[Le is one of thousands
of gay men in this bustling city of 13 million people who are benefiting from a
pioneering experiment that supporters hope will revolutionize the way the
Communist Party deals with nongovernment groups trying to stop the spread of
AIDS and other sexually transmitted diseases.]
By Dan Levin
 |
Gilles Sabrie for The New York Times
In October, a student gave blood for an H.I.V. test
at the Lingnan Health Center
in Guangzhou. The center tries to be a safe space
for gay men in an environment
that can be hostile toward them.
|
GUANGZHOU, China — As he waited to give blood for an H.I.V. test one recent afternoon, Le, a
25-year-old marketing professional, explained why he was there. “I was aware of
the consequences” of not using a condom,
he said, “but somehow I didn’t know how to say no.”
Le, a gay man who would
give only his first name, was being tested at the Lingnan Health Center, an
organization run largely by gay volunteers, whose walls are adorned with red
AIDS ribbons and a smiling condom mascot. In the past, Le went to hospitals to
be tested, he said, but the stigma of being a gay man in China made the
experience particularly harrowing.
“I’d always be concerned
about what the doctors would think of me,” Le said. “Here we’re all in the same
community, so there’s less to worry about.”
Le is one of thousands
of gay men in this bustling city of 13 million people who are benefiting from a
pioneering experiment that supporters hope will revolutionize the way the
Communist Party deals with nongovernment groups trying to stop the spread of
AIDS and other sexually transmitted diseases.
Encouraged by the new
slate of leaders who came to power in November, civil society activists hope
the model taking shape here in the prosperous southern province of Guangdong,
which has long served as a petri dish for economic reform, will be replicated
nationally, not just in the fight against disease but also on issues like
poverty, mental health and the environment.
While China’s Center for
Disease Control and Prevention has allowed community organizations across the
country to participate in disease testing programs since 2008, in practice
those efforts remain patchy. But in November, just before World AIDS Day the
following month, the grass-roots movement received a high-profile endorsement
from the incoming prime minister, Li
Keqiang.
At a meeting with
advocates for AIDS patients, Mr. Li, a large red ribbon pinned to his jacket,
promised more government support and shook hands with H.I.V.-positive people.
The image resounded in a society where those infected are routinely turned away
from hospitals and hounded from their jobs. “Civil society plays an
indispensable role in the national battle against H.I.V./AIDS,” he said,
according to the state news media.
Activists remain wary,
however, noting that the government has made similar promises in the past. And
despite the high-level support and a policy in Guangdong allowing grass-roots
groups to register directly with the government — instead of being forced to
find an official sponsor, as in much of the country — many organizations say
they still are stymied by dizzying bureaucratic hurdles or rejected for missing
unannounced deadlines.
Tao Cai, the director of AIDS Care China, which provides support to
30,000 H.I.V.-positive people nationwide but remains unregistered, believes the
obstacles come from local officials who are trying to prevent nonprofit groups
from competing with their fiefs. “In China,” he said, “we say reform never gets
out of Zhongnanhai,” a reference to the walled compound for senior leaders in
Beijing.
There is little doubt
that public health officials need help. Through October, nearly 69,000 new
H.I.V. infections were reported in China in 2012, a 13 percent rise from the
same period in 2011. Almost 90 percent of those cases were contracted through
sexual intercourse, with rising numbers involving gay men. Medical experts also
worry about syphilis, which has returned with a vengeance
after being virtually wiped out during the Mao era.
Reported cases of
syphilis, known in the south as “Guangdong boils,” have increased more than
tenfold in the last decade, according to national statistics. As
with H.I.V., gay men and sex workers are particularly at risk. Local health
experts estimate that 5 percent of men who have sex with other men carry
H.I.V., while around 20 percent test positive for syphilis.
The Chinese authorities
have long tackled the rise in communicable diseases among gay men with all the
sensitivity of a swinging billy club. In raids on bars, bathhouses and parks,
police officers and health officials often force those detained to hand over
their IDs and submit to blood tests.
