Mainstreaming Gender And Culture In HIV/AIDS Programs:Ongoing Challenges And New Opportunities Between China And India

Stigma,fear and ignorance were the main attributes of the HIV epidemic in the 1980s when it raged throughout the world killing thousands of people.With no operative cure present in the 1980s,there was despair for individuals identified to have HIV/AIDS with many facing unbearable illness and certain death within a few years(Mohite,Mohite&George,2015).Three decades later since the AIDS pandemic began,over seventy million people have been infected by the virus and approximately 35 million persons have died.Currently,37 million people globally live with HIV/AIDS with about 22 million people using various HIV/AIDS medications(Singer,2018).The Study’s aim was to investigate and analyze the role of gender and culture in the formulation of effective national strategies of dealing with the HIV/AIDS pandemic.Both qualitative and quantitative data was collected in an effort to answer the Primary research question in the study.The research provides more profound insights into the relationship between these societal notions and HIV and develop a structure that can be used to manage the situation.Paradigm of a study represents the principle,thinking,perspective or beliefs of a researcher.Linking the thinking procedure and the working in a study,the paradigm is divided into 3 categories i.e.Ontology,Epistemology,and Axiology.Further,philosophy of a research helps in interpreting the knowledge or views of a researcher.Positivism,interpretivism,and realism are the three philosophies used for the research(Kivunja&Kuyini,2017).Research design determines the structure of a study by stating the process of collecting dataset,compiling,and analyzing it to fulfill the objectives of the study(Akhtar,2016).There are four types of research design i.e.descriptive,explanatory,exploratory,and experimental.This study adopts a combination of descriptive and exploratory researches.The descriptive approach was suitable for the survey wherein perceptions of the general population on the prevalence of the disease and policy effectiveness,and vulnerabilities were to be assimilated using a quantitative approach.On the other hand,the perspectives of policymakers in both the countries was important in order to determine first hand the challenges and opportunities in implementation of the policies.This study is based on analyzing the perception of educated employees and students(in case of survey),and policy makers(in case of interviews).Purposive sampling type is used for both the studies.This is type of nonrandom sampling method which helps in determining the participants on the basis of certain pre-decided criteria.It is necessary to test the accuracy and validity of the questionnaire before the collection of the primary data from the field.The questionnaire was pre-tested on 25 respondents.The pre-testing was conducted to check the validity of the questionnaire.Validity refers to the degree to which a study accurately reflects or assesses the specific concept that the researcher is attempting to measure.It is also concerned with measuring instrument(Kish,1987).After conducting the pre-testing,some modifications were made in the final questionnaire to enhance the validity of the survey.In case of the survey,the researcher included only those respondents in the study who are aware about the HIV/AIDS.The aim was to derive required information about the role of gender and cultural factors without having problem of irrelevance.It was also decided that the sample population for the interview would involve only policymakers,who were directly involved in the process of execution of government programs related to control and management of HIV AIDS in China and India.The qualitative analysis is based on analysis the perception of 40 policymakers where 20 each has been selected form India and 20 from China.The sample size for the quantitative analysis has been selected using Cochran’s sample size formula(Singh&Masuku,2014)i.e.N=z2*p*(1-p)/e2 Where,N=sample size Z=z-score(based on confidence level of 95%)i.e.1.96 p=estimated proportion of attribute in population i.e.0.5 e=desired level of precision i.e.0.05Thus,the sample size is 384.16 i.e.approx.385.In order to have accurate number,sample size considered for the analysis is 1000.The response of 500 citizens from each country was collected.For quantitative analysis,a close ended survey questionnaire was designed.The questionnaire consisted of questions pertaining to factors which would help in providing information about vulnerable population,factors,role of gender and cultural factors,national HIV/AIDS management policies,and opportunities and challenges.In order to administer the questionnaire,the researcher first identified the respondents from his network of university students and employees working in different organizations in both countries.However,since this was insufficient,the researcher later applied the snowball sampling method to further reach out to a greater number of respondents.The questionnaire was administered using Google Forms,the link for which was emailed to the respondents,along with a letter inviting them to participate in the survey.Further,for interview based qualitative analysis,an open-ended questionnaire was used.Questions asked in the interviews pertained to the five main objectives of this study;establishing the vulnerable population,ascertaining the vulnerability factors,evaluating the current programs for management of HIV/AIDS,role of gender and culture in