HIV/AIDS, SARS, and COVID-19: the trajectory of China's pandemic responses and its changing politics in a contested world.

The COVID-19 pandemic has revealed the contested politics of global health governance, though we still don't know enough about the dynamics of domestic pandemic responses, or about the relationship between the politics of those responses and the politics of global health governance, both of which have changed significantly in recent decades. Focusing on three cases (HIV/AIDS, SARS, and COVID-19) of cross-border infectious diseases, this article explores the trajectory of China's pandemic responses in the context of globalization. Attending to changing politics at domestic, international, and global levels, I argue that those responses have been a complex combination of China's domestic politics (e.g., priorities, institutions, leadership, and timing), its international relations (especially with the US), and its engagements with global health governance. It is concluded that the increasing divergence of pandemic responses in a time of ubiquitous global health crisis demands urgent attention to the connections (including contestations) between domestic pandemic responses and the evolvement of global health governance from a broader perspective that considers changes in geopolitics.

Gender and Trajectories of Marital Breakdown: Accounts of Chinese Immigrant Women in Canada.

The relatively sparse literature has documented various challenges international migration poses to martial stability, yet we know little about immigrant women's experiences with marital breakdown. Drawing data from a qualitative study of Chinese economic immigrants to Canada, this article explores women's experiences of navigating the processes of this life circumstance, and of how gender-including their senses of changing gender roles in post-immigration and postmarital contexts-plays out in these trajectories. The results of this exploratory study illustrate the value of transcending dichotomous conceptions of the relationship between gender and migration, and of opening spaces in which to better understand immigrant women's increasingly diversified life trajectories and the range of barriers they encounter along the way. The study also reveals multiple opportunities for social work contributions: tackling systematic barriers to settlement, facilitating social support in the community, and recognizing individuals' diverse trajectory potentials (including the potential for this typically unwelcome event to be integrated as personal growth and transition).

Intimacy, identity and relationship in the accounts of Chinese immigrants to Canada: the contribution of narrative analysis.

In this paper we use narrative analysis to consider how the discursive resources that come with living 'in between' countries and cultures unfold in personal stories. We do this by presenting a close analysis of two transcripts drawn from a study about the vulnerability to HIV faced by Chinese immigrants to Canada. Our goal is to illustrate the application of narrative analysis and highlight the contributions it can make to conceptualising how transnationalism becomes consequential in accounts of intimate life. In narrative terms, transnationalism lends each life situation dual or multiple interpretive frameworks. Migrants from China to Canada situate their personal stories in relation to social and cultural norms and features of both nations. Yet, as our analysis makes apparent, 'Canada' and 'China' do not carry singular or consistent meanings in migrants' stories. Attention to the role of stories in self-making allows us to better understand why transnational contexts appear as they do in narrative accounts, and responds to calls for more accurate mappings of the interface between transnationalism and the subject. Attention to how stories are 'put together' shows that transnational discursive resources are assembled in ways that bolster, and also undermine, entitlements to safe and equitable intimate relationships.

'Race' and HIV vulnerability in a transnational context: the case of Chinese immigrants to Canada.

Although immigrants' sustained connections with their homelands are well documented, so far we know little about how 'race' - in particular, conceptions of race back home - influences the HIV vulnerability of racialised immigrants to Western countries. Drawing on data from a multi-sited, qualitative study of Chinese immigrants to Canada, this paper presents a contextualised understanding of the impacts of race on HIV risk faced by these individuals in a transnational context. Data were collected from four study sites in Canada and China as part of a study investigating the relationship between HIV risk and transnationalism. Although race appears to have bearing on their risk perceptions and sexual practices, immigrants' understandings of race are not necessarily consistent with dominant discourses of race in Canada, but are also mediated by their racial habitus developed in China. Findings reveal the complex power dynamics - not just power asymmetries but also power fluidity - around race from a transnational perspective and thus challenge the assumed dichotomy of dominance and subordination underpinning traditional explanations of the relationship between race and HIV risk. In the context of transnationalism, researchers should go beyond a nation-bound concept of society (i.e. the host society) and take into account the simultaneous influence of both host and home countries on immigrant health.

Culture, but more than culture: an exploratory study of the HIV vulnerability of Indian immigrants in Canada.

Explanations of immigrant health that ascribe to culture a fundamental causal role neglect the broader structural and contextual factors with which culture intersects. Based on a qualitative study of Indian immigrants' vulnerability to HIV in Canada, this paper presents a contextualised understanding of these individuals' understanding of, perceptions about, and responses to the HIV risk in their post-immigration lives. The study reveals that although culture - both traditional values and the norms of the diaspora community - appears to have constrained Indian immigrants' capacities to respond to the risk, this effect can be properly understood only by situating such constraint in the context of the settlement process that has shaped participants' living conditions, including their relationship with the diasporic community in Canada. We argue that HIV vulnerability should be conceptualised as a health inequality associated with broader systems of power relations (eg socio-economic marginalisation, gender inequality, discrimination, and racism). This more holistic conceptualisation of the intersection of culture, integration, and HIV vulnerability will facilitate exploration of HIV prevention strategies, through which interconnected inequalities of gender, race, and access to knowledge and resources can be challenged.

Changing behaviours and continuing silence: sex in the post-immigration lives of mainland Chinese immigrants in Canada.

