A sign on the side of the road that leads to Wenlou Village from the Shangcai County seat in rural Henan province describes the thoroughfare as a “Model Civilized Road.” It’s an accolade bestowed upon the long stretch of asphalt by the local government — a transparent attempt to encourage safe driving.

But the village has a much darker reputation than the sign indicates. In the 1980s, illegal blood donation stations moved into rural areas of Henan province in central China and offered to pay for blood. These operations extracted plasma, then sold it on to institutional buyers. For the peasants in villages like Wenlou, this was a quick and easy way to make money. But these illegal stations were often run with a negligent approach to hygiene and sterilization. The result was an AIDS epidemic that tore through the community and still lives on today.

By March 1995, the blood-rush was out of control, and Henan’s provincial government began cracking down on the donation centers. According to the Ministry of Health, up to 43 percent of donors at the illegal centers contracted HIV. When a village had over 100 inhabitants living with HIV, it was classified as “seriously affected.” Shangcai County was home to 22 such villages.

Over 10 years ago, media descended on the county to speak to residents with HIV. Many of those people are already dead, but Liu Yi has been more fortunate. He stands 172 centimeters tall and wears a beige cotton padded jacket. His spotless black leather shoes reflect back the drab landscape of the village he calls home.

When the AIDS epidemic hit Wenlou, residents were gripped by fear and ignorance. At the beginning of the outbreak, Liu remembers an HIV-positive villager going to eat at a hot tofu stall in the village. When he sat down, the customers all ran away. After he finished eating, the stall owner threw his bowl away, not daring to use it again.

Liu now works as a salesman, delivering non-staple food products to the surrounding countryside. He earns 2,000 yuan ($300) per month, while his wife earns 1,000 yuan working at a door factory. Because of his illness, Liu also receives a quarterly allowance of 1,900 yuan from the state.

It wasn’t until 2004 — over 10 years after the first illegal donation center arrived in the village — that the state launched free anonymous health checks, free antiretroviral drugs, and treatment to prevent mother-to-child transmission of HIV. Liu still has to take three kinds of antiretroviral medication, all of which he receives free of charge.

The treatment is working. CD4 cells are the body’s defense against infection — the more you have, the better. For an uninfected, healthy person, the range is 500-1,500 cells per cubic millimeter of blood. Liu’s CD4 cell count is consistently at 500, just on the edge of the lower threshold. It’s great news for Liu, though because his cell count is still on the low side, he comes down with a debilitating cold once or twice a year.

Having HIV hasn’t stopped Liu from smoking. On the afternoon he sits talking, he smokes nearly an entire pack of 20 cigarettes. When asked why he smokes, a sheepish smile creeps across his face. Liu explains that it is customary in the countryside to offer cigarettes when greeting clients. It's a gesture that oils the wheels of business for Liu. He has two daughters, both married, but his younger son is at university. Annual tuition fees are 6,000 yuan and, along with their son’s living expenses, easily constitute the family’s biggest expense.

But life could be worse for Liu.

A Dream On Hold

It’s a crisp, cold winter’s day when we visit Wenlou. The sun is shining, and some of Liu’s friends sit around a makeshift table, whiling away the hours playing poker. Fan Yong is one of them. A born optimist, Fan never stops smiling. In the ’80s his father often donated blood, but like many at the time, his father’s lack of understanding of the process led him to incorrectly believe blood donation could cause liver disease. Fan’s dad didn’t allow Fan to donate.
 

[node:field_quote]

In the spring of 1995, when Fan was 20 years old, the height of the blood-rush had passed in Shangcai County, but some people were taking the bus to donate in cities further afield. Fan's friends were donating and Fan had never been to a city before. One day that spring, curiosity got the better of Fan and he jumped on the bus to the city of Xinxiang, also in Henan province, wondering what adventure awaited him. 

Donating blood was quick, and Fan walked away with 70 yuan. But the money had barely gathered warmth in his pocket when he went to the shopping district and spent it on clothes. Before returning home, Fan stopped at the train station, where he watched trains pass through a station for the first time in his life.

Like many areas of rural China, those of working age often leave Shangcai to work in other provinces or cities, where jobs are more numerous and often better-paid. If a person living with HIV from Shangcai county wishes to do this, they are permitted to take a year’s supply of medicine with them. 

A few years ago, Fan went to work in Guangzhou, the capital of the southern province of Guangdong, but a deterioration in his health forced him to move back home. For the past two years Fan has been painting on construction sites. But even this work is physically demanding, and Fan can only work for short periods of time. Recently he’s been unable to work at all; an inflammation of the lymph nodes in his shoulder has kept him housebound. Already four months have passed, but there has been little improvement: Fan’s illness is hampering his recovery.
 
