Ethnicity and risk factors in needle sharing among intravenous drug users in Sichuan Province, China

Abstract

Combining survey and ethnographic data, this research examined differences in the risk factors associated with needle sharing amongst intravenous drug users (IDUs) in the Sichuan Province of China. A comparison was made between the province's majority Han population and its Yi minority. We developed a theoretical framework consisting of risk factors at the individual level (including risk factors such as lack of AIDS knowledge, low self-efficacy, and economic pressure), interpersonal level (having an IDU primary partner and lack of family support), and community level (social discrimination). The findings suggested that the Yi minority group was more socially disadvantaged and had a higher risk of contracting HIV than the Han group. Furthermore, the factors that put them at risk were different to those which affected the Han group. OLS regression results showed that, for Han IDUs, needle sharing was positively associated with having an IDU primary partner and with economic pressure. On the other hand, for the minority group, needle sharing was significantly associated with being male, AIDS knowledge, the lack of family support, and social discrimination. These findings highlight the need for HIV prevention work to target marginalized populations in China, such as ethnic minorities, and to tailor appropriate prevention strategies to meet the specific needs of different groups.

Acknowledgments

We are thankful to the Department of Sociology and the Social Science Faculty of the Chinese University of Hong Kong for providing us with funding for this research. China-UK AIDS Prevention and Care Project in Sichuan Province helped to make initial arrangements for the first author to visit the field site. Thanks also go to the research teams at Sichuan Province, Professor Wan Shao Ping, and Dr Roman David. Their help and support in the research process, and their comments on the draft of this paper, have been greatly appreciated. Finally, we thank the participants in this project for their patience and the generosity in giving up their time for us.

An early version of this paper was presented at the International Conference on Infectious Diseases and Human Flows in Asia, Centre of Asian Studies & School of Public Health, The University of Hong Kong, 9–10 June 2005.