I . ,.....

Identity, Community and HIY Related Communication Among

Men Who Have Sex with Men in China

9=t1Et1ffl
19971f: 11 A2-513
Rodney H. Jones
Department of English, City University of Hong Kong
enrodney@cityu.edu.hk
Abstract
This paper explores the way men who have sex with men in China understand HIV related issues
and communicate about them, and how they respond to various public health and media representations of
AIDS. It focuses on how information about AIDS is 'leamed', understood, talked about and acted upon
both among strangers and within communities of friends and acquaintances.
Individual and group interviews were conducted with two communities of such men in Beijing
and Fuzhou. In addition, observations and informal interviews were conducted at various public meeting
places for men who have sex with men in both cities.
The data is approached using Lave and Wenger's (1991) framework ofleaming and its
relationship with identities within communities ofpractice, and Mosovici's (1981) theory of social
representations, the mechanisms by which groups transform unfamiliar and threatening concepts into
familiar and manageable ones by anchoring them within already existing networks of knowledge and
relationships. Through this analysis a number of observations are made regarding the challenges involved
in educating men who have sex with men in China about AIDS. Among them are the difficulties Chinese
MSM have in incorporating condom use into their sexual interactions and their preference instead to see
HIV prevention as a function of identities which actors assume for themselves and impute onto their
potential sexual partners.
Understanding the ways communities build their own folk knowledge about AIDS around
already existing identities and discursive practices has important implications for the design of effective
health interventions and the development of conditions in which more appropriate understandings of HIV
prevention can be disseminated within such communities.
KEY WORDS: AIDS, China, Communities ofPractice, Ethnography, Gay and Lesbian Studies, Social
Representations
1. Introduction
Despite the growing body of literature from both inside and outside ofChina
documenting the widespread existence of homosexual behavior, particularly in the
country's urban centers (Hinsch 1990, Li 1992, Pan 1993, Ruan & Tsai 1988, 5j 3:-
1993,1i 1995), much work remains to be done in understanding HIV risk related
behavior among men who have sex with men and promoting safer sex education within
this group. Thus far, homosexuality has occupied a paradoxical position in media, public
health and academic discourses on HIV/AIDS in China, a position of both prominence
and invisibility. Although homosexuals are frequently classified as a 'high risk group' in
educational books and pamphlets on AIDS and portrayed as the 'source' of AIDS in
numerous media accounts, there are still few examples of health promotion
materials which are directed specifically at this population and address their particular
circumstances and special needs. Those that do exist tend to approach their audience from
the perspective of an 'outsider', offering exhortations and recommendations which many
men who have sex with men might have difficulty seeing as relevant to their own lived
experience. On such pamphlet, for example contains the curious advice:
1
Although the initial response has been slow, Chinese health workers and social
scientist are increasingly seeing the importance of addressing the educational needs of
this community and undertaking the research necessary to ensure educational efforts are
effective. In the realm of social science, most of the studies to date have consisted of
questionnaire surveys focusing on issues of knowledge, attitudes and behavior. Some
researchers, however, have recognized the need to explore how homosexuality and AIDS
are linguistically and socially constructed within communities of men who have sex with
men with the aim of designing approaches to health promotion that are more appropriate
to the target audience. Pan (1996:189), for example, writes:
Further enquiry will shed light on the meanings associated with male homosexual and bisexual
behavior, both for the actors involved and for Chinese society more generally. Access to such
meanings will be essential for the design of effective interventions for HIV prevention that speak
to the lived experience of the men concerned, addressing them in ways that seem appropriate and
meaningful. (emphasis mine)
This paper attempts to begin to answer this call. The data presented here are the
preliminary findings of a larger, ongoing study on how men who have sex with men in
China construct their understanding of HIV and AIDS through talk within communities,
and how this linguistic construction affects their risk behavior. The questions I address
are: What are the meanings associated with HIV and AIDS in groups of Chinese men
who have sex with men? How are these meanings learned and acted upon within these
groups? What are the relationships between these meanings and the meanings made
available in more mainstream discourses ofHIV and AIDS? and What impact do such
meanings have on the risk behavior ofthe individuals involved? I do not pretend to
provide comprehensive answers to any of these questions. Rather, my purpose is to
further open the door for exploration of these issues. In this regard I will not be providing
statistics on sexual behaviors or results of surveys about the knowledge or attitudes of
this population. What I will provide as much as possible are the actual voices of the men I
