Stigma, Sex and Family Life: Serodiscordance in Henan Province, China

Abstract

The HIV epidemic in central China resulted from widespread unsanitary blood collection practices common in the 1990s. In Henan Province, a blood selling “hot spot,” disease control agencies have been monitoring serodiscordant couples since the early 2000s. Sociological insights into ways these couples experience stigma and HIV risk were obtained from in-depth interviews with 52 HIV-positive individuals, forty of whom were enrolled after their HIV diagnosis and 12 who were initially-uninfected partners who acquired HIV during follow-up. Sexual and condom use behaviors within serodiscordant partnerships were largely dictated by male partners, regardless of whether consistent use was to protect themselves or their partner, or whether lax use placed themselves or their partner at risk. Most respondents did not see ART as a prevention strategy, perhaps due to limited understanding about viral suppression and infectiousness. Interviewees reported experiencing HIV stigma at the family level, most acutely in the form of anxiety that being an HIV-afflicted family might impair the marriage prospects of their offspring or damage relationships with in-laws. Thus, this chapter challenges the common conceptualisation of “serodiscordance” as pertaining only to intimate partners by showing that, in family-oriented rural China, mixed status encompasses and affects broader social relationships.