As we celebrate another World AIDS Day, you might be asking yourself: what has HIV and AIDS got to do with me? The causal gay man may or may not be aware of the fact that there is increasing interest in public health research in China regarding HIV infection and men who have sex with men, or MSM for short. Unlike in most Western countries, where HIV first struck gay men, China’s first major group to deal with this disease was among injection drug users. However, sexual contact has now overtaken injection drug users as the most frequent form of HIV transmissions. Based on 2007 figures, 12.2% of all HIV infections in China is due to homosexual sex, and this figure is expected to rise.1
China’s gay communities may not experience the epidemic proportions that the West has had to deal with regarding HIV, but gay men still need to be careful when engaging in sex. Based on scientific studies that have looked at MSM behaviors over the past decade in China, here’s what researchers have found:
MSM who have HIV are more likely to have other sexually transmitted infections as well: A review of 26 studies showed that the overall prevalence rate (the proportion of individuals in a population having a disease) among MSM who have HIV is 2.5%. But among this same group of people studied, the syphilis rate is 9.1%.2
Condoms are not used consistently: In fact, consistent condom use rarely rises over 40% for any group of MSM studied so far, and this includes sex with a casual partner.3 This suggests that whether a gay man is having sex with his partner or with someone anonymous, there is a more than 50-50 chance that he may not be using protected sex at that time.
How many sex partners does the average gay man in Beijing have?: According to one report published earlier this year, the median number of lifetime partners is ten.4 This means that it is likely that the person you had sex with has already had sex with a bunch of other guys before you.
The guy you are having sex with may be bisexual: MSM who identify themselves as someone who have sex with both men and women can range anywhere from 15% to 55% in the studies published so far, a much wider range than seen in MSM studies in the West. So even if the guy is having sex with just one other guy, there’s the possibility that he may be having sex with women. And without knowing what sex partners his female partner had before, she could inadvertently infect him.
Knowing your partner’s HIV test status: Not everyone who is HIV-infected knows that he is infected. There could be several reasons for not getting tested for HIV. It could be that the person does not think he is at risk for HIV infection. Or he is afraid of getting a positive test result. Or he is afraid that people might find out he is gay. Or he is afraid that the test results may not be confidential. Or that he does not know where the test sites are. Whatever the reason or reasons may be, it makes it more difficult to determine if your sex partner is HIV infected or not.
Maybe you don’t think you are in danger of getting HIV since the proportion of gay men infected is nowhere near as high as found in the West. But be careful during sex while you’re having fun. And on this year’s World’s AIDS Day, spare a thought on those who are dealing with a treatable but still deadly disease, especially for the gay men who have fought and lost the battle.
1 State Council AIDS Working Committee Office UN Theme Group on AIDS in China. A Joint Assessment of HIV/AIDS Prevention, Treatment and Care in China. 2007. (Accessed November 30, 2009 at http://www.undp.org.cn/downloads/otherlocal/HIV/20080104.pdf)
2 Gao L, Zhang L, Jin Q. Meta-analysis: prevalence of HIV infection and syphilis among MSM in China. Sex Transm Infect. 2009;85:354–358.
3 Wong FY, Z. Huang ZJ, Wang W, et al. STIs and HIV among Men Having Sex with Men in China: A Ticking Time Bomb? AIDS Educ Prev. 2009;21:430–446.
4 Ruan Y, Luo F, Jia Y., et al. Risk Factors for Syphilis and Prevalence of HIV, Hepatitis B and C among Men Who Have Sex with Men in Beijing, China: Implications for HIV Prevention. AIDS Behav. 2009;13:663–670.
