‘Race’ and HIV vulnerability in a transnational context: the case of Chinese immigrants to Canada

Abstract

Although immigrants’ sustained connections with their homelands are well documented, so far we know little about how ‘race’ – in particular, conceptions of race back home – influences the HIV vulnerability of racialised immigrants to Western countries. Drawing on data from a multi-sited, qualitative study of Chinese immigrants to Canada, this paper presents a contextualised understanding of the impacts of race on HIV risk faced by these individuals in a transnational context. Data were collected from four study sites in Canada and China as part of a study investigating the relationship between HIV risk and transnationalism. Although race appears to have bearing on their risk perceptions and sexual practices, immigrants’ understandings of race are not necessarily consistent with dominant discourses of race in Canada, but are also mediated by their racial habitus developed in China. Findings reveal the complex power dynamics – not just power asymmetries but also power fluidity – around race from a transnational perspective and thus challenge the assumed dichotomy of dominance and subordination underpinning traditional explanations of the relationship between race and HIV risk. In the context of transnationalism, researchers should go beyond a nation-bound concept of society (i.e. the host society) and take into account the simultaneous influence of both host and home countries on immigrant health.

Résumé

Alors que les liens durables des immigrés avec leur pays d’origine sont bien documentés, jusqu’ici, nous avons peu d’informations sur la manière dont la « race » - en particulier, telle qu’elle est conçue dans le pays d’origine – influence la vulnérabilité au VIH des immigrés racialisés dans les pays occidentaux. En s’appuyant sur les données d’une étude qualitative multi-site sur les immigrés chinois au Canada, cet article présente une explication contextualisée des impacts de la race sur le risque lié au VIH auxquels ces personnes font face dans un contexte transnational. Les données ont été collectées sur quatre sites au Canada et en Chine, dans le cadre d’une étude qui a exploré le rapport entre le risque lié au VIH et le transnationalisme. Bien que la race semble avoir une incidence sur les perceptions du risque et les pratiques sexuelles chez les immigrés, la compréhension de la race chez ces derniers n’est pas nécessairement en accord avec les discours dominants sur la race au Canada mais est également tempérée par l’habitus racial des informateurs, développé en Chine. Les résultats révèlent la dynamique complexe du pouvoir – non seulement l’asymétrie des pouvoirs, mais aussi leur fluidité – autour du concept de race, dans une perspective transnationale, et ainsi, remettent en question la dichotomie présumée entre domination et subordination, sous-jacente à l’explication traditionnelle du rapport entre la race et le risque lié au VIH. Dans un contexte de transnationalisme, les chercheurs doivent envisager le concept de société au-delà des frontières d’une nation (c’est-à-dire la société du pays d’accueil) et prendre en compte les influences simultanées des pays d’accueil et des pays d’origine sur la santé des immigrés.

Resumen

Aunque los vínculos mantenidos por los inmigrantes con sus países de origen están bien documentados, hasta ahora sabemos poco sobre cómo influye la etnia, —en concreto, el concepto de raza en sus países de origen— en la vulnerabilidad al VIH de inmigrantes con una identidad racial que viven en países occidentales. A partir de datos de un estudio cualitativo realizado en varios lugares con inmigrantes chinos de Canadá, en este artículo se presenta una comprensión contextualizada de los efectos que tiene la etnia en estas personas con respecto al riesgo de contraer el virus del sida en un contexto transnacional. Para esta investigación se recabaron datos de cuatro sitios en Canadá y China en el marco de un estudio en el que se investigaba la relación entre el riesgo de VIH y el transnacionalismo. Aunque parece que la etnia influye en el modo en que perciben el riesgo y en sus prácticas sexuales, las concepciones de etnia de los inmigrantes no son necesariamente coherentes con los discursos dominantes de raza en Canadá, sino que también están condicionados por las costumbres raciales que los informantes han desarrollado en China. Los resultados indican las complejas dinámicas de poder —no solo las asimetrías de poder sino también la inestabilidad del poder— en cuanto a la etnia desde una perspectiva transnacional y, por tanto, desafían la supuesta dicotomía de dominio y subordinación que respalda la explicación tradicional de la relación entre etnia y riesgo de VIH. En un contexto de transnacionalismo, los investigadores deberían ir más allá del concepto de la sociedad vinculada a la nación (es decir, la sociedad de acogida) y tener en cuenta los factores tanto de los países de acogida como de los países de origen que influyen a la vez en la salud de los inmigrantes.

Keywords:

• HIV vulnerability
• Chinese immigrants
• race
• Canada
• transnationalism

Introduction

Since the 1990s, the People’s Republic of China (PRC) has been a primary source of immigrants to Canada, sending 314,090 – in the category of Permanent Residents – in the past decade (2005–2014) alone (CIC 2014). The majority are well-educated professionals from the PRC’s growing urban middle class (Li 2011). Against the background of a ‘rising China’, with rapid advances in information and communication technology, and with their own settlement difficulties in the ‘new’ country, this generation of Chinese immigrants have maintained unprecedentedly close connections with their homeland through, for example, daily electronic communication, travel (including ‘return migration’), business, the ‘transnational’ or geographically separated family and development of a transnational identity (e.g. Guo 2013, 2016; Lin and Tao 2012) sustained through cross-border connections and simultaneous engagement with both Canada and China (Levitt and Glick Schiller 2004; Tsuda 2012).

