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Confronting Discrimination and Inequality in China

 | 
Errol P. Mendes
, 
Sakunthala Srighanthan

Part four. Discrimination Against Those Living with HIV/AIDS

Chapter Thirteen. Promoting the Right to Education for AIDS Orphans and Vulnerable Children (OVC)

A Study on Anti-Discrimination

Ma Yinghua, Ding Suqin, Wang Chao et Yuan Mengyao

Texte intégral

  • 1 Joint United Nations Program on HIV/AIDS (UNAIDS). Protocol for the Identification of Discriminati (...)

1According to the Protocol for the Identification of Discrimination against People Living with HIV (2000) by UNAIDS,1 “HIV/AIDS related discrimination” is defined as “[a]ny measure entailing an arbitrary distinction among persons depending on their confirmed or suspected HIV serostatus or state of health.” The study included three categories of AIDS-afflicted children: HIV-infected children, children orphaned by AIDS (refers to children under the age of eighteen who have lost one or both parents due to AIDS), and children made vulnerable by AIDS (refers to children with one or both parents infected with AIDS, and living in a household with one or more chronically ill adults). Discrimination may result in the neglect or infringement of such children’s right to education. According to sources, discrimination relating to the right to education may be divided into institutional discrimination and public discrimination. Institutional discrimination originates mainly from a legal and policy perspective. Public discrimination occurs in schools, and from parents and existing students. In addition, orphans and vulnerable children (OVC) stigmatization and discrimination may impair their right to education. This study was conducted between March 2006 and March 2008 to determine if OVCs are denied access to education due to discrimination, as well as the causes of such discrimination. Solutions are also proposed to ensure access to education, to create a caring and non-discriminatory education environment, and to promote anti-discrimination in China.

DESIGN AND METHOD

I. Policy Review

2Policy reviewed is carried out throughout the entire study. Prior to the field research, we collated AIDS and education-related laws and policies to see if there was any direct or indirect discrimination. After the field research, we compared our research findings with the earlier analysis, and examined the state of implementation and operability of such laws and policies.

II. On-Site Research

(I) Study Site and Study Subject

1. Study Site

  • 2 http://www.unchina.org/unaids/documentpercent201ink.htm.

3Heilongjiang, Beijing and Henan were selected using stratified sampling in order to have representation from areas with different AIDS situations (according to UNAIDS, there were 241 cases of HIV infections in Heilongjiang, 2,580 in Beijing, and 30,820 in Henan as of the end of December 20052).

2. Study Subject

  1. The public, including students, parents, teachers and the general public
  2. HIV-infected children and OVCs

(II) Measurement Tools and Parameters

4Both quantitative and qualitative analyses were used. We developed the outlines for the questionnaires and interviews with assistance from university and secondary school students. Further studies were carried out before the final questionnaire and interview designs were improved and finalized.

1. Quantitative Analysis

5Two types of self-administered questionnaires were used:

  1. Knowledge, Attitude and Practice (KAP) Questionnaire: Includes questionnaires for students, parents, teachers and the general public. Measurement parameters include the basic understanding of the general situation and of AIDS, attitude towards HIV/AIDS-infected persons, view and attitude towards the education of OVCs, AIDS-related discriminatory behaviour, and knowledge of the relevant policies and rights.
  2. Stigma Questionnaire: Includes questionnaires for OVCs, students and parents based on the HIV Stigma Scale3 and questionnaires designed by relevant local and foreign journals. By using the projective technique and situation analysis, we designed self-administered questionnaires, based on the attributes of the study subjects. Measurement parameters include general situation, basic knowledge of AIDS, stigma, and the general public’s perception of OVC stigma.

2. Qualitative Analysis

6Open-ended questions and small group interviews were used for self-administered questionnaires. Interview outlines include outlines for students, teachers, and OVCs.

(III) Data Analysis

1. Quantitative Analysis

7After all questionnaires were reviewed for completeness, logic and consistency, the data from the study was entered into EpiData 3.0 to establish a database. Data analysis was performed using SPSS 12.0. Appropriate statistical methods were selected based on data characteristics, and test was defined at a=0.05.

2. Qualitative Analysis

8Interview results from the recordings and notes taken during the on-site interviews were collated. Keywords were identified from the original information, and coded and classified. Additionally, based on the frequency of occurrence of such keywords, we established primary and secondary viewpoints. Analyses and interpretation were carried out based on these viewpoints.

(IV) Ethical Issues

9This study is in strict compliance with general principles of ethics in medical research.

  1. Respect for the children’s right of participation. Questionnaire and interview outlines were designed with students’ participation.
  2. Respect for the subjects’ right to informed consent. The subjects were informed of the purpose and details of the study prior to completing the questionnaire and participating in the interviews. Participation was voluntary.
  3. Respect for the subjects’ right to privacy. Investigation was carried out anonymously, and information provided by the subject was kept strictly confidential. Such information will not be used for purposes other than this study, to protect the subjects’ privacy.
  4. Guarantee of adolescent rights. The study will provide for the students who were interviewed with the relevant knowledge and information on AIDS, as well as guidance on the relevant issues.

RESULTS AND ANALYSIS

Part 1. Outcome of Policy Analysis

I. Provisions in Documents on International Human Rights on Non-Discrimination and the Right to Education

10According to Paragraph 1 of Article 2 of the Convention on the Rights of the Child by the United Nations Committee on the Rights of the Child, “State Parties shall respect and ensure the rights set forth in the present Convention to each child within their jurisdiction without discrimination of any kind, irrespective of the child’s or his or her parent’s or legal guardian’s race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status.” Paragraph 2 of the same Article provides that “State Parties shall take all appropriate measures to ensure that the child is protected against all forms of discrimination or punishment on the basis of the status, activities, expressed opinions, or beliefs of the child’s parents, legal guardians, or family members.” Paragraph 2 of Article 28 provides, “State Parties recognize the right of the child to education, and with a view to achieving this right progressively and on the basis of equal opportunity.”

11The provisions under Paragraph 3, Article 10 of the International Covenant on Economic, Social and Cultural Rights of the Committee on Economic, Social and Cultural Rights states, “[s]pecial measures of protection and assistance should be taken on behalf of all children and young persons without any discrimination for reasons of parentage or other conditions,” and according to Paragraph 1 of Article 13, “[t]he State Parties to the present Covenant recognize the right of everyone to education.”

12Article 7 of the United Nations Universal Declaration of Human Rights provides that “[a] ll are equal before the law and are entitled without any discrimination to equal protection of the law. All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.” Under Paragraph 1 of Article 26, “[e]veryone has the right to education. Education shall be free, at least in the elementary and fundamental stages. Elementary education shall be compulsory. Technical and professional education shall be made generally available and higher education shall be equally accessible to all on the basis of merit.”

