Institutional and structural forms of HIV-related discrimination in health care: A study set in Beijing

Abstract

This paper presents key findings of a situational analysis of institutional and structural levels of HIV/AIDS-related discrimination in Beijing, China, with a focus on the area of health care. Initially slow to respond to the presence of HIV, China has altered its approach and enacted strict legislative protection for people living with HIV/AIDS (PLWHA). In order to determine whether this has altered discrimination against PLWHA, this study examined existing legislation and policy, and interviewed key informants working in health care and PLWHA. The overall findings revealed that discrimination in its many forms continued to occur in practice despite China's generally strong legislative protection, and it is the actual practice that is hindering PLWHAs’ access to health services. A number of legislative and policy gaps that allow discrimination to occur in practice were also identified and discussed. The paper concludes with a call to rectify specific gaps between legislation, policy and practice. An understanding of the underlying factors that drive discrimination will also be necessary for effective strategic interventions to be developed and implemented.

Acknowledgments

This research was part of a grant made by Ford Foundation to Deakin University for ‘A situational analysis of HIV/AIDS-related stigma and discrimination in the Asia Pacific’. For their help and assistance, we would like to thank all our interviewees, as well as Dr Lisa Messersmith and Ms Eve Lee (Ford Foundation), Professor Pan Sui-Ming (Renmin University of China), Mr Li Xiang (Mangrove Support Group), Ms Xia Dong-yang, Mr Yang Shi and Mr Ma Shao-jun (Peking Union Medical College); Ms Wang Ke-rong (Beijing Ditan Hospital); Ms Wang Jie and Mr Wu Yi-long (Renmin University of China), Mr Li Qun-hui (Beijing Institute of Health Inspection), and Ms Fu Yan (Beijing Youan Hospital). We would also like to thank the anonymous reviewers for some very helpful suggestions. Dr Joe Thomas was a principal investigator of the project from May 2001 to March 2003.

Notes

1. As much as possible, the translation of policy and legislation aimed to convey the sense and intent of the original, and may not represent a strict legal translation.