The implications of immigrants’ transnational connections for their health, including HIV risk, have been largely neglected until recent years, however. In the form of, for example, cultural habitus, cross-border family ties and the transnational use of informal and formal healthcare services, the home country continues to be important for immigrants’ health (including HIV) related ideas, resources, practices and perspectives (e.g. Grieb 2009; Lee, Kearns, and Friesen 2010; Messias 2002). The lasting influence of the home country on Chinese skilled immigrants in Canada also manifests itself in their continuing silence about sex and HIV prevention, despite increasingly open sexual relationships in the ‘new’ country (Zhou 2012; Zhou and Coleman 2011). In the context of transnationalism, so far we still know little about how ‘race’ – a major social determinant of immigrants’ health in Western countries (Brondolo, Gallo, and Myers 2009; Hyman 2009) – influences the HIV risk faced by racialised immigrants and their capacity to respond to that risk. It is important that we know more, because racial contexts – such as history, politics, categorisation, hierarchy and interests – in immigrants’ home countries may be different from those in the host societies (Cheng 2014; Romero 2008).

Modern China’s discourses on race – in particular, discourses about an imagined ‘Chinese race’ – have been promoted by national elites to forge national unity in a culturally and ethnically diverse society and to counter foreign (not only Western) powers’ attempts at colonisation and imperialist aggression since the nineteenth century (Dikötter 2010, 2015). Immigrants from PRC may therefore not be familiar with Western ethnic and racial systems; and China’s endogenous racial constructions, with their inherent cultural and racial nationalism, may be in conflict with that of their Western counterparts. As an illustration, after the first case of HIV infection (a US tourist) in China was identified in 1985, both institutional and media discourses explained HIV as a disease from abroad, and negative images of foreign sexuality, along with racialised discourses on HIV and AIDS, were widely disseminated (Dikötter 2010). It is not yet clear how the perspectives on ‘race’ Chinese immigrants may have acquired in China influence their experiences with HIV risk after their arrival in Canada.

In Canada, ‘visible minorities’ or racialised people have been among those most affected by HIV (Public Health Agency of Canada 2013). Although the provision of ‘ethno-specific’ services in this country indicates significant progress over earlier colour-blind approaches to HIV and AIDS (Catungal 2013), race has had a clear bearing on various aspects of health (prevention, access to services and health outcomes), and at different levels (structural, social and personal) of individual experience. In their study of the experiences of, and responses to, HIV among African and Caribbean communities in Toronto, Gardezi et al. (2008) found that men and women in these communities face a wide range of interconnected issues – poverty, racism, unemployment, housing, social isolation and traditional norms around sexuality – that may increase their risk of HIV infection, create obstacles to testing and treatment and lead to the isolation of HIV-infected people. For young people from these communities, their fear of encountering racism and distrust in the health system also inhibits them from accessing sexual health services (Salehi, Hynie, and Flicker 2014).

Inter-racial intimacy is often conceptualised as a dynamic site in which the boundaries and power around race may be negotiated and challenged at an interpersonal level (Twine and Steinbugler 2006). Yet the findings of empirical studies also suggest complex interactions between race and other contextual factors, such as sexuality, gender and the dominant culture of a society. Studies of Latino and Asian men who have sex with men in both Canada and the USA reveal that men’s exposure to social discrimination (racism and homophobia) makes them vulnerable to unsafe sex and to HIV infection (Han 2008; Mizuno et al. 2012; Poon and Ho 2002). Internalising White normative notions of masculinity and racial stereotypes in the mainstream gay community, some gay Asian men in Canada were found to have negative feelings about themselves. Their strong preference for a White partner, combined with factors such as fear of rejection reduced these men’s ability to negotiate safer-sex practices (Poon 2000; Poon and Ho 2002, 2008). Although little is known about the HIV risk to racialised women in inter-racial intimate relationships, related research in Canada widely documents how multiple inequalities and marginalities (e.g. poverty, sexism, racism, violence and greater barriers to information and services) may compromise their ability to minimise the related risks, leaving them disproportionately vulnerable (e.g. Varcoe and Dick 2008; Williams et al. 2009).

Drawing on data from a larger qualitative study on the HIV vulnerability of Chinese-Canadian immigrants in a transnational context, this paper seeks to develop a contextualised understanding of the impacts of ‘race’ on these individuals’ vulnerability to HIV. Instead of seeing ‘race’ as a monolithic, contextless entity, I pay close attention to the dynamic relationships among race, intimate relationships and HIV risk in their post-immigration lives. Taking into account Chinese immigrants’ sustained linkages with their home country, I also explore the role of transnationalism – in the form of immigrants’ simultaneous embeddedness, or ‘double grounding’, in both home and host countries – in shaping their understanding of race (including their own ethno-cultural identity) and experiences of HIV-related risk.