13According to Guideline 5 of the International Guidelines on HIV/AIDS and Human Rights by the Economic and Social Council of the United Nations,

States should enact or strengthen anti-discrimination and other protective laws that protect vulnerable groups, people living with HIV and people with disabilities from discrimination in both the public and private sectors, ensure privacy and confidentiality and ethics in research involving human subjects, emphasize education and conciliation, and provide for speedy and effective administrative and civil remedies.

II. Legislation and Enforcement of Non-Discrimination and the Right to Education in China

(I) Relevant Domestic Legislation

141. Article 33 of the Constitution of the People’s Republic of China provides that “[a]ll persons holding the nationality of the People’s Republic of China are citizens of the People’s Republic of China. All citizens of the People’s Republic of China are equal before the law. Every citizen enjoys the rights and at the same time must perform the duties prescribed by the Constitution and the law.” And Paragraph 1 of Article 46 provides that “[c]itizens of the People’s Republic of China have the duty as well as the right to receive education.”

152. According to Paragraph 3, Article 3 of the Law of the People’s Republic of China on the Protection of Minors (effective 1 June 2007), minors shall be accorded equal rights under the law, regardless of gender, ethnic group, race, family financial situation, or religious belief. Paragraph 2 of the same Article provides that minors shall be entitled to the right to education, and the State, society, school and family shall respect and guarantee the right of minors to be educated. Under Article 13, parents or other guardians shall respect minors’ right to receive education, enable minors of school age to attend school and receive compulsory education according to the law, and shall not cause minors receiving compulsory education to drop out of school. Article 18 provides that the school shall respect the right of minors to be educated, show care and consideration for these students, and provide patient education and assistance for students with character and behavioural flaws, or who have difficulties learning. The laws and State regulations shall be observed and students who are minors shall not be expelled. According to Article 28, the various levels of the people’s government shall guarantee the right of minors to be educated, and shall take measures to ensure that minors from financially deprived families, from the floating population, and whose parent(s) have a disability receive compulsory education.

163. Article 9 of the Education Law of the People’s Republic of China provides that “[t]he Citizens of the People’s Republic of China shall have the right and duty to receive education. All citizens, regardless of ethnic group, race, sex, occupation, property status or religious belief, shall enjoy equal opportunities for education under the law.”

174. Article 4 of the Compulsory Education Law of the People’s Republic of China stipulates that “[t]he state, community, schools and families shall ensure school-age children’s and adolescents’ right to receive compulsory education, regardless of sex, ethnic group, race, family property status and religious belief, as provided by law.”

18The above laws provide general protection for non-discrimination and the right to education. China has also enacted laws relating to communicable diseases and AIDS.

195. According to Article 16 of the Law of the People’s Republic of China on the Prevention and Treatment of Infectious Diseases, no entity or individual shall discriminate against patients suffering from infectious diseases, carriers or suspected patients of infectious diseases.

206. Article 3 of the Regulations on the Prevention and Treatment of HIV/AIDS (effective 1 March 2006) provides that “[n]o entity or individual may discriminate against people infected with HIV, AIDS patients, and their family members. The legitimate rights of such persons in marriage, employment, medical treatment, and education shall be protected by law.” Under Article 45, “AIDS orphans and HIV-infected minors with livelihood difficulties receiving compulsory education shall be exempted from paying miscellaneous fees and for books. Such persons receiving pre-school education and high school education shall receive reduction or exemption of school fees and other similar fees.”

217. The Action Plan for Containing and for the Prevention and Treatment of the HIV/AIDS Epidemic (2006-2010) proposes, under the heading “Prevention and Treatment Strategy and Action Plan,” to develop extensive outreach education programs; to disseminate information on the prevention and treatment of AIDS and on free blood donation; and to create a social environment that cares for HIV/AIDS patients, and that supports the prevention and treatment of AIDS.

228. In 2003, the State promulgated the “Four Frees and One Care” (si mian yi guanhuai) policy that is aimed at the prevention and treatment of AIDS. The Regulations on the Prevention and Treatment of HIV/AIDS, implemented on 1 March 2006, provided a regulatory foundation for the “Four Frees and One Care” policy. The policy provides that AIDS orphans and HIV-infected minors, who have livelihood difficulties and are receiving compulsory education, shall be exempt from paying miscellaneous fees and for books. Such persons receiving pre-school and high school education shall receive a reduction of or exemption from their school and other fees. The county-level and higher level of government will provide relief for persons living with HIV/AIDS and their family members.

239. In March 2006, fifteen ministries, including the Ministry of Civil Affairs, published the Opinions on Improving Relief for Orphans. The Opinions provided preferential policies for orphans, including children orphaned by AIDS. These preferential policies concerned nine areas, including living, education, medical, rehabilitation, housing, and employment. The Opinions also provided that the Ministry of Education shall exempt orphans at the age of compulsory education from miscellaneous fees, shall provide them with money for textbooks, and shall give subsidies for living expenses to boarding students. Orphans accepted by ordinary high schools, secondary vocational schools and tertiary schools shall be included in the current system of education bursaries.

2410. The “Two Frees and One Subsidy” (liang mian yi bu) policy asserts that the State shall provide students receiving compulsory education (at the primary and secondary level) and who are from poor families with free textbooks. The State shall also exempt these students from miscellaneous fees, and shall provide boarding students with subsidies for living expenses.

25The above legal policies ensure non-discrimination and the right to education of persons living with HIV/AIDS, and provide OVCs with preferential and supportive policies. UNAIDS’s Protocol for the Identification of Discrimination against People Living with HIV identified 10 major areas in the social lives of HIV/AIDS infected persons in which distinctions, exclusions or restrictions, actual or presumed, may occur. Discrimination in education is determined by whether there is denial of access to education, and if there are restrictions imposed in an educational setting (e.g., segregation). Local laws and policies do not impose restrictions in an educational setting.

(II) Enforcement of Laws and Policies

26This study identifies problems with the enforcement of laws and policies by referring to relevant journals and other sources of information, as well as to questionnaires and interviews with the public, persons living with HIV and OVCs.

271. Although there are laws in China protecting the right to education of OVCs and persons living with HIV, these people continue to face discrimination in various forms.

  • 4 Y. Yang, K. L. Zhang, K. Y. Chan, et al., “Institutional and structural forms of HIV-related discr (...)

28According to OVCs and persons living with HIV, discrimination against them is manifested in various ways. For example, people give them peculiar looks, refuse to eat at the same table as them, and refuse to play with their children. Some people have even moved away from infected persons, transferred their children to other schools or discriminated against people who bear the same family name as the infected person. Furthermore, some family members have abandoned infected relatives. Schools refuse to allow OVCs to attend on other grounds. Discrimination from classmates, their parents and teachers may occur in school. For example, classmates will stay away from or ostracize OVCs; parents of classmates may tell their children not to play with them; and teachers who do not understand these children may treat them unfavourably in class. Despite the presence of relevant laws and regulations, discrimination still exists in various forms. The outcome of this study is in line with those of other studies.4

  • 5 State Council Working Committee to Combat AIDS, Report on the 2005 Declaration of Commitment on HI (...)
  • 6 State Council Working Committee to Combat AIDS, the UN Theme Group on HIV/AIDS in China, Joint Ass (...)
  • 7 China Ministry of Health, UNAIDS, World Health Organization, China AIDS Epidemic and Prevention Pr (...)

