title: Exploring the social meaning of curing HIV: a qualitative study of people who inject drugs in Guangzhou, China.
abstract: Our objective was to explore the social meaning of HIV and perceptions of an HIV cure among people who inject drugs (PWID) in Guangzhou, China, which speaks to ethical and resource challenges to development in this field. We conducted a qualitative research study using in-depth interviews. We analyzed interview transcripts from 29 PWID, eight physicians, and three social workers from an outpatient HIV clinic and two methadone maintenance treatment centers. The social meaning of HIV infection and perceptions of an HIV cure reflected patients' relationships with society, health systems, and physicians. First, HIV infection decreased perceived social worth and disrupted peer relationships. The possibility of being cured renewed patient hope for regaining physical well-being and achieving social mobility. However, the existence of a cure may not alter the HIV-related stigma due to its association with stigmatized behaviors and marginalized groups. Second, although stigma was a significant barrier to engagement in health care, hope for a cure may outweigh fears of stigma and enhance linkage to HIV testing and treatment as well as methadone services. A cure may exacerbate perceived health disparities if inaccessible to key affected populations such as PWID. The social implications of an HIV cure among this key affected population may inform the design and implementation of cure clinical trials. Careful management of patient expectations, focusing research on key affected populations, expanding HIV testing and treatment systems, improving access to harm reduction programs, and ensuring post-trial access are important considerations for HIV cure research.
authors.affiliation: 1 Department of Medicine, School of Medicine, University of California San Francisco , San Francisco, California.
authors.forename: Carissa E
authors.initials: CE
authors.lastname: Chu
authors.forename: Feng
authors.initials: F
authors.lastname: Wu
authors.forename: Xi
authors.initials: X
authors.lastname: He
authors.forename: Qingyan
authors.initials: Q
authors.lastname: Ma
authors.forename: Yu
authors.initials: Y
authors.lastname: Cheng
authors.forename: Weiping
authors.initials: W
authors.lastname: Cai
authors.forename: Paul
authors.initials: P
authors.lastname: Volberding
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002681:China; D003625:Data Collection; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008691:Methadone; D008875:Middle Aged; D012929:Psychological Distance; D062487:Social Marginalization; D057545:Social Stigma; D015819:Substance Abuse, Intravenous / Q000821:virology*
chemical_list: D019380:Anti-HIV Agents; D008691:Methadone