Blood selling in Henan Province probably created China's first significant HIV reservoir. Traditional Chinese taboos against blood donation made blood-buying a profitable venture, with entrepreneurs visiting many rural areas and collecting blood from poor villagers and townsfolk (8) . The first case of HIV acquired through plasma donation was reported in 1995 (11) . In the 1990s it was estimated that 70% to 90% of Chinese blood reserves were obtained from people who sold their blood commercially (2) . Approximately 1 million poor farmers trying to supplement their incomes regularly donated blood in Henan province during this period (6) . Unsanitary conditions and limited or non-existent infection control procedures contributed to the early spread of HIV. However, it was the practice of donating plasma only that enabled multiple donations from the same individual, who was presumably encouraged by the notion of multiple payments. In this manner, blood was centrifuged and the plasma removed, before pooling red blood cells from multiple donors and then reinjecting the mixture back into the original donor (10). Plasma selling not only disseminated HIV infection more widely, but it also ensured high viral titres in recipients of contaminated blood. It is estimated that up to 250,000 blood donors became HIV positive from blood donation during the 1990s (13) . In Donghu village for example, over 600 villagers sold their plasma to blood companies, among whom 231 became HIV positive (13) . In Wenlou village Henan, over 60% of the population are now HIV positive (6) . The overall HIV prevalence among former blood donors now appears to range from 1% to 40%, depending on the individual village (13) .