She is like any 20-year-old: bubbly, carefree, snuggled up on the sofa in pyjamas and engrossed in a TV soap opera.

But Chen Hong (name changed) is a different person when she stretches a condom with an HIV-prevention poster in the background. She is no longer the innocent youngster, casual in her attitude. Her eyes still shine but with a dull, rather forced, enthusiasm. She is committed to her responsibility of demonstrating how to use a condom.

"I make every customer use a condom each time he has sex," she says in a matter of fact way. Chen is a masseuse in a "hair-dressing salon" in Wuhan, capital of Central China's Hubei Province. But behind the veil she is xiaojie, a euphemism for prostitute.

Chen received special training in the skills of persuading her clients to use condoms from 30 year-old Xu Hui (name changed) - her procurer, or "mummy" - when she first came to the salon several months ago. Xu not only taught her the right way to use condoms, but also asked her to use them even when she performed oral sex on customers.

Chen knows the importance of a condom, and refuses to have unprotected sex even if a customer offers higher "fees". "What's the use of extra money if you contract AIDS?" she says.

Hubei Health Department records show there were about 1,100 "recreational centers" in Wuhan last year, with more than 4,100 women like Chen "working" for them. But a majority of them, about 3,000, know the hazards they face for being in such a "trade" and undergo regular medical check-ups for HIV and other sexually transmitted diseases (STDs). Chen is one of those who take the tests conducted by the city's health authorities.

Two years ago, Xu used to be afraid whenever health department officials visited her. "After all, prostitution is illegal in the country," she admits. Her fear was justified because if her true occupation was revealed, she could have landed behind bars. But the officials "assured me they wanted to help us avoid HIV", she recalls.

And as Yao Zhongzhao, director of 100% Condom Use Programme (CUP) in Wuhan says, "Cooperation with the public security bureaus is important in the campaign to promote the use of condoms in recreational sites."

Wuhan's Huangpi district authorities conducted a study on Yao's campaign in 2000, after which it was expanded to the entire province. At the start of the campaign, the women used to view Yao's staff with suspicion and reluctance, with many of them unwilling to cooperate. "You are burrowing into our group to get us all arrested," Yao remembers a procurer as saying.

Even officials of some other departments disapproved of CUP's activities, and pressured Yao into giving up his good work. A leading police officer of Wuhan's Public Security Bureau once warned him that the program was "inappropriate" because it could boost prostitution and even legalize it.

But Yao could foresee the threat of AIDS if the women didn't make their customers use condoms. With the active help of the health department, his efforts have borne fruit, for the use of condoms among prostitutes in Wuhan has jumped from 61 percent to almost 95 percent since CUP started its campaign three years ago. And more importantly, the STD infection rate has dropped from 30 per cent to below 15 per cent.

Moreover, contrary to the initial fears of police, there are no obvious signs of an increase in prostitution.

Such has been the positive impact of CUP that even Vice-Prime Minister Wu Yi praised it after a trip to Hubei in 2004. Yao's campaign has set an example for other provinces to follow, she said, and is doing wonders in HIV-prevention.

The campaign's success has prompted the public security departments to cooperate with health bureaus across the province to promote safe sex. "That doesn't mean police are lenient in their crackdown on prostitution," says a Hubei public security bureau deputy director, surnamed Li. Though he says "sexual transmission of HIV will come down when the number of prostitutes drops", police have become "more flexible". For example, they no longer take the use of condom as proof of a criminal offence.

Earlier, a condom found in a girl's pocket could have been evidence of soliciting, but now an arrest is only made if someone is "caught in the act", says Yao. More than 5,300 of the 5,600 known "recreational sites" in Hubei are part of the CUP campaign today.

After undergoing training, Xu Hui has become one of the city's 760-odd "peer educators" whose task is to teach prostitutes the methods of contraception and how to prevent HIV infection. By October 2006, Hubei had about 3,500 reported cases of HIV/AIDS, half of who had got the disease through infected needles in the 1990s when they sold their blood to illegal blood banks.

Realizing the dangers of such an illegal practice, the government cracked down on the illegal sale of blood. Once that stopped, unprotected sex became the major channel of STDs and HIV in Hubei. In 2004, the STD and HIV infection rate in unprotected sex was reported to be only 13 per cent. But in the first 10 months of last year, the province reported almost 500 new HIV cases, almost a third of who had contracted the virus after unprotected sex. The increase was much higher than that recorded two years ago.

China reportedly has 650,000 HIV cases, and despite the Hubei success story, the use of condoms among prostitutes across the country is still very low. Random samplings have shown that only about 39 percent prostitutes in the country use condoms, against Hubei's rate of 95 percent.

Yao attributes CUP's success to the "concerted efforts" of many government departments, including the public security authorities. Taking a leaf out of Yao's book, even the family planning departments have began distributing free condoms among prostitutes and tourism bureaus. Also, they have urged hotels to place condoms and leaflets on HIV prevention in their rooms.

China Features

(China Daily 04/06/2007 page12)