07.06.07
AIDS Education with Chinese Characteristics
The other day I was having lunch with a Chinese friend when the conversation turned to homosexuality.
“What is your attitude about homosexuals?” he asked me.
“I don’t really have any problem with it. I think it’s a personal decision.” I told him.
“Me to. I think China has a lot of gay people, most of them are not open about it though. I agree. People should be able to be gay if they want, and others should respect their privacy. But I do think it is quite dangerous because of AIDS,” he replied.
Like anywhere in the world these days, AIDS is a problem in China. Up until about 5 or 6 years ago, AIDS was not talked about much in China. The government’s stance was that AIDS was a Western problem and that China need not concern itself with these matters.
Today this is not the case. The central government has realized that AIDS is no longer a problem which can just be ignored and expected to go away, and now AIDS receives regular coverage in Chinese TV, newspapers, and public health campaigns. When I was teaching in Fuqing in 2004, my university even displayed posters about AIDS prevention around campus. The language used on them was vague, and did not contain much information about prevention, but at least the problem was being acknowledged, which is the first step towards a solution.
In the past few years I have noticed the amount of AIDS coverage in the Chinese media has been steadily increasing. This should be a welcome change, since HIV/AIDS is one of the few physical ailments which, in theory could be eliminated by prevention education alone.
In the United States, this was the approach taken in the 1990’s, and the result was a barrage of advertisement and educational campaigns. The message was simple. AIDS is real; AIDS is deadly; There are 3 ways it is transmitted (mother to baby, sexual intercourse, sharing drug needles); Anybody is susceptible.
When I was in high school, every few months we would have an assembly or a guest speaker which would reinforce our AIDS education. It was a bit overkill, but it was effective. Talking to most Americans my age these days, there is little ambiguity over how AIDS is transmitted. Whether or not people take the proper precautions is another issue, but at least the knowledge is there.
In China the message is different: AIDS is real; AIDS is deadly; But you are much more likely to contract it if you are homosexual, a drug user, or a prostitute. The connections can be subtle, but there is an implied connection with AIDS and homosexuality that pervades a great deal of the AIDS literature in China. This stereotype was actively spoken against in the US in the 90’s, as we were constantly reminded “AIDS is not a gay disease.” In China it seems to be working the other way around.
As we continued our conversation about homosexuality, the topic shifted more towards that of HIV/AIDS. We were discussing the differing ratios of AIDS among homosexuals and heterosexuals, and this is how my friend explained it.
“In homosexual sex there is a high incidence of the tissue being torn. AIDS cannot survive in the air, but it is transmitted through blood. In “regular” sex, the chance of tissue being torn is much less, and if no blood passes, then the AIDS virus cannot be transmitted.”
While the first part of his answer is accurate, it was the last statement which had me concerned.
“What about other fluids?” I asked, trying not to be too graphic.
“What do you mean? AIDS is transmitted by the blood.”
“No not that…” I responded.
“Oh, other bodily fluids,” he replied, suddenly realizing what I was referring to “I don’t really know about that.”
My friend is a well educated, affluent, Fuzhou resident in his early thirties, who would presumably be well-versed in worldly matters such as HIV/AIDS. However, I think he, like millions of other Chinese, have been victim to a glitch in the public health educational campaign which implies that AIDS is still a gay disease.
While his statement about AIDS being easier to transmit though homosexual sex is accurate, the fact that he did not even know it was possible to contract it through heterosexual sex has grave implications, especially when you consider that China has over 1 billion people who are neither gay, prostitutes, nor intravenous drug users.
AIDS is one of very few medical ailments which could be eliminated by prevention education alone. But in order for the prevention education to work, it must be emphasized that individuals who refrain from those “immoral” activities are succeptable as well. Based on the current Chinese AIDS coverage, this is not the message I am receiving.
Poagao
said,
July 6, 2007 at 6:11 pm
Also alarming is both of your claims that homosexuality is a personal choice.
canrun
said,
July 6, 2007 at 6:43 pm
A 38 year-old (male) PLA member flat-out stated in my class today that-quote- “all gay people have AIDS.” How in the HELL does one reply to that sort of statement? I tried the blood transfusion argument. No door. I tried the prostitution angle. Nope. No prostitutes in China, of course.
Man, this is indeed an uphill battle…
Benjamin Ross
said,
July 6, 2007 at 8:17 pm
Paogao-
Just to clear things up, neither of us were asserting that homosexuality is a personal choice. Rather, whether or not one chooses to act upon their homosexual desires is a personal decision, just like whether or not one chooses to act upon their heterosexual desires.
