Cablegate: Sw China: Big City Gay Hiv Prevalence Exceeds Ten Percent

DE RUEHCN #0282/01 3360721
R 020721Z DEC 09




E.O. 12958: N/A

CHENGDU 00000282 001.2 OF 003

1. (U) This cable contains sensitive but unclassified
information and is not for Internet distribution.

2. (SBU) Summary: The HIV rate among gay men living in Chengdu,
Guiyang, Kunming, and Chongqing exceeds 10 percent, according to
a large nationwide survey conducted by the China Centers for
Disease Control (CDC) during 2009. CDC researchers reported in
2008 that HIV prevalence among gay men in Chengdu rose from one
percent in 2004, to eight percent in 2007, to 10 percent in
2008. Chengdu physician Jiang Hua, leader of the Aibai NGO,
said multiple approaches are needed to raise awareness about HIV
among the gay population, including better information, more
democratically managed gay groups, and more respectful treatment
of this vulnerable population. The Chinese government has given
an NGO in Yunnan Province a grant to reach out to the gay
community through a local gay bar; media attention has now
delayed its opening. Between 40 and 74 percent of gay Chinese
men have sexual relations with women; owing to intense social
pressure, the great majority of gay Chinese men marry women.
One researcher told us President Obama's and Secretary Clinton's
positive statements about gay people contrasted favorably with
the angry dismissal by the PRC MOFA spokesman of a question
about gays in China. End summary.

China CDC Interview:

SW China Big City Gay HIV Prevalence Exceeds Ten Percent

--------------------------------------------- -----------

3. (U) China CDC HIV/AIDS Prevention Center Director, Professor
Wu Zunyou, told the PRC newspaper "International Leader" [Guoji
Xianqu Daobao] in late November 2009 that a March - May 2008
survey of 58,000 gay men found a prevalence rate of 4.9 percent
nationwide, and as high as 15 percent in some cities [URL at]. A series of three surveys in 2009
involving 56,000 gay men gave a clearer idea of the geographical
distribution of HIV/AIDS among this population group. HIV
incidence was highest among gay men in southwestern China, with
rates exceeding 10 percent in Guiyang, Kunming, Chengdu, and
Chongqing. Infection rates are far lower among lesbian women.
Several years ago in southwest China, Wu said, "Among 100 gay
men we would find only one who was HIV positive ... Now we find

4. (U) PRC Ministry of Health figures on HIV incidence show that
the proportion of gay men among all newly reported HIV cases is
increasing each year -- from 12.2 percent of the 50,000 new
cases of HIV AIDS in 2007, to 32.5 percent of the 48,000 newly
reported HIV infections in 2009. Wu commented that various
surveys show that between 40 and 74 percent of gay men have
sexual relations with women, adding that the rates of HIV
infection among their female partners is unknown. Professor
Zhang Beichuan of Qingdao University says the fact that the
great majority of gay men are in the closet creates conditions
for the rapid spread of HIV. Zhang estimates that owing to
intense social pressure, the great majority of gay men marry

5. (U) The number of HIV positive people in China is probably
around 740,000, up from the estimated 700,000 with HIV in 2007,
the "China Daily" reported November 25. Michel Sidibe,
Executive Director of the Joint United Nations Programmes on
HIV/AIDS (UNAIDS) said "Infection among men who have sex with
men (MSM) is a real cause for concern... In some southwestern
urban areas, up to 20 percent of the MSM population is
HIV-positive today."

Chengdu CDC Study:

HIV Prevalence Among Chengdu Gay Men Reached 10 Percent in 2008

--------------------------------------------- ------------------

6. (U) A 2008 study by three Chengdu CDC researchers published
in the August 2009 issue of the "Journal of Occupational Health
and Injury" found that the HIV prevalence rate among gay men in
Chengdu rose from one percent in 2004, to eight percent in 2007,

CHENGDU 00000282 002.2 OF 003

based on annual surveillance sampling surveys of about 200 gay
males each year. (See appendix in para 13.) The article,
entitled "HIV Risk and Behavior of Men Having Sex with Men in
Chengdu City from 2004 - 2007," found a rapid increase in HIV
prevalence. Most of the gay men had multiple partners, and an
increase in the number of gays under age 20 was noted. The
authors noted that Chengdu, compared with many other Chinese
cities, is relatively open-minded about homosexuality, and has a
large migrant and transient population. Reported condom use in
last sexual encounter increased from 55 percent 2004 to 63
percent in 2007, yet the authors believe actual condom use is
significantly less than is reported. In meetings this year with
NGOs, the Chengdu CDC released the 2008 figure: 10 percent HIV
prevalence among gay males in Chengdu.

