Abstract
Homosexuality has been documented throughout Chinese history with varying levels of societal tolerance—popular and thriving during the Ming and Qing dynasties to strictly prohibited and strongly stigmatized during the Mao era. With the dramatic social changes that have come to China as a result of its Opening Up and Reform Policy of the late 1970s, homosexuality has reemerged. However, despite liberalizing attitudes, men who have sex with men (MSM) continue to face severe stigma and discrimination as well as pressure from family to marry and bear offspring due to deep-seeded, traditional cultural values. Stigma, poor sexual health education, low rates of accurate HIV knowledge, and high rates of a broad range of sexual and drug use risk behaviors have made Chinese MSM vulnerable to infection with HIV and other sexually transmitted infections. Furthermore, the desire to remain hidden has meant that uptake of HIV prevention, testing, treatment, and care services has been suboptimal. The Chinese government has responded and MSM community-based organizations have gotten involved, but further efforts must be made to control and reverse the rapidly growing HIV epidemic among MSM in China.
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