Culturally appropriate care for a unique population living with HIV/AIDS in rural China

“I have received knowledge and skills training on AIDS treatment and care … (this) gives me confidence for my future clinical work on AIDS treatment and care to the local Yi AIDS patients." - Qubi Yilin, Yi training graduate

THE YI ETHNIC MINORITY IS ONE OF THE MOST ANCIENT POPULATIONS IN CHINA. Culturally and linguistically distinct from the Mandarin-speaking Han ethnic majority, the Yi have historically faced significant barriers to medical care and have the highest rate of HIV/AIDS among China’s 56 ethnic groups. Liangshan Yi Autonomous Prefecture has 2.22 million Yi – 50% of the Liangshan population, which represents the largest Yi community in China. Liangshan is a remote, impoverished, and mountainous area in southern Sichuan Province. Healthcare including facilities, equipment, personnel, and culturally appropriate resources have developed slowly. This has created a growing need for qualified physicians and healthcare models for Yi patients.

TO ADDRESS THIS NEED, U.S. CDC in China entered into a unique public-private partnership with China CDC, Merck Company Foundation, and the local nongovernmental organization, AIDS Care China, in early 2012. This partnership established a Rural AIDS Clinical Training Center at the Zhaojue People’s Hospital. The training center builds on U.S. CDC in China’s previous experience in developing rural training clinics by providing an intensive eight-week mini-residency program focused on comprehensive HIV/AIDS care and treatment practices. The center uses a community-based approach and emphasizes the recruitment of ethnic Yi physicians. During training these clinicians learn strategies to improve the quality of care and treatment for people living with HIV/AIDS. After two cohorts of trainees, 7 of the 17 training center graduates are from the Yi ethnic minority, which allows patients to interact with their provider in their native language. In addition, language facilitation and translation support is provided for the Mandarin-speaking trainees when they are providing services to Yi patients.

NO PSYCHOLOGICAL SUPPORT EXISTED for HIV-positive individuals in this area, so Zhaojue Hospital piloted a peer care and support program. People living with HIV/AIDS are recruited and trained as peer counselors to provide adherence and psychological support as well as follow-up services. This program has provided an improved system of care and treatment support for an underserved and hard-to-reach minority group. This training center will serve as a model that can be duplicated for the rest of Zhaojue County and eventually all of Liangshan Prefecture. This is an innovative approach to developing a culturally sensitive and appropriate training curriculum and community-based care model.