Skip to main content
SpringerLink
Log in

Stigma, Modernization, Sex Behavior, and Infection Risk Among Chinese Youth

  • Chapter
  • First Online:
Stigma, Discrimination and Living with HIV/AIDS

  • 4410 Accesses

Abstract

HIV intervention and education efforts in China continue to be frustrated by the clear stigma associated with the disease inherent in Chinese culture. While modernizing and evolving rapidly, the Chinese sociocultural context continues to be influenced by traditional Confucian and Taoist philosophies. At the same time, there is growing tolerance of premarital and extramarital sex, particularly among younger groups as a result of their access to and interest in media and other resources exposing them to world outside traditional Chinese culture. The dangers of sexual behavior risk inherent in this changing environment are clear and worthy of serious attention. In this study, we address the issues surrounding a need for innovative and effective HIV/STD prevention efforts given the influence of social stigma, traditional values and expectations, a relative absence of reliable and trustworthy information about sexual health, and expanding and unguided exposure to information from outside sources. Identifying and working respectfully within the cultural belief systems dominant in the sociocultural context is as important to intervention design as a thorough evaluation of a target population’s needs, behaviors, and characteristics. Findings from a relatively young and uneducated sample expose and explicate the salient cultural schemata in this context, as well as how these schemata, coupled with the rapidly changing social environment, should inform intervention planning and implementation. We expect that the benefits of this study’s approach, framework, and findings can be incorporated into future intervention design among Chinese populations. These considerations will help guide a program’s effectiveness by enhancing the “fit” of the intervention to the target population and help boost program strength and sustainability.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abdullah, A. S. M., Fielding, R., Hedley, A. J., & Luk, Y. K. (2002). Risk factors for sexually transmitted diseases and casual sex among Chinese patients attending sexually transmitted disease clinics in Hong Kong. Sexually Transmitted Diseases, 29(6), 360–365.

    Article  Google Scholar 

  • Abdullah, A. S. M., Fielding, R., Hedley, A. J., & Stewart, S. M. (2005). Effects of a brief health education intervention on AIDS among young Chinese adults in Hong Kong. Journal of Health Sciences, 51(2), 115–121.

    Article  Google Scholar 

  • Bandura, A. (1977). Social learning theory. New York: General Learning Press.

    Google Scholar 

  • Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs: Prentice-Hall.

    Google Scholar 

  • Beech, H. (2005, December 12). Sex, please—We’re young and Chinese. Time, 166, 61.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2009, April 24). HIV infection – Guangdong Province, China, 1997–2007. Morbidity and Mortality Weekly Report, 58(15), 396–400.

    Google Scholar 

  • Central Intelligence Agency. (2009). The world fact book. Retrieved March 24, 2010, from https://www.cia.gov/library/publications/the-world-factbook/geos/ch.html

  • China Center for Disease Control and Prevention. (2004). HIV/AIDS surveillance report in 2003. Beijing: China Center for Disease Control and Prevention.

    Google Scholar 

  • China Daily Online. (2004).Candid sex talk helps ignorant teenagers. Retrieved March 28, 2008, from http://www.chinadaily.com.cn/2004-03/02/content_310927.htm

  • Choi, K. H., Xiwen, Z., Shuquan, Q., Yiee, K., & Mandel, J. (2000). HIV risk among patients attending sexually transmitted disease clinics in China. AIDS and Behavior, 4(1), 111–119.

    Article  Google Scholar 

  • Detels, R., Wu, Z., Rotheram, M. J., Li, L., Guan, J., Yin, Y., Liang, G., Lee, M., Hu, L., & The NIMH Collaborative HIV Prevention Trial Group. (2003). Sexually transmitted disease prevention and characteristics of market workers in eastern China. Sexually Transmitted Diseases, 30, 803–808.

    Article  Google Scholar 

  • Elkind, D. (1967). Egocentrism in adolescence. Child Development, 38, 1025–1034.

    Article  Google Scholar 

  • Gao, Y., Lu, Z., Shi, R., Sun, X., & Cai, Y. (2001). AIDS and sex education for young people in China. Reproduction, Fertility, and Development, 13, 729–737.

    Article  Google Scholar 

  • Gillet, K. (2011). Stigma stays despite lifting of ban on people with HIV. Retrieved May 15, 2011, from http://www.ipsnews.net/print.asp?idnews=51247

  • Grusky, O., Liu, H., & Johnston, M. (2002). HIV/AIDS in China: 1990–2001. AIDS and Behavior, 6(4), 381–393.

    Article  Google Scholar 

  • Hruschka, D. J., Schwartz, D., St. John, D. C., Picone-Decaro, E., Jenkins, R. A., & Carey, J. W. (2004). Reliability in coding open-ended data: Lessons learned from HIV behavioral research. Field Methods, 16(3), 307–331.