Conceptual framework

Seen through the lens of transnationalism theory, international migration is not simply a movement from point A to point B, or an event that ends with settlement; rather, it is a lifelong process involving immigrants’ simultaneous engagement with both home and host countries (Levitt and Glick Schiller 2004; Tsuda 2012). Criticising nationally bounded thinking, or ‘methodological nationalism’, as having little relevance in the context of immigrants’ sustained ties with their homelands, Amelina et al. (2012) argue that ‘methodological transnationalism’ allows us to better contextualise our research questions, because it ‘[encompasses] cross-border social relations without normatively assigning them a global saliency or universality’ (7). According to Acevedo-Garcia et al. (2012), exploring immigrant health from a cross-national or transnational perspective can overcome the limitations of traditional approaches that position this research area as a ‘‘specialty’ topic involving a discrete de-contextualised population’ (2060).

In immigration studies, ethnicity and ‘race’ are still largely conceived of within the framework of methodological nationalism: that is, as the status quo in the national context of the receiving societies (Cheng 2014; Grosfoguel, Oso, and Christou 2015). Treating race as a ‘timeless’ and static aspect of immigrant health, however, neglects the effects of the complex social, economic and political dynamics embedded in the racialisation processes that have become further complicated in this transnationally connected world. The tendency to apply a polarised racial model of White-versus-the racialised Other to health (including HIV) research may reinforce the Eurocentrism and state-centralism of racial formation, and risk essentialising the diverse experiences (including their resistance) of racialised immigrants, whose lives may be not limited by the territorial boundaries of a particular national container (Fries-Britt, Mwangi, and Peralta 2014; Kibria 2002). Failing to attend to the wide range of aspects – such as country of origin and immigration trajectory, in addition to class, gender, sexuality and settlement experience – with which ‘race’ intersects will distort our assessment of the relationship between race and HIV vulnerability in a transnational context. In the context of racial inequalities, furthermore, understanding of the experiences of racialised immigrants in their own frames of reference is important to avoid further disadvantaging these individuals (Romero 2008; Treviño, Harris, and Wallace 2008).

Methods

The core purpose of the larger qualitative study (2011–2016), from which the data reported here were drawn, was to understand the HIV-related vulnerability of Chinese immigrants to Canada in a transnational context; one, in other words, in which their lives are not limited by the territorial boundaries of either Canada or China. The larger study is an expansion of its pilot project (2007–2009), and reveals immigrants’ close connections – both material and subjective – with China, as well as related effects on their exposure to HIV risk and their capacity to respond to it (Zhou 2012; Zhou and Coleman 2011). Eligible research participants were adult individuals who were from the PRC and had lived in Canada for at least one year; who self-identified as having close connections with China while living in Canada; who were willing to talk about the sexual health (including HIV) risk faced by themselves and/or by Chinese immigrants to Canada; who lived in either Toronto or Vancouver, or had returned to China; and who, if among the latter, at the time of the study, resided in either Beijing or Shanghai.

The four study sites were selected because most Chinese immigrants in Canada have settled in the metropolitan areas of Toronto or Vancouver (Statistics Canada 2007), while Beijing and Shanghai are the most globally integrated cities (GaWC 2012) in China, and are the only two Chinese cities that have direct flights to Canada on a daily basis. In a sense, these four sites constitute the most important hubs of the transnational networks of movement between Canada and China.

Purposive sampling was used to select participants. In Canada, participants were recruited through the Internet (e.g. recruitment notices posted on Chinese-language websites popular among immigrants from the PRC), Chinese community networks (including settlement services) and personal referrals. In China, recruitment was primarily through local researchers’ networks and personal referral. The different strategies used in China reflect both cultural norms (i.e. people rarely respond to recruitment by complete strangers) and practical challenges (e.g. HIV and sex are highly sensitive topics) in the local contexts. Although our original plan was to focus on Chinese immigrants to Canada, nine returned international students from Canada and one 10-year Canadian visa holder were also recruited in the study sites in China due to recruitment challenges encountered there.

The data were collected through one-on-one, semi-structured, in-depth interviews with 66 Chinese adult immigrants in Canada and China: 17 in Toronto, 18 in Vancouver, 15 in Beijing and 16 in Shanghai. Written, informed consent was obtained prior to each interview and demographic information was also collected. Apart from one participant who was interviewed in English at his request, all participants were interviewed in Mandarin by the researchers (including the author of this article) or trained research associates of this project at a location of each participant’s choice. The length of the interviews ranged from one to two hours. With the interviewees’ permission, all interviews were audiotaped. Participants were asked about their experiences of immigration from China to Canada; knowledge of HIV and AIDS; perceptions of sexual health (including HIV) risk; responses to the perceived risk; and relationships with the Chinese communities in Canada, and with China as the home country.

