Behind Closed Doors, AIDS Risks Grow in China

(Hangzhou) – University student Liu Ji told his uncle, who in turn told his aunt. Eventually, his younger sister and parents received the heart-wrenching news that Liu had contracted HIV.

"My parents couldn't work for a long time after finding out," said Liu, who attends an university in Hangzhou. "My mom just cried and cried."

Yet Liu failed to tell the whole truth. He led his family to believe that he contracted the virus that causes AIDS in late 2009 by sleeping with a prostitute. In fact, Liu is a homosexual who practiced unsafe sex with multiple partners.

Stories like Liu's are becoming more common among gay university students in China. Sexual behavior at universities is contributing to what health officials say is the rapid spread of the deadly AIDS virus in the nation's homosexual community. Soon, they say, the number of gays with HIV could rise to equal the infection levels seen among heterosexuals nationwide.

Moreover, Liu's promiscuity and failure to discuss his sexuality with his parents point to additional challenges for health experts trying to control HIV: Sex education is lacking in China, and a cultural stigma toward homosexuality keeps many Chinese gays in the closet.

Indeed, Liu agreed to speak with Caixin about his health woes only on condition of anonymity. Liu is a pseudonym.

Twenty university students in Hangzhou – all homosexual – tested positive for HIV in 2009, according to the local bureau of the Chinese Center for Disease Control (CCDC). Half were among 195 homosexuals who underwent voluntary testing in the city's Xihu District, which has a high concentration of university students.

Nationwide, the central government's Ministry of Health said, the number of university students infected with HIV or suffering from AIDS increased rapidly between 2006 and 2009. At the same time, the ministry said, the percentage of homosexuals in the infected student group rose to nearly 37 percent from 8 percent.

Health ministry data also links male homosexual behavior to 32.5 percent of the HIV infections in 2009, up from 12.2 percent two years earlier.

Zhang Beichuan, a professor at Qingdao University Medical School and a longtime homosexuality and AIDS researcher, said this ratio could rise to 50 percent in coming years. One reason, he said, is that CCDC recently started subsidizing voluntary screenings and guaranteeing patient privacy.

Healthcare Barriers

What many gay community supporters call a milestone toward easing China's deeply ingrained homosexual stigma came in 2001, when the government dropped homosexuality from its official list of mental disorders. That move has helped homosexuality become more socially acceptable while giving more gays the courage to publicly acknowledge their preferences.

But over the past year, a new wave of critical scrutiny aimed at homosexuals followed news that HIV infections were rising among gay and heterosexual university students.

In addition to facing cultural stigma, many homosexuals are at risk of contracting HIV due to inadequate sex education.

Dou Dou, who works with young homosexuals through a group in Guangzhou called Friend's Team, said more university students these days are particularly at risk due to a lack of proper sex education. As modern Chinese youths become more open about sex, he said, education is proving to be a weak link that increases infection risks in every corner of society, including university students.

Among 175 homosexuals who responded to a recent online survey by the Hangzhou CCDC, 20 was the average age for a first homosexual encounter. And within six months, 80 percent had engaged in anal sex.

More than 30 percent of those surveyed said they had not used a condom during anal sex during the previous six months, and only 20 percent claimed they would use a condom every time they had sex.

Liu said he decided he was homosexual during his second year at university. "Truly, I like only boys," he said.

He met his first boyfriend through a Hangzhou website for homosexuals. They communicated online for a long time. Since Liu didn't know how two men could make love, he was anxious to meet in person.

The man told Liu he'd slept with only one man in the past, so they decided they didn't need condoms. Later, fearing HIV, Liu underwent tests. The results were negative.

The relationship with the man continued for awhile. In addition, Liu found other gay men for one-night stands.

Liu regretted not using a condom during that first encounter. "Looking back, it was ridiculous," he said.

Liu insisted on using condoms with subsequent lovers. But one day he met a particularly dashing gay man and threw caution to the wind. This lover was likely the source of his HIV, he said.

A 25-year-old graduate student at a Beijing university who uses the pseudonym Chen Fei said he is a homosexual and well aware of the dangers of HIV. But he admits that he started having sex with men before taking the time to learn about safe sex.

"Nobody told us how to do it safely," Chen said.

Wang Long, president of the Zhejiang Homosexual Working Group in Zhejiang Province thinks health officials battling AIDS should pay more attention to the homosexual community, including gay university students. The national CCDC primarily focuses on women sex workers at risk of infection, he said.

An example of this skewed emphasis recently came to light in Zhejiang where, based on CCDC guidance, a group of organizations received 250,000 yuan from the AIDS Global Fund to help female sex workers, but only 35,000 yuan for drug users and 17,000 yuan for homosexuals.

After local activists got involved, officials agreed to reprioritize the project funding. As a result, 50,000 yuan was taken from the sex worker pool and transferred to programs for homosexuals.

1 yuan = 14 U.S. cents