have spoken to in China along with some suggestions about how we can make sense of
these voices and include them in the larger policy and planning debates on HIy related
health interventions within this population.
AIDS Prevention and Communities
The AIDS epidemic has been a major factor in the redefinition of health
promotion in the West as an activity which not only encourages behavior change from
the 'top down', but also enables communities to increase their control over the factors
that influence their own health (Rhodes 1994). Such redefinition can best be seen in the
concept of 'outreach', a process which explores 'possibilities for facilitating changes or
endorsements in everyday peer group and community norms about health and health
behavior' (Rhodes 1994:52), aiming to encourage community rather than individual
change.
Nowhere has the importance of community mobilization and community identity
in outreach work been emphasized more than in safer sex promotions among gay men in
North America, Europe and Australia (Watney 1990, Kippax et al. 1992, Kelly et al.
1992). The first community based response to AIDS, in fact, originated in the American
2
..
gay community with the publication of Callen's (1983) groundbreaking pamphlet, How
to Have Sex in an Epidemic, published before the discovery ofHIV and at a time when
the US government was still a long way from making AIDS prevention a national health
priority.
Part of the success of such approaches can be attributed to an already cohesive
community identity among gay men in the West facilitated by well established social and
commercial networks (gay bars, political organizations, newspapers and magazines).
Community based interventions have proved considerably more difficult, however, in
populations lacking strong, institutionalized notions of community identity, such as IV
drug users (Rhodes 1994).
One problem in addressing the needs of different communities is the way the
concept of community itself is defined. Health promoters and social scientists have at
different times and in different circumstances put forth widely different ways of
understanding and using the term (Rhodes 1994). Community has been seen, for
example, in terms of geographical proximity, in terms of ethnicity, in terms of social
networks, and in terms of shared norms and values. The way we define community, as
both a unit of analysis and a target for health related intervention, will have inevitable
impact on the validity of our research and success of our health promotion campaigns.
Some Chinese scholars of homosexuality (see for example }i'i] 1997) have
cautioned against applying Western concepts of sexual identity and Western experiences
of gay liberation to the Chinese context. Similarly, in exploring possibilities of
HIV/AIDS related community interventions in China, particularly among men who have
sex with men, it is important to remember that such Western notions as 'the gay
community' may not be so easily transferred to a nation with very different cultural,
political, social and historical conditions. Therefore, while not denying the importance of
such concepts as 'pride', 'empowerment' and sexual liberation in the Chinese context, I
prefer in this study to adopt a rather broader definition of community which, temporarily
at least, suspends the political and philosophical connotations the term has taken on in
much of the HIV/AIDS related outreach work in the West.
The definition I adopt has its roots instead in Marxist political theory and Soviet
psychology. It sees communities not as fixed, easily definable groups, but as ~ o n s t a n t l y
emergent collections of people who come together not necessarily on the basis of shared
identities, but rather on the basis of shared networks of knowledge, experience and
behavior (Becker 1967). Lave and Wenger (1991) call such collections of people
communities ofpractice, groups defined not so much by how they think, as by what they
do. Such a conceptualization of the term community moves us away from notions of
membership towards notions ofparticipation, allowing us to regard individuals not as
either belonging to or not belonging to particular communities, but rather as inhabiting
various positions within a field of participation with other social beings.
Communities ofPractice and Social Representations
Another important aspect of this perspective on communities is the relationship
between social participation within communities of practice and learning. Many
approaches to HIV/AIDS education both in China and the West tend to see learning as an
individual cognitive process in which a particular person encounters a body of
knowledge, masters it, and rather systematically applies it to his our her choices regarding
3
behavior. From this perspective, failure at either mastery or application are seen as
evidence of either some type of 'learning disability' or psychopathic or sociopathic
tendencies. It is this approach that has thus far dominated social scientific responses in
the field, seen most clearly in traditional knowledge/attitudelbehavior (KAB) surveys
which treat knowledge as something an individual either does or does not 'possess' and
behavior as a matter of individual 'choice', ignoring both the importance of the social,
political and ideological environment in which learning and behavior occur (Fishbein and
Middlestadt 1989, Wellings 1994) and the structural differences between scientific
knowledge and the informal, everyday, often 'irrational' ways real people understand the
world in real situations. While such studies undoubtedly provide valuable background
