Sexual health remains
a thorny issue in China.
How can members of Shanghai’s
gay community limit their exposure? Time Out finds out
For LGBT individuals, the available data on
sexually transmitted infections (STIs) in China makes for grim reading. The
World Health Organization, the Aids Relief Fund for China (ARFC) and UNAIDS,
the Joint United Nations Programme on HIV/Aids, all back an estimate that a
disproportionate 30 per cent of new HIV infections in China come from male-male
sexual activity, and that HIV often travels in tandem with other infections
such as syphilis, HPV (genital warts) and hepatitis B.
director of the ARFC, says that new syphilis and HPV cases in particular seem
to have skyrocketed among gay individuals in China.
The ARFC estimates
that, while the national rate of infection for syphilis among men who have sex
with men (MSM) is around 10 per cent, among the highest-risk groups –
particularly patrons of gay saunas and male brothels – it can be as high as 30
per cent. Both the ARFC and UNAIDS estimate that the national rate of HIV
infection is around five to six per cent, rising to 20 per cent in the
‘Going back to the
late 1980s when China’s epidemic started, it developed first among intravenous
drug users, and then spread to sex workers and their clients, and later to MSM,
who now make up the majority of new infections,’ says David Shallcross, a
programme assistant with UNAIDS.
It’s thought that
most LGBT Chinese remain in the closet for life, with many going on to marry
and conducting gay affairs. The fear of being ‘outed’, even if it means risking
the health of a spouse as well as one’s other sexual partners, is often too
great a deterrent. Add in a government that refuses to comment on LGBT issues,
and it’s easy to see how China’s
STI epidemic continues to rage through the gay community.
is not illegal, there’s still a risk of stigma,’ says Shallcross. ‘In China,
guarantees of confidentiality don’t always exist. People don’t feel secure
about how their information may be used.’
Humphrey Wou believes
that the rigid assignment of either a top (yi, or ‘1’) or a bottom (ling, or
‘0’) role to partners in a male-male sexual relationship has made risky
intercourse almost the norm for Chinese MSM.
‘Chinese gays learn to be gay by
watching straight people. Gay men are so fixated on these heteronormative roles
that this mitigates negotiation between the two sides – there’s a sexual
expectation, but no verbal communication. The assumption is that sex is pretty
much 100 percent anal,’ says Wou.
‘I see a lot of gay
men who want to use condoms, but won’t stress this to their partner. People say
I’m against men having anal sex. I’m not, I simply want people to do it right,’
However, Wou believes
that the work done by NGOs in China’s
fledgling gay communities is already having an impact. Simply educating MSM
about the importance of correct condom use, placing emphasis on lower-risk
behaviours and even just good oral hygiene can make all the difference. ‘In China,
people are taught that it isn’t hygienic to brush your teeth less than two
hours before sex, because gingivitis is so common. It’s not that oral sex is
unsafe. It is oral sex with gingivitis that is unsafe.’
He adds that LGBT
sexual culture in China
is, today, almost unrecognisable compared to the past. ‘Ten years ago, there
was no lube available anywhere in China,’ Wou says, laughing. ‘I
mean, can you imagine?’
While the data on new
infections can often seem terrifying, Wou believes that Shanghai’s LGBT individuals should count
themselves lucky, seeing the city as a resource-rich community for LGBT adults.
‘Second-tier cities are a totally different ballgame,’ he says. ‘Many of them
don’t even have a gay bar, let alone a gay sauna; many people still cruise in
parks or online instead, and so the risk of STI transmission is very high.’
A little common sense
and regular checkups are often all that is required. In this regard Wou says
those living in first-tier cities are often spoiled for choice. ‘There are so
many options it can get quite confusing,’ he says. ‘Rapid HIV home testing kits
are even available on Taobao.’
For a comprehensive
guide to sexual health in Shanghai,
including where to get tested for STIs, see www.timeoutshanghai.com/sexhealth.