title: Economic stress and HIV-associated health care utilization in a rural region of China: a qualitative study.
abstract: China is experiencing an emerging HIV epidemic, primarily affecting the rural poor. For this group, the costs of staying healthy are often beyond their means. A qualitative study was undertaken with 20 HIV-positive people living in a rural area in Anhui, eastern China, 20 of their family members, 20 health care providers, and 20 uninfected villagers. In this area, the majority of HIV-positive people were infected through contaminated commercial plasma/blood donation procedures. In-depth interviews were conducted with participants to identify the barriers and enablers to accessing health care services for HIV. A major concern for affected villagers was the unaffordable costs of health care, which leads them to delay seeking services until symptoms are severe. Use of the health care system was also influenced by the availability of subsidized medications, distance to the health care centre and quality of available services. In contrast, participants were very positive about antiretroviral treatment services, which are now free. In the study area, access to health care is heavily subsidized, yet many still found these services unaffordable. More equitable and affordable services will be needed if China is to control its HIV epidemic.
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.forename: Sheena G
authors.initials: SG
authors.lastname: Sullivan
authors.forename: Zhi
authors.initials: Z
authors.lastname: Dou
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents; D001294:Attitude to Health; D001782:Blood Donors; D002681:China; D004363:Drug Utilization; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000523:psychology / Q000628:therapy; D006297:Health Services Accessibility / Q000191:economics*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D011203:Poverty; D019035:Rural Health Services / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D012424:Rural Population
chemical_list: D019380:Anti-HIV Agents