information for researchers, their usefulness for AIDS educators is limited if not
supplemented by research focusing on the social context such as demographic and
economic analysis, media analysis and ethnographic observation of how knowledge,
attitudes and behaviors interact in particular communities.
A perspective focusing on communities ofpractice takes a very different approach
to learning, seeing it not as a function of the individual but as a function of social
interaction within groups. According to Lave and Wenger (1991:29), 'learners inevitably
participate in communities of practitioners, and ... the mastery of knowledge and skill
requires newcomers to move towards full participation in the sociocultural practices of a
community. '
This 'shift of analytic focus from the individual as learner to learning as
participation in the social world' (Lave and Wenger 1991:43) has important implications
for HIV/AIDS related health interventions. It reminds us first that there is often a great
difference between knowledge and knowing, and second that education is not something
that happens to communities, but rather something that happens within communities.
Therefore, in investigating ways in which outreach programs for men who have
sex with men in China might be developed, it is essential to first explore how these men
develop and share concepts, statements and explanations about HIV and AIDS in
communication within groups, and how they incorporate such concepts, statements and
explanations into their everyday social activities. Moscovici (1981) calls these concepts,
statements and explanations social representations. While scientific knowledge, he
writes, 'attempts to construct a map of the forces, objects and events unaffected by our
desires and consciousness, (social representation) stimulates and shapes our collective
consciousness, explaining things and events so as to be accessible to each of us and
relevant to our immediate concems'(187). Thus, social representations 'are phenomena
that are linked with a special way of acquiring and communicating knowledge, a way that
creates realties and common sense' (186).
What underlies the creation of social representations, according to Moscovici, is
the need of communities to transform concepts that are unfamiliar (and often, like AIDS,
threatening) into things that are more familiar, concrete and relevant to the purposes of
the group within which they are shared. He writes:
The act of re-presentation transfers what is disturbing and threatening to our universe from the
outside to the inside, from a remote to a nearby space. This transfer operates by separating
concepts and perceptions that are usually associated, and integrating them into contexts where the
unusual becomes familiar, where the unrecognized is fitted into a recognized category. (Moscovici
1981:89)
4
This transfonnation is achieved in a number of ways. One is the process anchoring,
through which the unfamiliar is attached to recognizable points ofreference and
incorporated into already existing networks of categories. From the point of view of
HIV/AIDS, this involves constructing prototypes of 'risky behaviors' and 'risky people'
that situate the problem at a comfortable distance from the actors.
Another process is what Moscovici calls objectification, the actions by which
abstract ideas are transfonned into concrete objects and behaviors. In the case of
HIV/AIDS this often involves appropriating 'facts' and 'advice' about the disease from
available sources and adapting them to already existing patterns of behavior in ways that
result in minimal disruption of these patterns.
In what follows I will attempt to demonstrate how particular groups ofmen who
have sex with men in China develop ways of dealing with the threat ofHIV through the
use of social representations, how they anchor the threat in behaviors and identities
outside of their experience, and how they adapt the tools for AIDS prevention provided in
mainstream health education to their own lives.
2. Methodology
The methodology used in collecting data for this study comes from the
ethnographic foundations of anthropological linguistics which combines four kinds of
participant observation: members' generalizations about the communities in which they
participate, members' individual experiences of participation within these communities,
objective observation of members' behavior and interaction with members (Reuch &
Bateson 1952).
Fieldwork was conducted at two sites in Mainland China, Beijing and Fuzhou,
between July 1996 and October 1997. A total of two months was spent in Beijing and six
weeks in Fuzhou. 14 structured individual interviews were conducted, along with 27
infonnal interviews in parks, bars, alleys and discos, and two structured group interviews,
one in each city. Infonnants ranged in age from 16 to 55. Among the infonnants were
students, factory workers, hotel workers, office workers, private businessmen,
unemployed men who had sex for money, a doctor, a public health worker and a police
officer. Most of the infonnants were contacted through introductions by other infonnants,
allowing me to observe interaction within already existing networks of friends and
acquaintances.
3. Observations
Patterns ofInteraction
Popular and public health portrayals of men who have sex with men in China
often represent them as both solitary and silent, isolated from social networks and
frequently engaging in anonymous sex devoid of any communication at all. In a recent
handbook for HIV/AIDS counselors, for example, describes a 'typical' sexual encounter
between such men in the following way:

