Ethnicity, socioeconomic characteristics and knowledge, beliefs and attitudes about HIV among Yunnanese Chinese, Hmong, Lahu and Northern Thai in a north-western Thailand border district

Figures & data

Table 1 Study populations in access to care census and survey.

			Interviewed respondents
Predominant community ethnicity	Surveyed communities	Total households in surveyed communities	Men	Women	Total	Percent of respondents who are members of predominant ethnicity
Hmong^a	1	215	73	98	171	99.4
Lahu^b	5	806	211	265	476	95.6
Yunnanese^c	6	1164	187	247	434	87.6
Northern Thai^d	3	503	36	52	88	87.5
Total	16	2687	507	662	1169	–

Respondents in all communities consisted of women who were identified in the community census as having given birth to at least 1 child born in five years prior to survey who consented to interview, and their husbands or partners, who consented to interview.

a Every Hmong community woman, and her husband or partner who met these criteria.

b A 50% random sample of women and their husbands or partners who met these criteria with replacement for women who were unavailable for interview in one large (599 household) Lahu community, and 100% samples in four smaller highland Lahu communities.

c A 50% random sample of women and their husbands or partners who met these criteria, with replacement for women who were unavailable for interview in Yunnanese communities.

d Every woman in Northern Thai study communities, and their husbands or partners who met these criteria.

Table 2 Respondents' reasons for delay or non-use of health services, by community ethnicity and sex.

	Respondents who reported delaying or not using clinic or hospital for specified reasons* (%)
	Northern Thai		Yunnanese		Hmong		Lahu
Constraints to use of modern health facilities	Men	Women	Men	Women	Men	Women	Men	Women
Wait time at facility too long	52.8	63.8	13.5	22.6	11.3	35.8	65.1	86.0
Lacked money for transportation	33.3	30.8	36.4	47.8	13.7	19.4	70.6	60.0
Lacked transportation	19.5	26.2	34.8	27.2	9.6	9.3	37.0	57.0
Lacked money for services or medicine	13.9	19.2	34.2	46.6	8.2	7.3	26.1	13.4
Tried medicine from market or drugstore first	27.8	30.7	16.6	8.5	23.7	36.1	44.1	34.3
Lacked someone to accompany to health facility	5.6	9.6	23.5	40.0	3.5	5.1	19.9	44.1
Lacked Thai language ability	0.0	1.9	29.0	42.5	1.4	1.0	15.1	36.3
Ineligible for government health services	0.0	3.8	26.7	41.3	1.4	1.0	11.4	12.8
Didn't know how to talk with doctor	0.0	5.7	9.6	23.5	4.1	5.1	17.5	36.6
Tried traditional method first	16.7	17.3	8.6	3.6	17.8	22.1	26.1	22.3
Seriously ill, but thought illness was not serious	22.2	21.1	7.0	2.8	1.4	5.2	9.5	23.0
Couldn't leave house or children to seek healthcare	22.2	17.3	5.4	7.3	1.4	8.2	14.7	23.0
Don't know enough about illness	22.2	19.2	3.8	2.4	4.2	3.1	7.1	21.1
Feared or experienced harassment from government officials	2.8	0.0	12.8	21.1	1.4	0.0	10.9	16.6
Feared prejudice or discrimination from healthcare providers because of ethnicity	8.3	1.9	5.4	2.8	2.8	2.1	5.2	19.6
Didn't know where to go	16.7	9.6	5.3	10.1	2.7	7.1	9.0	17.8
Feared or experienced scolding or cursing by healthcare providers	8.4	14.4	6.4	6.9	4.2	3.2	12.3	16.8
Couldn't leave job to seek healthcare	13.9	1.9	4.3	4.0	1.4	0.0	9.9	9.1
Didn't think illness could be successfully treated	13.9	7.7	4.2	3.2	3.1	1.0	4.7	11.0
Feared stigmatisation in your own society because of illness	0.0	1.9	2.7	4.8	1.4	0.0	0.5	9.4
Lacked permission from household member	0.0	1.9	2.1	3.2	1.4	5.1	7.6	9.1

*Arranged by rank of highest reported percentage of constraint for any ethnicity, for either men or women: 86.0 Highest for this group and sex; 65.1 second highest for this group and sex; 44.1 third highest for this group and sex.

