HIV cases are seeing the largest surge among gay students in China, according to a report from southeastern China.

The report released this month from health authorities in Nanchang, the capital of China’s Jiangxi province, showed that HIV infection rate among students at the city’s universities increased by 43% annually in the past five years. Over 80% of cases involved men-who-have-sex-with-men (MSM).

And Nanchang is not the only city that is facing such a trend – more than 100 new cases among students are being reported annually in Beijing; while Shanghai reported 92 students infected with HIV in 2015.

Data from China’s Health and Family Planning Commission show that the growth rate of student infections has surpassed that of other groups, with 81.6% of the cases concerning young MSMs who are still schooling.

The country’s health authorities are worried about this trend, especially in a country that declassified homosexuality as a mental illness only in 2001. There is also almost no public discussion of gay issues or rights, in any form.

Activists, though, attribute this trend to the health authorities’ improper handling of the issue.

‘The government emphasizes the morality of sex rather than the safety of sex,’ said 37-year-old Liu Jiulong, who shared that he was not aware of what homosexuality was until 11 years ago when he read about it online. He was subsequently diagnosed with HIV two years later, and the advertising company where he was working at decided to fire him after knowing of his status – citing that other employees were ‘scared to come to work’

‘If they (referring to the health authorities) continue to use this mentality to make public health policies, China will pay the price one day,’ Liu added.

Founder of Guangzhou-based sex education advocacy group Friend Public Welfare Allen Chen also echoed Liu’s thoughts.

‘The intention (of the health authorities) is good, but it is easy to cause panic because in the Chinese context, there is little knowledge of homosexuality and a lot of misunderstanding,’ said Chen, referring to how HIV-positive people are being banned from government jobs and past cases where HIV-positive students have been expelled or pressured to leave their schools by the administration. Last year, authorities also said they would inform universities of the identities of HIV-positive students on their campuses so that the rest of the student body can be warned.

Chen added: ‘As a result, the gay students are depicted as high-risk and thus are further stigmatized.’

Authorities, however, tried to defend their decisions.

According to Chinese health officials, the rise of MSMs in HIV statistics partly reflects success in reducing infections among intravenous drug users, among sex workers and from the illegal blood trade.

Also, even though information on infected students are released, authorities claim that schools are not supposed to publicly identify those students.

‘No country in the world has discovered an effective way to curb the epidemic among gay men,’ said Wu Zunyou, director of China Centre for Disease Control’s (CDC) AIDS Prevention Centre, on state broadcaster CCTV in 2015.

Wu added: ‘Most students know what AIDS is and how to prevent it, but the change of behaviour remains a big challenge.’

According to Wang Ning, an AIDS specialist from CDC, there should also be no reason to worry that the privacy of HIV-positive students will be violated as awareness of the disease grows.

One reason for the huge increase in infections, according to him, was that some HIV-positive people withhold their status from sexual partners.

‘The understanding of privacy varies in different cultures. In China, some people think privacy means they don’t need to tell anybody,’ said Wang.

Last but not least, officials have attributed the sharp increase of cases to the flourishing of gay dating sites and apps, such as Blued, which have made casual sex on campuses more easily accessible.

This was also echoed by academics such as East China Normal University’s Associate Professor of Sociology Wei Wei, who shared that a student ‘can (now) find a partner right from his dormitory’.

World Health Organization (WHO) officials, though, have urged China to crack down on discrimination against people with HIV or at risk of the disease, citing that stigmatization increases the difficulty of implementation of prevention efforts.

‘While HIV testing is widely available, we know that many people are hesitant about getting tested for HIV – because of fears of testing positive, the stress of waiting for results, inconvenience of going to a facility for testing…and the fear of stigma and discrimination,’ said Bernhard Schwartländer, WHO’s representative in China, referring to how China has provided free antiretroviral medications to HIV-positive people since 2003 when they were criticised on its tight control of information during the severe acute respiratory syndrome outbreak.

Still, the effects of China’s health policies are far-reaching.

‘It (referring to the country’s health policy) is always about warning and intimidation, and how horrible sex is,’ said Zhai Zhihao, a student at Huazhong University of Science and Technology in Wuhan. Zhai is out to his parents.

Zhai added: ‘HIV-positive students would feel very insecure if they get a call from the school, even if it is just to remind them to take their medications regularly.’