Stigmatizing attitudes and behaviors toward PLHA in rural China

Abstract

Stigma is a significant barrier to effective control of HIV/AIDS, despite laws to control it. The purpose of this study was to examine factors associated with HIV stigma in a rural Chinese community. A survey was conducted in north-west Anhui province among 963 residents to assess HIV-related knowledge, attitudes, and behaviors. Participants scored a mean of 16.6/26 (63.8%) for knowledge. Sixty-eight percent of respondents held at least one fear of casual transmission, 42% would blame people living with HIV/AIDS (PLHA) for their disease, and 73% thought having HIV is shameful. More than half reported that they had observed at least one stigmatizing behavior toward PLHA in their villages. Multivariable analysis indicated that people with higher education, higher HIV knowledge, higher household wealth and who learned about HIV from professional sources were less likely to hold a stigmatizing attitude, while people who had observed discriminating behaviors toward PLHA in their community and lived in villages with fewer PLHA were more likely to hold a stigmatizing attitude. Despite education campaigns, knowledge remains low and stigmatizing attitudes and behaviors toward PLHA remain a problem.

Keywords:

• HIV
• China
• stigma and discrimination
• knowledge
• attitudes
• practices

Acknowledgements

This project was funded by an NIH CIPRA Grant No. 1U19AI51915, and partially supported by NIH/FIC Grant U2R TW006918-01. Thanks are due to all residents of Fuyang who took part in this study, to the local health workers for their referrals and to local CDC staff who performed the interviews. Thanks are also due to Ms Bibi Essama, and Drs Monica Ruiz, Sonia Stoszek, Mary Jane Rotheram-Borus, Roger Detels, Li Li, and Ray Chen for their input during the planning of this study. A copy of the questionnaire is available upon request from the corresponding author.

China Integrated Programs for Research on AIDS (CIPRA) Project 2 Team : China CDC: Dr Zunyou Wu (Principal Investigator), Jie Xu, Keming Rou, Sheena Sullivan, Yun Gao, Su Su, Jialiang Huang, Xiaobin Cao, Zhi Dou, Zhihua Yan, Ning Dong, Jing Guo, Ruolin Zhang, Yuji Feng and Jianguo Shan.

Anhui provincial CDC: Jianjun Wang and Bin Su.

Fuyang prefecture CDC: Chen Xu (Site Manager), Xinping Ding and Ping Fan.

Anhui Medical University: Hongbo Zhang.