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China Health & Science

Let’s Talk about Sex, Grandpa: HIV on the Rise among China’s Elderly Men

There’s a sharp rise in HIV among Chinese elderly men, partly caused by a general lack of HIV & safe sex awareness.

Manya Koetse

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HIV among China’s elderly is a growing problem; it is mostly older men who get infected with HIV through extramarital sex. Their knowledge regarding safe sex is often lacking.

As it is World AIDS Day on December 1st, and while major discussions on the alleged first gene-edited babies immune to HIV are still top trending, other noteworthy HIV-related news is also gaining a lot of attention on Chinese social media these days.

At time of writing, more than 220 million people have viewed the Weibo hashtag “Number of Elderly AIDS Cases on the Rise” (#老年艾滋病病例上升#). The hashtag has emerged amidst news reports that there is a significant rise in the number of HIV cases among the elderly in China, particularly among men.

According to an article published on Weibo by Chinese news outlet The Paper, the number of known cases of HIV among Chinese men above the age of 60 has risen from 8391 cases in 2012 to 19815 cases in 2017.

One WeChat blogger’s response to the rise in number of HIV cases among Chinese elderly men (脊梁in上海).

On November 27, the Hangzhou Center for Disease Control and Prevention (杭州市疾控中心) released news information relating to the problems of the rising cases of HIV and AIDS among the elderly.

In the city of Hangzhou, the detection of HIV among patients who are over 50 years old has doubled over the past three years.

According to a specialist from the Hangzhou center, this rise of HIV has to do with the limited HIV awareness among elderly communities, and with the fact that they are often not accustomed to using condoms.

Extramarital heterosexual sex is the main way of transmission for elderly men, with some also getting HIV because of homosexual sex. For elderly women, marital sex is the main way of transmission.

Because they are often late in seeking medical treatment when they feel unwell, the detection of HIV is often late, which makes that there is a relatively high number of AIDS-related deaths among elderly patients.

The problem of the rising number of HIV patients among China’s elderly population has received more scholarly attention of the past few years. According to a 2014 study by Tang et al, the sharp rise of HIV among elderly became more visible after 2010. In 2011, people over the age of 60 accounted for 28.4% of the total HIV cases Guangxi province (this was 18.7% in 2009).

A study in Nanning, capital of Guangxi, found that heterosexual transmission accounted for 90% of HIV cases among those over 50 years old, and that low-cost commercial sex venues were a primary site of infection (Tang et al 2014, 2).

The research by Tang et al shows that the use of aphrodisiacs (cheaper alternatives to Viagra, often illegally produced in local workshops) is significantly associated with an increased HIV risk for men over 50 who purchase commercial sex with female prostitutes (3).

One popular WeChat blog explained the reasons behind the problem of HIV among China’s elderly as follows:

1. They see prostitutes because they are seeking ways to fulfill their sexual needs.
2. There is little awareness on HIV or AIDS. (According to one story quoted in the blog, an elderly man who was diagnosed with HIV even told the doctor he had washed himself with detergent every time after he had sex with a prostitute – he “did not understand” how he got infected.)
3. They do not know how to use condoms / they are not accustomed to using condoms.

A man washed himself with detergent after visiting a prostitute.

On Weibo, there are many commenters who show their sympathy for the elderly women who get infected with HIV within their marriage because of their husband’s extramarital sexual behaviors. “How tragic for them,” a popular comment said, while others wonder: “What’s the purpose of marriage then?”

The Center for Disease Control and Prevention advises people who have had extramarital sex, homosexual or heterosexual, to get themselves checked on HIV – also if there are people who suspect that their partner might have had sexual encounters outside of the marriage.

“The sex life of the elderly is a sensitive topic, but it needs to be talked about,” well-known lawyer Yi Shenghua (易胜华) writes on Weibo: “If we do not attach importance to the [open] discussion of this topic, the problem of AIDS among China’s eldery will only grow bigger.”

By Manya Koetse and Miranda Barnes

Tang Z, Wu X, Li G, Shen Z, Zhang H, et al. 2014. “Aphrodisiac Use Associated with HIV Infection in Elderly Male Clients of Low-Cost Commercial Sex Venues in Guangxi, China: A Matched Case-Control Study.” PLOS ONE 9(10): e109452. https://doi.org/10.1371/journal.pone.0109452.

Photo used in featured image by David Sinclair.

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©2018 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com

Manya Koetse is the editor-in-chief of www.whatsonweibo.com. She is a writer and consultant (Sinologist, MPhil) on social trends in China, with a focus on social media and digital developments, popular culture, and gender issues. Contact at manya@whatsonweibo.com, or follow on Twitter.