Developing Respect-Based Strategies

for HIV/AIDS Intervention Among Gay Men


7. (U) Dr. Jiang Hua and colleagues, in an article published in
the August 2009 issue of the "Journal of Preventive Medicine
Information," discussed the challenges of HIV/AIDS intervention
with gay men in Chinese cities, and the rapid rise in the HIV
prevalence rates in gay men in several large Chinese cities from
2002 - 2007. Jiang et al cite a prevalence of HIV among gay men
in Chongqing of 10.4 percent in 2006 from a sample of 1000 gay
men, and 16.9 percent in 2007 from a sample of 586 gay men,
based on a study supported by the Global Fund of HIV/AIDS.

8. (U) According to the article, since 2002 there have been over
117 working groups established in China to study gay males and
HIV "men who have sex with men," with 4100 volunteers, and over
50 websites set up to spread information on HIV prevention among
gay men. Dr. Jiang says that respect is very important in
communicating hazards and best practices to gay Chinese men.
Disrespect and marginalization result in anger that makes
effective intervention more difficult. Even the appellation
common in Chinese medical circles for gay males, "men who have
sex with men," is far from ideal, Dr. Jiang said, because it
defines people by sexuality. Gay people are human beings first,
with all their rights and needs, and then have a sexual
preference, he said.

9. (U) The affiliation of gay people in local communities in
which gay men learn from one another, an idea that arose in the
West, has promise for China, Jiang felt. The authors call from
more accurate media reporting and education in the high school
and university level that can change prejudices against gay
people in China. There is little known about the culture of
Chinese gays, something that needs to be better understood in
order to design more effective interventions and peer and
psychological support for gay men at risk of contracting HIV, or
who already have HIV.

Government-supported Gay Bar: Reaching Out to the Gay Community

--------------------------------------------- ------------------

10. (U) The first government-backed gay bar in China is about to
open in the tourist city of Dali, in Yunnan Province, PRC media
reported on November 29. Media interest in the story was strong.
Health authorities in Dali have given the NGO, Dali HIV/AIDS
Health Care Promotion Association, 120,000 RMB for HIV
prevention work, with half that amount earmarked for the gay
bar. NGO founder Dr. Zhang Jianbo said the gay bar would
provide a way to reach out to the gay community. "Without a
platform, it has been almost futile trying to reach this group
of people," Zhang told the South China Morning Post on November

11. (U) Several PRC media outlets on December 2 reported that
this bar closed after operating one day and will re-open later
after media attention has subsided. Qingdao University's Zhang
Beichuan told China National Radio "media attention to gay
issues is a two-edged sword. Too much media attention tends to
vilify and stigmatize gay people." [URL at ]

CHENGDU 00000282 003.2 OF 003

Contrasting Attitudes: PRC MOFA and U.S. State Department

--------------------------------------------- -------------

12. (SBU) Dr. Jiang Hua, a Chengdu physician who leads the
Aibai gay men's NGO (website at, said that
persuading gay people to use condoms and use other safe sex
practices will depend upon a wide range of social and
psychological interventions. Social climate is important for
building self-respect, and with it respect for the health and
safety of oneself and others. Jiang was moved by President
Obama's (on the Aibai website in Chinese at and Secretary Clinton's (at URL June statements about gay rights.
Aibai translated both statements into Chinese and featured on
them on its website. Dr. Jiang contrasted this with the June
18th response of the PRC Ministry of Foreign Affairs press
spokesman, who when asked about why PRC government's Green Dam
net filtering software would eliminate mention of gay people,
"This is the press room of the PRC Ministry of Foreign Affairs,
not some gay people's meeting!" Many people criticized the
MOFA press spokesman on the Aibai website (URL ).

13. (U) Appendix: Journal references for paragraphs four and

A. "HIV Infection and Risk Behavior of Men Having Sex with Men
in Chengdu City From 2004 to 2007," in Journal of Occupational
Health and Injury [Zhiye weisheng yu bingshang], August 2008.

B. "The Challenges on China's HIV/AIDS Intervention for Male
Having Sex with Male: An Appraisal Based Evidence from
Community, Behavior and Sociological Research," in Journal of
Preventive Medicine Information [Yufang Yixue Qingbao Zazhi],
July 2009

C. "Urgent Needs for Evidence-Based Interventions for Young
Chinese Gay Men: Results and Recommendations from Two Studies,"
by Jiang Hua, M.D.,(AIBAI), Sean Dickson (University of
Chicago), Charles Damien Lu, PhD (Department of Sociology, East
China Normal University) et al., in an August 2009 release from

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