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2 Dec 2004

HIV/AIDS in china: MSM issues

It is estimated that there are about 40 million homosexuals in China today. In part two of this series, Kenneth Tan goes on to examine the issues surrounding the fight against AIDS among men who have sex with men (MSMs) in China.

Although no official data exists on the number of homosexuals in China, experts estimate there are at least 40 million of them in the world's most populous nation. Yet, only till recently, there was near complete absence of public information on homosexuality, and public policies and discussions remained silent on the vulnerability of this group.

China is a land of contradictions. Anti-sodomy laws here were repealed as early as 1997, putting it ahead of many other Asian nations. And in a move widely considered as the de facto decriminalisation of homosexual acts, China stopped classifying homosexuality as a mental disorder in April 2001.

Nevertheless, social conservatism and the unwillingness of the government to acknowledge the widespread presence of homosexual people in the Chinese population prevented a public acknowledgment of the spread of HIV among them. Men who have sex with men continue to face contempt from the public at large and sporadic persecution from local police under anti-hooliganism laws.

Although there are no explicit laws prohibiting homosexuality or same-sex acts between consenting adults, neither are there laws protecting gay people from discrimination, nor are there any gay rights organizations in the PRC. The Chinese policy towards the gay issue today remains the oft-cited "Three no's": no approval, no disapproval, and no promotion.

In the most authoritative work on homosexuality in China so far, Tongxing Ai (literally, Homosexual Love), Professor Zhang Beichuan, a notable scholar of gay studies, says China has a similar proportion of homosexuals in its population to European or US populations. However, with strong social pressure in Chinese society, the proportion of active homosexuals may be somewhat lower than it is in the US and Europe.

Sexual Revolution
This pressure may now be easing since recent years have seen the emergence of open or semi-open gay spaces in nearly every Chinese province and municipality. In key cities such as Shanghai, Beijing and Guangzhou, there is now a plethora of gay bars, bathhouses, massage parlours, cruising grounds and other gathering places.

Sex shops, or rather "adult reproductive health stores," abound and are prominently located everywhere. For those who prefer to shop from the privacy of home, the Internet has placed a bewildering array of sex toys at their disposal which they would feel too embarrassed to buy in a shop. At last count, Eachnet.com, China's equivalent to ebay.com, listed 6,747 kinds of sex toys. And in August 2004, China's very first officially sanctioned adult toy trade fair opened in Shanghai.

The ban on condom advertisements has been overturned and the first officially endorsed condom ads was aired on the national China Central Television (CCTV) network in November 2003, ahead of the World AIDS Day.

Like elsewhere in Asia, the advent of the Internet has allowed many gay Chinese to connect and to find that they are not alone. Gay websites have blossomed all across the PRC and little gay communities are flourishing from the coast to the inland as more and more individuals experience their coming-out on the Internet.

Pan Suiming, a sexologist at People's University, believes the one child policy adopted in 1980 shattered the age-old Confucian belief that reproduction is the sole purpose of sex, and this is one of several factors that has helped to fuel the sexual revolution.
Meanwhile, in a move that has attracted the attention of international media, Fudan University has started to offer its students courses in "AIDS Health Social Sciences" and "Gay Social Sciences" - a first in a mainland Chinese university.

Problems faced by MSMs In China
Despite increasing openness and the emergence of a gay scene concentrated in large and mid-sized cities in China, not all homosexual men are willing or able to afford going out to clubs and bars. Many are unable to come out to their families and colleagues, and choose to remain underground, meeting other people like them at public newspaper noticeboards, toilets, bathhouses, car parks and backstreets.

With this growth of possibilities for sexual interaction is the rising potential for HIV spread among men who have sex with men. Condom use is low, and knowledge about HIV and other sexually transmitted disease remains cloudy.

As in other countries, the demonisation of homosexual men as the cause of AIDS has not helped in defeating ignorance and homophobia. When the first AIDS cases were reported in the 1980s, the official press called for a ban on homosexuality and a crackdown on 'sexual liberalisation', even though the first AIDS victims in China were understood to have caught it through intravenous drug abuse. And despite the fact that male-male sexual contact accounts for a low 1.5% of AIDS transmission, many Chinese people continue to see AIDS as a gay disease.
What's been done for MSMs in China
Gay health hotlines staffed by volunteers providing psychological support and information on sexually transmitted diseases and AIDS have sprung up in at least thirteen cities all across China, including second-tier cities such as Wuhan and Harbin.

In many cities like Kunming, Suzhou, Wuhan and Chengdu, volunteer groups have been formed by gay men to serve their local communities. Most of the work is centred around hotlines and AIDS prevention knowledge publicised on web sites, with the more organised groups planning outreach activities giving out free condoms and pamphlets in gay pubs and bars, and even cruising grounds.

Leading the work in Qingdao is renowned gay studies academic Zhang Beichuan, who is conducting research on AIDS among MSMs on a large scale. His studies have uncovered that the strong discrimination and pressure faced by homosexual men in China have led about a third of them to contemplate suicide, and a third of this group to actually attempt it.

One of Zhang's key projects is the publication of a bimonthly magazine circulated nationwide called Friend Exchange, which features health-related information and research findings on homosexuality. This pioneering magazine, with a circulation of 10,000, has been widely lauded by specialists everywhere.

The greater openness has also paved the way for specialised conferences on HIV/AIDS intervention work among men who have sex with men in China. At least two such conferences have been held this year, one in Harbin and another in Kunming.

The challenges ahead
The challenge in China is in creating a movement in a country where movements are not allowed. At present, there is a very limited, albeit growing number of HIV/AIDS NGO's in China. To register an NGO, one needs to jump through a series of bureaucratic hoops, besides possessing a minimum sum of 100,000 RMB (or US$12,000), a very steep and forbidding amount in China.

With the difficulty of registering and operating such a group in China, it is not difficult to understand why MSM-specific NGO's face twice the number of hurdles. Many such groups have little or no access to funding and professional expertise, and are forced to operate on shoestring budgets. In fact, many volunteer groups remain unregistered and constantly run into the risk of irking local authorities and being shut down.

Despite the growth of AIDS awareness groups targeting MSMs all over China, one must remember that these organisations are active only in the key cities. The bulk of MSMs in the towns and villages still have no access to the services they need.

The challenge ahead will be in convincing a government that has long been wary of the intentions of NGO's to give them the space they need to do what they need to do, so they can flourish right where they are needed.

In the words of AIDS activist Wan Yanhai, who himself was once detained for "leaking state secrets" by exposing the botched blood collection schemes in Henan, "NGO's are capable of doing what the government cannot do, and going where the government cannot go. The people affected by AIDS are diverse and have different needs. What China now really needs is to develop an army of AIDS-related NGO's that specialise in meeting all these different needs."

In the meanwhile, many homosexual men continue to remain in the dark, suffering in silence.


Reader's Comments

1. 2010-01-15 22:49  
The survey was a great idea but it asks the same mostly irrelevant questions that we asked 20 years ago.
Most of the reasons why people dont use condoms are not featured in the survey such as loss of libido after long term HAART medication.
Oral sex was vague, Frottage was not mentioned.
Education material that could have been canvassed as a yes no unsure was missing.
Sex presumed anal and/or vaginal penetration only as if that was the only way people had sex.
No options for people to contribute ways that they practice safer sex without condoms successfully were included.
Assumptions about risks, Comment on erotics and massage techniques and non penetrative options are missing.
We need to be educative as well as absorbed by gory details.

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