PUBLIC HEALTH

The HIV related risks among men having sex with men in rural Yunnan, China: a qualitative study

W C W Wong¹, J Zhang², S C Wu¹, T S K Kong³ and D C Y Ling⁴

¹ Department of Community and Family Medicine, Chinese University of Hong Kong, Room 408, School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong
² People’s Number Two Hopsital, Dali Old Town, Yunnan, China PRC
³ Faculty of Social Sciences and Humanities, University of Macau, Macau
⁴ Department of Economics, California State University, Fullerton 800 N, State College Blvd, Fullerton, CA 92834, USA

Correspondence to:
Correspondence to:
Dr William C W Wong
Department of Community and Family Medicine, Chinese University of Hong Kong, Room 408, School of Public Health, Prince of Wales Hospital, Shatin Hong Kong, Hong Kong; cwwong{at}cuhk.edu.hk

Objectives: To explore the characteristics and issues specific to HIV related risk behaviours among men who have sex with men (MSM) in rural China.

Method: Qualitative study using semistructured in-depth interviews in Dali prefecture, Yunnan. 24 informants recruited through a local MSM network, snowballing and by word of mouth. The main outcome measures were themes identified as increased exposures and risks to HIV.

Results: Risk behaviour, social stigma, one child policy and concepts of traditional Chinese medicine (TCM) had significant roles in the spread of HIV in rural China. Many MSM lead a life with double identities in China and condom use was found to be variable with attempts to "rationalise" the risky behaviour being its major determining factor. Health seeking behaviours of genitourinary problems were infrequent and illogical, which were further held back by the existing healthcare system and lack of sensitivity expressed by the health professionals.

Conclusions: Clear education messages to the general public while raising awareness among health professionals of the health risks and needs in MSM are essential in the prevention of the current HIV epidemic.

Abbreviations: MSM, men who have sex with men; STI, sexually transmitted infections; TCM, traditional Chinese medicine

Keywords: HIV; MSM; China

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