While China’s Center for Disease Control and Prevention has allowed community organizations across the country to participate in disease testing programs since 2008, in practice those efforts remain patchy. But in November, just before World AIDS Day the following month, a grass-roots movement received endorsement from the incoming prime minister, Li Keqiang.  At a meeting with advocates for AIDS patients, Mr. Li, promised more government support and shook hands with H.I.V.-positive people. The news reversed the practice of routinely turning possible gay people away from hospitals and hounding them from their jobs. “Civil society plays an indispensable role in the national battle against H.I.V./AIDS,” he said to the state news media.
Through October, nearly 69,000 new H.I.V. infections were reported in China in 2012, a 13 percent rise from the same period in 2011. Almost 90 percent of those cases were contracted through sexual intercourse, with rising numbers involving gay men. Medical experts also worry about syphilis, which has returned with a vengeance after being virtually wiped out during the Mao era.        
Reporters say that Mr. Li, the incoming premier, has a spotty record when it comes to H.I.V. In the 1990s, when he was the top official in central Henan Province, a botched blood-collection program there infected hundreds of thousands of people with H.I.V. Critics say Mr. Li was more interested in covering up the problem than dealing with its causes. Even as he was holding court with AIDS groups, over a hundred of those infected in the scandal marched in Beijing to the Ministry of Health demanding justice.
For the vast majority of Chinese, AIDS remains a fearful issue. People who get infected with H.I.V. often become social outcasts, a situation made more perilous by the absence of legal protections for those who lose their jobs or their homes.  For example, after artist Da Wei came out as gay and H.I.V.-positive on Chinese television in 2005, he was promptly fired. Then he was evicted from his apartment by his landlord — a doctor — who showed up at his door with printed images of his face from TV. “He said he had no problem with my health condition, but what would the other tenants think?” the man recalled in a phone interview.
Even medical professionals who work with AIDS patients are not immune from discrimination. “Other doctors are afraid they’ll catch H.I.V. from my lab coat,” said Chen Xiejie, the vice director of infectious diseases at the Guangzhou No. 8 People’s Hospital. “If I go to their offices they say, ‘Don’t sit down.’ They won’t even shake my hand.”        
Other discrimination exists: Homosexual characters are banned from television, gay film festivals cannot advertise, and the police often force lesbian and gay organizations to cancel programs during politically delicate events.
Despite the state-sanctioned prejudices, Chinese health officials say cooperation with grass-roots organizations is beginning to transform the government’s approach to such issues.
“The fight against S.T.D.’s is not just about public health,” said Yang Bin, the director of the provincial sexually transmitted disease control center. “It’s a political issue, too.”
And soon it will be an aging issue as well.