    Article  Google Scholar 

  • Hwang, K. K. (1999). Filial piety and loyalty: Two types of social identification in Confucianism. Asian Journal of Social Psychology, 2(1), 163–183.

    Article  Google Scholar 

  • Juan, S. (2009). China’s HIV population to hit 740,000. Retrieved March 24, 2010, from http://www.chinadaily.com.cn/2009-11/24/content_9038385.htm

  • Lau, J. T. F., Siah, P. C., & Tsui, H. Y. (2002a). Behavioral surveillance and factors associated with condom use and STD incidences among the male commercial sex client population in Hong Kong – Results of two surveys. AIDS Education and Prevention, 14(4), 306–317.

    Article  Google Scholar 

  • Lau, J. T. F., Tsui, H. Y., Siah, P. C., & Zhang, K. L. (2002b). A study on female sex workers in southern China (Shenzhen): HIV-related knowledge, condom use, and STD history. AIDS Care, 14(2), 219–233.

    Article  Google Scholar 

  • Li, X., Fang, X., Lin, D., Mao, R., Wang, J., Cottrell, L., Harris, C., & Stanton, B. (2004). HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China. AIDS Education and Prevention, 16(6), 538–556.

    Article  Google Scholar 

  • Li, X., Wang, H., Williams, A., & He, G. (2009). Stigma reported by people living with HIV in South Central China. The Journal of the Association of Nurses in AIDS Care, 20(1), 22–30.

    Article  Google Scholar 

  • Li, L., Liang, L. J., Wu, Z., Rotheram-Borus, M. J., & The NIMH Collaborative HIV/STD Prevention Trial Group. (2010). AIDS, 24, 115–122.

    Article  Google Scholar 

  • Lieber, E., Weisner, T. S., & Presley, M. (2003). EthnoNotes: An internet-based field note management tool. Field Methods, 15(4), 405–425.

    Article  Google Scholar 

  • Lieber, E., Li, L., Wu, Z., Rotheram-Borus, M. J., Guan, J., & The National Institute of Mental Health (NIMH) Collaborative HIV Prevention Trial Group. (2006). HIV/AIDS stigmatization fears as health seeking barriers in China. AIDS and Behavior, 10(5), 263–271.

    Article  Google Scholar 

  • Lieber, E., Chin, D., Li, L., Rotheram-Borus, M. J., Detels, R., Wu, Z., Guan, J., & The National Institute of Mental Health (NIMH) Collaborative HIV Prevention Trial Group. (2009). Sociocultural contexts and communication about sex in China: Informing HIV/STD prevention programs. AIDS Education and Prevention, 21(5), 415–429.

    Article  Google Scholar 

  • Liu, H., Xie, J., Yu, W., Song, W., Gao, Z., Ma, Z., & Detels, R. (1998). A study of sexual behavior among rural residents of China. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 19, 80–88.

    Article  Google Scholar 

  • Liu, H., Li, X., Stanton, B., Liu, H., Liang, G., Chen, X., Yang, H., & Hong, Y. (2005). Risk factors for sexually transmitted disease among rural-to-urban migrants in China: Implications for HIV/sexually transmitted disease prevention. AIDS Patient Care and STDs, 19(1), 49–57.

    Article  Google Scholar 

  • Marsella, A. J., & Choi, S. C. (1993). Psychological aspects of modernization and economic development in East Asian nations. Psychologia: An International Journal of Psychology in the Orient, 36(4), 201–213.

    Google Scholar 

  • Millstein, S. G., & Moscicki, A. B. (1995). Sexually-transmitted disease in female adolescents: Effects of psychosocial factors and high risk behaviors. Journal of Adolescent Health, 17(2), 83–90.

    Article  Google Scholar 

  • People’s Daily Online. (2003). China targets adolescent health with sex education. Retrieved May 28, 2007, from http://www.englishpeopledaily.com.cn/200307/14/print20030714_120158.html

  • Rou, K., Sullivan, S. G., Liu, P., & Wu, Z. (2010). Scaling up prevention programmes to reduce the sexual transmission of HIV in China. International Journal of Epidemiology, 39, 38–46.

    Article  Google Scholar 

  • Ruan, F. F., & Matsumura, M. (1991). Sex in China: Studies in sexology in Chinese culture. New York: Plenum Press.

    Google Scholar 

  • Ryan, G. W., & Bernard, H. R. (2003). Techniques to identify themes. Field Methods, 15(1), 85–109.

    Article  Google Scholar 

  • SocioCultural Research Consultants, LLC. (2010). Dedoose version 3.1. www.Dedoose.com

  • Stutterheim, S. E., Pryor, J. B., Bos, A. E. R., Hoogendijk, R., Muris, P., & Schaalma, H. P. (2009). HIV-related stigma and psychological distress: The harmful effects of specific stigma manifestations in various social settings. AIDS, 23(17), 2353–2357.