Grass-roots health
groups have been frequent targets of official harassment as well. In most
provinces, they can legally register with the Bureau of Civil Affairs only if
they are sponsored by a government agency. But advocates say few agencies are
willing to vouch for groups focused on politically fraught issues like
homosexuality, prostitution or sexually transmitted diseases.
In the face of such
constraints, the majority of China’s estimated 1,000 H.I.V. organizations
operate in a legal purgatory that deprives them of tax benefits and makes it
risky to accept foreign donations, usually their main source of support.
Mr. Li, the incoming
premier, has a spotty record when it comes to H.I.V. In the 1990s, when he was
the top official in central Henan Province, a botched blood-collection program
there infected hundreds of thousands of people with H.I.V. Critics say Mr. Li
was more interested in covering up the problem than dealing with its causes.
Even as he was holding court with AIDS groups, over a hundred of those infected
in the scandal marched in Beijing to the Ministry of Health demanding justice.
Mr. Li’s views appear to
have changed. In November, social media erupted over the case of a 25-year-old
man seeking treatment for lung cancer who was turned away from two
Beijing hospitals because he was H.I.V.-positive. A hospital in nearby Tianjin
finally removed the tumor — but only after he altered his medical records to
conceal his H.I.V. status from doctors. As a battle raged online between those
condemning his actions and those sympathizing with his plight, Mr. Li ordered
the Health Ministry to prohibit hospitals from rejecting AIDS patients.
For the vast majority of
Chinese, AIDS remains a fearful issue. People who get infected with H.I.V.
often become social outcasts, a situation made more perilous by the absence of
legal protections for those who lose their jobs or their homes.
After he came out as gay
and H.I.V.-positive on Chinese television in 2005, an artist who goes by the
pseudonym Da Wei was promptly fired. Then he was evicted from his apartment by
his landlord — a doctor — who showed up at his door with printed images of his
face from TV. “He said he had no problem with my health condition, but what
would the other tenants think?” the man recalled in a phone interview.
Even medical
professionals who work with AIDS patients are not immune from discrimination.
“Other doctors are afraid they’ll catch H.I.V. from my lab coat,” said Chen
Xiejie, the vice director of infectious diseases at the Guangzhou No.
8 People’s Hospital. “If I go to their offices they say, ‘Don’t sit down.’ They
won’t even shake my hand.”
The Lingnan Health
Center, a comfortable space decorated with couches and a fish tank, strives to
be more welcoming toward the dozens of gay men who come each day to roll up
their sleeve and learn their fate. If they get bad news, patients can return
for counseling and information on medical treatment.
“We want it to feel like
home, not a hospital,” said Meng Gang, Lingnan’s founder.
The center’s employees
say unsafe sex is all too common among those tested, a result of deeply
closeted lives.
“With gay men the sex is
all underground,” said Xiao Mi, a Lingnan staff member.
According to Mr. Meng,
most gay men will forgo condoms rather than challenge a partner who says he is
not infected with H.I.V. “It’s an issue of face,” he said.
Mr. Meng founded Lingnan
five years ago as a health-focused offshoot of his gay advocacy
organization, Guangtong, which offers services like sex education,
counseling on coming out, and online dating through its Web site, which
receives around three million visitors a year.
Guangtong delves into a
realm the Chinese government prefers to keep shrouded. Homosexual characters
are banned from television, gay film festivals cannot advertise, and the police
often force lesbian and gay organizations to cancel programs during politically
delicate events.
Despite the
state-sanctioned prejudices, Chinese health officials say cooperation with
grass-roots organizations is beginning to transform the government’s approach
to such issues.
“The fight against
S.T.D.’s is not just about public health,” said Yang Bin, the director of the
provincial sexually transmitted disease control center. “It’s a political
issue, too.”