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    Jazz Player

    January 7, 2019 at 7:04 am

    How do Families deal with the secrets? I’m from the US and my wife Chinese. Her father has the virus. Her mother doesn’t want anyone to know. I’m not sure what happens to Family Value, held in such high regards, here in China…Comments and Suggestions Appreciated…

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China Health & Science

‘Cecolin’ Is Here: First Made-in-China HPV Vaccine Priced at US$47

China is the third country in the world to produce its own HPV vaccine, and it is cheaper than its foreign counterparts.

Manya Koetse

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While Chinese media praise Cecolin for being China’s first domestically produced HPV vaccine, Chinese social media users are more concerned with its price, quality, and availability.

In the first week of 2020, the first China-made HPV vaccine was approved by Chinese drug regulators. The domestically produced HPV vaccine became a major topic of discussion on Chinese social media. On Weibo alone, the topic received more than 580 million views since early January.

The human papillomavirus (HPV) vaccine prevents infection with the specific viral infection that causes cervical cancer. The earliest HPV vaccine, ‘Gardasil’ by American multinational pharmaceutical company Merck & Co., first became available in 2006. Along with Pfizer’s ‘Prevnar 13’ – the vaccine deployed for the prevention of pneumococcal pneumonia – Gardasil is among the world’s best-selling vaccines.

With the introduction of the first Chinese HPV vaccine, the virtual monopoly position of Merck’s vaccine might now change as the Chinese vaccination is entering the market.

The Chinese vaccine is named ‘Cecolin’ (馨可宁), and was co-developed by drug maker Innovax (万泰沧海生物技术) and Xiamen University. It is intended for girls and women aged 9-14 (two shots needed) and 15-45 (three shots needed). According to CGTN, some 8 million shots will be produced in China in 2020.

Gardasil and Cecolin are not entirely the same, however. Gardasil is a so-called quadrivalent vaccine, which targets four different antigens (HPV types 6, 11, 16 and 18), while Cecolin is a bivalent vaccine only protecting against HPV 16 and 18 types, the two most common viruses leading to cervical cancer. Another type of HPV vaccine is the nonavalent kind, the Gardasil 9 vaccine, preventing diseases caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Nearly all sexually active people will be exposed to HPV at some point in their life, and if girls and women are given the vaccine before any natural infection with HPV, the vaccines have been shown to protect against pre-cancer of the cervix. Males can also get the quadrivalent and nonavalent HPV vaccines to protect against genital warts, anal precancers, or the spread of HPV to sexual partners.

While Chinese media emphasize the fact that China is now the third country in the world, after US and UK, to succeed in producing its own HPV vaccine, one of the topics receiving the most attention on Chinese social media is the price of the Cecolin vaccine.

Cecolin is currently priced at 329 yuan (US$47) per shot, which is considerably cheaper than the approximate $250 per dose of the Gardasil vaccine in the United States.

The nonavalent vaccine costs about 1300 yuan or more per shot in China ($186+), with the quadrivalent Gardasil being priced at approximately 800 yuan per shot ($115), and the imported bivalent vaccine costing 600 yuan per dose ($86).

Weibo user shares receipt of 9-valent vaccine, 1338 yuan per dose.

Many Weibo commenters praise the arrival of the Chinese vaccine and its relatively low price. A complete vaccination programme would now only be either 660 or 1000 yuan ($94/$143, depending on needing two or three shots) instead of $260 or more.

“Whoa that’s cheap!” some commenters write, with others saying: “This makes it possible for the poorer girls to get their shots.”

But there is also a lot of discussion on the quality of the vaccine, and whether the bivalent vaccine is effective enough (for clarity -the two HPV types the vaccine protects against causes 84.5% of all cervical cancers in China). Some Weibo users say they would still like to get the more expensive nonavalent vaccine instead – even if they will need to spend around 4000 yuan ($570) on their completed shots.

Other commenters are most concerned with the general availability of HPV vaccines in China, as there is still a shortage of vaccinations.

The imported HPV vaccine was issued 1,46 million times in 2017, going up to 7 million shots in 2018 and 8,7 million in 2019. On Weibo, some commenters say they have previously gone to Hong Kong to get their shot.

One user from Nanjing writes: “I made an appointment for my site and needed to wait for four months, I finally got it. I don’t want to wait around for the domestic shot to become available here.”

