An ethnography of HIV/AIDS and sexuality in the People's Republic of China

China's HIV epidemic is now a growing reality, yet there is virtually no evidence of it in the HIV/AIDS literature. This report documents ethnographic and epidemiologic findings from field visits conducted in Beijing, Chengdu, and Kunming; the latter in Yunnan province, site of China's most severe nidus of HIV infection. This report also elaborates those cultural, social, and political factors involved in China's attempt to manage its growing HIV epidemic. Contemporary attitudes toward sexuality in China which impinge upon such management, as revealed through ethnographic interviews, are reviewed. Data from the First Sino‐American Management of HIV Disease Symposium (to which the author was a delegate) are also blended with the ethnographic material to further clarify the cultural and epidemiologic status of HIV/AIDS in China. It is the conclusion of this report that HIV/AIDS and its management pose a transforming, ineluctable challenge to China's traditional attitudes toward sexuality.     

Naming sexual body parts: Preliminary patterns and implications

A Consultation on partner notification for preventing HIV infection was convened by the World Health Organization's Global Programme on AIDS (GPA) and Sexually Transmitted Disease Programme (VDT) from 11–13 January 1989 in Geneva. A total of 27 participants from 20 countries attended the Consultation, including experts in public health, law, epidemiology, biomédical and social science aspects of AIDS and sexually transmitted diseases (STD).     

Sexually transmitted diseases as a risk factor for HIV transmission

A Consultation on sexually transmitted diseases (STD) as a potential risk factor for human immunodeficiency virus (HIV)¹ transmission was convened by the World Health Organization's Global Programme on AIDS (GPA) and Sexually Transmitted Disease Programme (VDT) from 4–6 January 1989 in Geneva. A total of 32 participants from 21 countries participated, including experts in public health, epidemiology, biomedical and social science aspects of STD and AIDS.     

Rising Powers and Regional Orders: China's Strategy and Cross-Strait Relations

The neo-Gramscian approach has become popular within academic debates to theorize processes of global neoliberal convergence. But, it has also been challenged in the context of the ever more pronounced regionalizing tendencies of the current multipolar global order. This is especially so with the rise of China which introduces an alternative logic to regional social order formation processes from a typical neoliberal capitalist social order convergence. This paper argues, however, that a Gramscian approach can precisely account for such regional social order formation processes through the concept of regional historical blocs. This is demonstrated through a case study of the social order shaping effects that a Cross-Strait historical bloc forged between China's ‘contender state’-wielding elite bureaucracy and Taiwan's ascendant social forces has had on fostering Taiwan's internationalization toward China. This illustrates that, in addition to a broader global social order convergence process, a neo-Gramscian approach is equally useful to explain similarly defined regional social order convergence.     

IMPLICATIONS OF INTERNET TECHNOLOGY FOR MEDICAL SOCIOLOGY IN THE NEW MILLENNIUM

This research examines how parental heterosexism—negative attitudes toward homosexuals and homosexuality—and other family characteristics relate to the development of children's attitudes toward people with HIV/AIDS (PWA). Attention is directed to the overall relationship between parents’ and children's attitudes and to the potential mechanisms through which these linkages are manifested. Based on social learning theories of childhood socialization, a range of mechanisms is considered, focusing on heterosexist attitudes in parents and communication with children about AIDS. Findings indicate that parental attitudes concerning homosexuals influence children's attitudes toward PWA, implying that there can be negative as well as positive consequences of parents’ beliefs on children's attitudes. The possibility of negative parental effects on children's prejudices toward PWA suggests that in-school HIV/AIDS education at younger ages is more important than previously thought.     

HIV/AIDS Orphans' Education in Uganda

Abstract

The HIV/AIDS epidemic in most sub-Saharan African countries has created a crisis in the African family structure. In Uganda, older people's roles have been reversed from being provided for to providers. Older people, who are already poor, face the loss of economic support from their adult children and unexpected social, psychological and economic burden due to the care-giving role they assume. In this study, we used cross-sectional data from Kayunga district in Central Uganda to examine the impact of HIV/AIDS on the role of older persons. We found that there were HIV/AIDS related deaths in 82.3% of the surveyed households. In almost 34% of the households, the care-givers of HIV/AIDS orphans were older people over 50 years old. Almost all households headed by older people (97.8%) had on average three school-going orphaned children living in the household.     

Introduction

This paper will study the role that new media plays in shaping social memory by exploring China's grass-root narratives existing in blogs. By conducting a content analysis, the main features of China's storytellers are illuminated. While emphasizing the role of narratives in shaping a nation's social memory in China, explanations for the source of a new social memory are being searched. In doing so, the linear-model of cause and effect between technology and social change, including McLuhan's term “digital village” are being questioned. The author predicts that, under today's circumstances, China's memory policy including an internalized self-censorship will still have its effectiveness.     