The research design of this project was informed by multi-sited ethnography (Amelina et al. 2012; Marcus 1995), a method that can capture migrants’ cross-border relations, as well as their geographical and cognitive trajectories, in the context of transnationalism. Although ‘tracing’ research participants through multiple sites is unfeasible for this study, questions comparing their experiences in the two countries were asked during the interview. Exploring the multiple perspectives involved with respect to a specific process, action or idea also enables researchers to understand how power relations from seemingly disconnected sites affect groups of people in motion (Marcus 1995).

Participants comprised 31 women and 35 men, and their ages ranged from 21 to 58 years, with an average of 36.7 years. Except for three unknowns, the year of their first arrival in Canada from China ranged from 1989 to 2013, although the majority (48/63) arrived during the period of 2000–2010. Immigration status in Canada at the time of the recruitment was as follows: permanent residents (34/66), (naturalised) citizens (22/66), international students (7/66), 10-year visitor visa holder (1/66) and unknown (2/66). All participants had post-secondary education: the majority (58/66) at the university level, with eight at the college level. Regarding relationship status, 18 were single, 30 were married, 5 were living common-law, 12 were separated or divorced and 1 was unknown. Most participants self-identified as heterosexual, with five identifying as gay or lesbian, and one as bisexual.

To ensure the data were accessible to all researchers in the project, interview transcripts were translated into English. All transcripts were imported into NVivo (9.2), a computer software programme for qualitative data analysis. Initially, a tentative coding scheme, consisting of a set of major coding categories (e.g. ‘transnational connections’, ‘intimate relationships’ and ‘HIV risk’) and sub-categories (e.g. ‘interracial sex’, ‘risk perceptions’ and ‘risk responses’) and their defining criteria, was developed by the research team based on their reading of selected transcripts. Then the coding scheme was tested multiple times and adjusted by coding selected transcripts from different study sites. After repeated discussion within the team, the collectively agreed-upon scheme was then applied to the entire dataset. At the stage of writing, individual researchers were able to develop a comprehensive synthesis of the themes relating to their paper’s focus while attending to the bigger context in which the selected data are situated. The following section focuses on the emergent themes relating to ‘race’, including ethno-racial awareness; risk perceptions associated with race and ethnicity; and inter-racial or inter-ethnic sex. Pseudonyms are used to protect participants’ identities.

Findings

‘Race’, ethnicity and sexual desire

Western discourses of race appeared to have been unfamiliar to most participants before their immigration, and for some to have remained so even after it. Instead, other non-racial terms such as ‘non-Chinese (bushi huaren)’, ‘Westerners’ (xiren), ‘native-born Canadian’ (jianada bendiren) and ‘foreigners’ (laowai or waiguoren), were often used interchangeably. When discussing their relationship with the mainstream population, a few participants also used some of the racial or ethnic categories adopted in Canada, like ‘minority’ (shaoshu zuyi) and ‘Asian’ (yayi). For those who engaged in inter-racial or inter-ethnic intimate relationships, most specified the ethnic or national backgrounds of their sexual partners, and sometimes further added racial information, as illustrated by the examples below:

Now I have a boyfriend, an American, a White, but he is working in the USA. (Mr. Huang, 43 years)

[Here I have had] one White boyfriend, [and] one Korean, one Japanese. (Ms. Li, 29 years)

[My previous boyfriend] is a German. [… The most recent one is] a French. (Ms. Jing, 32 years)

Among the [sex workers I visited], two of them are Korean, the rest are from [the PRC] and Hong Kong. (Mr. Liu, 23 years)

[Women I’ve dated so far include mainland] Chinese, Taiwanese, Singaporean, and Malaysian. … I’ve also dated Caucasian women, but not to the extent of becoming weekend lovers. (Mr. Ruan, 45 years)

My previous boyfriend is a Norwegian [met in China]. (Ms. Zou, 31 years)

Although both Caucasian and Asian sexual partners were reported by participants, none identified their sexual partners as Black, except for 41-year-old Mr. Qian who said that one of his sexual partners ‘looked a little like Whitney Houston, rather pretty, and quite stand-out’.

As a multiethnic society, Canada provided some of the men with an opportunity to realise their sexual fantasies. Mr. Qian, who was geographically separated from his wife and child in China, was frank about his sexual attraction to ‘non-Chinese’ women: ‘I always think it is cool to find someone who is not of the same ethnicity as you … who do not look the same, and whom you feel are different.’ The notion of sexual exploration, or even sexual consumption, was also present in the narratives of several men who visited inter-ethnic sex workers. Being impressed by the courtesy of sex workers from other East-Asian cultures, Mr. Liu (23 years) described these women as ‘more cultured’. Men’s imaginations about women of other ethnicities, along with their own emotional needs for power or a sense of control, were further explained by another man:

Caucasian women are quite like our [Shanghai] women, very independent, very dominant, maybe too dominant. … They are different from the women from northern China, Japan, or Korea, who have great respect for men. … Women in my life are mostly dominant, so I have to find things in other areas that I can control. (Mr. Du, 28 years)

