HIV Related Stigma among Service Providers in China

Summary

Principal Investigator: Li Li
Abstract: China has 1 million Persons Living with HIV (PLH) with the rate rising exponentially over the last five years. Yunnan Province represents the largest portion of China's HIV epidemic, primarily among injecting drug users. While undocumented systematically, substantial experience with other stigmatizing disorders and anecdotal accounts document that HIV-related stigma is high and impedes effective responses for prevention and care in China. This application addresses HIV-related stigma among health care providers in Yunnan Province. Stigma is defined as a multidimensional construct with sociocultural, structural, and interpersonal determinants; providers' stigmatizing attitudes and behaviors can be influenced by educating providers about HIV-related policies and providing access to implement the policies, training providers over time to be knowledgeable about transmission and how to protect themselves, acceptance of PLH, and diffusing positive messages to peers. It is anticipated that providers' attitudes and behaviors will influence health care delivery to PLH. A collaborative research team from the Chinese Center for Disease Control and the UCLA Center for Community Health will implement a 3-year investigation among health providers and administrators in Yunnan Province in 3 phases. Phase 1 will consist of qualitative interviews regarding HW-related experiences, stigma, barriers and facilitators of care to PLH, and assessment measures for these concepts with: 1) 20 PLH and 10 of their family members; 2) 20 service providers; and 3) 20 health service administrators, with the addition of questions focused on HIV-related policies and procedures. Phase 2 will consist of a survey of 900 service providers and administrators in Yunnan Province on the prevalence and sources of HIV-related stigma. Using the results from the initial phases, an intervention will be developed and pilot tested with 50 service providers and evaluated using a comparison group of 50 providers over 6-months. The goals of the intervention will be to reduce stigmatizing attitudes towards PLH and diffusion of positive messages about PLH from service providers, education on HIV-related policies and access to resources to implement HW testing, universal precautions, and HIV treatment and care (using current Chinese standards of care). These data will prepare the team to conduct a randomized controlled trial across different levels of health care providers in China.
Funding Period: 2003-09-12 - 2007-06-30
more information: NIH RePORT

Top Publications

  1. pmc HIV-related avoidance and universal precaution in medical settings: opportunities to intervene
    Li Li
    Center for Community Health, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA 90024, USA
    Health Serv Res 46:617-31. 2011
  2. pmc HIV-related stigma in health care settings: a survey of service providers in China
    Li Li
    Semel Institute Center for Community Health, UCLA, Los Angeles, California 90024, USA
    AIDS Patient Care STDS 21:753-62. 2007
  3. pmc Occupational exposure to HIV among health care providers: a qualitative study in Yunnan, China
    Chunqing Lin
    UCLA NPI Center for Community Health, University of California, Los Angeles, CA, USA
    J Int Assoc Physicians AIDS Care (Chic) 7:35-41. 2008
  4. pmc Individual attitudes and perceived social norms: Reports on HIV/AIDS-related stigma among service providers in China
    Li Li
    University of California at Los Angeles, Los Angeles, CA, USA
    Int J Psychol 44:443-50. 2009
  5. pmc Disclosure of HIV status is a family matter: field notes from China
    Li Li
    Institute Center for Community Health, University of California, Los Angeles, Los Angeles, CA 90024, USA
    J Fam Psychol 21:307-14. 2007
  6. pmc Institutional support for HIV/AIDS care in China: a multilevel analysis
    Li Li
    UCLA Semel Institute Center for Community Health, Los Angeles, CA, USA
    AIDS Care 20:1190-6. 2008
  7. pmc A brief HIV stigma reduction intervention for service providers in China
    Sheng Wu
    UCLA Semel Institute, Center for Community Health, Los Angeles, California 90024, USA
    AIDS Patient Care STDS 22:513-20. 2008
  8. pmc To tell or not to tell: HIV disclosure to family members in China
    Li Li
    UCLA NPI Center for Community Health, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024, USA
    Dev World Bioeth 8:235-41. 2008
  9. pmc Diffusion of positive AIDS care messages among service providers in China
    Li Li
    UCLA NPI Center for Community Health, Los Angeles, CA 90024, USA
    AIDS Educ Prev 19:511-8. 2007
  10. pmc Measuring HIV-related stigma among Chinese service providers: confirmatory factor analysis of a multidimensional scale
    Judith A Stein
    Department of Psychology, University of California Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095 1563, USA
    AIDS Behav 12:789-95. 2008

Scientific Experts

  • Li Li
  • J A Stein
  • Sheng Wu
  • Chunqing Lin
  • Zunyou Wu
  • Manhong Jia
  • Haijun Cao
  • Zhihua Yan
  • Li Jung Liang
  • Haixia Cui
  • Jianhua Li