d

. <*JJt 1996:170)
5
Although such behavior undoubtedly occurs, most of my informants indicated that this
was by far the least desirable form of interaction, particularly among those who
considered themselves more educated, and many demonstrated a similar contempt for
such behavior as that found in more mainstream discourses. Others, admitted to such
forms of interaction but claimed that public sex was often the result of constrains on
private space and difficulties in establishing contact with like minded men in more
conventional circumstances.
Increasingly, however, particularly in Beijing and to some extent in Fuzhou as
well, private spaces for meeting and interacting with potential friends and partners have
increased, engendering changes in both the cohesiveness ofMSM communities and the
ways they organize their interaction. Some of the spaces are physical: bars, discos, coffee
shops, karaoke lounges and the like. Others are virtual spaces created by increased access
to technology. In both cities, for example, pagers are fast becoming 'standard
equipment' in MSM interaction. Because they allow contact without requiring users to
reveal their identities or to commit to face to face interaction, they have become
important tools for meeting potential friends. A 35 year old businessman in Beijing
described the process like this:
1.f - l'JlII a . iii!. iAiR-1' A.. . i!l'A.
. . i!*fiiJ
5tJIHiI!. - .:!it Ii't rPJ .!Ii!. Wi
A 25 year old office worker in Fuzhou also preferred this way of meeting friends,
considering it 'safer':
Pagers are also used in parks and other places to alert friends about possible police
activity, and, in Beijing a group of Chinese and expatriate men have established a pager
hotline for inquiries about community venues and community activities. For individuals
with access to more sophisticated technology, several internet homepages such as Gay
China provide services by which users can place personal ads.
Identity and Risk Behavior
Since the beginning of the epidemic in the West, individuals, groups, and societies
have constructed their perceptions of risk around concepts of identity, from broad notions
of national identity which see AIDS as a 'foreign disease', to more narrow notions of
group identity which have constructed it as a 'gay plague' or a disease of prostitutes or
drug addicts. In every society and culture, individuals and groups construct an identity
matrix around the disease and position themselves within that matrix. Therefore,
designing appropriate health interventions requires an understanding of the identity
matrix dominant in a particular community and how it enables or inhibits risk behaviors.
Among the informants in this study, identity formations were the single most
important tool for preventing HIV infection. Most of the men I talked to believed that
they could avoid infection not just by avoiding certain kinds of people, but also, to a
certain extent, by avoiding appropriating certain kinds of identities for themselves.
6
Central to this issue in this study is the notion of homosexual identity itself and
how homosexual and bisexual identities are labeled by both the actors and the society at
large. Significantly, most ofthe men that I spoke to were either married or planned to
marry in the future, and many did not assume for themselves a Western style gay identity,
or even a bisexual identity. In response to questions about AIDS, several presented this
fact as evidence that they were not at risk for HIV infection. A 28 year old doctor in
Fuzhou, for example, indicated that he saw little need to use condoms during sex with
men since he himself was not a 'full time' homosexual:
7tk .
. . " .
Another young man (24) in Beijing who had sex with other men for money used a similar
rational for seeing himself as not at risk, insisting that he was neither a homosexual nor a
prostitute.
X: . '1


X:i!fsIlA'1

Furthermore, those who did identify themselves as homosexual were unlikely to use the
labels commonly used in medical and health promotion literature to refer to themselves.
In particular, many resisted the term seeing it as having negative connotations.
There was some regional and generational variation in preferred terms of self reference.
Informants in Beijing mostly preferred the English word 'gay' or more indirect
references such as A. In Fuzhou, several of the younger, better educated
informants preferred to refer to themselves as 1RJ;t (comrades), a term gaining increasing
popularity among circles of men who have sex with men in Taiwan and Hong Kong. A
22 year old office worker in Fuzhou put it this way:

-.tt:tc . .
The resistance of traditional Western labels for sexual behaviors and sexual practices has
important implications for both social scientific research and epidemiological studies.
The distinction often made in Western studies between 'gay men' (those who identify
with the gay community), bisexual men, and 'men who have sex with men' (those who
do not identify themselves as gay), problematic enough in the Western context (see
Watney 1993), seem even less stable within the Chinese context. This observation calls
into question epidemiological surveys showing an extremely low prevalence of
homosexual transmission in China, since many of the individuals involved who have had
sex with men might not conceptualize themselves as homosexuals or even conceptualize
their behavior as homosexual behavior. Furthermore, because of strong stigmatization of
homosexuality in contemporary Chinese society, even those who might in other
circumstances identify themselves as homosexuals would be unlikely to do so in the
7
context of an HIV antibody test. One of the few infonnants who had taken such a test, a
28 year old hotel worker in Fuzhou, related his experience this way:
Besides sexual identity, other dimensions of identity also played an important role
in infonnants' perceptions of personal risk, specifically in regard to the partners they
chose. In response to questions about condom use, most of the respondents in both cities
demonstrated the belief that if they chose their partners carefully, condom use was
unnecessary. In other words, HIV prevention tended to be anchored to more familiar
notions of personal and group identity rather than the less familiar practice of condom
use. Comments like the following were common:
& .
.
.. . . (Fuzhou, Metal Worker, 56)

IJ\'L" . . tt$.VJ\,L' (Fuzhou, Office Worker, 22)
.. ..


