http://www.nature.com/nsu/030616/030616-19.html

Stigmatization fuelling Chinese HIV
Married homosexual men could make sex significant route of
transmission in China.
20 June 2003

HELEN R. PILCHER

A stigmatization of homosexual behaviour may be fuelling China's
emerging HIV epidemic. Married men who have caught the infection from
other men could be spreading the infection to their wives, new
research suggests.

So far, prevention campaigns have failed to target this risk group.
"In view of the high rates of unprotected sex in such men, HIV-1
infection rates will continue to rise unless prevention measures are
implemented," says Kyung-Hee Choi from the Center for AIDS Prevention
Studies (CAPS) at the University of California at San Francisco.

Her survey of 481 gay men - the first of its kind in China - suggests
that Chinese homosexuals over 39 years old are nearly five times more
likely to be HIV positive than younger gay men, and five times as
likely to be married[1].

China is in the grip of a serious HIV epidemic among intravenous drug
users, sex workers and former blood donors. The United Nations
estimates that, by 2010, some 10 million of the country's
billion-strong population could be infected.

Currently, 70% of infections are from injecting drug use, but sex
could become the main route of transmission. There are estimated to
be between 2 million and 8 million gay men in China, who might
contribute to the spread of the virus.

Appropriate surveillance strategies are needed to curb disease
spread[2], advises epidemiologist Nicholas Grassly, who counsels the
Joint United Nations Programme on HIV/AIDS. "Tailor-made prevention
programmes should be based on estimates of the size, location and
behaviour of vulnerable populations," he says.

Targeted campaigns could promote condoms among gay men. Results can
be seen quickly, explains Grassly. In Cambodia, prevention efforts
have doubled condom usage to 87% in the past 5 years.

Around 3% of the gay men Choi quizzed in Beijing were HIV positive.
Although this figure is relatively low, it could escalate rapidly
without intervention, she warns. Half the men reported having had
unprotected sex with men in the previous 6 months; almost a quarter
said they had had unprotected sex with women during the same period.

As is found elsewhere in the world, many Chinese gay men are also in
stable heterosexual relationships. "Most gay men are afraid of coming
out for fear of losing their job and becoming ostracized by family,
friends and colleagues," says Choi.

"Stigmatization of homosexual behaviour fuels an epidemic, rather than
creating an atmosphere in which risk can be openly discussed and
protective actions such as safer-sex practices can be adopted," says
Jeff Mandel from the University of California, San Francisco, who
helps countries to design AIDS prevention strategies.

India faces a similar problem. Around 23% of men in Bombay who have
sex with men are HIV positive, explains physician Maninder Singh, who
manages a CAPS research project there. Up to 35% are also married.
"Many men don't use condoms with other men because they don't consider
it real sex," says Singh.

References

1. Choi, K. et al. Emerging HIV-1 epidemic in China in men who have
sex with men. The Lancet, 361, 2125 - 2126, (2003).


2. Pisani, E. et al. Back to basics in HIV prevention: focus on
exposure. British Medical Journal, 326, 1384 - 1387, (2003).
2. Pisani, E. et al. Back to basics in HIV prevention: focus on
exposure. British Medical Journal, 326, 1384 - 1387, (2003).
|Homepage|

Take my word for it, this is also true in the US, especially in
African-American and Hispanic and other "ethnic" communities which
tend to stigmatize gay men. There is such a fear of being thought
"homosexual" that many married bisexual men keep everything extremely
secret, and expose their wives to HIV infection. Of course, many
straight men secretly cheat with women, too, and many wives also
cheat. I've worked with all kinds of situations in my HIV and syphilis
surveillance work during the early 90's, including HIV+ drug addicts
who tested + in prison and then, when released, gave HIV to their
girlfriends or boyfriends. People lie a lot.

If you are interested, read "Confessions of the Sex Police" at website
http://gjminter.addr.com

Gary


baby_p_nut2@yahoo.com (Baby Peanut) wrote in message news:<96d83290.0306241818.17732ab1@posting.google. com>...