In need of more protection

By K.M. | BEIJING

LIKE banquets and the grain liquor know as baijiu, prostitution has become a widely accepted feature of the business rituals of millions of Chinese men. So when rumours erupted recently of an AIDS epidemic among middle-end Chinese sex workers in the manufacturing centre of Dongguan, the government was forced to speak up.

There is a problem with HIV and AIDS spreading in the southern city, health officials acknowledged. But they insisted that the rumoured numbers are greatly exaggerated.

Dongguan, a gritty factory-laden sprawl in Guangdong province, is home to hundreds of KTVS, or karaoke parlours. Often located in business hotels, these are barely disguised brothels where the services of female “hostesses” are bought and sold. The KTV façade spread rapidly across China in recent years, with hostess bars even infiltrating well-known American and European chain hotels.

On Jan. 21st, the Dongguan health bureau refuted rumours that 2,700 KTV hostesses in the city are HIV positive. In fact, it said, there are just over 2,000 confirmed HIV/AIDS infections in the entire city and that only one-fifth of those are among women. Still, the health bureau acknowledged that the city “is entering a high incidence period of HIV/AIDS.” It has unrolled a mass AIDS education campaign and is urging “high-risk” groups like sex workers, their clients and gay men to take precautions.

“We should use knowledge to guide our behaviours and avoid high-risk behaviours,” the health bureau said. “If a high-risk behaviour occurs, we should be responsible for ourselves and the families to proactively take the tests and take necessary treatment in a timely manner.”

The health officials said similar rumours had been spreading in Dalian, Beijing, Fuzhou and other cities. Amid the nationwide unease over China’s sprawling sex trade there are deep concerns over the health and safety of women in the industry, says Lan Lan, a Chinese sex-worker activist who herself started working at the age of 13 as a prostitute.

China has somewhere between 2.5m and 6m sex workers, most of them women. Surveys indicate that only 50% use a condom with every client, making it easy for sexually transmitted diseases to spread unchecked. And because the prostitute population is transient and criminalised, tracking sex workers and their health is a difficult proposition.

Lan Lan is sceptical of the Dongguan government’s official AIDS/HIV count. While China’s Centre for Disease Control and Prevention does test sex workers for HIV, it focuses on high-end brothels and KTVs. The women who service poorer migrant workers and work the streets routinely go uncounted.

“The government’s statistics only include the people that have been tested and confirmed. There are many more cases that the government does not know,” she says.

Yet it is easy to see how one HIV infection could spread like wildfire. Lan Lan used Tianjian, her home, as an example. Testing shows that 17% of sex workers in that city have syphilis and only 50% use condoms with every client.

“If an HIV carrier comes to this area, the virus will be quickly spread,” she says.

Shen Tingting, advocacy programme director for the NGO Asia Catalyst, notes that heterosexual sex is now the leading route of AIDS transmission in China, accounting for 46.5% of cases in 2011, according to UNAIDS. By that count, almost 29% of the 780,000 Chinese people estimated to be living with HIV and AIDS are women.

But the numbers further underscore China’s difficult past with its AIDS epidemic and duelling statistics. Xinhua reported that as of September 2013, there were just 434,000 people in China with HIV/AIDS. China’s AIDS epidemic is unusual, and during the 1990s was fuelled in large part by infections transmitted through its illicit plasma and blood trade. Chinese news media have reported troubling increases in AIDS infections contracted through sex, particularly among young gay men, in the past two years.

In that mix, female prostitutes are particularly vulnerable, and difficult to monitor. Ms Shen said KTVs and other establishments often switch staff every few months, both because clients want fresh faces and the women don’t want to be tagged as criminals.

“It is very important for the government to pay more attention and direct resources toward sex workers, especially female sex workers,” said Ms Shen. “Because this group is criminalised, they can’t operate out in the open and call for rights.”

(Picture credit: Frederic J. Brown/AFP)