Date: Sun, 7 Dec 1997 16:32:10 +0800 (HKT) From: William Stewart Dear friends, The following is a proposal for continued work on HIV prevention in China. Please forward to anyone you think might be interested, or have a couple of dollars to throw our way. *************************************************************** SOCIAL SUPPORT AND STD/HIV EDUCATION AMONG MEN WHO HAVE SEX WITH MEN IN BEIJING, CHINA 1. Men who have sex with men in China Homosexuality has a long and documented history in China. Imperial records from the Han dynasty recount stories involving same sex affectionate and erotic relationships, episodes from which some of the terms used to refer to homosexuality today are drawn. Classical Chinese literature abounds with homosexual vignettes. In the twentieth century however, official acceptance of homosexuality has been reversed. Although China has no specific law on homosexuality, men who have sex with men in China are routinely affected by other legislation, including public order legislation. Reports throughout the country indicate that police harassment, arrests, detention, beatings and rape in detention are unfortunately all too common. Few of these incidents are subject to proper reporting since many of the men concerned are unwilling to come forward. In addition, social sanctions against homosexuality are maintained by other quasi-official means. The Chinese medical and psychiatric associations still maintain homosexuality in the official manual for categorisation of mental disorder, despite it having been removed from international reference manuals such as ICD-10 and DSM-IV. Moreover, homosexuality is subject to social sanctions in the form of stigmatisation, family pressure to marry, lack of living space for those who do not marry and constant criticism through media. Despite this bleak picture the Chinese community of gay men is increasingly large and increasingly visible. Some Chinese cities have gay bars and discos and meetings are frequently held in individuals' homes. A network of personal contacts spans the country, and facilitates communication. The internet is increasingly used by Chinese in China and abroad for maintaining contact. Some, though unfortunately few, men are able to be open about their sexual orientation at work and with family members. In addition to this, there is a large incidence of same sex sexual behaviour among people who would not necessarily consider themselves as gay or homosexual. Research studies have indicated that 0.5% of married Chinese in cities and 2.3% in urban areas said they engaged in homosexual activities, and 7.5% of college students in one survey said that they had same sex affectionate relationships. Many parks, newspaper notic boards, toilets, public bathhouses or backstreets in China are known as places where men can meet one another for sex. One side effect of this growth of possibilities for sexual interaction is the potential for HIV spread among men who have sex with men. Condom use is low, and knowledge about HIV and other STD is cloudy. Attempts to provide this knowledge are hampered by official attitudes. In Beijing two hospitals have reported that about a third of their HIV positive patients (12 out of 38 and 10 out of 33 respectively) were infected through male to male sex. Meanwhile the number of reported infections of other sexually transmitted diseases in homosexual men increased 263% between 1993 and 1994. 2. Background to this proposal In order to address some of these issues, in April 1997 a group of concerned individuals in Beijing launched a beeper (pager) hotline to answer questions about gay life in China, provide social support, and information about sexually transmitted diseases and HIV. The hotline provides confidential support through a revolving team of workers, each of whom have participated in two training sessions, one involving information on STD and HIV from a doctor at a Beijing Hospital and a public health researcher at a Beijing university. Initially this service was only advertised through the internet, by networks of personal contacts. Notwithstanding this limited advertisement, the hotline had received 30 calls from throughout China by the end of November 1997. These calls were varied in nature and a number of them required sustained counselling over a number of calls. The hotline is now able to provide referral on to confidential HIV testing facilities should they be required. In addition to this the group also held a safe sex evening at a bar in Beijing for World AIDS day 1997. Supported by a variety of private donations, over 150 condom packs including condoms, lubricant, safe sex information and details of the hotline facility were distributed. In order to evaluate this activity a number of in-depth interviews will be held which will also seek to elucidate information on HIV/STD needs, concerns about HIV testing, and preferred forms of health education activity. Cards with the hotline details have been distributed to some personnel working in facilities such as STD clinics or other HIV hotlines where there is a possibility that homosexual men may refer and benefit from peer support. 3. Future plans The group has identified some priorities for extending their work. These are outlined below. -- the continuation of safe sex activities. A one-off event was felt to be likely to provide little impact on behaviours, and sustained education provision, through bars and ultimately parks and bathhouses is envisaged. Following the evaluation of the December 1 evening, it is hoped that educational materials can be produced which are specific to men in the mainland, since at present materials produced in Hong Kong are being used. -- the continuation of training for hotline volunteers. More support on counselling issues and information about sexual health is needed and a series of small group sessions for volunteers and interested others is planned. -- referral to HIV testing facilities. Many gay men in Beijing wish to test for HIV but are deterred by fears about anonymity and consequences of testing positive. Although links have been made with a Beijing clinic where testing can be provided anonymously, it is hoped that dedicated materials discussing the advantages and disadvantages of testing can be produced. In addition, activities are needed both to help hotline volunteers in providing this advice, and in sensitising clinic personnel to the needs of the homosexual community. -- support for people with HIV. An HIV diagnosis often means social difficulties, including ostracisation, even within the gay community. As a long term aim it is hoped that the hotline can provide referral to social and emotional support for those who are diagnosed with HIV. Financial support may be considered, particularly for men who have lived by selling sex, and no longer wish to do this but have little other option for work. 4. Options for support Because of the nature of official attitudes towards homosexuality in China, gay community groups are unable to apply for funding or support through government mechanisms. Whilst they can provide detailed financial accountability , they cannot guarantee the sustainability of work. However, there are a number of ways in which support could be given, detailed below: -- provision of condoms and lubricant. At present condoms are bought by members of the group, but ones recommended for anal sex are fairly expensive at 44 RMB (5.4 USD) for a pack of twelve. A target of 12,000 condoms for distribution in the first half of 1998 would therefore require 5400 USD. Lubricant to accompany these condoms, difficult to acquire in Beijing and currently brought in from Hong Kong would cost 1463 USD. A system of getting lubricant wholesale from Australia is currently under investigation. -- development of dedicated educational materials. Materials specifically aimed at mainland Chinese are needed both on safer sex and on HIV testing. 500 USD would enable one of these sets to be produced for an initial print run. -- workshops. Currently held in members homes, they are cheap to organise, but covering of travel costs and materials would require 50 USD per session. Two more sessions on HIV and STD are planned, whilst at least two on counselling and support for people with HIV are needed. -- copying of materials. The groups has access to materials on HIV and STD produced by UNAIDS and the EC as well as gay organisations throughout Asia, but to copy them so that each member can have a copy would require 10 USD a set. Donations of other materials on lesbian and gay life and on health issues to develop a resource centre are welcome. -- phone bills. THe beeper requires that the volunteer must return the call, meaning that they pay phone bills. At present 100 USD a month would cover requirements, but it is hoped that the volume of calls will increase as word gets round. The annual fee for the beeper is 75 USD. For any information on how to help in this community led project, or for a more detailed project plan, please contact, in the first instance: Billy Stewart billy@bltda.com.bta.net.cn or call 6821 5888 call 7293 in Beijing ****************************************************************************** * To subscribe to QUEERPLANET, send mail to: majordomo@abacus.oxy.edu * * In the mail message, enter ONLY the words: subscribe queerplanet * * To unsubscribe to QUEERPLANET, send mail to: majordomo@abacus.oxy.edu * * In the mail message, enter ONLY the words: unsubscribe queerplanet * * Words in the Subject: line are NOT processed! * ******************************************************************************