Challenges for accessing and maintaining good quality of HIV care among men who have sex with men living with HIV in China: a qualitative study with key stakeholders

ABSTRACT

HIV care in China is shifting toward a community-based model involving a wide range of stakeholders. We aimed to understand key stakeholders’ perceived challenges of providing high-quality care for men who have sex with men (MSM) living with HIV. In-depth interviews were conducted with a diverse sample of stakeholders (N = 17) in two Chinese cities, including providers, policymakers, and community workers. Interviews focused on stakeholders’ challenges in HIV-related work and perceived barriers for MSM in accessing and maintaining HIV care. Thematic analysis strategies were used. Three cross-cutting themes related to accessibility and quality of care (QoC) emerged. First, MSM- and HIV-related stigma were perceived to increase the risk of MSM dropping out of care. While acknowledging stigma, some providers also expressed discriminatory views such as stereotypes of the MSM community. Second, stakeholders expressed concerns about QoC including healthcare workforce shortages, limited training opportunities, and high work stress while facing increasingly unmet needs from clients. Third, stakeholders shared challenges in mobilizing community resources to expand HIV care including unclear division of responsibility and strict auditing. Supportive policies and resources may be needed to bolster China’s primary care workforce and MSM-competent care and, more broadly, high QoC for sexual and gender minority patients.

KEYWORDS:

• HIV
• stakeholder
• quality of care
• men who have sex with men
• community-based model

Disclosure statement

No potential conflict of interest was reported by the author(s).

ORCID

Chunyan Li http://orcid.org/0000-0001-9388-1799

Additional information

Funding

The study is funded by the Center for AIDS Research at the University of North Carolina at Chapel Hill [grant number # P30 AI50410] and the Carolina Center for Public Service.