China Development Brief, No. 53 (Spring 2012)
As part of her series on NGOs in Anhui, Guo Ting provides a moving account of an MSM (Men who have Sex with Men) worker’s 14 year effort to provide a space for gay men in Fuyang, Anhui to get counseling and HIV testing. Like the accompanying profile of Ma Zhengzhou, this article provides an up-close look at the challenges of AIDs prevention in remote provinces, and the close links between AIDs and MSM groups, the local Centers for Disease Control (CDC), and other local government and public institutions and NGOs working to stem the rise of AIDs in China.
Perhaps it is difficult for many people to accept love between same sex couples. Many HIV prevention groups that work with men who have sex with men (MSM) are resting their hopes on more open-minded and tolerant messages in their organizational names. Either way, the Yang Guang Blue Sky Public Interest Group (阳光蓝天公益小组,hereafter the Yang Guang Group) in Fuyang City, Anhui Province is also in this situation. Yang Guang, the online name of Yang Guang Group’s director, works at the Fuyang City Center for Disease Control and Prevention (CDC), and has been engaged in HIV prevention work for MSM groups since 1998. People are surprised to hear he has been working on AIDS prevention in Anhui for so long given that the Academy Award-winning The Blood of Yingzhou District, which reported on the HIV epidemic in Fuyang, only came out in 2007. [Editor’s Note: The Blood of Yingzhou District focused on children who were orphaned by the HIV epidemic that swept through the area.]
In Yang Guang’s words, MSM work in small and medium sized underdeveloped cities lacks many things: support from policy and leaders; frameworks or models for intervention; and funding and personnel. There is also a lack of understanding among society and one’s colleagues. Yet despite the difficulties endured over the years, we hope our efforts will create a brighter future for the local MSM community.’
The Yang Guang Group in Small and Medium-sized Underdeveloped Cities
In the mid-1990s, Yang Guang returned from the military to work in the local disease prevention station (which later became the local CDC) as a doctor. At that time, there were already a few experts there studying the transmission of HIV. Yang Guang worked with these experts to understand the severity of HIV and HIV transmission. In 1998, Yang Guang was working part time as a host for a radio hotline answering health questions, and he was also giving out basic information about HIV. Some who were concerned about HIV topics called the hotline telephone for more information. In May of that year, a male audience member called to ask about HIV and discuss his own homosexual experiences. This was the very first time Yang Guang came into contact with the MSM population.
Yang Guang has always made use of his passionate and candid personality to communicate, introducing methods to prevent the spread of sexually transmitted diseases (STDs) and HIV. Of course, there were many things he did not understand at the time, so he went to books and magazines to find the answers. Yang Guang wrote letters to the HIV expert Guo Yaqi asking for advice. Guo then introduced him to Zhang Beichuan, a famous doctor who started the LGBT journal, Friends (朋友通讯). After this series of introductions, Yang Guang gradually deepened his understanding of the MSM community and their attention to AIDS prevention, and began to work towards solving this problem. Due to enormity of the problem, Yang Guang worked mostly with the gay population in Hefei, Anhui Province. His work focused on making materials relating to HIV/AIDS prevention available, distributing condoms and giving out copies of Friends.
After the SARS outbreak in 2003, information about the transmission of HIV in Fuyang gradually surfaced, the situation has become more relaxed, Yang Guang formed the local Yang Guang Group. Their work is focused on HIV prevention in the MSM community in the Fuyang region. This group is composed of many part-time volunteers, similar to most MSM groups, with a variety of hotline counseling, peer education and outreach activities.
Since 2004, Yang Guang has operators at the phones 24 hours a day to answer calls. Since the first personal phones to today’s modern cell phones, their phone number has been published online, and callers throughout the country can always get help, no matter how busy. The money for the operation of this service comes from Yang Guang’s personal salary.
