VZCZCXRO4873
RR RUEHGH RUEHVC
DE RUEHCN #0282/01 3360721
ZNR UUUUU ZZH
R 020721Z DEC 09
FM AMCONSUL CHENGDU
TO RUEHC/SECSTATE WASHDC 3587
INFO RUEHPH/CDC ATLANTA GA
RUEHOO/CHINA POSTS COLLECTIVE
RUEHCN/AMCONSUL CHENGDU 4298

UNCLAS SECTION 01 OF 03 CHENGDU 000282 
 
SENSITIVE 
SIPDIS 
 
STATE PASS NIH/FOGARTY CENTER FOR INTERNATIONAL HEALTH 
DEPT FOR EAP/CM 
 
E.O. 12958: N/A 
TAGS: SOCI PGOV KHIV CH
SUBJECT: SW CHINA: BIG CITY GAY HIV PREVALENCE EXCEEDS TEN PERCENT 
 
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 
tinyurl.com/HIV-gay-SWChina].  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 
10." 
 
¶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 
women. 
 
¶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 
¶30. 
 
¶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 
tinyurl.com/gaybar-closed ] 
 
 
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 www.aibai.cn), 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 
tinyurl.com/obama-aibai) and Secretary Clinton's (at URL 
tinyurl.com/clinton-aibai) 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 
tinyurl.com/mofa-gaychinese ). 
 
¶13.  (U) Appendix: Journal references for paragraphs four and 
five: 
 
¶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 
Aibai. 
BROWN