Imagine that you work for some local newspaper. And tomorrow is the World AIDS Day. Editor gives you a task to compose a thematic crossword for the entertainment section. Crossword where all words are somehow related to AIDS. Now, I ask you to take a minute and try to think what words you would use for the puzzle…

Most of my colleagues to whom I gave this challenge said that the first word that came to their mind was “condom”. Funnily enough, only few came up with more than one word at all (so, possibly the newspaper’s issue wouldn’t have a crossword :smile: ).

I am telling you this story in order to illustrate how strongly westerners associate the usage of condoms with the prevention of AIDS and other STDs. And I am almost sure that Chinese respondents would give a different answer. Because according to a 2003 survey, 17% of China’s population had never heard of HIV/AIDS and 77% did not know that condom use could prevent its transmission!

For a long time (and in many places until now) condoms in China have been associated mainly with contraception. As such they could be distributed among population by family planning officials – but to married couples only. Advertisement of condoms for out-of-wedlock usage was viewed as a decadent Western trend unacceptable in Chinese society. Not surprisingly many brands of Chinese condoms feature mainly Western bodies on their boxes.

In the article “Vilifying and Promoting Condoms” Tiantian Zheng – professor of sociology from the State University of New York – recalls the story told to her by a 28 years old Chinese woman:

Although I am married, people always say that I look like I am 21.  One day after work, I had time to stroll along the street and happened to step into a drug store.  Dozens of colorful packages of condoms lying under the counter caught my eyes and aroused my curiosity.  I thought I should get one and try it out.

After studying them for a while, I still had no idea which one I should buy.  So I turned to the shopping assistant, asking: “Could you please recommend one with good quality?”  She looked me up and down, and then sneered at me, saying, “You don’t know?  You should go ask your clients!”  I was dumbfounded.  I was so angry with her words that I stood there and could not say a word.  Tears rolled down my eyes.  I left the store, crying the whole way home and swore that I would never buy condoms again.

Thus, in today’s China we have a paradoxical situation when people are liberal enough to enjoy sex (including premarital sex), but feel too shy to talk about it and buy condoms. And the main reason for unsafe sex is not the lack of condoms but the cultural and psychological barriers related to their usage. Indicative are the results of 2002 survey in Jiangsu province where 69% of college students claimed that they could get condom if they need one, but only 30% said they know how to correctly use a condom.

In the light of this survey the following tragicomic story from Zheng’s article doesn’t seem unreal:

One of the owners of an adult health product shop told me that she used to be the leader of the city’s family planning office during the Maoist era. She told me many stories about condoms during that time.  She said:

People at that time came to me complaining that condoms did not work because their wives continued having babies. So I asked the guys how they had used the condoms. The men put the condoms on their thumbs and said that was how they had used them, just the way it was demonstrated to them when condoms were distributed…

But what do you want from rural Chinese living forty years ago when today’s Chinese sex education teachers are too shy to name the parts of human body. Dr. Marty Klein – renowned psychotherapist and sex therapist – describes his meeting in March 2011 with  sex education teachers-in-training at Chengdu University:

I emphasized, the effective sex education teacher needs way more than information and a curriculum; the teacher needs a healthy attitude about sexuality. That’s mostly what I’m here to discuss, I said.

And that was the biggest issue for them. Knowing what a clitoris is is one thing. Being able to say the word is another. If you can’t do that, you’ll never get your students comfortable with saying it.

These student teachers were unable to say the word. And it wasn’t just in the class – they acknowledged they’d never say it in private, either. So of course I had them say it a few times, until they were laughing.

Shyness is not the only obstacle for the widespread usage of condoms in China. Another issue is related to the underestimation of possible risks bordering with criminal ignorance.

Look at the frightening statistics gathered from female sex workers in China. One survey, for example, showed that in 2000 in the province of Hunan nearly 90% of sex workers ‘never used’ condoms!

And here is the reasoning given by one KTV hostess from Shanghai in 2004:

I know I might contract STI and AIDS doing such things (commercial sexual transactions). But I have been choosy, making sure that my clients are clean. I wash myself clean and ask my clients to do the same before we began. […] Generally speaking, I don’t use condoms. I only use them in the case of dirty clients.

Regarding KTV girls Tiantian Zheng showed how the dynamics in their relationships with customers influence the incidence of condom usage. Sex workers who insisted on using condom lost clients and plenty of women were willing to forgo condoms. When a client relationship repeated itself, it was considered insulting by clients to be asked to use condoms. As repeat visits were an important step toward establishment of “husbands,” there was powerful incentive to refrain from insisting on anything in case of long term client relationships which might lead to significant support.

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As you can see the ignorance about sexually transmitted infections and their prevention is a true national problem in China. And there are many factors contributing to this sad (and dangerous) situation.

I just hope that the trend for growing usage of condoms in China, as witnessed in the last years (see the chart below) will continue and people will regard it as a sign of maturity and not promiscuity.

Just a blogger, Crystal Tao