292. To some extent, the laws and regulations have been successful in guaranteeing the right of OVCs to education. However, implementation is inconsistent in different areas, and not all OVCs benefit from these laws and regulations. Policies such as the Regulations on the Prevention and Treatment of HIV/AIDS and the Action Plan for Containing and for the Prevention and Treatment of the HIV/AIDS Epidemic (2006-2010) protect the rights of persons living with HIV/AIDS. The “Four Frees and One Care” policy was especially successful at addressing the living and educational difficulties of children orphaned by AIDS. According to Chinas report on the Declaration of Commitment on HIV/AIDS 2005, various regions were aggressively implementing the “Four Frees and One Care” policy that provide free schooling and living subsidies for children orphaned by AIDS. There are 4,385 children of school age attending school for free, and this accounts for 92.71 percent of AIDS orphans of that age group.5 According to the Joint Assessment of HTV/AIDS Prevention, Treatment and Care in China (2007), as of the end of March 2007, there were 277 Care Centres (e.g. “Sweet Home” (wenxin jiayuan) and “Sunny Home” (yangguang jiayuan)) in 127 demonstration zones, providing aid for 3,167 orphans (93 percent of all school-age children) under the “Two Frees and One Subsidy” program.6 However, implementation was inconsistent, and not all children benefited from the program. The “Four Frees and One Care” policy is better implemented in AIDS endemic areas; those living in non-endemic areas are neglected, since living subsidies and free schooling for children orphaned by AIDS are not guaranteed.7

303. Inadequate Support Measures and Regulatory Enforcement of Laws and Policies

31The “Four Frees and One Care” and “Two Frees and One Subsidy” policies provide schooling assistance for OVCs living in poverty. However, OVCs often do not wish to expose their identities because of their unusual circumstances. The result is that they do not benefit from these policies. In fact, they will be further discriminated against if their status is disclosed.

  • 8 http://www.ha.xinhuanet.com/add/zfzx/2007-09/10/content_l1102468.htm.

32Results of our qualitative interviews reveal that OVCs applying for aid must do so through their school. In some areas, students receiving aid get books labelled with words, such as “Provided Free by the State.” During our policy review, we also found that the way in which certain provinces provide aid jeopardizes the privacy of OVCs. For example, the “Two Frees and One Subsidy Implementation Measures for Compulsory Education in the Rural Areas of Henan Province provides that, “[u]pon determining the students to receive aid, the school shall exempt such students from paying for text books, and shall indicate on the title page’ This book is provided free by the State’,” and, “to receive aid, the student shall personally submit the application, and a public announcement shall be made by the school and the village committee where such students family is located.”8 The Provisional Implementation Measures for the Two Frees and One Subsidy Program for a region in Chongqing also provides:

  • 9 http://www.cqjlp.gov.cn/zwgk/3884.htm.

[t]he student or his/her guardian shall complete the application form for “Two Frees and One Subsidy.” The school and the village committee (town or subdistrict office) shall conduct a preliminary review of such an application. The review comments shall be endorsed and published, and the schools shall collate the relevant information to be submitted to the district education committee, education committee and district finance committee for centralized review and approval. The names of students who qualify for aid will be given to the schools, and the schools and village committees (town or sub-district offices) shall again publish such names on their notice boards, in order that they will be monitored by the local public and public opinions.9

33The regulations in other provinces and cities are similar. Thus, many children would rather forego the subsidy than reveal that they are infected persons or persons from a family with an infected person.

34Regulatory enforcement in certain areas is weak. For example, instead of giving subsidies to families of HIV-infected persons, such subsidies found their way into the pockets of relatives and friends of cadre members.

354. Lack of Adequate Awareness of the Laws and Regulations among the Public.

36Despite the presence of laws and policies, on-site investigation showed that there is little awareness of the laws and policies on this issue.

3718.6 percent of students, 33.0 percent of parents, 35.0 percent of teachers, and 18.2 percent of the general public know about the Convention on the Rights of the Child and the provision on the right of children to education. The percentage of those who have only heard of the Convention is 24.3 percent, 21.9 percent, 32.0 percent and 22.4 percent respectively.

3826.3 percent of students, 36.3 percent of parents, 42.3 percent of teachers, and 35.8 percent of the general public have heard of the “Four Frees and One Care” policy. Those who have knowledge of the details of the policy are 37.0 percent, 42.5 percent, 46.5 percent and 32.4 percent respectively. Ignorance of the laws and policies may lead to disregard or even infringement of those rights. Therefore, there is a need to augment public knowledge of the laws and policies in order to instil a more rational attitude towards infected persons and OVCs, and a greater respect for their rights. Enforcement of the laws would keep discriminatory behaviour in check.

395. Disparity in Definition between the Law and Reality

40The Regulations on the Prevention and Treatment of HIV/AIDS provides that “no entity or individual shall discriminate against persons living with HIV/AIDS and their family members” and that “the legitimate rights of persons with AIDS and their family members to marriage, employment, medical treatment and school education are protected under the law.” In reality, most discrimination is emotional experiences, whether it is discrimination as determined by the public, or discrimination that persons with HIV personally found intolerable. The public ranks the top five most common discriminatory behaviours as: “use of abusive language towards infected persons and their family members,” “refusal to shake hands with infected persons,” “refusal to allow infected persons or their children to be put in childcare centres or to attend school,” “refusal to participate in group activities with infected persons,” and “staying away from infected persons to avoid being infected.” We need to explore the ways in which such discriminatory behaviours can be contained, and how to build a caring and nondiscriminatory environment.

Part 2. On-Site Investigation

I. Outcome of Quantitative Research

(I) Results of the Analysis of the KAP Questionnaire

1. Basic Information of Study Subjects
(1) Students

411,775 student responses were received. 1,664 were valid, and the valid response rate was 94.81 percent. Among them, 594 or 35.7 percent were students from Heilongjiang, 502 or 30.2 percent were from Beijing, and 568 or 34.1 percent were from Henan. 865 or 52.0 percent were male, and 799 or 48.0 percent were female. 446 or 26.8 percent were primary students, 423 or 25.4 percent were secondary students, 483 or 29.0 percent were high school students, and 312 or 18.8 percent were university students. The average age was 15.36 ±3.079 years.