Table 3 Contact with people living with HIV/infected person.^a

	Men		Women
	Yunnanese	Northern Thai	Yunnanese	Northern Thai
Would you eat food prepared by infected person?
Yes	6.0	62.5	6.9	55.3
No	94.0	37.5	93.1	44.7
Total n	167	32	232	38
Would you eat with an infected person?
Yes	6.0	75.8	7.8	78.7
No	94.0	24.2	92.2	21.3
Total n	166	33	232	47
Would you sit on a chair where an infected person had sat?
Yes	10.0	91.2	6.0	89.4
No	90.0	8.8	94.0	10.6
Total n	170	34	233	47
Would you touch an infected person?
Yes	3.4	65.5	4.3	76.7
No	96.6	35.5	95.7	23.3
Total n	179	29	233	43
Would you take care of an infected person?
Yes	3.6	58.3	7.5	76.7
No	96.4	41.7	92.5	23.3
Total n	169	24	227	43

a Totals and percentages in this table do not include ‘Don't know’ and ‘It depends’ or ‘No answer’.

Table 4 Would you use translator services if they were available?

			Lahu	Yunnanese	Hmong	North Thai
Men: Would or probably would use			95.7	95.1	89.0	63.3
Would not use			4.3	2.4	4.1	33.3
Don't know			0.0	2.4	6.8	3.3
Total n			211	205	73	33
Women: Would or probably would use			99.2	92.7	96.9	48.0
Would not use			0.4	1.6	2.1	42.0
Don't know			0.4	5.7	1.0	10.0
Total n			263	245	96	50
Fisher exact p: Yes+probably versus No	Lahu versus Yunnanese	Lahu versus Hmong	Lahu versus North Thai	Yunnanese versus Hmong	Yunnanese versus North. Thai	Hmong versus North Thai
Men	0.2387	0.5936	< 0.0000	0.3297	< 0.0000	< 0.0000
Women	0.1494	0.1739	< 0.0000	0.5626	< 0.0000	< 0.0000

Table 5 Statistical significance of differences between Thai-speaking and non-Thai-speaking respondents in the Yunnanese communities.

	Statistical significance^a
Variable (response of Thai-speaking respondents)	Men	Women
Population characteristics
Thai citizen (yes)	< 0.000	< 0.000
Some education in Thai system (yes)	< 0.000	< 0.000
Have health insurance (yes)	< 0.000	< 0.000
Annual income (above median)	NS	NS
Knowledge/beliefs about HIV transmission
Believe mosquito bites can transmit HIV (no)	< 0.05	< 0.000
Believe sitting on a chair where an infected person had sat can transmit (no)	< 0.00	< 0.000
Knowledge/beliefs about HIV treatment
Ever heard of ARVs (yes)	< 0.00	< 0.000
Believe modern medicines can treat HIV effectively (yes)	NS+	< 0.05
Knowledge of prevention of mother-to-child-transmission
Treating HIV-infected women can help prevent transmission to child (yes)	< 0.05	NS+
Not breastfeeding by HIV-infected woman can help prevent transmission (yes)	< 0.05	NS+
Use of HIV-related services
Ever counselled for HIV (yes)	< 0.05	< 0.000
Ever tested for HIV (yes)	NS+	< 0.000
Intent to avoid contact with HIV-infected person
Would eat food prepared by HIV-infected person (yes)	< 0.05	< 0.00
Would eat a meal with an HIV-infected person (yes)	< 0.05	< 0.00
Would sit on a chair where an infected person had sat (yes)	< 0.00	< 0.00
Would touch an HIV-infected person (yes)	NS+	< 0.00
Would take care of an HIV-infected person (yes)	< 0.05	< 0.00
Constraints to use of needed health services
Lack of Thai language (lower proportion)	< 0.000	< 0.000
No one to accompany to health facility (lower proportion)	< 0.000	< 0.000
Don't know where to go for services (lower proportion)	< 0.000	< 0.000
Don't know how to talk with doctor (lower proportion)	< 0.00	< 0.000

a Probabilities of differences between Thai-speaking and non-Thai speaking respondents in the Yunnanese community in the direction predicted by the hypotheses that Thai-speakers will more closely resemble Northern Thai community respondents. Probabilities calculated by Fisher exact test: NS+not significant at p ≤ 0.05, but in predicted direction, NS not significant at p ≤ 0.05 with no difference, or difference not in predicted direction.

Table 6 Can sitting on a chair where an HIV-infected person had sat transmit HIV?

	Yunnanese community respondents		Thai community respondents
	Cannot speak Thai	Can speak Thai	All speak Thai
Men
Yes	40.9	29.0	0.8
No	38.6	60.2	94.4
Don't know	20.5	10.8	6.6
Total n	88	93	36
Women
Yes	33.8	30.1	0.0
No	16.1	43.4	92.3
Don't know	28.8	26.5	7.7
Total n	118	83	52
Fisher exact p ‘Yes’ versus ‘No’	Men 0.0029	Women: < 0.0000	–