Blood Problems in China Pose AIDS Crisis Risk : Health: Cash for badly needed contributions attracts migrants, prostitutes and drug addicts--even ‘vampire’ gangs. Outdated screening methods compound risk.

An advertisement for jobs with room and board lured the 17 young men to the city. By the time police rescued them, they were battered and weak, the latest victims of Chinese “vampires.”

Instead of work at a brewery for the equivalent of $35 a month, the young migrants to eastern Huaiyin city found themselves hostages of a gang. Its members forced them to sell their blood and beat and drugged them if they refused.

“Vampire gangs” are merely the most ruthless and organized patrons of a medical system so chronically short of blood it must offer cash for contributions.

Most of the clientele is not coerced, just desperate. Many are poor migrants, likely to turn to prostitution or drugs.

In that nexus of mobility, misery, crime and sex, Chinese and Western health experts fear the AIDS virus is seeping into the nation’s blood supply.

No one knows how extensive the contamination is. But in a proposed plan for fighting AIDS, the Ministry of Health lists the blood-for-cash system, its own inadequate screening methods and reliance on migrant donors as the primary sources of an expected epidemic.

With money being offered, the donation system naturally attracts the down-and-out, including drug addicts, prostitutes and migrants--all high-risk groups for AIDS, an expert with the World Health Organization in Beijing said. He spoke on condition of anonymity because he works closely with the Chinese government and did not want to jeopardize the relationship.

So far China has avoided the fates of Asian neighbors Thailand and the Philippines, where prostitution and promiscuity have rapidly spread the AIDS virus. But those social ills, largely eradicated after the Communists took power in 1949, are re-emerging in China with economic reforms and the need for a more mobile labor force.

Publicly, the government claims only 1,774 Chinese citizens have been infected, including 64 with full-blown AIDS, since the first case in China was reported in 1985.

Health officials acknowledge that figure is wildly low. Qi Xiaoqiu, deputy director of the Health Ministry’s Department of Disease Control, said as many as 90,000 Chinese may carry the AIDS virus. By 2000, they will number “several hundreds of thousands,” he said.

The government initially scorned AIDS as a foreigners’ disease. But it became concerned in the early 1990s with a surge in sexually transmitted diseases, a key indicator of sexual activity, Qi and other health experts said.

Since then, the government has conducted studies on AIDS, launched testing programs, ordered blood screening in large cities and prohibited people from giving blood outside their hometowns.

The State Council, China’s Cabinet, is studying an ambitious five-year plan for fighting AIDS that the ministry drafted with WHO’s help, the experts said.

Much of the plan, a copy of which was seen by the Associated Press, concerns stemming the spread of AIDS through sex--the vehicle that experts believe will drive the epidemic.

The main strategy focuses on AIDS counseling for high-risk populations: prostitutes, drug addicts, homosexuals, long-distance truck drivers, patients with sexually transmitted diseases and migrants, especially women.

The plan lists cleaning up the blood supply as the second priority.

Drug use is growing in Chinese cities and, with it, the fear that the AIDS virus may be spreading among needle-sharing addicts. But health officials believe that is a lesser threat.

“China is the first country to have policies and plans in place before an epidemic,” said Emile Fox, a WHO specialist who has set up AIDS projects in Rwanda and other African countries.

Although the State Council has not yet approved the plan after 11 months of study, Qi said the government fully supports his department’s efforts. The real problem comes from local governments, he said.

“In 1993, we requested that [blood] screening be done in the big cities,” Qi said. “But it is expensive. Local officials say they don’t have [an AIDS] problem so they don’t do it. And, even if you can afford the reagents [used in the screening], they’re hard to find.”

China’s blood shortage is rooted in traditional attitudes toward family and health. Many Chinese believe blood is a precious, irreplaceable gift from one’s parents and donating it dishonors them and saps the body’s vitality.

Shortages are compounded by endemic hepatitis, so many people cannot give or, if they do, the blood is thrown out when screened.

Nowhere are the ravages of an AIDS epidemic expected to be more severe than in China’s economically vibrant provinces where hygiene standards, even in hospitals, are low and mobility is high.

According to the ministry’s draft AIDS plan, 120 million Chinese, mostly uneducated peasants, are roaming cities and towns looking for work. About half the nation’s blood providers do so for money--2.5 million to 3 million people--and “they often come from very poor rural backgrounds,” it says.

Most prostitutes, most drug users and most patients with sexually transmitted diseases are migrants, the WHO expert said.

In the central boom town of Hejian, the blood center at People’s Hospital is often filled with people from out of town, the official Beijing Youth Daily reported in June.

“Nobody asked them where they were from. Nobody cared whether their health was up to it,” the newspaper said. “As long as the supervisors saw the blood was red, they drew it.”

Depending on how much blood they give and where, blood sellers get anywhere from 50 yuan (about $6), a half-month’s wages in rural areas, to about 600 yuan ($72), a month’s pay at an urban factory.

Vampire gangs live off the blood trade by preying on migrants and keeping most, if not all, of the fee.

About 30 people fell victim to the gang in Huaiyin, 500 miles south of Beijing, before police broke the case in August, the official Xinhua Daily reported. Most had to sell three-fourths of a pint of blood a week, the Health Ministry’s upper limit for one donation every three months.

One gang tricked Zhang Long, a peasant from outside Beijing’s port city of Tianjin, to go to Hejian, 300 miles southwest, the Beijing Youth Daily said. Within a month he sold blood 17 times, once as much as 1 1/2 pints.

“Once big and tough, Zhang Long didn’t know sickness and his body exuded health,” the newspaper said. “But after giving blood those 17 times, his health collapsed, he had no strength and he trembled when he walked.”

Only after he was near death did the gang leader let him go--and then only to recruit more victims.

In large cities, where blood is supposed to be screened and only residents are supposed to donate, blood merchants trade with corrupt hospital workers. They cover their tracks with the help of residents who lend their identity cards.

Residents get their IDs back along with proof of a donation. Their state-run employers then reward them with bonuses and holidays, incentives intended to promote voluntary blood giving.

Hospitals in Beijing have been told to stop the trade and to get all blood solely from a Red Cross-run blood center, Qi said.

But even if hospitals followed screening procedures and residency requirements, contamination would continue, the WHO expert said.

Tests used in China are one or two generations behind those in the West, and even the best tests cannot detect every case, he said. The AIDS virus also can lie undetected in blood from six weeks to a year after infection.

China ought to screen out the high-risk donors, not just the blood, he said.

On one Beijing street, around the corner from a major tourist hotel, women, mostly from other parts of China, jam dingy, narrow “barbershops” offering haircuts, massages--and sex.

“I haven’t sold blood yet,” said one young woman who came from southern Jiangxi province, known for its poverty. She made a modest $60 since arriving in Beijing a month ago.

“But if I can make money doing it, I’ll sell blood tomorrow,” she said.