4293.4 percent of the students had heard of AIDS a year ago; 5.9 percent had heard of AIDS within the last year. Only responses from those who had heard of AIDS were used, which comprised 1,645 questionnaires in total. 51.1 percent among those surveyed had received AIDS-prevention education (including seminars) in school, 48.9 percent had not.

(2) Parents

43582 parents were surveyed. 123 or 21.1 percent were from Heilongjiang, 230 or 39.5 percent were from Beijing, and 229 or 39.3 percent were from Henan. 242 or 41.6 percent were parents of primary students, 194 or 33.3 percent of secondary students, and 146 or 25.1 percent of high school students. Most parents had high school or secondary vocational education (30.2 percent), and vocational or university education (40 percent). Those with secondary, post-graduate and below primary education account for 17.2 percent, 10.9 percent and 1.8 percent respectively. 541 or 94.6 percent of the parents had heard of AIDS a year ago, and 25 or 4.4 percent learned about AIDS within the last year. Only the 566 questionnaires of respondents who had heard of AIDS were used in our analysis.

(3) Teachers

44219 responses were received. 205 or 93.61 percent were valid responses. Teachers from 23 provinces were surveyed; 60 or 29.3 percent were from Hielongjiang, 21 or 10.2 percent were from Beijing, and 94 or 45.9 percent were from Henan. Teachers from the remaining provinces constituted 14.6 percent of the total number surveyed. Of the teachers surveyed, 62 or 30.2 percent were male, 143 or 69.8 percent were female. The youngest teacher surveyed was 21 years old, and the oldest was 62. Mean age was 35.77 ±9.340 years. Among those surveyed, 8 or 3.9 percent had high school or secondary vocation education, 180 or 87.8 percent had vocational or university education, and 17 or 8.3 percent received post-graduate education. The mean value of teaching years was 13.24 ±11.38 years.

(4) General Public

45158 responses were received. 152 or 96.2 percent were valid responses. 46 or 30.3 percent had families located in Heilong Jiang, 39 or 25.7 percent in Beijing, 19 or 12.5 percent in Henan, 11 or 7.2 percent in Hebei, 10 or 6.6 percent in Shandong, and the remaining 17.7 percent were from 12 other provinces, including Liaoning, Tianjin and Zhejiang, from each of which between one and four responses were received. Males accounted for 61 or 40.1 percent, and female accounted for 91 or 59.9 percent. The youngest was nine years old, and the oldest was 66. The mean age was 30.03±10.120 years. In terms of education level, eight or 5.3 percent had secondary education, 35 01 23 percent had secondary vocation or high school education, 90 or 59.2 percent had vocation or university education, and 18 or 11.8 percent had postgraduate education. One person or 0.7 percent did not respond.

46Among those surveyed, 143 or 94.1 percent had heard of AIDS a year ago, and 7 01 4.6 percent learned of it within the last year. Only the 150 respondents who had heard of AIDS were used in our analysis.

2. Public Attitude towards AIDS

47(1) Public Understanding of the Relation between AIDS and Morality; and the Lives of Infected Persons

48In response to the question, “Do you agree that AIDS is caused by immorality (drug abuse, casual sex, etc.)?”, the percentage of students, parents, teachers and the general public who expressed disagreement was 30.3 percent, 28.7 percent, 44.2 percent and 49.0 percent respectively.

Table 1: Public Understanding of the Relation between AIDS and Morality, and the Lives of Infected Persons

Table 1: Public Understanding of the Relation between AIDS and Morality, and the Lives of Infected Persons

49(2) Public Compassion towards Persons Infected with AIDS through Different Channels Refer to Table 2 for the publics ranking of compassion pertaining to the different channels of infection and the respective breakdown in percentages. We see that the publics ranking is consistent with the general view that infection through “Blood Transfusion or Surgery” and “From Mothers Pregnancy or Breast-Feeding” is worthy of sympathy, while infection through “Sharing of the Same Injection Needle during Drug-Taking” and “Casual Sex” is not. This is an indication that people generally treat infected persons differently based on the way in which they were infected.

Table 2: Public Compassion towards Persons Living with AIDS infected through Different Transmission Routes

Table 2: Public Compassion towards Persons Living with AIDS infected through Different Transmission Routes

50(3) Public’s Behaviour towards School Education for OVCs

51The percentages of students, teachers, parents and the general public who believe that students living with HIV should continue with their education are 60.7 percent, 62.8 percent, 77.6 percent and 7.2 percent respectively. The percentages for the same groups who agree that they themselves (or their children) should attend the same class as children who have parent(s) living with AIDS are 58.9 percent, 40.3 percent, 79.0 percent and 28.9 percent respectively. The percentages for the same groups who agree that they themselves (or their children) should attend the same class as students living with AIDS are 49.7 percent, 32.6 percent, 62.0 percent and 27.0 percent respectively.

52Refer to Table 4 for the public’s behaviour towards a hypothetical AIDS-infected child. We see that most of the public do not discriminate against infected persons and are willing to provide assistance. However, a small proportion displays discriminatory behaviour, such as “demand infected persons transfer to another school.”

Table 3: Public’s Attitude towards School Education for OVCs

Table 3: Public’s Attitude towards School Education for OVCs

Table 4: Public’s Attitude towards Hypothetical OVCs

Table 4: Public’s Attitude towards Hypothetical OVCs
3. Public Awareness of Rights and Policies
(1) Right to Education

53Table 5 indicates that more than 90 percent of the public agree that OVCs should have the right to education.

Table 5: Public Attitude on the Right to Education

Table 5: Public Attitude on the Right to Education
(2) Privacy

54Refer to Table 6 for the public’s attitude towards the right to privacy and the right to know the identity of those living with HIV around them. The information indicates that the public tends to believe in the right to know the identity of persons living with HIV around them, whereas they tend to believe in the protection of privacy if they were the infected persons.

Table 6: Public Attitude towards the Privacy of Persons Living with HIV

Table 6: Public Attitude towards the Privacy of Persons Living with HIV

554. Public Understanding and Ranking of the Unjustifiability of the Different Behaviours Towards Persons Living with HIV

56Refer to Table 7 for the ranking and percentages of different groups on the unjustifiability of different behaviours towards persons living with HIV.

575. Analysis of Factors Affecting Anti-Discriminatory Attitude Anti-discriminatory attitude is analyzed as follows: first, values are assigned to anti-discriminatory attitudes. Positive attitudes are assigned positive values, and negative attitudes are assigned negative values. A full mark is-13 – 14 points for students, - 14 – 13 points for parents, - 12 – 15 points for teachers, and-14-13 points for the general public. A higher mark indicates a more positive attitude. Statistical analysis for the differences between the groups was carried out using ANOVA or t-test. Upon determining that the data is statistically significant after ANOVA, multiple comparisons were carried out using LSD. Second, values were assigned for “relation between AIDS and morality,” “knowledge of the lives of infected persons,” “right to education,” “right to privacy,” and “policy,” and the Spearman Rank Correlation with students’ anti-discriminatory attitude was performed. Third, the total anti-discriminatory attitude value as a dependent variable was used, and all variables were included in a multiple linear regression analysis.