Meanwhile, imaginations or stereotypes about ‘Western men’ or ‘White men’ as, for instance, good-looking, romantic, sexually skilled or simply different from Chinese men were also reported by a few women and by Mr. Huang (44 years) who self-identified as gay. Explicitly indicating his preference for Caucasian sexual partners, Mr. Huang commented: ‘Generally speaking, Caucasian gay men are the best looking group of people, while Asian gay men are completely on the other end of the spectrum.’ While discriminating against ‘non-White’ men (including Chinese men), 25-year-old Ms. Yun also presented almost unconditional acceptance of Caucasian men: ‘It is good as long as he is a Caucasian.’ When being asked to explain further about their ‘personal [racial] preference’, however, they made, explicitly or implicitly, a connection between having a Caucasian partner and their possible access to the perceived mainstream society, with all of its opportunities:

It’s not only sexual satisfaction; there is other stuff as well, but it’s hard to say what. It’s the whole package of the Caucasian men that very much appeals to me. (Mr. Huang, 43 years, emphasis added)

I would have a sense of achievement if I could be integrated into the White people’s circle … because many people would admire you. … For Chinese international students or newcomers, even if your English is good enough, there is still a gap between you and them. It’s not a problem with English, but a problem with your background. (Ms. Yun, 25 years)

One heterosexual man also expressed his desire to ‘eventually’ have a ‘Western woman’ as a partner because ‘we should try our best to integrate into the society.’ He explained:

Chinese immigrants’ social status is very low in Canada, just like the lagging-behind students in a class. I don’t see anything promising in mingling with lagging-behind students. But Westerners are different: they don’t face any language barrier, they are better networked in this society, and they still constitute the majority of the Canadian population. (Mr. Zhang, 48 years)

Yet several divorced women who had dated Caucasian men tended to see such an arrangement as a compromise, or in terms of having ‘no [better] choice’, because they thought that being a middle-aged, divorced woman often disadvantaged them when dating Chinese men. While ‘the Chinese guys I met on the dating website spared no effort prying into why I got divorced’, 41-year-old Ms. Lin commented: ‘Foreigners don’t pry into your past.’ Despite her preference for men of the same linguistic and cultural backgrounds as herself, 54-year-old Ms. Wang who used to teach at a university in China similarly felt it almost impossible for her to find a ‘suitable’ Chinese partner, given her age and a disability resulting from a work injury. Her relationships with Caucasian men, however, were always sabotaged by, for instance, cultural and educational differences, her unwillingness to compromise (e.g. regarding safer sex or geographical relocation) or incidents that she viewed as ‘racist’ or unfriendly toward China as her home country.

Culture, ‘race’ and perceived HIV risk

When asked about their perceptions of HIV risk, participants often presented transnational comparative perspectives. Seeing culture as a ‘double-edged sword’, some commented that the general conservative attitudes toward sex and sexuality in Chinese culture had both discouraged ‘promiscuity’, lowering HIV risk, and made HIV a taboo topic that increased the risk. When it came to themselves, many thought that they might face greater HIV risk now, in Canada, than they had before immigration, given that their intimate relationships had become ‘complicated’ – such as by having multiple sex partners – due to geographical separation from their spouse, post-immigration divorce and difficulties developing a long-term relationship.

Without referring to information relating to safer sex, some participants expressed nervousness about, or fear of, sexual contact with ‘non-Chinese’ individuals. Consistent with China’s earlier construction of HIV as a ‘foreigners’ disease’, they considered it risky to have sex with ‘Westerners’, ‘foreigners’ or ‘Caucasians’, who were often imagined or stereotyped as self-indulgent, ‘promiscuous’ or even hypersexual. According to these participants, ‘there are more same-sex relationships and drug use among Caucasians [than among Chinese]’ (Mr. Du, 28 years); Caucasians ‘like to go to bars, or like to have fun’ (Ms. Sun, 27 years); and Caucasian men ‘do one-night stands, and like fooling around with several women at the same time’ (Ms. Shan, 21 years), and ‘can’t live without a woman’ (Ms. Wang). The tendency to ‘other’ HIV risk as something affecting other cultural, ethnic and racial groups more than the Chinese, is further illustrated in the following quotations:

I’ve never visited Caucasian [sex workers], I don’t dare. … I feel that a Caucasian’s view of sex is a few times more open than that of a Chinese, so I am not too sure [about them]. (Mr. Liu, 23 years)

My younger brother [in another Western country] told me that I should pay attention to my sexual health if I dated my [now ex-]boyfriend. He said that Caucasians are not that safe, and I should be extra careful to avoid getting myself into trouble. (Ms. Wang, 54 years)

I may have sexual relationships with [Chinese women], but not with Caucasian women. They are too open, so I think their risk is very high. (Mr. Ruan, 45 years)

