Expressions of HIV-Related Stigma among Rural-to-Urban Migrants in China

In China, HIV-related stigma is considered as a formidable barrier in the combat against the HIV epidemic. There have been few qualitative investigations on HIV-related stigma in China, especially among a vulnerable population of rural-to-urban migrants. Based on 90 in-depth interviews conducted in 2002–2003 with rural-to-urban migrants in Beijing and Nanjing, China, this study examines the forms and expressions of HIV-related stigma from migrants' perspectives regarding HIV infection and individuals at risk of HIV infection. Consistent with the general framework on stigma, Chinese rural-to-urban migrants' attitudes toward HIV infected individuals take forms of denial, indifference, labeling, separation, rejection, status loss, shame, hopelessness, and fear. These stigmatizing attitudes were mainly derived from fears of AIDS contagion and its negative consequences, fears of being associated with the diseases, and culturally relevant moral judgments. In addition to universal AIDS stigma, both traditional Chinese culture and socially marginalized position of rural migrant population have contributed to culturally unique aspects of stigmatizing attitudes among rural-to-urban migrants. These multifaceted manifestations of HIV-related stigma suggest that HIV stigma reduction intervention needs to address multiple aspects of HIV stigma and stigmatization including personal, cultural, institutional, and structural factors

Attempted suicide among young rural women in the People's Republic of China: Possibilities for prevention

This article reports on a sample of 147 women under age 35 living in rural areas in China who had attempted suicide and were treated in the emergency room of hospitals in four different locations. The interview instrument took 2 to 3 hours to complete and included audiotaped in-depth interviews with the patient and family members (separately); detailed evaluation of the circumstances surrounding the attempt, life events, and the family environment; and a formal psychiatric evaluation by an attending-level psychiatrist. Overwhelmingly, the method used by the attempters was poisoning with highly lethal pesticides and organic fertilizers. The women's suicidal behavior was characterized by high levels of impulsivity; little effort to seclude themselves before and after ingesting poison; and low rates of mental illness, including depression. Detailed suggestions are made about ways to implement suicide prevention strategies within the particular social and economic context of China

Measuring accessibility to health care services for older bus passengers: A finer spatial resolution

Health care accessibility is a vital indicator for evaluating areas where there are medical shortages. However, due to the lack of population data with a satisfactory spatial resolution, efforts to accurately measure health care accessibility among older individuals have been hampered to some extent. To address this issue, we attempt to measure accessibility to health care services for older bus passengers in Nanjing, China, using a finer spatial resolution. More specifically, based on one month's worth of bus smart card data, a framework for identifying the home stations (i.e., a passenger's preferred station near their residence) of older passengers is developed to measure the aggregate demand at the bus stop scale. On this basis, a measurement that integrates the Gaussian two-step floating catchment area (2SFCA) and the adjusted 2SFCA methods (referred to as the adjusted Gaussian 2SFCA method) is proposed to measure accessibility to health care services for older people. The results show that: (1) almost all home stations experience inflated demand, especially those located in the suburbs; (2) despite abundant health care resources, home stations in urban districts are rarely identified as high accessibility stations, due to high demand densities among the older population; and (3) more attention should be paid to two types of home stations – those with a medical institution and those with bed shortages, respectively. The first type is predominantly distributed in the periphery of the city, in the suburbs where the travel time required to access the nearest health care service by bus is longer. The second type is mostly located in the outskirts of urban districts and in the central area of one suburb. These findings could help policymakers to implement more appropriate measures to design and reallocate health care resources