Table 7: Understanding and Ranking of the Unjustifiability of the Various Attitudes towards Persons Living with HIV

Table 7: Understanding and Ranking of the Unjustifiability of the Various Attitudes towards Persons Living with HIV

58(1) Analysis of Factors Affecting Anti-Discriminatory Attitude among Students The results show that total anti-discrimination points for students was 4.85 ±3.990 points. No statistical significance was found for the differences between students of different regions and different genders. The differences in scores between students of different levels are statistically significant. Primary students scored 3.26 ±4.105 points, secondary students scored 4.80 ±4.121 points, high school students scored 5.40±3.385 points and university students scored 6.19 ±3.845 points. Thus, students with a higher level of education tend to have a more positive attitude towards persons living with HIV. Scores for students who received education (5.53 ±3.951 points) are higher than scores for students who did not have education (4.12 ±3.905 points), and the difference is statistically significant.

59Analysis of the relevant results indicate that the overall anti-discrimination score is positively correlated with the total score for knowledge of AIDS, and the scores for knowledge of non-transmission route, prevention knowledge, knowledge of diagnosis and treatment, relation between AIDS and morality, knowledge of the lives of infected persons, right to education, and policy; the correlation coefficients for each of these categories being 0.387, 0.417, 0.295, 0.290, 0.175, 0.199, 0.413 and 0.114. Thus, an anti-discriminatory attitude is highly correlated with scores for knowledge (especially “knowledge of non-transmission route” and “knowledge of diagnosis and treatment”) and the right to education. An anti-discriminatory attitude has no correlation with transmission route or privacy.

60Regression analysis shows that, compared to mothers with secondary education or lower, the attitudes of mothers with university or vocational or higher education tend to be more negative. The overall score for anti-discriminatory attitude does not correlate positively with the scores for non-transmission route, relation between AIDS and morality, knowledge of the lives of infected persons, right to education and right of privacy.

61(2) Analysis of Factors Affecting Anti-Discriminatory Attitude among Parents Overall the anti-discriminatory attitude among parents was 2.47 ±3.998 points. There is no correlation between parents’ attitude and a child’s sex, school level, parents’ status, educational level and occupation. Results of the relevant analysis indicate that the anti-discriminatory attitude of parents is positively correlated with the scores for knowledge (non-transmission route, prevention, and diagnosis and treatment), relation between AIDS and morality, knowledge of the lives of infected persons, right to education, right to privacy and policy. The results of regression analysis show that the overall score for parents’ anti-discriminatory attitudes positively correlates with the scores for the knowledge of non-transmission route, relation between AIDS and morality, knowledge of the lives of infected persons, right to education, right to privacy and policy. Compared to parents in Heilongjiang, parents in Henan have a greater positive tendency.

62(3) Analysis of Factors Affecting Anti-Discriminatory Attitude among Teachers The overall score for the anti-discriminatory attitude of teachers was 7.02 ±3.328 points. The differences in the anti-discriminatory attitudes between teachers of different groups were statistically insignificant. The relevant analysis results indicated that the overall score for teachers’ anti-discriminatory attitude is positively correlated with knowledge (of non-transmission route, prevention, and diagnosis and treatment), relation between AIDS and morality, right to education, right of privacy, and policy. The results of regression analysis show that, compared to Heilongjiang, teachers of Beijing, Henan and other regions tended towards greater positivity. There is no statistical significance with other variables.

63(4) Analysis of Factors Affecting Anti-Discriminatory Attitude among the General Public

64The overall score for anti-discrimination among the general public was 3.67 ±3.767 points. The difference in scores between the general public with different education levels showed statistical significance. Further analysis showed that the general public with high school or secondary vocation level education or lower scored lower than those with vocation, university or post-graduation education. This indicates that discrimination is more apparent among the portion of the general public with a lower level of education. Relevant analysis results showed that an anti-discriminatory attitude in the general public is positively correlated with the scores of knowledge (of transmission route, non-transmission route, and prevention), relation between AIDS and morality, and knowledge of the lives of infected persons. Correlation with knowledge of non-transmission route, knowledge of prevention, and the relation between AIDS and morality is high. Regression analysis results showed that the anti-discriminatory attitude of the general public is not correlated with non-transmission route, relation between AIDS and morality, and policy. The anti-discriminatory attitude among the general public tends to be more positive with higher scores for non-transmission route, relation between AIDS and morality, and policy.

(II) Results of Analysis of the Stigma Questionnaire

1. Basic Information of Study Subjects
(1) Students

65215 students were surveyed. All were from Beijing. 78 or 36.3 percent were male, and 135 or 62.8 percent were female. 2 or 0.9 percent did not respond. 100 or 46.5 percent were secondary school students, 69 or 32.1 percent were high school students, and 46 or 21.4 percent were university students. Students surveyed were between the ages of 12 and 22, and the mean age was 15.55 ±2.786 years. 199 or 92.6 percent of students have received training on the prevention of AIDS in school, and 16 or 7.4 percent have not received any training.

(2) Parents

6650 parents were surveyed. All were from Beijing. 19 or 38.0 percent were female, and 31 or 62.0 percent were male. Parents’ ages were between 33 and 68, and the mean age was 41.44 ±5.379 years. 1 parent or 2 percent had a primary or lower level of education, 10 or 20 percent had secondary education, 18 or 36 percent had high school or secondary vocation education, 17 or 34 percent had vocational or university education, 3 or 6 percent had post-graduate education; 1 parent or 2 percent did not respond.

(3) OVCs

6718 OVCs were surveyed. All were from Henan. 9 or 50 percent were male, and 8 or 44.4 percent were female. 1 student or 5.6 percent did not respond. All 18 students are currently attending a special primary school for OVCs. Among them, 4 or 22.2 percent were in primary 3, 4 or 22.2 percent in primary 4, 5 or 27.8 percent in primary 5, and 5 or 27.8 percent in primary 6.

2. HIV Stigma Comparison

68Situational analysis is used, and case studies were prepared to compare HIV stigma among students, parents and OVCs.

Case 1

69Xiaoli, a high school student, has good grades, and has been a ‘Triple AStudent’every year. Her dream is to study in a top university in the country. Lately, she has not been feeling well, and has been feeling lethargic. She has been suffering from serious flu with increasing frequency. Once, she was down with mild pneumonia. She also discovered that she had skin ulcers that took a long time to heal.

70She visited the doctor, who suggested that she take an AIDS test. The test results were positive. She told her parents and family members, and her parents refused to accept the fact that their daughter is infected with AIDS. Zhu Xu, her boyfriend, saw that she was depressed and asked her what was bothering her. Xiaoli was very confused, as she did not know if she should tell him the truth.

