| In China, couples wanting to get married typically go through a medical exam first. The goal is to identify possible physical or mental problems that might interfere with producing healthy children. But a person’s health status, including sexually transmitted diseases like HIV, is protected by China’s right to privacy laws. One person who claimed to be a doctor from Hubei province recently called attention to the difficult moral dilemma health providers face when one engaged partner is found to be HIV positive. In an anonymous post that’s since been deleted, the person said that if doctors inform partners, it will likely destroy relationships. If they don’t reveal the diagnosis, they carry the guilt of putting the uninfected partners in dangerous situations. The post went on to say doctors have been both threatened and fired both for informing and not informing the partners. “The only thing premarital health check-ups achieve is causing doctors troubles,” it added. The post went viral on Weibo, attracting 130 million views. Opinions on social media have been divided about how to handle the situation. While many said it’s patients’ rights to have their health information kept to themselves, others say their sexual partners deserve to know if they could contract a life-altering illness. Many others question the purpose of premarital health checkups if information about sexually transmitted diseases is kept secret from future spouses. One husband who contracted HIV from his wife sued the hospital where she got her premarital check in 2015 for not informing him she was infected, though a court later ruled in the hospital’s favor. In 2023, another court annulled a marriage after a man concealed his AIDS history from his wife. Since doctors who violate the law can lose their practice licenses, most only play the “emotional card” and work to convince the HIV positive patient to be honest, according to interviews by China’s national broadcaster. Premarital health screening used to be mandatory until 2003, when it became voluntary and numbers of couples who did it fell. But in recent years, the premarital exam rate rose significantly to 76%, according to state media, as couples became more aware of reproductive health and the checkups were made free in most places. HIV remains a particularly sensitive topic in China, where stigma around the disease and limited sex education continue to hinder public understanding. While HIV cases have been decreasing worldwide, it’s rising sharply in China. Between 2002 and 2021, the rate of reported HIV and AIDS cases rose from 0.37 per 100,000 people to 8.41, according to China’s Center for Disease Control and Prevention. Most new infections are linked to unprotected sex. While the national privacy law remains on the books, in 2021 the province of Yunnan authorized doctors to disclose a patient’s HIV status to their partner if the patient refuses to reveal it. In the Guangxi province, the local health authorities have the right to inform a partner if a patient fails to do so within a month. Meanwhile, many lawyers, doctors and academics are calling for the national law to be changed to allow all doctors to reveal HIV status to sexual partners. — Karoline Kan | 
