Shanghai Daily news

Men who have sex with men may make the country's AIDS situation worse if it is not addressed properly.
This group forms a sexual bridge between high risk groups and the rest of society.
Men who have sex with men (MSM) is a different concept from that of a male homosexual. It is based on sexual behavior rather than sexual orientation.
Apart from gay men, MSM can be male sex workers who have girlfriends, but engage in sexual behavior with other men. They can also be men who are married but have sex with male partners or sex workers.
According to Hong Kong-based Chi Heng Foundation, a charitable organization whose MSM project was named Best Practice Model for AIDS outreach in China by the United Nations in 2002, there are between 20 and 30 million gay men on the mainland.
Compared with intravenous drug use and blood transmissions, MSM has not been the main mode of HIV transmission in China so far. But experts predict that sexual transmission of HIV will become predominant in the near future. And MSM has a disproportionally high share in this development.
According to UNAIDS, China will be home to as many as 10 million HIV carriers by 2010. About 1.5 million of those could be via MSM.
In an Internet survey targeting visitors of gay Websites, more than 2,500 men responded to a questionnaire. Among them, 32 percent said that they have both male and female sex partners. Eleven percent acknowledged they provide commercial sex services. Among these people, about 36 percent said they provide sexual services to either just female clients or to both female and male clients.
When asked about condom use for the past six months, only 30 percent said they use a condom every time they have sex. Thirty-nine percent said they use a condom sometimes while 31 percent said they never use one.
What's more, many said they tend to use a condemn more often if they have sex with clients, but they don't use one when with a girlfriend.
As for the use of water-based lubricants, another important tool in safe sex, especially male-to-male sex, 85 percent said they use one. But 60 percent also admitted they would use baby oil, toothpaste or other substances if a lubricant was not available.
Considering the high degree of bisexual behavior and unsafe sex, as well as the interrelationship between sex workers and drug users, the potential threat MSM poses to mainstream society - as well as the group itself - is unfathomable.
But it's difficult to reach out to these individuals. Due to social stigmatization they are unlikely to disclose their MSM behavior.
Usually, they resist health checks. Even if they go to a hospital, they generally don't report their true sexual behavior. They do not report physical abuse incurred either. Male sex workers are even more difficult to reach due to the illegal nature of their trade.
That's why a specifically designed AIDS prevention program for MSM is required. However, the group has not received the due recognition and resource allocation thanks to social conservatism and lack of knowledge. Chung To, the founder and chairman of Chi Heng Foundation, is disturbed with the status quo.
"When government officials applied for AIDS prevention and education funds for high risk groups, it never occurred to them that MSM is a high risk group despite all my campaign efforts," To said at a lecture at Fudan University on Monday.
The soft-spoken man was so angry that he stopped for a few seconds to regain his composure.
To went on to say that Global Fund, an international organization created to fight AIDS, asked: "Why is MSM not on the list of your concerns?"
A good question indeed and one that deserves an answer.