71“Xiaoli, the key character in the case, is a person living with HIV. We used this case to explore HIV stigma among students, parents and OVCs. The projective technique is used for students and parents: respondents subconsciously project their own attributes, attitudes and subjective processes onto other people. It is generally believed that the attitude of the majority reflects the true attitude of the group in question to some extent. The attitude of OVCs towards the character Xiaoli will reflect their own stigmas to some extent because they share similar experiences with her. What OVCs believe to be the attitude of the majority reflects the stigma and discrimination that they have experienced. 35 variables were set for the above case, and values were attributed to them. Each variable is assigned a score of between-2 and 2, the higher the score, the greater the tendency towards a more positive attitude.

72Table 8 indicates the average score for each variable among the various groups. The box plots in Figures 1, 2, 3 and 4 describe the distribution of the scores of variables within different benchmarks for the different groups. “– Other” refers to what was believed to be the majority’s view.

73From Table 8 and Figure 1, in terms of intention, we see that the overall behaviours of students, parents and OVCs are positive. In terms of the variables dealing with intention, OVCs display the highest scores, followed by students, then parents. Some of the differences between variables showed statistical significance. Students, parents and OVCs reported that the behaviour scores of the majority were lower than those of their own behaviour. Certain variables are statistically significant, which implies that the scores for the actual behaviour intention of students and parents were even lower. There is no statistical significance between the difference between the perception of the majority’s behaviour by OVCs and those of students and parents. This shows that there is no difference between the discrimination felt by OVCs and actual discrimination.

74Table 8 and Figure 2 show that, in terms of emotional response, the behaviours of students, parents and OVCs were positive. OVCs scored the lowest, whereas students scored higher, implying that OVCs have a stronger stigma. Some of the differences observed between the variables of students and those of OVCs are statistically significant. However, the differences between parents and OVCs were statistically insignificant. Students and parents reported lower scores for the attitudes of the majority compared to their own, which showed that the true emotional responses of students and parents were even lower. The scores for emotional responses of OVCs were lower than those of their own behaviour; which implies that the scores of the true emotional responses for students and parents should be even lower.

75Table 3 and Figure 3 show that in terms of behaviour response, the behaviours of students, parents and OVCs were generally positive. Behaviour response scores of students and parents were lower than those of OVCs. Differences between certain variables were statistically significant. The scores on the behaviour response of the majority as reported by students, parents and OVCs are close to their own scores. Only the differences for specific variables of students were statistically significant. The behaviour response scores experienced by OVCs are higher than the scores for true behaviour responses for students and parents.

76Table 8 and Figure 4 show that in terms of disclosure of illness, the scores for students, parents and OVCs were negative, which imply that they support disclosing the illness. Parents scored slightly higher. Students, parents and OVCs reported that the majority’s scores are not very different from their own. Only differences for specific variables for students were statistically significant.

Table 8: Stigma of Students, Parents and OVCs towards Persons Living with HIV

Table 8: Stigma of Students, Parents and OVCs towards Persons Living with HIV

Figure 1: Behaviour Intention Box Plot of Different groups towards Persons Living with HIV

Figure 1: Behaviour Intention Box Plot of Different groups towards Persons Living with HIV

Figure 2: Emotional Response Box Plot of Different Groups towards Persons Living with HIV

Figure 2: Emotional Response Box Plot of Different Groups towards Persons Living with HIV

Figure 3: Behaviour Response Box Plot of Different Groups towards Persons Living with HIV

Figure 3: Behaviour Response Box Plot of Different Groups towards Persons Living with HIV

Figure 4: Disclosure of Illness Box Plot of Different Groups towards Persons Living with HIV

Figure 4: Disclosure of Illness Box Plot of Different Groups towards Persons Living with HIV
3. Comparison of Stigma of Children Orphaned by AIDS
Case 2

77Xiaolang, age twelve, is a primary five student and is a member of the class’s sports committee. He is vivacious and performs well in his studies; hence, he is a favourite among teachers and classmates. However, some time ago, Xiaolang started missing classes frequently, and did not appear as happy as he used to he. When his friends asked him what the matter was, he denied that there was anything wrong. Finally, when the form teacher asked him what happened, he said his father was ill, seriously ill. He has to help take care of his father, and missed classes as a result.

78After some time, Xiaolang was able to attend class again. However, his enthusiasm had clearly waned. Friends heard from unidentified sources that his father had diedfrom AIDS. Since then, they started staying away from him. Xiaolang used to be surrounded by friends during physical education lessons. Now, classmates would disperse as soon as he appears, even keeping hundreds of metres away. Some would make signs behind his back. The teacher started to stop marking his homework, and his seat was moved to the back of the classroom. Not long after, the principal requested a meeting with his mother, and told her in a regretful tone that many parents had demanded that Xiaolang transfer to another school. If Xiaolang does not transfer, they would transfer their own children to another school. The principal hoped that Xiaolang and his mother would give the matter due consideration.

79“Xiaolang, the character in the case, is a child orphaned by AIDS. We used this case to examine the stigma of students, parents and OVCs toward children orphaned by AIDS. Based on the above case, 19 variables were set. The procedures employed were the same as those in Case 1.

80Table 9 and Figure 5 showed that in terms of emotional response, the scores for the different variables were positive for students, parents and OVCs. Students scored the highest, followed by parents; OVCs scored the lowest. The differences for some of the variables were statistically significant. This reveals that OVCs have a stronger stigma. The scores for the emotional response of the majority as reported by students are lower than their own. Results from the same reports by parents and OVCs are consistent. Comparing OVC stigma and the actual attitude of students, there are more variables with statistically significant differences. However, when compared to parents, only the difference for one variable is statistically significant. This shows that OVC stigma is stronger than the actual stigma of students and parents.

81Table 9 and Figure 6 show that the scores of students, parents and OVCs for “rights awareness” are positive. This indicates that students and parents respect nondiscrimination and the right to education of children orphaned by AIDS. OVCs are also aware of their rights. The difference between students’ scores for “Schoolmates should give Xiaolang more love” and the scores for parents and OVCs are statistically significant; students’ scores are higher. The score for rights awareness of the majority as reported by OVCs is lower than the scores for the actual rights awareness of students and parents. These differences are statistically significant.

82Table 9 and Figure 7 show that in terms of education, the scores for students and OVCs for the variable, “Hopefully, a special school will be built, so that Xiaolang can go to school with children of similar circumstances” are negative. Although parents’ score was positive, they believed that the score for the majority was also negative. This indicates that all three groups of people hope that a special school will be built for OVCs. Also, the score for “Xiaolang will threaten the health of other students if he remains in school” for OVCs is negative, which implies that they believe that children orphaned by AIDS will threaten the health of other students. This could be the reason for their wish to have special schools built. However, this survey was conducted only in a school where OVCs congregate, which means that investigation results of OVCs are not representative.