'1 (Beijing, TV Director, 29)
Not only were identities preferred over condoms as tools for the prevention of HIV
transmission, but many of the men I spoke to saw condoms themselves as imputing an
undesirable identity onto ones partner or assuming an undesirable identity for oneself.
Suggesting condom use was perceived as indicating lack of trust, symbolic of
promiscuity, moral failing and disease. According to a 47 year old worker in Fuzhou:
ft
ft!llt . ')f" )f'!llt .. .
.
From the point of view of social representations, such statements are important in
understanding the nature of the prototype these men construct of the individual at risk of
HIV infection. In both sites of investigation this prototype consistently clustered around
several distinct dimensions of identity: physical identity or appearance (whether the
individual looked healthy or not), ethnic identity, regional identity, identities based on
where the potential partner was encountered, identities based on class or educational
background, , and the kind of reputation the potential partner had within the community.
8
By far the most consistently used measure of potential risk involved ethnic
identity, with nearly all of the informants believing that foreigners were potentially more
dangerous in terms of HIV transmission. One young man encountered in a park in
Fuzhou, for example, said:
amm
_*tt mmffl
.. .. .. .

A 37 year old lawyer in Beijing offered a more statistical assessment of risk:
A letter from one of my informants indicates just how strong the association between
foreigners and AIDS can be, even to the extent that simply being seen with a foreigner
can instigate rumors about HIV infection:
Last weeken (sic), I went to the park again. I was told some rumor concerned me, it was
rumored that I had AIDS. The reason was I touched a foreigner and I got much money by the
prostitution. But I care little for the rumor. I know it was the fIrst time for the gays in the park
to fmd I can speak English... So this time they saw I talked to you in the park, they envied me and
rumored me... To my surprise, the rumor spreaded so quickly and widely, I mean my lover got
wind of it... He complained that the white are not only dirty but had AIDS...
One young man encountered in a park in Beijing, however, seemed to believe that the
potential risk from contact with foreigners was somewhat offset by the relative higher
degree ofknowledge about AIDS prevention he expected foreigners to possess. The
disturbing result of this assessment was that he seemed content to leave the issue of AIDS
prevention in the hands of his potential foreign partner rather than learn about it himself:
X: '1
.
X: '1
B: . .
x: '1
B: . . fi!!.mil . .
. .
Regional identity was also an important factor in risk assessment. In both Beijing
and Fuzhou, informants often expressing the belief that the threat of AIDS was
geographically distant, situated in Yunnan and the special economic zones close to Hong
Kong. Particularly in Beijing, many informants believed that encounters with residents of
their own city were less risky than with outsiders, primarily because non-residents were
perceived to be both less educated about AIDS and more likely to be involved in
prostitution. Moreover, certain gathering places were avoided because they were known
to be frequented by non-residents involved in prostitution. Thus, location within the city
9
..
also became an important dimension of risk assessment, with individuals frequenting
some places perceived as more risky than those frequenting others:
ll1Ixx 1J. . 1.. .IHE: -@ JL .
:1-Jft1.. fl!!frJ JL . ffi:Ji! 00
. ff1&$ .
.
Ji tE Jj( .A. N: ff XX fig. . JIG PJr ftl1&$. . ffi . JIG ff 1& .
.. JlGJitEN:ffU JlGN:ff
*&1Jft
. .. ..

. . . .
it1#: 7.1< ,\ttSt:Ji!!(J. T .-W 1&Jlff . JilT .;',t; iJt .
. JIG 1\t XX fig m.. . JIG 1\t fik frJ . JilT JIG XX
(Beijing, TV Director, 29)
The dimension of identity most closely related to community cohesiveness and
communication was the dimension of reputation. In both cities informants felt that an
important indicator of risk was their potential partner's standing within the community.
The hotel worker in Fuzhou related the following story:

mfik *M.* fl!!
.. .. PROMISCUIOUS . . P4
1i+-Jm:$ .. $:Ji! .. .
.A. . * .fil! . mfil! . T . .
. .
Along with internal identity formations, extra-community issues of identity also
played a part in HIV related risk behavior, particularly in regard to informants' lack of
willingness to submit to an HIV antibody test. Of all of the men I spoke to, only two had
been tested. The others noted several factors which discouraged them from getting a test
including cost, inconvenience and ignorance as to where such a test might be obtained.
By far the most frequently cited factor, however, was concern about revealing their
identities within the context of an HIV test and perceptions, despite government and
media assurances to the contrary, that being identified as an HIV positive individual
would result in stigmatization and even detention. A 30 year old office worker in Beijing
offered the following view:
I : ... .. .. GAY .