    Article  Google Scholar 

  • UNAIDS (Joint United Nations Programme on HIV/AIDS). (2010). Global report: UNAIDS report on the global AIDS epidemic, 2010. Geneva: UNAIDS.

    Google Scholar 

  • Wallman, S. (2001). Global threats, local options, personal risk: Dimensions of migrant sex work in Europe. Health, Risk & Society, 3(1), 75–87.

    Google Scholar 

  • Weller, S. C. (1998). Structured interviewing and questionnaire construction. In H. R. Bernard (Ed.), Handbook of methods in cultural anthropology (pp. 365–409). Walnut Creek: AltaMira Press.

    Google Scholar 

  • Wu, D. Y. H. (1996). Chinese childhood socialization. In M. H. Bond (Ed.), The handbook of Chinese psychology (pp. 143–154). New York: Oxford University Press.

    Google Scholar 

  • Wu, Z. Y., Zhang, J. P., Detels, R., Li, V., Cheng, H., Duan, S., Li, Z. R., Dong, L. L., Huang, S. F., Jia, M. H., & Bi, X. Q. (1997). Characteristics of risk-taking behaviors, HIV and AIDS knowledge, and risk perception among young males in southwest China. AIDS Education and Prevention, 9(2), 147–160.

    Google Scholar 

  • Wu, Z., Rou, K., & Cui, H. (2004). The HIV/AIDS epidemic in China: History, current strategies, and future challenges. AIDS Education and Prevention, 16(3), 7–17.

    Article  Google Scholar 

  • Yang, K. S. (1996). The psychological transformation of the Chinese people as a result of societal modernization. In M. H. Bond (Ed.), The handbook of Chinese psychology (pp. 479–498). New York: Oxford University Press.

    Google Scholar 

  • Yang, K. S. (1998). Chinese responses to modernization: A psychological analysis. Asian Journal of Social Psychology, 1(1), 75–97.

    Article  Google Scholar 

  • Yang, X. (2005). Does where we live matter? Community characteristics and HIV and sexually transmitted disease prevalence in southwestern China. International Journal of STD & AIDS, 16, 31–37.

    Article  Google Scholar 

  • Zhang, K., Li, D., Li, H., & Beck, E. J. (1999). Changing sexual attitudes and behaviors in China: Implications for the spread of HIV and other sexually transmitted diseases. AIDS Care, 11(5), 581–589.

    Article  Google Scholar 

  • Zhang, I., Zhu, J., Tian, P., Chen, Y., Song, Y., & Chen, Y. S. (2000). Sexual behaviors and associated factors among unmarried female migratory workers in Guangzhou. Chinese Journal of Family Planning, 60, 162–164.

    Google Scholar 

  • Zhang, L., Gao, X., Dong, Z., Tan, Y., & Wu, Z. (2002). Premarital sexual activities among students in a university in Beijing, China. Sexually Transmitted Diseases, 29, 212–215.

    Article  Google Scholar 

  • Zhang, H., Stanton, B., Li, X., Mao, R., Sun, Z., Kaljee, L., Clemens, M., Ravendhran, S., & Qu, M. (2004). Perceptions and attitudes regarding sex and condom use among Chinese college students: A qualitative study. AIDS and Behavior, 8(2), 105–117.

    Article  Google Scholar 

  • Zhou, Y. R. (2009). Help-seeking in a context of AIDS stigma: Understanding the healthcare needs of people with HIV/AIDS in China. Health & Social Care in the Community, 17(2), 202–208.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 644 36th Street, Manhattan Beach, CA, 90266, USA

    Eli Lieber Ph.D.

  2. Center for Culture and Health, Fieldwork and Qualitative Data Research Laboratory, University of California, Los Angeles, CA, USA

    Eli Lieber Ph.D.

  3. 956 Parkman St., Altadena, CA, 91001, USA

    Ioakim Boutakidis Ph.D.

  4. Child and Adolescent Studies, College of Health and Human Development, California State University Fullerton, Fullerton, CA, USA

    Ioakim Boutakidis Ph.D.

  5. 1352 Cedar St., Santa Monica, CA, 90405, USA

    Dorothy Chin Ph.D.

  6. Department of Psychiatry, Semel Institute of Neuroscience and Human Behavior, Los Angeles, CA, USA

    Dorothy Chin Ph.D.

Authors
  1. Eli Lieber Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ioakim Boutakidis Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dorothy Chin Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eli Lieber Ph.D. .

Editor information

Editors and Affiliations

  1. School of Public Health, La Trobe University, Bundoora, 3086, Victoria, Australia

    Pranee Liamputtong

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Lieber, E., Boutakidis, I., Chin, D. (2013). Stigma, Modernization, Sex Behavior, and Infection Risk Among Chinese Youth. In: Liamputtong, P. (eds) Stigma, Discrimination and Living with HIV/AIDS. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6324-1_14

Download citation

Publish with us

Policies and ethics

Search

Navigation