83Figure 7 indicates that there are quite a number of outliers and extreme values. The score of OVCs for their own attitude is lower. They also believe that the majority will hope for a special school to be built, and that demanding children orphaned by AIDS transfer to another school is reasonable. Thus, the stigma experienced by the OVCs surveyed is stronger. They hope that special schools could be built, so that children orphaned by AIDS can attend together.

II. Results of Qualitative Analysis

(I) Summary of Open-Ended Questions in KAP Questionnaire

841. Do you think students living with HIV should be allowed to remain in school?

85(1) Those who replied in the affirmative gave reasons that fall within the following categories: 1) from a rights perspective: everyone has the right to education, everyone is equal, and AIDS infection does not deprive them of such right; 2) from a medical perspective: AIDS is not contagious, and studying in the same class as the infected person is not threatening to one’s health; 3) from an emotional perspective: people should sympathize with persons living with HIV, and not ostracize them; 4) from a non-discrimination perspective: people should not discriminate against persons living with HIV, and should exercise the spirit of humanity; 5) from a learning perspective: even infected persons have to learn in order to pursue their dreams and a good future; 6) being infected with AIDS is not their fault; 7) from the country’s perspective: the country requires talent.

86(2) Those who replied in the negative gave the following reasons: 1) worry that they will be infected (this is the main reason); 2) treatment of the disease should be the focus; 3) infected persons will be discriminated against; 4) students living with HIV should learn with other children who are infected as well.

Table 9: Sense of Humiliation of Students, Parents and AIDS-affect Children toward Children Orphaned by AIDS

Table 9: Sense of Humiliation of Students, Parents and AIDS-affect Children toward Children Orphaned by AIDS

Figure 5: Emotional Response Box Plot of Different Groups towards Children Orphaned by AIDS

Figure 5: Emotional Response Box Plot of Different Groups towards Children Orphaned by AIDS

Figure 6: Rights Awareness Box Plot of Different Groups towards Children Orphaned by AIDS

Figure 6: Rights Awareness Box Plot of Different Groups towards Children Orphaned by AIDS

Figure 7: Attitude to Education Box Plot of Different Groups towards Children Orphaned by AIDS

Figure 7: Attitude to Education Box Plot of Different Groups towards Children Orphaned by AIDS

87(3) Those who gave responses that are dependent on the transmission route, or who had no comments gave the following reasons: 1) not sure if others can be infected; 2) relate transmission route to morality; 3) depends on the seriousness of the illness; 4) conflict between awareness of self-protection and morality.

882. Are you agreeable to you or your child attending the same class as a student who has a parent or who is a person living with AIDS?

89(1) Those who agreed with this statement gave the following reasons: 1) AIDS is transmitted via blood and sexual activity and not via normal study activities; 2) we should care for and help this student; 3) we should not discriminate; 4) if only the parent of a child is infected, it does not imply that the child is infected as well. The fault of parents cannot be attributed to the child; 5) we should treasure friendship, and think that “because he is my friend, I can be closer to him.”

90(2) Those who do not agree gave the following reasons. Most were afraid of being infected and did not feel safe. Parents felt that “children may scratch their skins during play and get infected,” and that “the children are young and do not know how to take precautions. This has nothing to do with a loving heart.” (3) Those who gave responses that are dependent on the transmission route or who did not have comments gave the following reasons: 1) one cannot be sure that a student is infected just because their parents are infected with AIDS; 2) it depends on the parent’s or the child’s route of infection; 3) it depends on the seriousness of the illness; 4) caught between fear for the disease and a sense of morality; 5) parents believe that children have inadequate awareness and ability to protect themselves.

913. Do you think you have the right to know if there is anyone living with HIV around you?

92(1) Those who replied in the affirmative gave the following reasons; 1) the public has the right to health. Knowledge enables them to take effective precautionary measures to prevent themselves or other people from being infected; 2) people can better help the infected person after knowing about the infection; 3) people have the right to know; 4) yes, if information is obtained from “legitimate channels.” (2) Those who replied in the negative gave the following reasons; 1) it is a private matter, other people do not have the right to know; 2) that knowledge will cause harm to persons living with HIV, even discrimination; 3) do not want to know because they believe they will not be infected.

934. In your view, what kind of behaviour towards children orphaned by AIDS and children living with HIV is considered discriminatory behaviour?

94Answers included language, such as insult, ridicule, sarcasm, etc.; avoidance, such as staying away; refusal to join any activity where the infected person is present; aggressive behaviour; infringement of rights, such as restrictions on employment, medical treatment, etc. Excessive care may be a disguised form of discrimination.

(II) Results of Interviews with Students

1. Overview of Students Interviewed

95One university, high school, secondary school and primary school from each of Heilongjiang, Beijing and Henan were selected. Interviews with one or two groups were carried out in each school. 17 groups, or 136 students, were interviewed in total. 65 or 47.8 percent were male, 71 or 52.2 percent were female. 58 or 42.6 percent were from Heilongjiang; 36 or 26.5 percent were from Beijing, 42 or 30.9 percent were from Henan. 28 or 20.6 percent were primary students, 49 or 36.0 percent were secondary students, 33 or 24.3 percent were high school students, and 26 or 19.1 percent were university students.

2. Results of Interviews with Students

96(1) Students’ knowledge of AIDS

97All students interviewed had heard of AIDS. The main channels from which they learned of AIDS were mass media, such as television, newspaper and radio, and school-conducted courses, display boards and posters. A small number had heard from their parents.

98When AIDS was mentioned, most students would think of issues relating to the disease and the emotional experience of persons living with HIV. A small number thought of AIDS-related social problems. The things that came to the minds of most of them were “death,” “transmission,” “incurable” and “how to prevent the disease.” In terms of emotional experience toward persons living with HIV, most would think of “discrimination,” “fright,” “care,” “pitiful,” “terrifying,” “scary,” “the infected person will feel lonely,” and “pain.” When it came to AIDS-related social problems, most students thought of “orphans,” “drug abuse,” etc.

99Most students are aware of the three transmission routes of AIDS (blood, sex and mother-to-child), and were able to identify if various daily activities would facilitate transmission. However, there were some misconceptions about transmission routes; some students thought that HIV can be transmitted through saliva, air, the sharing of a cup, etc.

100(2) Attitude towards Persons Living with HIV/AIDS

101Most students were caring and non-discriminatory towards persons living with HIV/AIDS, and respected the rights of such persons. There were students who felt that HIV is terrifying, and would discriminate against or avoid HIV-infected persons.

102The majority of the students believe that their attitude should depend on the transmission route. Some students feel that “if a person was infected due to an innocent cause, then that person deserves sympathy; if infection was due to drug-taking, then the infected person deserves it.” There were students who did not share this belief. They were of the opinion that “even drug abusers do not wish to be infected” and should not be punished with a disease. These students felt that HIV infected persons should be treated equally, regardless of whether infection was via drugs or mother-to-child transmission.

