By Lin Gu, Visiting Scholar ‘07

I was standing nervously in the corridor — one floor upstairs, a group of strangers were deciding whether or not to allow me to join their monthly gathering as an intruder, or more precisely, a reporter.

Minutes later, I heard a ‘yes’ from above, and the verdict immediately relieved me of anxiety. Facing a roomful of 20 people, all HIV-positive and ex-drug users, I introduced myself. The topic for the day was nutrition and daily diet. With fruits and snacks on the table, and smokes in hand, they laughed at the occasional jokes of the speaker and after the two-and-half-hour talk, some stayed and had dinner together. I was invited too. This was part of an initiative called Evergreen Tree: Caring for People Living with HIV/AIDS — with support from the China-UK HIV/AIDS prevention and care project.

During my 10-day trip in Yunnan in southwestern China in the spring of 2006, I sat in on training workshops for drug users, sex workers, HIV positive people and homosexuals. And I also joined local gay volunteers in handing out free condoms and AIDS prevention pamphlets in the bars and parks of Kunming, the provincial capital. If AIDS remains a taboo in some more inland Chinese areas, it is far from being so in Yunnan where China’s first drug-related AIDS infection was reported in 1989. Just catch a taxi in Kunming or in Jinghong – the town on the border with Myanmar – and you easily bump into billboards small and large with slogans about the ‘people’s war’ on drugs and AIDS. But what struck me most during this recent visit was that AIDS has lent a human face to these once-invisible social groups.
The updated figure offered by both UNAIDS and China’s Ministry of Health indicates that nearly 200 new infections occur daily in China, with the total number of HIV cases now standing at 650,000 at the end of 2005. AIDS is no longer a distant siren, but a harsh reality that must be faced. The Chinese government can no longer afford to ignore those living at the margins of society. For these people fall easy victim to the epidemic, and the virus will explode into mainstream life if no substantial early intervention takes place.

The government has made some pragmatic moves. In July 2005, China’s Vice-Minister of Health Wang Longde — also the country’s top AIDS official — sat down for the first time with gay representatives to talk about how to curb AIDS in China’s gay community. He also instructed the media that there was no need to deny the existence of homosexuality and that gay volunteer groups had best be mobilized to contain the crisis. This unprecedented move illustrates that at least the health department no longer turns a blind eye to a long-marginalized group like homosexuals.

Thanks to the support of international funding, more than 60 grassroots gay volunteer groups have sprung up, mainly in the big cities of China. They run AIDS hotline services, organize weekend outings and help local health officials conduct surveys and tests. AIDS prevention, in most cases, has offered a legitimate reason for some of these volunteers to come out of the closet and organize themselves.

Other socially-excluded groups, though not as vocal as homosexuals and often with more hesitation, have also joined in on the AIDS chorus. HIV positive people come top in the hierarchy of stigma, with the price of public service all the more costly. Sex workers and drug users also have good reason to hesitate about public service as both are illegal in China.

When health workers tried to teach sex workers how to bargain better with their clients about condom use, these young women posed the question: if you as a doctor teach me bargaining skills to face a client, then why do police try to arrest me in the first place? Drug users-turned peer educators who assist in sporadic needle-exchange programs say they also live under constant threat of arrest. AIDS thus constantly challenges the official space for flexibility in China.

For now at least in Yunnan, where many community-related AIDS projects were piloted, government agencies and quasi-official NGOs still take the lead. There is a hope among some international donors that these grassroots groups can cooperate with the government as an equal partner, while others express deep skepticism about the autonomy and independence of these groups, who are often “attached” to a government department or semi-official NGO in order to gain a certain degree of legitimacy.

The reality on the ground is that registration regulations for NGOs remain strict and the legal status of these groups is often unclear. And many inexperienced volunteers still need to get to grips with the basics of organizational planning. But the current legal limbo might be a blessing in disguise for these nascent groups, a chance for them to build their experience, skills and capacity in preparation for full-fledged operation.

Progress is being made steadily. My first visit to Colorful Sky, Kunming’s local gay outreach project supervised by the provincial health bureau, turned out to be a red-letter day for the group. For it was on that day that they received the green light from an international foundation to launch a new program in helping gay men living with AIDS.

“This is truly the first time that we designed a project and applied for a grant independently,” said Li Jinyong, the project manager for Colorful Sky, “and we’ve made it!”

I could easily sense his pride that the group was at last learning to fly. And the hope remains that in the future there will be more proud birds to join the flock.