Social Networks,Migration, and Care in Tanzania

This paper explores the impacts of the HIV/AIDS epidemic on children and families in northern Tanzania using the concept of social resilience.1 1. This paper is based on a presentation entitled, “Social Networks, Migration and Care in Tanzania: Supporting Women, Children and Young People's Resilience,” prepared for the 2nd African Conference on the Social Aspects of HIV/AIDS Research, International Convention Centre, Cape Town, May 9–12, 2004, organized by the Human Sciences Research Council, South Africa (see: www.sahara.org.za). View all notes The study is based on the findings of child-focused research with street children and children and families from HIV/AIDS-affected households. The paper illustrates the coping strategies that children and young people, and parents and caregivers adopt at the household level. In particular, it examines how the burden of care affects different generations of women and highlights their resilience, together with the importance of social networks and the fluidity of movement between rural and urban areas. The research suggests that migrating to urban areas to seek a living in the informal sector represents a survival strategy adopted by some children and young people orphaned by AIDS when their families and communities are unable or unwilling to support them. The paper concludes by exploring parents’, caregivers’, children's, and young people's views on the forms of social support that would promote their resilience and thereby help to mitigate the impacts of the epidemic at the household level.     

‘Pain on Top of Pain,Hurtness on Top of Hurtness’: Social Discrimination,Psychological Well-Being,and Sexual Risk Among Women Living With HIV/AIDS

ABSTRACT

This qualitative study explored how a subsample (n = 26) of participants in Protect and Respect (N = 184), a safer-sex intervention for women living with HIV/AIDS (WLH/A), discussed their experiences of social discrimination and the impact of discrimination on their lives, psychological well-being, and risk behaviors during group intervention sessions. The majority of participants was Black (83%), earned less than $10,000 per year (80%), and acquired HIV through heterosexual sex (58%). Analyses demonstrated that social discrimination manifested in the women's lives as poverty, HIV/AIDS-related stigma, and gender inequality. These experiences caused intense psychological distress and limited WLH/A's ability to implement the safer-sex skills that they learned during the intervention. We discuss the applied and theoretical implications of our findings, advocating for HIV and sexual risk-reduction interventions that are based on an ecological framework that addresses holistically the individual, relational, and sociostructural factors that affect women's sexual risk behaviors.     

Family-Based HIV Preventive Intervention

Summary

Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth's exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth's best hope to grow up and survive multiple dangers in urban neighborhoods (Pequegnat& Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided.     

Economic Dependency and HIV/AIDS Prevalence in the Developing World: A Comparative,Longitudinal Analysis

The HIV/AIDS pandemic has plagued global society for over three decades. While breakthroughs in antiretroviral treatments (ART) have proven effective in suppressing the virus and HIV/AIDS intervention outreach have widened, epidemic control remains unevenly achieved among countries. At least 95 percent of HIV/AIDS sufferers originate from developing countries. Dependency theory suggests that developing countries' reliance on debt, trade, and foreign investments pose negative effects on their populations' health. Guided by dependency theory's propositions, this cross‐national study assesses whether increasing dependence on trade, debt, and foreign direct investment potentially increases adult HIV prevalence in developing countries from 1989 to 2012. Using a sample of over 80 nations, we perform a two‐way fixed‐effects OLS regression to evaluate the impact of increasing debt, trade, and foreign investment on adult HIV prevalence. Total debt, short‐term debt, external debt, and GDP were found to increase HIV prevalence. The findings for debt support dependency theory's predictions concerning the ramifications of global economic inequality on HIV/AIDS prevalence.     

Emigration from China: A Sending Country Perspective

This paper aims to provide a comprehensive overview of the policies pursued by the People's Republic of China (PRC) regarding the emigration of Chinese nationals. Most of the available literature on migration management has focused on receiving countries. With a few exceptions, little attention has been directed at migration management policies pursued in countries of origin. In the case of the PRC, policies regarding overseas Chinese have been fairly well documented and researched, but very little has been written about how the Chinese authorities manage ongoing emigration flows. This gap becomes particularly salient as the importance of the “partnership with the countries of origin” in devising migration policies is being increasingly acknowledged by receiving countries in Europe (Commission of the European Communities, 2000). Over the last 20 years, there have been significant changes in the Chinese Government's policies and perspectives on emigration. But, just like most other governments, the Chinese authorities do not have a single blanket policy covering all categories of emigrants. Emigration is normally managed on a case‐by‐case basis and the Government's attitude toward the same type of emigration may vary depending on different cases and circumstances. Because of this, this article examines China's major emigration‐related policy spheres one by one. Specifically, six issues will be discussed: (1) exit control; (2) diaspora policy; (3) student migration; (4) labour export; (5) regulations on emigration agencies and, finally (6) the Government's response to human smuggling. This article shows both the coherence and the fragmentation in China's policies toward emigration. The coherence is due to the fact that all the policies are inherently linked to China's overall economic and social development strategy. The emigration management regime is sometimes fragmented partly because emigration consists of different streams and is handled by different Government departments, partly because some emigration issues (such as regulations on emigration agents) are very new for the Chinese Government and the authorities are still exploring them. Overall, the Chinese authorities increasingly see emigration as a means to enhance China's integration to the world and are keen to avoid conflicts with the international community over migration issues. At the same time, China's emigration policies need to be more balanced, in particular, the emigration of unskilled labour should be given more priority.     

