Thailand, which has for years been a hot destination for Chinese tourists, has now also become a draw for those seeking to buy cheap drugs to prevent HIV.
Pre-exposure prophylaxis, commonly known as PrEP, is a type of medicine that, if taken daily, can reduce the risk of HIV infection via sexual intercourse by more than 90 per cent, according to health studies. Several countries recommend the drug as a weapon to prevent the spread of HIV among people in high-risk groups, such as gay men.
While China's Food and Drug Administration approved PrEP in 2015 for the treatment of HIV/Aids, it has not been approved for prevention. That means doctors are not allowed to prescribe it to patients unless they test positive for the virus.
Mr Xiao Dong, who runs the Beijing-based non-government organisation Tongzhi which is committed to combating Aids, said he began travelling to Thailand early last year for vacations and to stock up on the anti-HIV medicine. As an openly gay man, he said, health and safety are his top priorities: "I use both condoms and PrEP to guard against HIV," he said.
Advocates say prevention is worthwhile, given that the prevalence of HIV among Chinese gay men averages more than 5 per cent in most cities and can exceed 10 per cent in major metropolises, according to the National Centre for Aids and Sexually Transmitted Disease Control. Given increasing awareness, more gay men in China have followed suit.
Mr Xiao said he knows nearly 100 men from Beijing who have also travelled to Thailand to purchase PrEP. "It's a positive sign that our community has become more responsible for our own health, and each other's. They are willing to pay out of pocket," he said.
Thailand is easy to visit, as Chinese citizens do not require a visa, and the country is recognised for its friendliness towards the lesbian, gay, bisexual and transgender community. It also offers easy, affordable access to PrEP, said Mr Xiao, adding that generic products can cost 300 yuan (S$61) for a one-month supply, while brand-name products are about 800 yuan for the same amount.
By contrast, the brand-name drugs sell for nearly 2,000 yuan in China, said Dr Wu Hao, director of the infectious diseases department at Beijing's You'an Hospital. You'an treats most of the Aids patients in Beijing.
Last year, he said, more than 90 per cent of the newly detected HIV sufferers in the Chinese capital were gay men. According to Dr Wu, who specialises in sexually transmitted diseases, the efficacy of PrEP has been widely recognised internationally.
PrEP has also been included in the HIV/Aids prevention and treatment guidelines of the World Health Organisation and health authorities in the United States.
China, however, has not introduced PrEP in its national guidelines, Dr Wu said, adding that the government was unlikely to give the drugs free to willing subjects, due largely to the high costs involved.
Dr Wu said his department will launch a year-long PrEP research study later this year, with the centre recruiting 600 to 1,000 gay men and giving them free PrEP medicine. "I welcome PrEP as prevention for those who are at high risk of infection, given that condom use is low, particularly among gay men in China," he added.