On September 24, dozens of activists walked along a stretch of the Great Wall of China located in Tianjin City, northeast of Beijing, as part of AIDS Walk China.
The event has been held annually since 2012, with the goal of raising awareness about the virus and fighting its spread in the country of 1.35-billion people.
Last year’s walk garnered a little under $20,000—enough provide milk powder for babies born to HIV-positive mothers. This year, the goal is to educate sexually active Chinese students, whose understanding of the virus—and of sexuality in general—lags behind their raging hormones.
HIV infections are increasing rapidly among young gay Chinese men: Between 2008 and 2014, the number of HIV-positive people age 15-24 increased 58.8%. But Chinese high school and college students lack basic safer-sex education.
In Nanchang, a city of five million, the infection rate has ballooned 43% annually in the past five years. More than 80% of new cases were the result of same-sex encounters between young men.
In part, the statistics can be attributed to increased testing, and successful efforts to curb the virus among sex workers and intravenous drug users. But it’s also due to the secrecy and shame surrounding homosexuality in China, where great importance is placed on tradition, family and children.
Legalized in 1997, homosexuality was still classified as a mental illness as recently as 2001. It’s estimated that as many as 90% of gay Chinese men are in marriages of convenience to women.
At the same time, technology is making it easier for gay men to find each other: Blued, a Chinese gay dating app, garnered more than 14 million users in its first year alone.
Access without education is a deadly combination.
The sheer number of people living with AIDS in China is about half the number in the U.S. (about 575,000 compared with 1.2 million), but it’s growing much faster: There are some 100,000 new cases a year compared with 40,000 here. (Though it’s worth noting that comprehensive testing and accurate data are harder to come by in the People’s Republic.)
“No country in the world has discovered an effective way to curb the epidemic among gay men,” Wu Zunyou, director of China CDC’s AIDS-prevention center, said in a statement last year. “Most students know what AIDS is and how to prevent it, but the change of behavior remains a big challenge,” he said.
China provides free antiretroviral medications to those with HIV, but the stigma is brutal: There are no laws protecting HIV-positive people from workplace or housing discrimination, and concepts like patient confidentiality are somewhat alien.
People with HIV are banned from government jobs and authorities inform colleges of which students have the virus. (Students whose schools have learned they’re positive have been known to be expelled).
And despite official guidelines, hospitals routinely turn away HIV/AIDS patients.
“The government emphasizes the morality of sex rather than the safety of sex,” AIDS activist Liu JiuLong told the Wall Street Journal.
“If they continue to use this mentality to make public-health policies, China will pay the price one day.”