China Enlists Railway System in HIV Prevention Drive

BEIJING, China — One billion passengers ride China’s vast railway system each year. Millions are rural migrants seeking jobs in the cities. A significant number may engage in behaviour that puts them at risk of acquiring HIV, but many know next to nothing about how the virus spreads or how to prevent infection.

Train travel offers a unique opportunity to educate this large floating population about HIV. Since 2002, an innovative campaign has mobilized Chinese railway workers for this task. (See a video news report on this campaign.)

“On average passengers will spend two hours in the station and 20 hours on the train,” notes Han Shu Rong, Deputy Director General in the Ministry of Railways’ Department of Labour and Health. “There is a lot of time to conduct activities on AIDS prevention. It’s easy for people to accept it.”

On the 44-hour journey from Beijing to Panzhihua, a city located in the south of Sichuan province, two half-hour prevention messages are broadcast over the train’s video screens, one in the morning and one in the evening. Staff also hand out flyers, and they have been trained to answer questions about HIV. “We pay special attention to providing information to the passengers,” says conductor Jiang Xiao Ying.

“The main target group is men between 25 and 40,” Han states. “Rural people are shy talking about sexual issues. We conducted research on the effectiveness of different approaches to shape messages for migrants. In a limited time, we try to get across information about the three HIV transmission routes and prevention. Our research indicates that passengers learn a lot.”

Besides educating the passengers, the Ministry of Railways undertakes HIV awareness efforts aimed at protecting the 2.2 million Chinese railway workers and their families.

Education is also under way in nine major transit hubs, as part of a pilot effort started by the Ministry with support from UNFPA, the United Nations Population Fund. Officials hope they will eventually be able to expand the programme to many more of the country’s 5,700 train stations.

Some 70,000 people pass through the Beijing West Station each day. Electronic boards flash messages about HIV and in the waiting rooms large screens televise instructive videos. Station workers often distribute brochures. During busy travel periods, such as the annual spring holiday when up to 300,000 passengers a day use the station, workers staff tables to give out information face to face. In the station’s clinic, health personnel provide counselling. People who want to know their HIV status are referred to testing facilities.

Condom promotion, once a sensitive topic in China, is an explicit part of the railway campaign. Information materials stress the effectiveness of condoms in preventing HIV infection. Condom vending machines have been installed in station toilets, but Han acknowledges that they are often out of order, adding, “We are trying to procure better machines.”

Han appreciates the support given by United Nations agencies involved in HIV prevention, particularly help in learning about other countries’ experiences. “Our collaboration with UNFPA is special,” she says. “They were the first agency to work systematically with the railway system.”

To Siri Tellier, former UNFPA Representative in China, the railway campaign is indicative of a high level of official commitment to fighting the epidemic: “I think it’s quite clear and widely recognized that the Chinese Government has really taken much stronger steps to prevent HIV in the last three years.”  

— William A. Ryan