Participatory communication and HIV/AIDS prevention in a Chinese marginalized (MSM) population.

HIV/AIDS in China has entered a critical stage of rapid and widespread increase. It has been estimated that more than one million people in China have been infected with HIV and the rate of increase tops the world. The number could swell to 10 million by 2010 if more intense and effective preventive measures are not adopted immediately. Sex between men has been a mostly 'hidden' source of the spread of HIV in China. Homosexuality is no longer a criminal act in China, however, traditional 'official-led' so-called peer education programmes among men who have sex with men (MSM) have little effect in adopting and diffusing a key message to their networks. This is because the climate in HIV prevention through community-based advocacy among MSM has not been substantially changed which is due to these men still facing strong opposition and resistance from society, as a quite marginalized population in China. This study carried out in Chengdu is the first to explore how to use a socially and culturally appropriate participatory communication to promote safer sex behaviour with gay men and MSM in Chengdu, China. The study examined effectiveness of peer-led health message diffusion in promoting condom use through a participatory communication approach among these men in the programme. Key findings showed that the peer-based participatory communication strategy was effective for encouraging condom use with casual sexual partners in the intervention group. There was no significant change in the comparison group. It indicates that participatory involvement is the major driving force for HIV-related safer sex behaviour change and can be recommended to promote safer sex practice among gay men and MSM in their broad contexts.