotected population in terms of a lack of basic sex education for young people, condom usage is low, age of first sexual intercourse is lower, the incidence of premarital sex has increased, STD and Hepatitis B rates are up, and the dangers of HIV/AIDS not fully understood. Coupled with this, there is low access to a properly funded and functioning public health system, let alone a confidential and non-judgmental one.
Compared with the tremendous unmet needs of adolescents, many of the initiatives, programmes or policies that have been attempted on sexual health, by the Government and others, are scattered, smallin scale, uncoordinated and mostly pilot in nature. Policies or mechanisms for providing reproductive health information, counselling, and services to unmarried youth are neither systematic, comprehensive or well implemented. Sexual and reproductive health services specially tailored to adolescents are almost non-existent. More prominent political commitment and resources for HIV/AIDS are essential. HIV/AIDS is more than a purely medical problem, it is a wide-ranging societal problem of which there is insufficient awareness.