Canrun-
Sounds like your student is really out of touch with the times. Even the Chinese media makes acknowledgment of prostitutes..ahem…I mean sex workers.
Emil
said,
July 6, 2007 at 8:56 pm
Haha
How could anyone claim there is no prostitutes in China?
ough I dont see it to strange why chinese people think aids is just something that gays could get. At least what I have experienced in nothern europe, aids is nothing you really think about when having intercourse with anyone, because it is considered non-existant, unless you are gay
Maureen
said,
July 6, 2007 at 11:29 pm
As always, a well-observed post. Your writing reminds me of Peter Hessler (who else, right? every American-in-China-writer’s dream) bcs I can sense how you really respect and get along with the people you meet, even as you grope towards the essence of that strange, omnipresent, shrinking-then-growing cultural gap of “…with Chinese Characteristics.” The effects of authority are strange– while there are some areas where information is woefully lacking (say, AIDS), every so often I am surprised by how savvy people are at picking apart propaganda and social phenomena. I never know how to predict when I’m about to receive a party-line mantra, or a shot of startling honesty.
James
said,
July 7, 2007 at 12:11 am
Seems like China is catching up with this HIV/AIDS epidemic, percentage of growth may be higher than U.S. Indeed, it is alarming….
At the end of 2003, an estimated 1,039,000 to 1,185,000 persons in the United States were living with HIV/AIDS CDC has estimated that approximately 40,000 persons in the United States become infected with HIV in adults, adolescents, and children, in the 33 states with long-term, confidential name-based HIV reporting….
Keith
said,
July 7, 2007 at 2:56 am
I agree with Poagao. It does sound like you’re asserting that one’s sexual orientation is a decision. Of course, the decision is whether to act, for behavior can be chosen but orientation can’t.
Also, as far as I know, it’s not more likely for homosexuals to get HIV than heterosexuals. It all boils down to the type of sex you have. If either straights or gays have nothing but blow jobs, the risk is very low.
Ken Erickson
said,
July 7, 2007 at 9:38 am
I’ve run into other interesting bits of Chinese folklore about HIV. A Chinese man I knew used to tell me that he wasn’t afraid of HIV because he could “tell by looking” if someone was healthy. Of course, the only way to know if you are NOT infected with HIV, if you are sexually active at all, is with an HIV test. My friend was afraid to get one because, he said, he was certain his doctors would blab to his family that he was gay.
Maybe in a big, public clinic, the anonymity you might desire for an HIV test would be there. My friend was an upscale Chinese gay guy who went to a private doctor.
Messages about HIV need to go hand in hand with the availability of HIV testing. How is that working out, these days, in China?
When my friend was in the hospital, some years later, and dying of an AIDS related infection, a doctor approached me in a crowded Beijing hospital elevator lobby and said in a loud voice, “So, how long has Mr. X known that he had AIDS?” I was astounded because the elevator lobby was crowded with people, some of whom spoke English.
But these days, blowing your cover as a gay or lesbian person in China should be less worrisome than contracting HIV. It should be, but it may not be.
Jenn
said,
July 7, 2007 at 11:13 am
I worry about the vast majority of the Chinese people who are not well educated like your friend. Not only may they have misconceptions about how AIDS is contracted (in villages in Yunnan provinces many people will not even take money from people known to have HIV) and who is more prone to it, but really know absolutely nothing about STDS or sex in general. It is shocking to me that the general population would no so little about these topics because of the national family planning policy. Everything makes it seem like they should know more.
Poagao
said,
July 8, 2007 at 1:01 am
In light of so many fundamentalists claiming that homosexuality is a choice, you might want to work on your wording. In the post you said that you think “it (homosexuality) is a personal decision”, and your friend said people “should be gay if they want”. It’s an identity rather than an action. I can force myself to use my right hand, but I’d still be left-handed (not the best analogy, I know). I know you didn’t mean it that way, I’m just sayin’, is all.
Chip
said,
July 8, 2007 at 11:38 pm
This goes up there with the rampant lack of information on Hepatitis B (a disease which is, ironically, also rampant). I’m constantly amazed at the total ignorance of how it is spread, and how it isn’t. The intense discrimination of it from personal relationships to the job market frightening too. China’s method of dealing with diseases by systematic discrimination is ineffective at best, inhumane and feudal at worst.
zuraffo
said,
July 9, 2007 at 1:28 am
Ben, I hate to do this but it spells “susceptible”.
zuraffo
said,
July 9, 2007 at 1:30 am
In the last paragraph. Funny how it was correct at its first appearance.