The unlinkable SCMP has a front page story to co-incide with World AIDS Day, on the user-pays principle in practice.

Gains made in controlling the spread of HIV and other sexually transmitted diseases (STD) were being jeopardised by the charges, introduced at the height of the Sars outbreak, because they deterred sex workers from undergoing testing....From April 1, non-residents have been charged HK$700 for consultations at public social hygiene clinics. HIV treatment costs non-residents HK$1,910 per consultation...The figures showed there were 19,672 samples obtained at the STD clinics for HIV testing from April to September - a 30 per cent drop from the same period last year.

The group (HK Coalition of AIDS Service Organisations) pointed out the policy exempted attendances at tuberculosis and chest clinics. "Tuberculosis treatment is provided free exceptionally because prompt treatment is considered the single most effective and preventive tool."

So if you want a sure-fire way to ensure HIV becomes a bigger problem in Hong Kong this seems to be the easiest way to go about it. Richard often talks about the problems of AIDS in China and it seems Hong Kong is destined to follow the same path. This is a case where the Glorious Motherland have shown exactly what not to do.

It beggars belief that any half-decent public health official can see this making sense. Do not for a second believe that this would remain a problem unlikely to affect HIV infection in the greater HK population. Prostitution has a murky but certain place amongst the male psyche here. Such ineptness is often funny in the context of the usual political shenanigans of this city. But when it comes to such life and death matters as this it borders on criminal negligence. These sex workers are exactly the ones that need cheap or even free health care; it's great they get it for TB. It makes a hundred times more sense for them to get it for HIV.

Sometimes this place can be just plain scary.