Experiences of Chinese Families Affected by AIDS Via Blood Transfusion: An Exploratory Case Study

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INTRODUCTION

HIV/AIDS is spreading from populations with high risk behaviors to the general populations with relatively low levels of high risk behaviors (China Ministry of Health/UNAIDS, 2004; D'Cruz, 2003; Gogate, 1998). In China, through the transfusion of infected blood products, the pandemic has been exacerbated through several methods of transmission within the general population, including through the reception of infected blood in the course of legitimate medical procedures. The State Council/UN Theme Group (2004) reported that a number of HIV infections via blood transfusion were reported during 2004 in areas where former commercial blood and plasma donation in the 1990s was common, despite aggressive national efforts to strengthen blood supply safety.

In remote, rural provinces in central China, poorly managed blood-collection centers sprang up in the early 1990s in response to a national blood shortage. Some of these were private; some run by the local health departments; and others run by administrative or collective enterprises. Few were set up with the necessary technology or with trained staff to maintain a safe, sanitary environment. In many of the remote centers, needles were commonly used on multiple blood donors, and blood plasma was often processed without sanitizing the equipment between patients (Lu et al., 2005; State Council/UN Theme Group, 2004).

No screening procedures were in place to protect blood supplies from carrying the HIV virus because AIDS was a relatively unknown health risk in China in the early 1990s. After the blood products were collected, they were transported to urban health centers where they were infused into unsuspecting victims during healthcare procedures, such as surgery or child birth. (China Ministry of Health, 2000; Lu et al, 2005; UNAIDS, 2004, Wu et al., 2004). No public information is available that reports the number of secondary victims who may have been infected; however, UNAIDS (2005) has reported that this situation has infected persons in no fewer than 17 Chinese provinces.

In China as in most places around the globe, AIDS-infected individuals often experience discrimination, including lack of social compassion, inequitable access to social services and health care, and public humiliation (Chitale et al., 1992; Lau et al., 2003; Lew-Ting & Hsu, 2002). Even within the AIDS community itself, persons who contracted the disease by virtue of socially unacceptable behaviors, such as IV drug use or prostitution, are typically treated with less compassion than those whose infection resulted from the legal selling of blood. Secondary victims, including those who contracted HIV through blood transfusions, are generally extended considerable concessions and are less scrutinized (Lu et al., 2005; Wu et al., 2004). At a different level, very little attention has been given to the experiences of those families whose loved ones were infected through blood transfusions. Exploring the experiences of families helps strengthen the understanding of how AIDS is impacting China. This level of analysis helps identify needs caused by this crisis that might otherwise go unnoticed.

In a collection of studies looking at families in crisis, particularly health-related crises, McCubbin et al. (1999) found that, while most researchers set out to study crisis and its resultant devastation of the family, they often found that resilience, growth, and new meaning emerged as central themes. These studies showed that, even amid extreme circumstances, many families tended to share a remarkable resilience that helped them find ways to create a new way of functioning. It also enabled them to reestablish a balance using a new system for that given family. As a result, the families seemed to find new meaning in the crisis, which allowed them to transcend the crisis to live rich and fulfilling lives together (e.g., DeFrain, 1999, 2005; DeFrain, Cook et al. …