Barcelona 2013
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| Abstract #303 - E-Posters English | ||||
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Session: 50.51: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Dr. Haochu Li - Wayne State University School of Medicine, United States |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: In response to the growing HIV epidemic, the Chinese government has practiced the ? Four Free and One Care? Policy since 2004, providing free counseling, free HIV testing, free antiretroviral treatment, basic living allowance to people with HIV (PWH), and care about children affected by HIV, supplemented by stigma reduction education for healthcare providers and the general population. Formal healthcare has long been emphasized. But very limited attention has been given to informal healthcare. An insiders? view of informal healthcare is also largely absent. Drawing on an ethnography among HIV positive men who have sex with men (MSM) in Shenzhen, Guangdong Province, conducted in 2010, we explored what roles informal healthcare play in HIV/AIDS prevention and intervention in contemporary China. | ||||
| Method / Issue: In this ethnographic study, thirty two repeated in-depth interviews and 13 one-time in-depth interviews were conducted among 45 HIV positive MSM. Twenty health care providers were interviewed with 9 in two group discussion and 11 in-depth interviews. Sixteen volunteers were interviewed with 6 in a focus group and 10 in informal interviews. Participant observations in MSM venues, NGO offices, and local health care settings were also conducted. Data content analysis was employed. | ||||
| Results / Comments: Informal healthcare practiced by participants included self-care, mutual care among peers and friends, care in community-based grassroots organizations, and care on tongzhi (gay) websites. Center for Disease Control and Prevention (CDC) staff reported low utilization of healthcare services they provided (e.g. counseling and testing) in the CDC system, but instead many MSM actively sought services from community-based grassroots organizations/groups where they felt comfortable and relaxed. However, very limited funding was delivered to these grassroots organizations/groups. Informal healthcare played alternative and reciprocal roles in HIV/AIDS prevention and intervention among MSM populations, but it was largely under developed and lack of professional support. The hierarchical philosophy and operation in formal healthcare system presented a tendency of controlling instead of building the MSM communities, asymmetric power relationship between formal healthcare system and MSM communities, lack of collaboration between healthcare institutes and community-based grassroots organizations/groups, and disproportionate funding distribution. | ||||
| Discussion: The top-down working style prohibited an effective response to the HIV epidemic. A concern of the mismatching between informal and formal healthcare therefore emerged. Effective self-care decision-making is to some degree influenced by professional treatment recommendations. The current study calls for empowering the MSM communities in China, including much more significant technical and financial support to community-based grassroots organization/groups, greater and more sustainable community-based supportive services, greater involvement of PLWH, and significant health navigators linking service resources to MSM in need, as ways in which quality of healthcare services can be maximized. | ||||
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