This content was originally published by Radio Free Asia and is reprinted with permission.
In January 2025, a 79-year-old gentleman went viral on social media after testing positive for HIV at a clinic in the southwestern Chinese province of Guangdong where he was being treated for chronic obstructive pulmonary disease.
Asked when he could have become infected, the gentleman told the , Yangcheng Evening News , that he had found a partner after his wife died 10 years before, but had “never used contraceptives”.
News of the case fast went viral on social media, registering in the list of popular search matters on Sina Weibo.
The social media backlash betrayed considerable cultural prejudice about the sexual lives of older folks, authorities told RFA Mandarin in new interviews.
And the event highlighted a public health problem that has been brewing in China for many years.
Research have shown that older people are a fast-growing high-risk team for HIV infection.
A 2020 report in the journal Microbiology found that 58.4 % of new HIV infections reported in the southwestern megacity of Chongqing were in the over 50s, while 46 % of newly reported cases in the southwestern region of Guangxi were in men aged 50 and over.
Some studies have predicted that almost 33 % of HIV positive people in China will be over the period of 60 by 2035.
” The percentage of older individuals among among previously reported HIV or AIDS people in China has been steadily increasing since 2015″, past China Red Cross national Ren Ruihong told RFA Mandarin in a new interview. ” It’s just that nothing has paid that little interest”.
Changing transfer designs
Huang Yanzhong, a senior fellow at the Council on Foreign Relations, said habits of HIV transmission in China have changed greatly since the 2000s, when it was largely driven by remote blood-selling methods.
” Before about 2010, the spread of HIV/AIDS in China was mainly due to body offering, which was more likely to attract advertising focus”, Huang said. ” But the multiply of HIV/AIDS in China has undergone quite significant changes, with the increase in the number of old HIV people the most important problem”.
As of June 30, 2024, China has more than 1.32 million people confirmed to be living with HIV/AIDS, exceeding the number of infections in the United States ( which stand at around 1.2 million ) — nearly 1 % of the population, according to a report from China Radio International.
Disease rates among the over 50s stand at about 2.1 %, half the occurrence in the wider community, and higher than in most other places.
While younger at-risk parties may be more aware of the need to take measures or getting tested, the danger of getting HIV as an older man in China is that you may never get out until it’s too soon.
” The issue about older HIV/AIDS individuals is that they often don’t find out until the condition is very sophisticated”, Chinese AIDS professional Pale Yanhai told RFA Mandarin.
” It shows that prevention efforts shouldn’t only target specific high-risk parties, but really target the entire community, including older people”, he said.
According to China’s Statistical Communiqué on the Development of Civil Affairs in 2023, the number of people aged 60 and above in China was 297 million in 2023, or 21.2 % of the entire population.
But there is almost no mention of their sexual life in the mainstream media.
A 2019 survey by the Shenzhen University’s School of Communication found that around 40 % of respondents think older people are “pure”, while others believed they were “healthy”.
The findings suggest that social views don’t assume people of a certain time to have sex life at all.
The latest statistics show a noticeable sex difference when it comes to reported HIV infection.
Between 2012 and 2018, the number of instances in older men rose threefold, while they just doubled in women.
Yet Chinese women over 50 are also increasingly getting infected with HIV, accounting for 38.1 % of cases in the over-50s in 2016, compared with 17.8 % in 2010.
There are also clear local differences, also. According to the Chinese Journal of Epidemiology, from 2015 to 2022, HIV infection in the above 60s were largely concentrated in the south and southern parts of the country.
Shenzhen Center for Disease Control and Prevention data for January-October 2023 shows a total of 198 cases in the over-50s, 75.8 % of whom were men. The amount accounted for 15.1 % of total new HIV cases for that time.
According to Huang, those numbers are probably just the tip of the iceberg.
” These are just the publicly released data, so the true figures are perhaps higher”, he said. ” Many of them don’t get out until they develop other diseases due to decreased resistance, and go to hospital for treatment”.
” But a lot of folks may not have signs at all, and the older people are unlikely to take the initiative to get tested for HIV”, Huang said, citing the event of the 79-year-old man whose case was reported by the , Yangcheng Evening News.
Ties with sexual staff
More than 90 % of cases in this age group are the result of homosexual distribution, most commonly during” business or illicit sex”, according to a new record in the Chinese Journal of Epidemiology.
This is borne out by a survey by sociologist Pan Suiming, whose survey of the nation’s sexuality found that 53 % of Chinese people aged 55-61 have sex at least once a month, and 14 % have sex more than once a week.
Some 47 % reported never having sex at all, while 40 % of men over 50 told the Shenzhen University survey they had used the services of sex workers. Almost half were married.
The statistics point to a growing number of older guys across China engaging in business gender, while a 2012 study by the book Population Research found that some older men who seek out sexual workers become long-term clients, and feeling as if they have a relationship with them.
The sense of cosy familiarity means people are far less likely to use condoms. And surveys have found that more than 40 % of sexually active people in China said they would never use protection at all.
Yet the perception of older people as somehow “pure” means that many who seek out sex workers or find lovers are castigated by their families.
And there is a general lack of education around HIV/AIDS, according to a 2020 survey by the World Health Organization and the Chinese Center for Disease Control and Prevention.
Researchers interviewed 45 people over 60 in three rural areas, nearly half of whom were HIV positive. They found that none of the respondents knew much about HIV.
In December 2022, Practical Preventive Medicine conducted a survey on AIDS-related knowledge, sexual behavior, and acceptance of HIV testing among people aged 50 and over who participated in community health examinations in an unnamed province.
It found that the overall awareness rate of AIDS prevention and control knowledge was only 32.9 % among city-dwellers. Out in rural areas, that number was just 23.3 %.
And there is scant support for HIV/AIDS awareness campaigns.
” Even back in the day when there were a lot of NGOs, there wasn’t much support for HIV/AIDS prevention work or publicity”, Ren said.
” A lot of organizations didn’t want to be associated with it, and non-government organizations have been declining in China since 2012″, she said.
” There aren’t any younger or middle-aged people to publicize this stuff”.
