Timothy D Becker1, Ohemaa B Poku2, Xinlin Chen3, Jeffrey Wong4, Amar Mandavia5, Minda Huang6, Yuqi Chen7, Debbie Huang8, Hong Ngo9, Lawrence H Yang8,10. 1. Department of Psychiatry, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 2. Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. 3. Department of Psychiatry, New York University School of Medicine, New York, NY, USA. 4. School of Psychology, University of Queensland, Brisbane, Australia. 5. Teachers College, Columbia University, New York, NY, USA. 6. Department of Psychology, University of Hartford, West Hartford, CT, USA. 7. Department of Educational and Psychological Studies, University of Miami, Miami, FL, USA. 8. Mailman School of Public Health, Columbia University, New York, NY, USA. 9. Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA. 10. Department of Social & Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA.
Abstract
Objectives: Asian Americans have poor HIV-related outcomes, yet culturally salient barriers to care remain unclear, limiting development of targeted interventions for this group. We applied the 'what matters most' theory of stigma to identify structural and cultural factors that shape the nature of stigma before and after immigration from China to the US.Design: Semi-structured interviews were conducted with 16 immigrants to New York from China, recruited from an HIV clinic and community centers. Deductive followed by focal inductive qualitative analyses examined how Chinese cultural values (lian, guanxi, renqing) and structural factors influenced stigma before and after immigration. Results: In China, HIV stigma was felt through the loss of lian (moral status) and limited guanxi (social network) opportunities. A social structure characterized by limited HIV knowledge, discriminatory treatment from healthcare systems, and human rights violations impinged on the ability of people living with HIV to fulfill culturally valued goals. Upon moving to the US, positions of structural vulnerability shifted to enable maintenance of lian and formation of new guanxi, thus ameliorating aspects of stigma.Conclusions: HIV prevention and stigma reduction interventions among Chinese immigrants may be most effective by both addressing structural constraints and facilitating achievement of cultural values through clinical, peer, and group interventions.
Objectives: Asian Americans have poor HIV-related outcomes, yet culturally salient barriers to care remain unclear, limiting development of targeted interventions for this group. We applied the 'what matters most' theory of stigma to identify structural and cultural factors that shape the nature of stigma before and after immigration from China to the US.Design: Semi-structured interviews were conducted with 16 immigrants to New York from China, recruited from an HIV clinic and community centers. Deductive followed by focal inductive qualitative analyses examined how Chinese cultural values (lian, guanxi, renqing) and structural factors influenced stigma before and after immigration. Results: In China, HIV stigma was felt through the loss of lian (moral status) and limited guanxi (social network) opportunities. A social structure characterized by limited HIV knowledge, discriminatory treatment from healthcare systems, and human rights violations impinged on the ability of people living with HIV to fulfill culturally valued goals. Upon moving to the US, positions of structural vulnerability shifted to enable maintenance of lian and formation of new guanxi, thus ameliorating aspects of stigma.Conclusions: HIV prevention and stigma reduction interventions among Chinese immigrants may be most effective by both addressing structural constraints and facilitating achievement of cultural values through clinical, peer, and group interventions.
Entities:
Keywords:
China; Chinese Americans; HIV; immigrants; stigma; structural vulnerability
Authors: Lawrence Hsin Yang; Arthur Kleinman; Bruce G Link; Jo C Phelan; Sing Lee; Byron Good Journal: Soc Sci Med Date: 2006-12-22 Impact factor: 4.634
Authors: Lawrence H Yang; Ari R Ho-Foster; Timothy D Becker; Supriya Misra; Shathani Rampa; Ohemaa B Poku; Patlo Entaile; Melody Goodman; Michael B Blank Journal: AIDS Behav Date: 2021-02