In the course of making race-based assumptions about HIV risk, some deeper rationales – such as their (mis)understanding of cultural differences and unfamiliarity with both Western cultures and ‘non-Chinese’ individuals – also surfaced, as shown below (emphasis added):

You don’t know their culture or background that well. … I like Westerners because of the uncertainty … but with this uncertainty the risk is also higher. (Mr. Zhang, 48 years)

Chinese young people are very open nowadays as well. But with regard to the spectrum [of possibilities] that they would go to for sexual pleasure, foreigners are more willing to experiment or adventure. (Mr. Dai, 28 years)

Unless I know a Caucasian woman very well from school or work, I would not have sex with her. … Caucasians are at the same risk with the second generation of [Chinese-Canadians], whose mindset is pretty much the same as that of local Caucasians, since they were born and raised in Canada, too. (Mr. Ruan, 45 years)

[My ex-boyfriend] told me many [sex-related] stories about them, which really scared me off dating foreign guys. … They have a totally different lifestyle, and their way of thinking and viewing the world is very different from mine. (Ms. Zhao, 21 years)

In contrast, two men, both of whom currently had a Caucasian same-sex partner, thought Chinese immigrants faced greater HIV risk than ‘Westerners’, because the latter were ‘very experienced and knowledgeable about sex’ (Mr. Huang) or ‘[had] a bottom line of risk taking due to their mastery of the knowledge’ (Mr. Ma, 35 years). In addition, these participants believed that not having been educated on the subject back home meant that gay men from China ‘do not know how to protect themselves’. Mr. Huang further explained:

Look at those White gay men: They probably have dated many guys, but they are all healthy, because they are experienced, and know how to protect themselves. But most Chinese gay men are not like this, and it takes time to gain experience.

The assumed low HIV risk associated with ‘sexually skilled and experienced’ Caucasian gay men, however, also led him to trust them unquestioningly when unsafe sex was, indeed, practised:

Foreigners seem to know their way around in terms of having sex, such as how to use a condom. … Some foreigners don’t like to use a condom, but I think that they know what to do when they are not using one.

Similarly, a woman who explicitly indicated her preference for dating Caucasian men found herself more likely to ‘trust’ these men than Chinese or other racialised men, for some reason that she was not yet able to articulate. She said:

Actually, when I make contact with White men, my guard is very low, very much lower than when I connect with Chinese men. I’m very picky with Chinese men. But when it comes to White men, I’m not very picky. I don’t know why. (Ms. Yun)

Risk responses: ‘race’, but more than ‘race’

Awareness of HIV-related risk and its effect on their responses varied greatly among those participants who actually dated or had sex with ‘non-Chinese’ individuals. Only a few had a clear sense of HIV risk, while most of the other participants had a poor or inconsistent awareness. When she started dating Caucasian men after her marriage breakdown, 50-year-old Ms. Hua saw herself as ‘at a high risk’ of HIV infection, although she did not know how to protect herself or where to get information about safer sex. She often worriedly ended the relationship right before sex. Occasionally realising her sexual practice was ‘very dangerous’, Ms. Yun had never discussed safer sex with any of her multiple partners, in part due to her lack of relevant English vocabulary.

Despite their varying degrees of awareness of HIV-related risk, some participants’ actual responses to the risk were also shaped by other factors, such as their notions of ‘proper’ or ‘adequate’ protection and capacity to communicate about, negotiate and adopt safer-sex practices. Making a causal link between HIV risk and individual characteristics (e.g. ethnicity, ‘race’, cultural background and socioeconomic status), some thought they could reduce the risk by being ‘very discreet’, ‘picky’ or ‘careful’ about who they dated or slept with. For instance, Ms. Yun decided to only date Caucasian men ‘with steady, good jobs’, because she believed that men with good careers and higher social status would be the least likely to take such a risk.

Although condom use seems like a relatively straightforward answer to the perceived risk, the condom meant different things to participants. Seeing it primarily as a means of birth control, Ms. Yun, the young woman who preferred to date Caucasian men, simply said: ‘I felt that as long as you don’t get me pregnant, I don’t care if you use a condom or not.’ Seeing condom use as indicating lack of sincerity, trust and intimacy, some felt uncomfortable using them, and hesitated to insist. Ms. Lin was even ‘shocked’ when her Canadian-born Caucasian boyfriend requested using a condom, which was then interpreted by her ‘like we are engaging in the sex trade’. She recalled:

[My boyfriend said that using condoms] has nothing to do with how I feel about you or how close we are. It’s not like I don’t trust you. … I realised that if he hadn’t insisted, it wouldn’t have occurred to me to use protection at all. … I think most foreigners have this awareness. I asked him why he wanted to use a condom. He said that that was how they were taught in high school, and that protection is very important. (Ms. Lin, 41 years)

Some women also felt embarrassed about proposing condom use with their inter-racial partners, because it is considered the ‘man’s responsibility’ and, thus, for the man to initiate. ‘In my heart I wish [men] would use it,’ Ms. Yun commented, ‘but I didn’t strenuously demand it’. Women further added that their cultural upbringing also made it difficult for them to refuse men’s request for unsafe sex, because as Ms. Sun put it, ‘Asian women are less likely to say “no”.’