In China, reluctance to discuss sex continues to be widely observed despite the sexual revolution there. That silence generates questions about health risks in the contexts of HIV/AIDS and international migration. Based on a qualitative study of mainland Chinese immigrants in Canada, this paper explores the impacts of immigration processes on sex and sexuality. The findings reveal a gap between these individuals' changing sexual behaviours and the continuing silence on sex. Although Canada has exposed them to a new living environment that has shaped the dynamics and patterns of their sexual practices, their incomplete integration into the host society and their close connections with China as the home country mean that traditional Chinese norms continue to influence their understanding of these changes. With the increasing openness of these immigrants' sexual relationships, the obsolescence of their consciousness and knowledge of sexuality should be addressed in order to reduce their vulnerability to sexual inequalities and consequent health risks.

The phenomenology of time: lived experiences of people with HIV/AIDS in China.

Based on a qualitative study of lived experiences of people living with HIV/AIDS in China, this article explores the role of time - in particular, time as lived (or, perceptual time) - in these individuals' construction and reconstruction of the meanings of their illness experiences. Although their HIV infection interrupted the linear flow of time, the end of which is death, they had reconstructed the meanings of time according to their priorities in the process of living with this disease. Making sense of time beyond a linear time framework benefited these individuals by enabling them to restore their control over their lives and transform a process of deteriorating and dying into a process of living and growing. It is concluded that time, as a distinct form of illness experience, merits further examination in future AIDS research as well as in health research.

Help-seeking in a context of AIDS stigma: understanding the healthcare needs of people with HIV/AIDS in China.

Despite the rapid increase of HIV infection cases in China, the majority of this population have not yet accessed AIDS-related healthcare services. Most current research in China focuses on HIV prevention and disease control, and pays inadequate attention to the barriers facing HIV-infected individuals in accessing and adhering with healthcare services. This article, as part of a research project on the illness experiences of people with HIV/AIDS in China, aimed to explore these individuals' healthcare experiences, shedding light on the gaps between their needs and existing healthcare services. Data for this qualitative study were collected through individual in-depth interviews with 21 HIV-infected adults in China. The results of data analysis suggest that these individuals' healthcare experiences were greatly affected by social discrimination and the limitations of healthcare resources. While AIDS stigma has reduced the social resources available for this population, HIV-related health institutions were perceived by them as an indispensable source of social support. It is concluded that healthcare institutions, as one of the few places in which HIV-infected people are willing to disclose their HIV positive status, should incorporate social care into healthcare service development and delivery so as to facilitate this population's accessing healthcare services and to address their unmet needs that go beyond the conventional scope of health care. Improving the visibility of people with HIV/AIDS in health care will also have a long-term impact on their own well-being and on HIV prevention in China.

Endangered womanhood: women's experiences with HIV/AIDS in China.

Women in China are increasingly affected by HIV/AIDS. Current AIDS studies have examined the HIV risks faced by this gender group, paying inadequate attention to women's actual experiences with the disease. This oversight has inhibited our ability to understand the impact of gender on women's capacity to respond to HIV/AIDS in their postinfection lives. Based on a qualitative study on illness experiences of HIV-infected people, this article examines the interactions between HIV/AIDS and gender roles in the Chinese context. It was found that traditional gender norms have played a key role for HIV-infected women in their efforts to tackle this disease and to make sense of their daily lives. HIV infection has created a conflict between women's intention to fulfill their conception of "womanhood" and a decreased ability to do so, which, in turn, has adversely affected their self-perceptions and well-being. To avoid worsening the inequality women experience, therefore, we must also work on the socioeconomic conditions, for example, through delivering comprehensive care to affected families and developing a gender-sensitive welfare policy, so that the gender imparity that permeates this epidemic can be challenged and transformed.

"If you get AIDS... you have to endure it alone": understanding the social constructions of HIV/AIDS in China.

Recent AIDS research has documented the widespread discrimination toward people living with HIV/AIDS (PLWHA) in China. General ignorance and misconceptions about this disease have been identified as the two primary reasons for this prejudice. Yet, little attention has been paid to social constructions of HIV/AIDS in the Chinese context and to the processes by which such constructions are experienced, understood, reacted to, and, perhaps, reconstructed through social and interpersonal interactions. Based on a qualitative study of Chinese PLWHA's illness experiences, this paper explores how HIV/AIDS, as a social construct, is understood by these individuals in the context of their daily encounters. It is discovered that, despite their knowledge of HIV/AIDS, PLWHA's perceptions about and responses to this disease are greatly influenced by their experiences of interacting with others (e.g., their families, friends, and health workers). The conflicts between individuals' mastery of knowledge pertaining to, and their overreactions in practice toward, HIV-infected bodies suggest that AIDS education should not be limited to the dissemination of knowledge per se, but that the interpersonal or interactive dimensions of discrimination and efforts to combat it must also be taken into account.

Homosexuality, seropositivity, and family obligations: perspectives of HIV-infected men who have sex with men in China.

The HIV epidemic has had major impact on men who have sex with men in China. Most current studies view male-to-male sex as a behavioural dimension or variable affecting HIV infection, paying little attention to the socio-cultural meanings of homosexuality and their impacts on men's experiences with HIV/AIDS. This oversight has impeded understanding of the health practices of this population. Based on a qualitative study of experiences of Chinese people living with HIV/AIDS, this paper explores the complex processes in which men who have sex with men struggle and negotiate with their sexuality, family obligations, and this disease. To facilitate Chinese men who have sex with men in responding effectively to HIV and AIDS, researchers and practitioners should take into account a wide range of contextual factors including desired gender roles, family obligations, homophobia, and HIV-related stigma that contribute to current constructions of 'homosexuality' in China.