A Weibo user from Liaoning is appreciative that those who want to have the vaccine now have more options: “If you can financially afford it, you can choose the nonavalent vaccines, if you can’t afford it, you can get the quadrivalent or bivalent ones.”

Starting from May of 2020, Cecolin will be available at community hospitals across various regions in China.

By Manya Koetse
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©2020 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

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China Health & Science

40-Year-Old Woman Completes Shanghai Marathon While 8 Months Pregnant

Pregnant marathon runner Lili clashes with Chinese traditional attitudes towards women who are expecting a baby.

Jessica Colwell

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A 40-year-old woman named Li Lili (黎莉莉) became news in China after she ran the Shanghai Marathon last Sunday while 32 weeks pregnant, completing the race in five hours and 17 minutes.

This was the third marathon Li has run during her pregnancy. She ran the first two during week eight (with a time of 3:54:43) and week 22 (with a time of 4:47:58) of her pregnancy.

Lily is an avid runner, having completed 62 marathons during her lifetime. Her story went viral on Weibo under the hashtag “8 Months Pregnant 40-Year-Old Woman Runs Marathon” (#40岁孕妇怀胎8月跑完全马#), which has received over 200 million reads at time of writing.

[Li has run three marathons during her pregnancy, one in each trimester.]

Her story has ignited debate across Weibo this week regarding the merits and dangers of vigorous exercise during pregnancy. In interviews with the press, however, Li remained defiant in the face of her critics.

“For many people, they are worried about this because they don’t understand it,” she told video news site Pear Video in an interview.

“Many people have told me it is dangerous. They criticize me, just like they criticized Chen Yihan,” she says, referring to Taiwanese actress Ivy Chen (陈意涵) who faced fierce online criticism after posting pictures of herself running while five months pregnant in 2018.

Actress Ivy Chen’s controversial Weibo post from 2018, showing her running 5 kilometers while five months pregnant.

“But most of these critics have never even been pregnant,” Li continued: “The fact is, I did this because I have a very deep understanding of my own body. I’ve run over 60 marathons, I am an extremely good runner. I’ve run a marathon in 3:28, which is considered an excellent time even for talented athletes, even for men. I have my own training methods, I’ve been training for a very long time, and have carefully prepared for these marathons.”

The reactions to Li’s story online have ranged from enthusiastic praise to outright condemnation.

“Wow! I admire how strong she is! It is said that each person knows what is right for them in their own heart. It’s none of your business what she does with this unborn hero!” gushes the most popular comment on Pear Video’s Weibo post about the story.

But another popular comment argues that marathon running is actually inappropriate for Chinese women in general: “Foreigners running marathons is fine, but this is not for Chinese women. Pregnant Chinese women running marathons is equivalent to them not caring for their children.”

The results from a poll put out by Chengdu Economic Daily so far show the majority of readers do not oppose Li’s decision to run a marathon, with 54,000 choosing the option “One case cannot represent the whole, it will vary from individual to individual” and 38,000 choosing “Support, if the mother’s body is strong enough.” Only 17,000 chose the option “Oppose, pregnant women should not engage in vigorous exercise.”

“What do you think of a 40-year-old woman running a marathon while 8 months pregnant?” asks a Weibo poll by Chengdu Economic Daily.

Some comments on the poll argued that Li was irresponsible to take part in a marathon, in case something did go wrong: “Problems come up when you least expect them. If it’s just you running on your own, that’s one thing. But this is a group race. I can’t say if it’s right or wrong, but it could bring a lot of trouble to other people.”

But the majority of popular comments expressed outright support and admiration, or at the very least opposition to Li’s critics, telling them to mind their own business.

The support for Li’s decision appears to fly in the face of Chinese traditional attitudes towards pregnant women. The list of dos and don’ts for Chinese mothers-to-be is long and complex, ranging from the bizarre (no eating/drinking dark foods so as not to affect the baby’s skin color) to the more common (avoiding shellfish).

The belief that pregnant mothers should avoid exertion is high on the list, extending even to the month after birth.

But despite these strong traditions, Li’s strength and determination have clearly inspired new support for expectant mothers who wish to continue an active lifestyle while pregnant.

Also read: ‘Sitting the Month’ – a Gift or Torture?

Also read: Bad Mom To Be? Pregnant Woman Intentionally Trips 4-Year-Old Boy in Baoji

By Jessica Colwell
Follow @whatsonweibo

Spotted a mistake or want to add something? Please let us know in comments below or email us. First-time commenters, please be patient – we will have to manually approve your comment before it appears.

©2019 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

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