China’s discomfort over discussing sex, and especially homosexuality, is a major problem when it comes to HIV, according to a scientific journal.

A consortium of six researchers in China point out in Nature that the spread of HIV among gays is not seen in other high-risk groups, with the proportion of gays in reported HIV cases rising from a mere 0.3% before 2005 to 13.7% in 2011.

‘A stigma against homosexuality’ is fuelling the problem among an estimated 18 million men said to engage in homosexual sex in the country, they say.

As people are uncomfortable talking about sex in general, let alone homosexuality, there are therefore a pervasive stigma against people with HIV, a lack of general sex education for young people and poor epidemiological data about the spread of HIV in some populations.

Afraid to seek out HIV information resources or testing, these poorly educated men eager to hide their activity, once infected, can lead to a vicious circle among their partners. A proposed official requirement for people to register real names for HIV tests may only make things worse, GSN reported earlier.

Even if gay men work up the courage to ask about HIV testing and information, healthcare workers may have insufficient training or they may be uncomfortable to talk about related sexual conducts.

‘This, coupled with stigma that leads men to hide their homosexual activity, means that men delay HIV testing and treatment – and, as a result, put all their partners at risk,’ researchers say.

The issue is made even worse by high-risk behavior as around 40% of gay men in China reportedly have exchanged money for sex, while they are also found among the country’s 145 million internal economic migrants that are prone to unprotected sex and exchanging sex for money.

Breaking through stigmas about sex, and homosexuality and HIV in particular, is a key solution. First, at the political level, policymakers must make discrimination against HIV-positive individuals punishable by law and include sufficient incentives or penalties to ensure enforcement, according to the researchers.

Second, health professionals must cooperation across disciplines to better characterize where and how HIV is gaining ground, and to translate these date into public-health applications.

Highlighting the power of leading by example for combating stigma, the researchers cited the widely broadcast anti-HIV discrimination announcements that basketball legend Magic Johnson and native player Yao Ming did in 2004, and how a man stood up during an AIDS summit with former US president Bill Clinton at Tsinghua University in Beijing.