Developing an innovative cross-cultural strategy to promote HIV/AIDS prevention in different ethnic cultural groups of China

Abstract

The HIV and STIs epidemic in China has had a significant impact among China's ethnic minorities. However, the official traditional approach, which has used an anti-epidemic social campaign, has not paid any attention to the diversity of cultural backgrounds of the many ethnic minority groups. This study carried out in Sichuan Province is the first to explore how to use cultural resources for developing an effective strategy for promoting HIV prevention in different cultural groups in China. One hundred and fifty male volunteers drawn from the Yi (50), Tibetan (50) and majority Han (50) cultural groups were assigned to a direct training programme. After training, these participants spread safe sex messages to other contacts who became an indirect peer diffusion group. A third group of 150 male volunteers from the same three cultural groups but from another relatively comparable community acted as controls. Each participant was interviewed before and after the intervention to assess knowledge, attitudes and behavioural intentions regarding HIV/AIDS prevention. The study examined the cultural appropriateness and effectiveness of peer-led health message diffusion in promoting condom use through a traditional oral communication approach from the direct training groups to the indirect intervention groups and broad peer networks within the Yi, Tibetan and Han cultural communities. Key findings showed that the peer-based oral communication strategy was effective for encouraging condom use with casual sexual partners in both the direct training group and the indirect peer diffusion group in all three cultural groups. There was no significant change in any of the comparison groups. Although change in the majority Han cultural group was generally greater than in the ethnic minority groups, the results clearly suggest that the methods can be successfully adopted to promote safe sexual behaviour in different cultural groups of China.

Effectiveness of Peer Education Interventions for HIV Prevention in Developing Countries: A Systematic Review and Meta-Analysis

“…Eighteen studies (Agha & van Rossem, 2004; Asamoah, 1999; Merati et al, 1997; Ford et al, 2000; Morisky et al, 2006; Broadhead et al, 2006; Ergene, Cok, Tumer & Unal, 2005; Gao et al, 2002; Ozcebe, Akin & Aslan, 2004; Kinsler, Sneed, Morisky & Ang, 2004; Leonard et al, 2000; Morisky, Ang, Coly & Tiglao, 2004; Norr, Norr, McElmurry, Tlou, & Moeti, 2004; Wang & Keats, 2005; Williams et al, 2003; Vaz, Gloyd, & Trindade, 1996; Laukamm-Josten et al, 2000; Walden, Mwangulube & Makhumula-Nkhoma, 1999), with a combined study population of 15,989, generated twenty-six discrete effect size estimates on HIV knowledge (Table 4). Pooled, these data show that peer education had a moderate but positive effect on this outcome (OR: 2.28, 95% CI: 1.88, 2.75).…”

Condom embarrassment: coping and consequences for condom use in three countries

“…Weisse, Turbiasz, & Whitney, 1995). In the past, such programs and campaigns have increased condom use and changed beliefs about contraceptives in both developed and developing countries (Agha, 2003;Keller & Brown, 2002;Lou, Zhao, Gao, & Shah, 2006;Wang, Hertog, Meier, Chaohua, & Ersheng, 2005;Wang & Keats, 2005;Xiaoming, Yong, Choi, Lurie, & Mandel, 2000). Discussion of condom embarrassment and suggestions about how to cope with purchase embarrassment should be incorporated into these programs.…”

A systematic review of published evidence on intervention impact on condom use in sub-Saharan Africa and Asia

“…Sixty-two met the inclusion criteria: 44 from sub-Saharan Africa and 18 from Asia. [69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86] Many ( 84 85 and two targeted women using postabortion or safe motherhood services 63 66 . Factors cited as diminishing the likelihood of documenting a significant increase include small sample sizes, 53 57 65 86 the use of very short or long follow-up periods, 52 76 no adequate control group, 60 61 high preintervention levels of condom use, 54 84 85 or contextual changes that undermined the intervention.…”

“…36 49 51 The exceptions included an intervention among HIV-discordant couple-cohorts in Rwanda, 37 and peer education and condom promotion among male transport workers in Senegal and Tanzania who frequently had multiple partners. 34 35 In addition, high levels of condom use in regular partnerships were reported postintervention among three ethnic groups in a Chinese study, 79 who were potentially using condoms for contraception.…”