. .. @.tE
..
.-lX . .. .
.* .
.. . ..

JlG1\tm ..
. JIG . ..
.. l:J .
10
. . . .
. iiJ .. m/Fm 1

ttm
T . . M.* .

..
.
1M
I: m . .. ... .
**a
,"" .. . .
mT

Ram


. Whether they involved relationships within the community or outside of it, a
major aspect of the netwQrks of identities the men I spoke to maintained was the idea of
trust. Perceiving a potential partner as someone you could 'trust' was central to
informants' social representations of AIDS prevention. Similarly, a perceived mutual
lack of trust between the informants and the state and institutions responsible for AIDS
prevention and treatment made it less likely for them to either accept advice from these
bodies or take steps to discover their HIV status.
Appropriation of Social Representations from the Mainstream
In the absence ofHIV and safer sex information from within the community itself,
men who have sex with men in China appropriate and adapt concepts and representations
from mainstream media and public health campaigns. Throughout their responses,
informants consistently invoked discourses of traditional Chinese values, morality, sexual
hygiene, biomedicine, love and faithfulness and the importance of knowledge which are
the stock and trade of most Chinese HIV/AIDS related public health messages. Like
notions of identity, however, such concepts did not always result in avoidance of risk
behavior. Rather, they were often used to rationalize risk behavior. \
Although media portrayals and public perceptions of men who have sex with men
place them squarely outside the bounds of traditional morality, most of the men I talked
to saw traditional Chinese concepts of morality as central to their lives. This is perhaps
most dramatically seen in the frequent mention of filial piety in discussions about
marnage
..

ffM


.
iiJ . .. .
.., . .
. ..
(Beijing, TV Director, 29)
11
. . .
..
.
. (Beijing, Teacher, 30)
By far the most commonly appropriated message from mainstream AIDS
prevention messages was the idea that 'sexual morality' and steadfast
faithfulness to a single partner was the best protection against AIDS. Nearly all of my
informants (even those who were married) expressed the aspiration to establish and
maintain a long term monogamous relationship with another man. In terms of risk
behavior, this aspiration and the emotions that accompanied it, sometimes worked against
maintenance of safer sexual behavior and condom use. Specifically, many informants
indicated that they would be more likely to participate in anal intercourse without a
condom with a partner that they 'loved':
THIS PEOPLE DEEPLY .
..

. (Fuzhou, Student, 24)

f1'Mrt1J . !ilt;f.f1'M B (Beijing, Office Worker, 37)

. . (Fuzhou, Hotel Worker, 28)
Conclusion
In this paper I have begun to explore some of the ways men who have sex with
men in China anchor their social representations of AIDS prevention within already
existent beliefs about identities. Further understanding of how such men conceive of and
make use of identities and networks of social relationships will be essential if effective
programs in AIDS prevention are to be designed for this group.
The data presented here has both positive and negative implications for the future
of community based AIDS prevention work among MSM in China. One positive aspect
was the widespread perception among my informants that AIDS was indeed a potential
threat to them along with evidence that many were taking steps to avoid it using the
social tools they had at hand. The negative side, however, is that condoms were rarely
part of these preventive efforts. During the research I asked many men to suggest ways
condom use might be promoted among their circle of friends and acquaintances. Most,
however, were unable to offer constructive suggestions, some even taking the rather
fatalistic view evidence in the following response:
.
.. (Fuzhou, Hotel Worker, 28)
Perhaps the greatest obstacle to HN prevention among men who have sex with
men in China is fear: fear of revealing their identities to friends, family members and
public health workers, fear of taking an HIV antibody test, and fear that there is really
very little they can do to escape the threat of AIDS. Along with this fear, however, is
12
.. ..
some degree of hope coming from the friendship and support they share within the
community and the thought that someday this shadow of fear might be lifted. As one man
put it:


faIL .. .
.
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