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HIV/STD Stigmatization Fears as Health-Seeking Barriers in China

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Internationally, stigma prohibits effective HIV/STD identification, prevention, and care. Interviews with 106 persons in an urban center in Eastern China, some known to have engaged in stigmatized risk acts (sex workers, STD clinic patients) and some vulnerable for stigmatization fears to influence health-seeking behaviors (market employees, rural-to-urban migrants). Interviews focused on community norms, values, beliefs, and emotional and behavioral reactions to HIV/STD stigmatization related events. Attributions for infection were found to mark individual's failure to adhere to sexuality norms; define a condition warranting the avoidance of infected persons and dismissal by medical professionals; and promote anticipation of negative emotions (i.e., shame, fear, and embarrassment) and devalued social roles and status. Strategies reported to avoid stigmatization include avoiding HIV/STD knowledge; avoiding health care professionals, particularly in public settings; and conforming to community norms of shunning those suspected of risky behaviors. Results have direct implications for community marketing campaigns in China.

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ACKNOWLEDGMENTS

The study was funded by NIH/NIMH (grant #1U10MH61513) as a five-country Cooperative Agreement implementation of the Community Public Opinion Leader (C-POL) prevention program. The steering committee members for the study are Carlos F. Caceres, M.D. (Peru); David D. Celentano, Sc.D. (U.S./India); Thomas Coates, Ph.D. (U.S./Peru); Tyler Hartwell, Ph.D. (U.S./RTI); Danuta Kasprzyk, Ph.D. (U.S./Zimbabwe); Jeffrey A. Kelly, Ph.D. (U.S./Russia); Andrei Kozlov, Ph.D. (Russia); Willo Pequegnat (NIHM); Mary Jane Rotheram, Ph.D. (U.S./China); Suniti Solomon, M.D. (India); Godfrey Woelk, Ph.D. (Zimbabwe); and Zunyou Wu, M.D. (China). Our appreciation to the research team in Fuzhou, China, for their efforts in collecting and preparing the data for this study and to Michael Johnson, Ph.D., and Lai Ling Chau for their help developing and preparing this manuscript.

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Authors and Affiliations

  1. Department of Psychiatry and Biobehavioral Sciences, Neuropsychiatric Institute, Center for Culture and Health, University of California, Los Angeles, California, USA

    Eli Lieber

  2. Department of Psychiatry and Biobehavioral Sciences, Neuropsychiatric Institute, Center for Community Health, University of California, Los Angeles, California, USA

    Li Li & Mary Jane Rotheram-Borus

  3. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

    Zunyou Wu

  4. Fujian Institute of Health Education, Fuzhou, China

    Jihui Guan

  5. UCLA/NPI, Center for Culture and Health, 760 Westwood Plaza, P.O. Box 62, Los Angeles, California, 90024-1759, USA

    Eli Lieber

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The National Institute of Mental Health (NIMH) Collaborative HIV Prevention Trial Group

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Correspondence to Eli Lieber.

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Lieber, E., Li, L., Wu, Z. et al. HIV/STD Stigmatization Fears as Health-Seeking Barriers in China. AIDS Behav 10, 463–471 (2006). https://doi.org/10.1007/s10461-005-9047-5

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