transmission of the disease and challenges and opportunities in the implementation of the policies.The quantitative analysis approach in this study involves the frequency,correlation,and regression analysis using the SPSS Software.Initially for representing the demographic,and background profile of the respondents,frequency analysis has been used.For fulfilling the objective of identifying the vulnerable population,factors contributing in prevalence of HIV/AIDS,and determining the challenges and opportunities that a country face in implementing a HIV/AIDS prevention policy,frequency analysis method has been used.In order to determine the impact of gender and cultural factors on transmission and management of HIV/AIDS and determine the effectiveness of policies,correlation and regression analysis method has been used.The qualitative analysis approach involved the demographic profile analysis followed by the thematic analysis of the responses of the policy makers.As the effective tool for data collection was used in the study followed by the appropriate usage of analysis techniques,thus the results derived from the analysis are reliable and accurate.The data coding means systematically reorganization of the raw data into a format that is machine readable(Neuman,2006).In this research the frequently used codes were 1,2,3,4 and 5.Among other findings,the study established that there is a significant relationship betweengender and risk of HIV/AIDS infection in both India and China.Further investigation and analysis established that women are at a higher risk of HIV infection in both India and China as Compared to their male counterparts.The inconsistency in the results is,perhaps,based on the fact that culture is a wide topic,and contextualization is very important to clarify what aspect of culture specifically.There were aspects of culture that showed statistical significance,for example,cultural inertia,which implies that culture should be examined as a whole,but by focusing on facets that are relevant to the subject of investigation at a particular period.An analysis of Indian respondents shows that in India sex workers,orphans,drug abusers,young boys and girls,and uninformed people are the most vulnerable population.They are more prone to the risk of HIV/AIDS.Major factors which contribute in infecting citizens of India is unprotected sex,sex business,lack of hygiene maintenance in healthcare institutions,poverty,lack of education,false beliefs that HIV is found in female,early marriages,or widow inheritance,and lack of knowledge about safe sex.All these factors tend to make HIV/AIDS prone to females,and young population in India.Analysis of Chinese respondents show that in China apart from uninformed people,mostly sex workers,drugs abusers,young boys and girls,and migrant workers are the most vulnerable population of China.Population of China is mainly affected by HIV/AIDS due to drug injections,involvement in sex business,lack of hygiene in health institutions,Lack of education,lack of knowledge about relevance of safe sex,and multiple partner sex.As recommendation for india With respect to the vulnerable groups increased awareness and commitment from the government,donors and NGOs can help to fight HIV/AIDS.This could further create and opportunity to overcome the barriers,laws and the attitudes that has forced this vulnerable group to go in isolation.Further these vulnerable groups should also work towards developing their own groups and organizations for better prevention and right recognition.Such organizations can probably give voice to the community and could develop a new partnership with other community based and government organizations.Moreover,there should be comprehensive quality health care services.Policymakers while designing the HIV prevention policies should focus on the fact the services such as management of sexually transmitted diseases,HIV counseling and testing is equally provided to everyone.For China it could be recommended that In order to increase the awareness on this issue there could be community radio that can be established.This could work as an easy,agile,dynamic and efficient channel in order to disseminate information in the community.Skill building workshops can be an effective approach that can possibly bring sex workers out of isolation.Educating them on HIV/AIDS,providing them information regarding the treatment procedure,educating them on adopting safer sex can reduce the risk of HIV/AIDS among them.Behavioral change could also play an important role in improving the condition with respect to HIV/AIDS in both the countries.Although it is not easy to convince people that by changing their behavior,they can reduce their vulnerability to HIV infection.It is a complex process that requires social and economic factors such as gender,culture and the poverty issues must also be addressed to bring change in the overall behavior.Despite efforts of international and national HIV/AIDS prevention organizations,many people are still infected by these pandemics.Thus,in order to fulfill the requirements of a HIV/AIDS infected patient,it is required to know the perspective of them.Hence,for further studies,focus could be on including the perspective of HIV/AIDS infected people about the factors which mainly lead to transmission of these pandemic and what are their further requirements.This would help in suggesting more effective policies which would fulfill the needs of a HIV/AIDS infected person along suggesting the measures which would help in prevention of the transmission of HIV/AIDS.