MSM rising in China
HIV prevalence among men who have sex with men (sometimes referred to as MSM) has been rising in China. China’s Health and
Family Planning Commission officially estimates prevalence among this group to be 7.7 per cent. Men who have sex with men are estimated to represent over a quarter of new reported infections each year.
Homosexual sex was decriminalised in China in 1997 and removed from the official list of mental disorders in 2001. However, economic and cultural factors means men who have sex with men often face stigma and discrimination and hide their sexual identity. This hostile environment is preventing a greater understanding of the epidemic in China among men who have sex with men.
Despite this limitation, some research is being conducted and published. For example, a 2015 study in 11 major Chinese cities of more than 8,900 men who have sex with men showed the average prevalence of HIV infection to be 9.9 per cent, with average incidence of 5.5 per 100 people, which is higher than official figures. Incidence has also been assessed by a 2014 study of young men who have sex with men (aged 18- 25) which found incidence to be as high as 18.9, 10.6 and 5.6 per 100 people of this age group in Guiyang, Beijing and Shanghai respectively.
Ignorance of HIV status is a major factor in the rising epidemic amongst men who have sex with men. The 2015 study mentioned above found high-risk behaviour among men who have sex with men in China to be high. Around 45.7 per cent of respondents reported having unprotected sex with male partners and 10.9 per cent with female partners. Around 38 per cent had exchanged money for sexual activities. Data from seven of the 11 cities suggests that districts with highest rates of illicit drug use among men who have sex with men also shared the highest HIV prevalence.
However, a 2013 study in Chongqing City, which has a high HIV prevalence among men who have sex with men, found that HIV testing was actually higher for men who have sex with men
(58 per cent) than the average populations (44 per cent).
Strategies such as self-testing have also been explored in China amongst men who have sex with men. A 2014 study found 20 per cent had used self-testing kits for HIV. The increased use of selftesting kits greatly correlated with factors such as the individual being married, having a recent HIV test and if they had engaged in anal sex. It is clear that the HIV epidemic among men who have sex with men is concerning in China but more targeted prevention strategies for this affected population will enable a more effective response that meets this group’s needs.