Current Situation Of Discrimination Of China's Women Living With HIV/AIDS During Their Medical Visits

BackgroundBy of the end of 2009, the estimated number of people living with HIV/AIDS (PLWHA) in China was 740,000, with women accounting for 30.5% of that population. AIDS-related discrimination coerces PLWHA to remain a hidden population, and withdraw from seeking required support and treatment services, often delaying effective treatment opportunities. In the face of AIDS, women tend to be more vulnerable than men, and suffer more stigma and discrimination. There is a paucity of research on this form of gender-based discrimination, which makes it more necessary to carry out this study.ObjectivesThe purpose of this research is to understand the context of discrimination against women living with HIV/AIDS during their medical visits, to summarize the main challenges and reasons behind this treatment, and provide relevant policy recommendations for addressing discrimination against women.MethodQuantitative and qualitative methods were used in this study, In particular, convenience-sampling methods were used in Liuzhou City, Guangxi Province, Changsha, Hunan Province, Guangzhou Guangdong Province, and Beijing, and questionnaire surveys were used for 100 women and 107 men living with HIV/AIDS, including one-on-one interviews. The surveys collect demographic information, behavioral information during medical visits, and prevalence of discrimination in the healthcare setting. The interviews were consolidated and analyzed using Epidata3.1 software for entry data and SPSS 16.0 for statistical analysis. Sampling and snowball sampling methods were used to access participants, and in-depth interviews were carried out with women and men living with HIV/AIDS, as well as doctors and healthcare providers, in order to understand their experiences and perspectives of discrimination in a healthcare setting. These interviews were coded and summarized for analysis.Results1) The questionnaire surveys were carried out with 100 women and 107 men living with HIV/AIDS in total. Personal in-depth interviews were carried out with 20 interviewees, including one CDC manager, one manager, three healthcare workers in the infectious disease department, two doctors in non-HIV/AIDS departments in designated hospitals, and 10 women and three men living with HIV/AIDS.2) Based on the research, findings estimate that 20% of women and 4.7% of men have the self-perception of experienced gender-based discrimination from medical staff, translating into a statistically significant difference of 2=11.436, P= 0.001. A further 28% of women and 15% of men have the self-perception of experienced discrimination from medical staff based on their mode of transmission, a statistical significance ofχ2= 5.257, P=0.022.3)-Following confirmation of an HIV infection,19% of women had been infected with HIV because of reduced frequency of physical examinations, and 18% of women reduced the number of medical visits. An estimated 46.9%(46/98) had undergone a gynecological examination, and 20.37% of people were concerned about revealing their HIV status during medical visits.4) An estimated 86.9% and 49% of women think the standard of medical treatment is "good" and "very good" respectively. The proportion of women who were able to resolve their health problems in hospitals differed between AIDS-designated hospitals and non-designated hospitals were 91.3% and 52.9% respectively, translating into a statistical difference ofχ2=12.484, P= 0.007, andχ2=10.314, P=0.006.5) at the macroscopic view, there are positive factors to promote the medical visits of women living with HIV/AIDS in the police, economic, society and technical aspects, but the negative factors are also obviously.6) The qualitative surveys found that the main reasons for discrimination against women with HIV/AIDS during medical visits included:lack of advocacy for women, insufficient training for medical staff, fear of occupational exposure, and lack of adequate risk protection in place for staff.ConclusionsThis research reveals that discrimination exists frequently during medical visits for both women and men, particularly women have more self-perception of experienced discrimination on gender-based and mode of transmission from medical staff.. The healthcare settings of gynecology and reproductive are not optimistic, and self-discrimination among women themselves induce them to reduce of the frequency of medical visits. The establishment of AIDS-designated hospitals both facilitates and hinders the medical visits of women living with HIV/AIDS. The macroscopic view either promotes or blocks the medical visits of women living with HIV/AIDS. The main reasons for discrimination against these women in the healthcare setting include:insufficient level of AIDS awareness in hospitals; stereotypes of HIV/AIDS; inadequate levels of occupational protection for staff; concerns about the impact of medical resources, and potential for cross infection and the patient arrears.