Bearing the double burden of her divorce and settlement difficulties, a woman in her 50s observed that immigrant women like herself were vulnerable to exploitative relationships with local Caucasian men, because they were new to Canada and often in dire need of help. This sentiment was elaborated on by a female college student who had dated multiple Caucasian partners:

There is this White guy, about 40 years old, he likes me. He proposed to me, but I haven’t accepted. I like his job; he works for the city government, and his friends are all managers. I think that if I’m with him, he can mention me to his friends. … I felt that he’s very old, too old [for me]. … But I’ve never refused him. … I’m just stringing him along like this. … Because I’m not highly educated, I’ve felt that I need to rely on people like that. (Ms. Yun, 25 years)

Similarly, a man in an inter-racial relationship also expressed ambiguity when he decided to prioritise his relationship over safer sex. He explained why he used no protection, despite his HIV concerns:

[My boyfriend] is a very good guy, and he seems transparent to me and I like him very much. … So I trust him, and I think that he doesn’t have anyone else at this moment. But I’m pretty sure that for the first one or two months, when we first started, he did have someone else on the side. … After two months, we became really close, so I think he hasn’t had anyone since then. (Mr. Huang, 44 years, emphasis added)

Comparing himself with some of his immigrant peers who were still ‘stuck’ in Chinatown, ‘renting a room in a house’ and ‘had little sex life in Canada’, this man, who had been a very successful professional in China, was satisfied with his current life, which included owning an apartment in a luxury high-rise building downtown, a non-menial job and a relationship with a Caucasian boyfriend who was ‘only attracted to Asian guys’. While his Asian gay friends ‘all want to find a White partner eventually’, most had been unable to do so.

Rather than ‘giving in’, however, Ms. Wang (54 years) decided to end her relationship with a Caucasian man she once dated when he said ‘[Other Chinese women] can do this, why can’t you do this as well?’ She was also the only woman who initiated, and insisted on, condom use with her Caucasian partners. Attributing her strong determination and capacity to having had to rebuild her life after a failed marriage and her healthcare training since she immigrated, she also saw the importance of maintaining a sense of dignity and equality in such a relationship.

Discussion

This study of Chinese immigrants to Canada illustrates the dynamic relationships between race, intimate relationships and HIV risk in individuals’ post-immigration lives. Instead of simply embracing the racial discourses of Canada, these individuals’ understandings of race and of their own ethno-racial identity were influenced both by their racialised encounters in Canada and the racial habitus developed in China. The findings suggest the need to develop a more contextualised and nuanced understanding of the impacts of race, which is neither taken for granted nor statically hegemonic, on immigrant health, including HIV vulnerability, from a transnational perspective.

For most participants in this study, race appears to be a contested concept, and racial categories were often used interchangeably with other identifications relating to ethnicity (e.g. Korean), nationality (e.g. American), culture (e.g. Westerner) and immigration status (e.g. ‘native-born Canadian’). Rather than positioning themselves as the racialised Other in the existing White-centric racial system, most participants tended to utilise a set of China- and Chinese-centric categorisations: that is, Chinese versus ‘non-Chinese’, ‘Westerners’ and even ‘foreigners’ – a term used in China to refer to non-Chinese people, regardless of their racial, ethnic, cultural, national or geographical backgrounds (Dikötter 2015). The continued influence of racial habitus – such as the linking of HIV risk with other racial groups – cultivated in China, and their general lack of the racial consciousness that exists in Canada, appear to have two, paradoxical, implications for their vulnerability to HIV. On the one hand, their tendency to racialise HIV risk may offer a false sense of security, and thus lead to poor preparation, at the level of both knowledge and practice, for HIV risk. This mode of Othering HIV risk may also reflect these immigrants’ cultural and racial positioning in Canada, in which they delineate their difference from – but not necessarily inferiority to – the mainstream populations in terms of culture (including gender norms), lifestyle and access to sexual freedom and personal space (Portes, Guarnizo, and Landolt 1999).

On the other hand, however, their unfamiliarity with Western discourses of race, and their different understanding of race, de facto provides them with a space in which to reduce the harm inflicted by racialisation in Canada on their identity constructions and capacities to resist racial inequalities at an interpersonal level. Although it is premature to argue about the role of immigrants’ racial awareness (or lack of it) in the host society in mediating their capacities to pursue sexual health, in this study a female participant who strongly identified with China – she not only saw China as integral and even central to her identity, but also viewed a potential partner’s acceptance of her home country as a condition for starting an equitable relationship – was the only person who reported insisting on safer sex with Caucasian partners. Studies of racialised immigrants and international students in the USA also found that those individuals may not automatically absorb a racial consciousness that is different from the one back home. What is more, their racial ignorance may have protected them from internalising the racial hierarchy that disadvantages them (Cheng 2014; Fries-Britt, Mwangi, and Peralta 2014; Kibria 2002). For the Chinese immigrants in this study, their relatively privileged socioeconomic status (e.g. as highly educated professionals) back home and the possibility of return migration (i.e. migrating back to China) may also mean more diversified settlement patterns than earlier generations of Chinese immigrants.