Battling for Survival, Battling for Moral Clarity: "Illegality" and Illness in the Everyday Struggles of Undocumented HIV+ Women Migrant Workers in Tel Aviv

Undocumented migrant workers living with HIV/AIDS in Israel, like their counterparts elsewhere, are doubly abject due to their lack of legal status on one hand and their ill health on the other. Unlike Israeli citizens living with HIV/AIDS, who can access an array of state funded treatments and support services, undocumented migrant workers living with HIV/AIDS are marginalized both by the state's exclusive immigration regime and by its efforts to shake off responsibility for their health needs. At the same time, HIV treatment and care are generally unavailable in migrants' countries of origin. Despite the state's exclusionary orientation and in contradiction of official policies, certain forms of HIV treatment are available to undocumented migrants through the day‐to‐day efforts of a small array of activist Israeli NGOs, (state‐employed) doctors, and state officials. The tension between these simultaneous, oppositional processes of exclusion and inclusion generate a “gray area”— a zone of competing values, claims and interests‐ in which undocumented migrants living with HIV/AIDS and these other stakeholders search for new options and possibilities while continually taking pains to protect their own varied, and often competing, interests. Actors thus constantly bargain with laws, health policies, and one another in a collective battle not only over migrants' chances of survival, but also over the rationality and the morality underlying the state's “and their own” decisions and choices. Anchored within this complex, indeterminate zone, the present article draws upon ethnographic field research conducted among undocumented HIV+ migrant women in Tel Aviv to explore some of the stakes, mechanisms, and outcomes of these complicated, high stakes negotiation processes.     

Shattering the Myth of Invulnerability: Exploring the Prevention Needs of Sexual Minority Women Living with HIV/AIDS

Developing effective safer-sex programs for women living with HIV/AIDS (WLH/A) is a national HIV prevention priority. Existing programs focus predominantly on heterosexual women's experiences and ignore the needs of sexual minority women (SMW). Thus, we conducted semi-structured interviews with 16 sexual minority WLH/A to better understand their sexual risk behaviors and corresponding HIV prevention needs. Most of the interviewees were African American (75%) and poor (75%). We used strategies of Grounded Theory to code the interviews for key themes, which included the following: differences between relationships, risk, and protective behaviors in male and female relationships; links between substance abuse and unsafe sex; need for safer-sex or prevention programs to address SMW-specific skills and topics; and the importance of addressing women's resiliency and the social context of women's risk in prevention programs. Conclusions include concrete suggestions to make safer-sex programs more responsive to the needs of SMW.     

Gendered Economic,Social, and Cultural Challenges to HIV/AIDS Prevention and Intervention for Chinese Women

ABSTRACT

China is experiencing the most rapidly expanding HIV prevalence in the world, with the percentage of Chinese women living with HIV/AIDS also increasing significantly. Chinese women's risk of HIV infection is heavily influenced by patriarchal cultural beliefs, Confucian doctrines, and rapid social and economic changes in China. Chinese women generally have a low level of awareness of HIV/AIDS. With inherent inferior social status and economic disadvantage, their vulnerability to HIV infection is heightened by adverse impacts of massive rural-to-urban migration, explosion of the commercial sex industry, and prevalence of gender-based violence. In order to target HIV/AIDS prevention and treatment programs for Chinese women, their specific needs and gendered obstacles must be addressed and tackled. These include strategies that aim to fight against poverty, improve education, enhance HIV/AIDS awareness, facilitate new life-skills acquisition and behavior change, make available woman-centered services for testing and treatment of HIV, and eradicate gender-based discrimination and violence. There is also an urgent need to further develop various public health infrastructure in China, especially in remote and rural areas. The pool of gender experts in China should also be expanded to conduct a thorough gender analysis and design a national response to address the evolving HIV/AIDS epidemic in Chinese women.     

Public Relations and Chinese Modernity: A 21st-Century Perspective

ABSTRACT

This study approaches the history of China's public relations (PR) industry from the perspective of modernity. Coupled with China's modern transformation and modernization since the late 1970s, Chinese PR industry and practitioners sought to establish legitimacy in the following 30 years. Three developmental stages are identified: Introduction and Enlightenment (1978–1992), Marketization and Professionalization (1992–2003), and Diversification (2003–present). In each stage, the theme and practice of PR interplayed with China's modernization and modern transformation. Situated under unique political, economic, and social contexts, China's PR faced, and is still facing, crises in reputation, utility, social values, identity, legitimacy, and professional ethics.     

China's Divorce and Remarriage Rates: Trends and Regional Disparities

China's rapid economic growth and significant increase in divorce and remarriage rates since the early 1980s provide an excellent case for studying the divorce and remarriage patterns in economic transition. Following extremely low divorce and remarriage rates in the 1960s and 1970s, China's crude divorce rate increased from 0.33 in 1979 to 1.59 in 2007, and the percentage of remarriages among the people who married each year increased from 3.05% in 1985 to 10.24% in 2007. Our graphical and econometric analyses based on the most recently available data suggest that the variations in divorce rate and remarriage rate across regions and over time were associated with regional factors, per-capita income, and education level. Also, there was a positive trend in both divorce and remarriage rates across all regions in China over the study period.