Detail Information

Publications15

  1. pmc HIV-related avoidance and universal precaution in medical settings: opportunities to intervene
    Li Li
    Center for Community Health, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA 90024, USA
    Health Serv Res 46:617-31. 2011
    ..To determine the association between adherence to universal precaution (UP) and avoidance attitudes toward patients living with HIV/AIDS (PLH) among service providers...
  2. pmc HIV-related stigma in health care settings: a survey of service providers in China
    Li Li
    Semel Institute Center for Community Health, UCLA, Los Angeles, California 90024, USA
    AIDS Patient Care STDS 21:753-62. 2007
    ..A better understanding of HIV-related discrimination in health care settings requires consideration of both individual and institutional factors...
  3. pmc Occupational exposure to HIV among health care providers: a qualitative study in Yunnan, China
    Chunqing Lin
    UCLA NPI Center for Community Health, University of California, Los Angeles, CA, USA
    J Int Assoc Physicians AIDS Care (Chic) 7:35-41. 2008
    ..Further training and emphasis on universal precautions and PEP guidelines may reduce the risk of occupational infections...
  4. pmc Individual attitudes and perceived social norms: Reports on HIV/AIDS-related stigma among service providers in China
    Li Li
    University of California at Los Angeles, Los Angeles, CA, USA
    Int J Psychol 44:443-50. 2009
    ..Results underscored the importance of understanding social norms and personal attitudes in studying HIV-related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs...
  5. pmc Disclosure of HIV status is a family matter: field notes from China
    Li Li
    Institute Center for Community Health, University of California, Los Angeles, Los Angeles, CA 90024, USA
    J Fam Psychol 21:307-14. 2007
    ..This study illustrates that family is an intricate part of the disclosure process in China and demonstrates the importance of including families in HIV-AIDS interventions...
  6. pmc Institutional support for HIV/AIDS care in China: a multilevel analysis
    Li Li
    UCLA Semel Institute Center for Community Health, Los Angeles, CA, USA
    AIDS Care 20:1190-6. 2008
    ..Urgent need exists to address the unbalanced healthcare system in China and to consider the policy implications for an effective response to the HIV/AIDS epidemic...
  7. pmc A brief HIV stigma reduction intervention for service providers in China
    Sheng Wu
    UCLA Semel Institute, Center for Community Health, Los Angeles, California 90024, USA
    AIDS Patient Care STDS 22:513-20. 2008
    ..This brief intervention pilot showed potential in reducing HIV stigma and discrimination among service providers in China. Further intervention trials are needed to test the efficacy and long-term outcomes of this intervention...
  8. pmc To tell or not to tell: HIV disclosure to family members in China
    Li Li
    UCLA NPI Center for Community Health, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024, USA
    Dev World Bioeth 8:235-41. 2008
    ..There is an immediate need to re-examine HIV notification policies so that there are consistent guidelines and procedures for providers throughout China...
  9. pmc Diffusion of positive AIDS care messages among service providers in China
    Li Li
    UCLA NPI Center for Community Health, Los Angeles, CA 90024, USA
    AIDS Educ Prev 19:511-8. 2007
    ..Reported characteristics of a potential provider opinion leader in China will inform the design and implementation of future intervention programs...
  10. pmc Measuring HIV-related stigma among Chinese service providers: confirmatory factor analysis of a multidimensional scale
    Judith A Stein
    Department of Psychology, University of California Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095 1563, USA
    AIDS Behav 12:789-95. 2008
    ..The final stigma subscales included: Discrimination Intent at Work, Opinion about Health Care for HIV/AIDS Patients, Prejudiced Attitudes, Internalized Shame, and Fear of PLWHA...
  11. pmc Using case vignettes to measure HIV-related stigma among health professionals in China
    Li Li
    UCLA NPI Center for Community Health, University of California Los Angeles, 10920 Wilshire Boulevard, Los Angeles, CA 90024, USA
    Int J Epidemiol 36:178-84. 2007
    ..We examined Chinese health professionals' attitudes towards patients with AIDS vs patients with hepatitis B...
  12. pmc Universal precautions in the era of HIV/AIDS: perception of health service providers in Yunnan, China
    Sheng Wu
    Jane and Terry Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, 10920 Wilshire Boulevard, Suite 350, Los Angeles, CA 90024, USA
    AIDS Behav 12:806-14. 2008
    ..Effective universal precaution interventions need to target both administrators and providers, and address both structural barriers and individual attitudinal and behavioral factors...
  13. pmc Stigmatization and shame: consequences of caring for HIV/AIDS patients in China
    L Li
    University of California, Los Angeles, CA 90024, USA
    AIDS Care 19:258-63. 2007
    ....
  14. pmc Mandatory HIV testing in China: the perception of health-care providers
    Li Li
    Center for Community Health, Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA 90024, USA
    Int J STD AIDS 18:476-81. 2007
    ..Results underscore the importance of implementing universal precautions in health-care settings and call attention to social and ethical issues associated with HIV/AIDS control and treatment in China...
  15. pmc Understanding family support for people living with HIV/AIDS in Yunnan, China
    Li Li
    UCLA NPI Center for Community Health, University of California, Los Angeles, CA 90024, USA
    AIDS Behav 10:509-17. 2006
    ..This study illustrates that the support provided by family makes multiple levels of positive impact on people living with HIV/AIDS, suggesting the importance of including families in HIV/AIDS interventions...