Yet such capacity should not be exaggerated; after all, migrants do not arrive in ‘an empty or neutral space’, but in spaces ‘that are already “polluted” by racial power relations with a long colonial history, colonial imaginary, colonial knowledge and racial/ethnic hierarchies linking to a history of empire’ (Grosfoguel, Oso, and Christou 2015, 641). In a society permeated with racial inequalities, sex is indeed a site of power struggle, and ‘sexual capital’ produced through inter-racial sex – or more precisely, sex with Caucasians – can be converted to other forms of social and cultural capital (Farrer 2010). For some participants, an inter-racial intimate relationship does not necessarily mean ‘colourless love’ but, rather, the opportunity to access resources – such as mainstream social networks, career possibilities, opportunities to practise English and a sense of achievement – that they otherwise cannot access, to accelerate their settlement and integration in Canada and/or to prevent their further marginalisation.

Power asymmetries in inter-racial or inter-ethnic intimate relationships are further complicated by other social dimensions, such as gender, age and immigrant status. While for some divorced middle-aged women in this study inter-racial intimate relationships opened up a space in which to overcome the (Chinese) cultural barriers to a new relationship, these relationships also made them vulnerable to both sexual exploitation and HIV risk, given their socioeconomic disadvantages in such encounters. In addition, the two participants who explicitly expressed a desire for Caucasian partners were unable to engage in safer sex in part because of their strong desire for integration and their internalised racial hierarchies based on physical attractiveness, access to social capital and ‘trustworthiness’. It is important to note here that inter-racial sex is also highly gendered, in part because racialised men are more likely to be discriminated against than their female counterparts in both the same-sex and heterosexual dating markets (Lundquist and Lin 2015). The sexual desires of the male participants who visited Asian female sex workers in Canada were also structured by their pursuit of a man’s power, and by cultural and sexual stereotypes about these women.

Conclusion

In conclusion, findings present two potentially major contributions to our understanding of, and future interventions in, the HIV-related vulnerability of Chinese immigrants, as well as of other racialised immigrant groups in Canada. First, the intersection of immigration and HIV vulnerability in a transnational context suggests the need to avoid over-reliance on immigrant settlement in the host country alone to explain vulnerability to ill health (including HIV risk) and to explore the influences of these individuals’ connections with homeland on their health ideas and practices. Second, Chinese immigrants’ different racial logic, as revealed in this study, also makes visible Eurocentric conceptions of race in the host country, and challenges its rigidity in understanding the power dynamics – not just power asymmetries but power fluidity – underpinning immigrants’ health. Although race and its embedded power relations have impacts on these individuals’ sexual experiences, their transnational perspectives (experiential, cognitive and emotional) enable them to both challenge the dominant discourses of race in Canada and to overcome the assumed dichotomy of dominance and subordination in inter-racial intimate relationships. A properly contextualised understanding of the intersections of race, immigration and HIV-related risk calls for a methodological transnationalism that challenges the nation-bound concept of society (i.e. the host society), and takes into account the simultaneous impacts of both host and home countries on these immigrants’ risk awareness, risk perceptions and (un)safe sexual practices (Amelina et al. 2012).

It is not appropriate to conclude without mentioning some of the limitations of the study. Due to its purposive sample and multi-sited nature, the results of this investigation may not be generalisable for Chinese immigrants to Canada as a whole. Beyond this, it is important to recognize that race was not the focus of this study, but rather emerged as a theme at the stage of data analysis. A lack of more systematic exploration of Chinese immigrants’ racialisation experiences in Canada may have prevented us from fully understanding their effects on experiences of HIV-related risk, including their capacity to respond to this risk. Despite these limitations, this article does shed light on Chinese immigrants’ own perspectives on race and their relevance to immigrant health in a transnational context, an area that merits further, in-depth, examination in future research.

Disclosure statement

No potential conflict of interest was reported by the author.

Funding

This work was carried out with the aid of the Canadian Institutes of Health Research [grant number 111081] and a McMaster Art Research Board Scholarly Publications.

Acknowledgements

The author wishes to express her appreciation to research participants of this study in both Canada and China. I also thank this project’s research investigators Christina Sinding, Yingying Huang, Wei Wei, William D. Coleman, Roy Cain, Jacqueline Gahagan and Evelyne Micollier; research associates and assistants Helen Hong Su, Liping Peng, Emmy Arnold, Nancy Johnson, Xiaoqing Gao, Xiaoxin Ji and Jane Ma; and collaborators Chi Heng Foundation, Shanghai, China; Institute of Sexuality and Gender, Renmin University of China; Asian Community AIDS Services, Toronto, Canada; and St. Stephen’s House, Toronto, Canada, for their contributions at different stages of the study.