The overwhelming majority of urban and rural people in China have heard of HIV, but less than a third of the population know that condoms are an effective way of preventing transmission of the virus according to a study conducted in the Spring of 2002.
It’s currently thought that as many as 1 million Chinese are infected with HIV, a figure which UNAIDS is predicting will increase ten-fold by 2010 unless comprehensive HIV prevention and awareness programmes are introduced by the Chinese authorities. To assess current levels of knowledge about HIV amongst the inhabitants of the world’s most populous country, the Futures Group added a series of questions to a Horizon Research survey conducted in April-May 2002. The survey was carried out in ten large cities and ten rural towns and was completed by 6,777 people, who were broadly representative of the age, education, income and employment profile of the Chinese population.
The overwhelming majority of people, 93% of the urban population and 83% of small town residents, had heard of HIV. However, less than three quarters of city dwellers and two thirds of town residents knew the three main routes of HIV transmission: sex, blood and contact with other body fluids. The study also showed that massively increased HIV prevention efforts are needed, as only 31% of city dwellers and 23% of town dwellers knew that condoms were an effective way of preventing the sexual transmission of HIV.
The level of knowledge about HIV and ways to prevent its transmission was also related to gender, age, education, and income. Male town residents were more likely than their female neighbours to know that condoms can prevent the spread of HIV (a little under 28% versus 19%). Older people were less likely to have heard of HIV than younger people and know about effective prevention measures. Higher monthly income was also found to be a predictor of enhanced knowledge about HIV, as was the number of years spent in education. Over 97% of college graduates in cities and 93% of town dwelling graduates knew of HIV, compared to only 83% of city dwellers with lower education attainment and 67% of town dwellers.
The study also found high levels of prejudice directed at people with HIV. Nearly 60% of the urban sample and over two thirds of the town sample thought that people with HIV should be prevented from returning to work, and nearly a third of both city and town residents said that they would refuse to care for a relative with HIV. Shame and stigma was also attached to HIV by both city and town dwellers, with 39% of city dwellers and 49% of town dwellers saying that they would want the HIV status of a family member keeping secret.
Again, answers were related to gender, age, and educational and income level, with women, younger people and people with a college education less likely to stigmatise HIV.
The overwhelming majority of both city (79%) and town residents (81%) thought that HIV posed little risk to them, and only a third of city dwellers said that they had changed their behaviour because of HIV. Where there had been behavioural change, sticking to one sexual partner or reducing the number of sexual partners was the most commonly reported strategy (29%). Only 5% of men and women in cities said they now used condoms for every sexual encounter.
High levels of suspicion about the safety of China’s blood supply were found by investigators, with approximately 40% saying that they would be cautious about receiving a blood transfusion. The investigators note that these figures indicate the study sample were “aware of the plight of people in China who became infected from selling blood.”
Amongst people at high risk of HIV (people under 50, and people with more than one sexual partner), higher knowledge about the three main routes of HIV transmission was found by the investigators, and also more understanding about effectiveness of condoms as a means of HIV prevention (approximately 42% of city residents and 37% of town residents).
The study concludes that “there is fairly widespread awareness of HIV and its existence in China”. However, “general awareness of HIV issues must be increased for people to understand how to protect themselves” reduce stigma, and “ultimately bring the AIDS crisis under some form of control in China.”