So far, the spread of HIV in China has remained at levels less than one-fifth that of Europe and the United States, but now researchers warn that discomfort over discussing sex is a major problem. According to the Chinese Ministry of Public Health, the transmission of HIV between homosexuals has risen (.pdf) from 0.3 percent before 2005 to 13.7 percent in 2011.
In a comment published online today in Nature a consortium of Chinese researchers compare attitudes toward sexuality in China today to those in Western countries a quarter of a century ago. They write:
Chinese people aren't uncomfortable just in discussing homosexuality — sex in general is still considered extremely personal and is rarely addressed openly or directly, irrespective of orientation. This discomfort has resulted in a pervasive stigma against people with HIV, a lack of general sex education for young people and poor epidemiological data about the spread of HIV in some populations around the country.
The result is a hidden population of individuals who are afraid to seek out HIV information resources or testing and counselling centres. Poorly educated, unaware of their HIV status and under pressure to conceal their sexual encounters, these men often engage in high-risk behaviour. And once one man hiding his activity becomes infected, the disease will spread among his partners, in an ongoing cycle. It is therefore no surprise that incidence of HIV has skyrocketed in this population.
Although cases of HIV among homosexual men represent a much smaller portion of those infected, (just 13.7 percent compared to 50 percent in the U.S.) the researchers say there is cause for concern. They call for more testing and public programs as well as better social and media awareness:
Leading by example is one of the most powerful ways to combat stigma ... In 2003, a man stood up during an AIDS summit with former US President Bill Clinton at Tsinghua University in Beijing, and in doing so became one of the first Chinese people to publicly reveal his HIV status. Clinton embraced the man, named Peng-fei Song, bringing him positive media attention. Song later became a strong advocate for HIV awareness and prevention. China needs to encourage more individuals affected by HIV/AIDS to step up and help to change people's perception of the disease.