Unlike in large cities, small and medium sized cities better preserve interpersonal relations, and relationships between friends and family are more complicated. Thus, many people who engage in high risk behavior are apprehensive about getting tested for diseases. They are often not willing to go to the CDC because they fear they will see people they recognize. In 2006, Yang Guang and a friend worked together to open up a public service bar called Night Colors (夜色). The bar is located less than 50 meters from the CDC in Yingzhou District of Fuyang and became a site for counseling and testing for the MSM community. Taking privacy and security into account, the bar opened up two separate small rooms which provided counseling and testing in a relaxed environment. Most volunteers were doctors or CDC workers who worked during the day and at night went to the bar to provide testing services. The bar also offers peer education training, has a large number of informational materials, and provides condoms and lubricants. Because the sexual attitudes of small and medium sized cities are still quite conservative, volunteers must pay close attention to creating a culture of safety and awareness. They also have to remind people that the slogan“always have condoms in your bag” reflects a modern and responsible attitude, and should not be seen as shameful. Shameful behavior is unsafe sex.
In addition, using his position as a CDC staff member, Yang Guang strives to narrow the gap between the CDC, other governmental organizations and MSM groups. He has applied for funding from the Global Fund, which is used mainly in activities that strengthen the connections between the CDC and MSM groups. In this way, many CDC staff can gain a deeper understanding of the MSM community. At the time, the reputation of Night Colors bar was far-reaching and even people from Hefei [Anhui’s capital] would come to get tested. Yang Guang is thus known as one of the earliest promoters of HIV prevention in Anhui.
The Difficult Plight of MSM Work
Even though the Yang Guang Group’s work with MSM groups is some of the most progressive in all China, there are more and more groups that are starting to work in HIV prevention in the MSM communities. Looking back over the Yang Guang Group’s development, Yang Guang’s language betrays a sense of anxiety.
In his view, some individuals engaged in HIV/AIDS prevention and treatment work have deep-rooted prejudice and discrimination for the infected. Groups and organizations will often only look at the skills of applicants when recruiting new employees. Many organizations will overlook prejudices and misunderstandings that their employees might have towards homosexuals.
In December 2009, Yang Guang applied for funding from the Global Fund for a joint venture with local government departments and universities to host a large-scale activity. They extended special invitations to Zhu Liya, who works for the U.S. CDC in China, Mu Rongfeng, of the Hebei Light of Love Care Group (河北爱之光感染者组织), and several famous actors.
Yang Guang remembered one rainy night when the university was packed with students, volunteers and a large number of reporters who came to support the event. Zhu Liya, Mu Rongfeng and various Hong Kong actors and performers came and were all very excited. When one of the officials was brought to speak, he said people living with HIV should not have children, because their children will simply be a burden to society. As soon as the words left his mouth, a number of students stood up to protest, believing the statement discriminated against those infected with HIV and violated their reproductive rights.
More common than such slips of the tongue in public are misunderstandings of the MSM community. For example, some CDC staff believe that homosexual acts occur because men are not satisfied having sex with just women and want more. They believe contracting HIV is the result of an active sex life. A county in Fuyang found that sex among homosexuals has led to half of all new cases of HIV, but local MSM intervention work is not able to expand because the local government department leader does not like the sound of homosexual sex. He asked the county to report all homosexual transmission as heterosexual transmission.
Years ago, a government department in Fuyang was working on producing a promotional calendar for HIV prevention and treatment. They had one slogan which said: “To prevent HIV, do not engage in homosexual acts and do not do drugs.” Some passers-by took pictures of this and posted them to an online forum which, in turn, was picked up by the media. This incident caused an uproar. Later, after orders were given to track down the source, it was found that the slogan was taken off the internet by a local official, and printed for public dissemination without any discussion and approval.
