Zhihua Yan

Disclosure of HIV status is a family matter: Field notes from China.

This study examines the role that family plays in disclosure of HIV-AIDS in China. In-depth semistructured interviews were conducted with 30 individuals living with HIV-AIDS infected through different routes. The vast majority of participants were between the ages of 20 and 39 years old (93.4%) and about a third (36.7%) were women. Two primary disclosure processes, involuntary and voluntary, are described. In both processes, family members other than the patient are usually the first to know HIV status. Positive impacts of disclosure include strengthening family relations and help with medical care and counseling, whereas negative impacts include fear, isolation, avoidance, and psychological burden. This study illustrates that family is an intricate part of the disclosure process in China and demonstrates the importance of including families in HIV-AIDS interventions.

Universal Precautions in the Era of HIV/AIDS: Perception of Health Service Providers in Yunnan, China

With a rising HIV/AIDS epidemic, it has become especially important for health service providers in China to understand and correctly adhere to universal precautions. Using qualitative interview data, perspectives from both health administrators and service providers working at all levels of China’s health care system were examined. Service providers admitted selective adherence and non-adherence to universal precautions in their daily medical practice, and gave their explanations for such behaviors. Lack of time to put on protective gear, gear’s interference with medical procedures, lack of administrative support, heavy workload in hospitals, inaccurate risk assessment, and beliefs that compliance with universal precautions is unnecessary, time consuming and costly were mentioned as reasons behind noncompliance. Effective universal precaution interventions need to target both administrators and providers, and address both structural barriers and individual attitudinal and behavioral factors.

Measuring health-related quality of life in children living in HIV/AIDS-affected families in rural areas in Yunnan, China: preliminary reliability and validity of the Chinese version of PedsQL™ 4.0 Generic Core Scales

Objectives:To investigate the preliminary reliability and validity of the Chinese Mandarin version of the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales in a sample of general children and children living in HIV/AIDS-affected families. Methods:The PedsQL 4.0 was administered to 116 children aged 8-18 years from HIV/AIDS-affected families and 115 of their caregivers. The questionnaire was also administered to a control group of 109 children and 107 of their caregivers. Results:Most of the self-report and proxy-report scales in both groups exceeded the reliability standard of 0.70, whereas the self-report emotional functioning and school functioning subscales were slightly less than 0.70. On average, children living in HIV/AIDS-affected families scored significantly lower than the control group. The level of agreement between self-reports and proxy reports was low. Correlations were higher on average for the younger age group than for the older age group. Conclusions:The Chinese Mandarin version of PedsQL 4.0 is a valid and reliable instrument for use with children living in HIV families. The health-related quality of life for children living in HIV families is lower than children from ordinary families.