An assortment of pill bottles sits on a wooden bench at the head of Fan’s bed. The small, run-down hut he shares with his HIV-positive wife sits opposite a much larger three-story house. Fan started building the house for his son to move into once he finds a wife — a custom in China’s countryside. But Fan’s health forced him to stop without finishing, though not before the project caused him to accrue 100,000 yuan in debt. Today, the empty shell serves as a daily reminder of a dream he was forced to put on hold.

Treatment has meant that there is a 95 percent success rate in preventing perinatal transmission of HIV in Shangcai County. For people like Fan, this has meant not passing the suffering on to his children. Despite this, Shangcai still has a reputation that it is finding hard to shake. At the height of the epidemic, the press descended on Wenlou en masse, branding it an “AIDS village” in the process. 

This reputation stuck to residents of Wenlou like a bad odor, following them wherever they went and often preventing them from getting jobs. Ignorance around AIDS is still widespread in China. Many people still believe that if you touch the hand of a child with HIV, you could get infected. Wenlou’s older generation, desperate to protect their children from such discrimination, has decided silence is the best tactic. Or, as Fan puts it, “We do not discuss our children.” 

A Child Lost

It’s December 2015, and the first snow of the season is melting in Shangcai. Zhou Cunnian walks through the wheat fields, his feet getting progressively heavier with mud. In the pocket of his black padded jacket, he carries a pack of cigarettes, though he doesn’t smoke. On July 25, 2007, Zhou’s 13-year-old son Dun died as a result of AIDS. Zhou is taking the cigarettes to burn as an offering at his grave, an unadorned mound of mud among Wenlou’s wheat fields.

By 3:30 p.m., the sound of children playing floats across the fields. It is the end of the school day at Huang Bin Hope, Dun’s former primary school. Standing near his son’s grave, Zhou squints his eyes and looks into the distance. He points to a run-down single-story house at the edge of the fields. It’s the house he shares with his wife, Xiumei.

Inside, a fresh coat of paint flatters to deceive. Bare lintels above the doors are a testament to the fact a 6,000-yuan loan hasn’t been enough for a full refurbishment of Zhou’s home, and his family has had to make do with superficial renovations. In the living room a 14-inch TV made by former state company Ruyi sits atop an old chair. Zhou bought the set in 1993 with 1,400 yuan that he made from selling his blood.

Xiumei is now the only member of the family who lives with HIV. One day in 1993, Xiumei went to the blood center. As her blood was being taken, she suddenly began to feel faint, and she eventually lost consciousness. This had never happened before, and for Xiumei it was the first warning sign that she was pregnant with Dun. Although Dun has been dead for eight years, Xiumei can’t bear to face his grave and hasn’t visited once.

Zhou doesn’t believe Dun contracted HIV from his mother. In 2000, at the age of 7, Dun was often getting sick and had to receive intravenous drips at the local hospital. Many of the people who received IV treatment at the hospital contracted HIV.

Xiumei worked outside the village, and Zhou put in long hours at a ceramics factory in the village, so Dun was mostly raised by his maternal grandmother who lived nearby. In 2005 Dun developed a rash on his inner thigh, and he later suffered a bout of encephalitis. Further tests revealed that Dun had AIDS. During the first half of 2006, he was in the hospital receiving treatment for encephalitis. Soon Dun showed signs of recovery and was discharged. But after a month the illness returned with a vengeance. Dun spent another eight months in the hospital, during which time he lost sight in both eyes and suffered from a persistent, piercing headache. He died on July 25, 2007.

A local activist says that according to statistics from the Centers for Disease Control and Prevention, there were 8,582 cases of HIV infection in Shangcai County as of Sept. 30, 2015, with a total of 100 deaths from AIDS in the first nine months of 2015. The subject is still so sensitive in Shangcai that the source requested anonymity for fear of reprisals from the local government.

Years later, and the effects of the outbreak are still being felt in the lives of the residents of Shangcai County. Liu Yi worries that after another 10 years, the epidemic will have faded from the public consciousness. For the people of the county, though, it will be hard to ever forget.

(Header image: Fan Yong stands behind a utility pole in Wenlou Village, Shangcai County, Henan province, Dec. 1, 2015. Xu Haifeng/Sixth Tone)

A Chinese version of this article first appeared in Sixth Tone’s sister publication, The Paper.