In addition, the social psychology and atmosphere of small and medium-sized cities has become a problem. Because the Yang Guang Group can only apply for small grants to support activities, it does not have the financial ability to employ full-time workers. Yang Guang hopes that a new group at Fuyang Teachers College (阜阳师范学院) can expand its work with homosexual advocacy and HIV awareness. However many students at the school, after being contacted, seemed interested in joining more mainstream charity groups and organizations. Some students wanted to join the group but were apprehensive about working closely with gays living with HIV. Others were afraid they would not get support from the school, while still others were afraid to reveal their sexual orientation. Some students are interested in joining the new group for financial reasons, saying they would join if they were paid first. In this regard, Yang Guang was very unpleased. He feels you should not expect to be paid up front before contributing to charity work. If you have not done anything, how can you expect to be paid? In fact, Yang Guang has already invested a considerable sum of money into the Yang Guang Group.
From 2006 to 2010, Night Colors Bar had been open for five years but was only breaking even. The original idea to come out with a profit has never been realized. In 2010, the rent for Bar had gone up, and it eventually was forced to move. In early 2011, Yang Guang rented a small room on the nicest part of Yingzhou Road in Fuyang. He and several volunteers painted and refurbished the office, hoping to open an office that resembled the Beijing LGBT Center (北京同志中心). Here, they would be able to invite MSM community members to participate in activities, watch movies and provide consulting. In addition, they would also be able to offer free testing.
In order to subsidize the rent and utilities, Yang Guang bought a lot of beer and beverages, with the intent of selling them to anyone who came to participate in the activities.
One year later, however, the beer still sat in the corner unopened. Yang Guang said people from small and medium sized cities do not like the kinds of activities that people in big cities like. They do not like to sit around and chat quietly, but instead prefer the excitement and clamor of the bar. The yearly rent of the office is 9000 RMB, and there are an addition of 1000 RMB for property costs, which are all taken from Yang Guang’s own wages. While he and I were leaving the office, the building manager came to talk to him about these various expenses.
As Others Make Progress, Only I Remain Marching in Place
To have worked so hard, with the road ahead so difficult, many would want to give up, but Yang Guang will not part with his cause. Yang Guang’s eyes were red and bloodshot when I spoke with him. He gets little sleep, working during the day and offering counseling and testing at night. But he repeated, Fuyang is such a great base, and our work should be at the forefront of China’s HIV prevention centers as a model to prevent the spread of HIV. The current head of the National Center for Disease Control and Prevention of STD and AIDS (国家疾病防控中心性病艾滋病防控中心), Wu Zunyou, returned to China from the US in the 1990s and worked in Fuyang on an HIV intervention program. Anhui has had many specialists working there, including Professor Zhang Konglai, from Peking Union Medical College (协和医科大学), Wan Yanhai, China’s most famous AIDS activist, and Chang Kun, who is a rising star in Fuyang. Yang Guang still remembers in 2004 when Chang Kun had returned to Anhui from Xinjiang, Wan Yanhai gave him a call and asked him to pay attention to Chang Kun’s work. Talking about Chang Kun’s growth, Yang Guang breathed a sigh of relief.
Yang Guang also had a full-time opportunity to engage in NGO work. When Save the Children (救助儿童会) had a dedicated project office in Hefei and Fuyang, they hoped Yang Guang would work with them full time, but he felt he had done so many years of MSM intervention work, he had doubts about changing to the area of child welfare.. Now, he has some regrets; after all, Save the Children is a well-known NGO, and he now thinks he might have had the chance to work with other HIV organizations after joining Save the Children.
Speaking about the future of the Yang Guang Group, Yang Guang says he has thought about officially registering his group since the policies for NGO registration are more relaxed. Speaking about office space for the group after it registered, he thinks about an empty room in one of his family member’s house which could be used as an office. But considering everything he owes his family for years of work, he sighs again, and feels anxious about the situation.
If he did manage to register his group, what would be the future direction of its work? Yang Guang thinks the clinic model of Marie Stopes International (玛丽斯特普) could be implemented in Fuyang. Using this model, the service charges of the clinic could be used to support the public interest HIV intervention work. Many members of the MSM community study medicine, and might have difficulty finding other jobs. The money from clinics could be used to offer these individuals jobs. Upon saying this, his bloodshot eyes showed a glimmer of hope.