103(3) Attitude towards OVCs

104Although there are controversial attitudes towards persons living with HIV/AIDS, the attitude that students expressed toward OVCS is that they were “innocent,” “deserve sympathy,” “we should care for them,” “we should not discriminate against them,” “we should treat them equally,” “they should have the same right to education as children of the same age,” and “we should help them through our own efforts and those of the State and school.”

105Most students believe that OVCs have the right to education and that they should be able to attend school. However, many students suggested that special schools should be built for OVCs, and that infected students, especially children living with AIDS, should be segregated from the others. There were also many students who were against this idea, and believed that it constitutes discriminatory behaviour.

106Some students believe that if they are careful about protecting themselves, attending school with OVCs will not threaten their health. Other students thought that their health would be threatened, and that they cannot face OVCs with calm or free of reservation. These students felt that they would remain friends with OVCs if they were friends before, but that the relationship would not be as close as before the child became an OVC. A minority of students made it explicit that they were unwilling to attend school with OVCs.

107(4) Discrimination against OVCs

108Students believe that discrimination against OVCs could manifest itself in the following ways: deliberately staying away from or ostracizing OVCs, such as not sitting at the same table as them; verbal attacks, such as ridicule and insult; refusal to allow OVCs to attend school; parents demanding OVCs transfer schools or have their own children stay away from OVCs; building a separate school for OVCs and segregating them from the other students; behaviours that infringe on their privacy; and excessive concern: students believe that what OVCs need is equality, and excessive concern may make OVCs feel special and inferior. As a result, OVCs with a strong sense of pride will be hurt.

109(5) Reasons for Discrimination

110The students interviewed believe that the main reasons for discrimination against persons living with HIV and OVCs are:

  • Lack of knowledge; knowledge of AIDS is incomplete and unsystematically acquired; lack of understanding regarding transmission routes; and the belief that AIDS is transmitted through daily contact.
  • Fear of AIDS because “AIDS is a communicable disease and incurable till now. Fear of being infected.”
  • Connecting AIDS with bad behaviour and morals, because “AIDS comes together with many bad behaviours; hence, many people will think of hideous things at the mention of AIDS, and feel that infected persons are guilty.”
  • Many students believe that discrimination originates more from the care and love that parents have for their children. Some students think that such protective behaviour from parents is not restricted to AIDS. For example, one student told of “a classmate who shared the same table with me had tonsillitis. My parents refused to let me share a table with him when they knew of it.”
  • Lack of publicity, inappropriate advertising methods, and lack of depth in advertising content. Some students stated: “Inadequate publicity. We had opportunities to attend seminars, but most know little”; “Care is not knowledge. We should organize talks in communities to increase the level of understanding among parents and residents.” There were students who proposed, “Current ads focus on the nature of AIDS as a disease. This exaggerates the outcome of the disease and produces fear. On the other hand, very little on the prevention of AIDS has been mentioned, and people’s fear cannot be alleviated.” Others said, “Some publicity focused on the wrong message and create too much fear. Fear is exaggerated, but prevention is neglected.”
  • A minority of students think that discrimination depends on personal disposition, or on the inability to empathize with others.

111(6) Recommendations for Eliminating Discrimination

112To eliminate discrimination, students are of the opinion that there should be greater public knowledge about the disease. Some felt that a publicity campaign must start with the general public, and that the content and format of current forms of publicity on the issue must change. For content, students recommend, “intimidating language should be avoided. Instead, focus should be on prevention and the message of love in order to help people to confront the disease objectively.” In terms of format, one suggestion was that publicity methods should be more audience friendly, and fun. Most students think that the school should organize seminars and health classes, instead of being limited to distributing publicity materials only. On the matter of discrimination from parents, most students believe that parents have good intentions – that their discrimination is caused by love for their children – but that parents’ views are nevertheless wrong. Students recommend that the school should send the message through students, or organize classes for parents to promote understanding and support.

(III) Results of Interviews with Teachers

1. Overview of Teachers Interviewed

113Interviews with teachers were carried out in two groups. One group consisted of four interviewees, while another group consisted of six interviewees. Two were male, and eight were female. Most teachers had undergraduate qualifications; there was one Chinese language teacher, one mathematics teacher, four English teachers, two geography teachers, one tourism major teacher, and one head of political education. The average age of the teachers was 31.1 +2.807 years.

2. Results of Interview with Teachers

114(1) Teachers’ Knowledge of AIDS

115All teachers interviewed had heard of AIDS. They relate AIDS to: sex, drug-abuse, blood donation, blood transfusion, death, terrifying, frightful, affecting the next generation, expensive medical fees, and affecting the next few generations, etc.

116Teachers said that they are aware of the three transmission routes, and that AIDS is not communicated through daily work and learning. Their knowledge of AIDS is mainly derived from television. The school has also distributed CDs and student readings.

117(2) Behaviour towards Persons Living with HIV/AIDS

118Some teachers believed that persons living with HIV must be given benevolence and care because they are victims as well as patients. These teachers also did not relate the illness to the transmission route because they believe that infection may have been caused by a one time mistake.

119Some teachers related the disease to the route of infection. They believe that certain people were infected as a result of a moral flaw, but that some infected persons, such as children who were victims of mother-to-child transmission, are innocent.

120(3) Attitude towards the Right of Children Orphaned by AIDS to Education

121Even though the teachers surveyed had not come into contact with children orphaned by AIDS, they believed that these children have the right to education. The teachers also believe that teachers are responsible for and have a duty to help and protect these children.

122(4) Acceptance by the School of the Difficulties of OVCs

123Teachers believe that schools have difficulty accepting OVCs mainly because of parents. Many parents simply refuse to accept an OVC into the same class as their children. The school has little choice if parents will not yield. Protection of the rights of OVCs requires the joint efforts of every member in society.

124The teachers revealed that if parents demand that OVCs be transferred to another school, they would talk directly with parents to try to convince them to change their minds. Teachers also try to explain to parents that giving OVCs the right to education does not cause any hazard to other students.

125(5) Teachers’ Responses and Difficulties if an Infected Student is in their Class

126Teachers said that the identities of OVCs should be kept confidential if they have not been disclosed. There is no need to disclose a child’s circumstances to other students and parents if the child is not infected. If an OVC’s status has already been disclosed, then mitigating measures must be taken.

127Some teachers also believe that the presence of an OVC in their class will put huge pressure on them, and it may make it difficult to communicate with other teachers or parents. Some parents may accept working alongside infected persons, but may not tolerate their children to be in contact with infected children. The teachers are of the opinion that parents’ discrimination is closely related to their educational level.

128Some teachers think that even though they can accept infected children, acceptance by other students is just as important. They made some suggestions on how the school should convince other students to accept and respect an OVC: the school and its teachers must do a good job at imparting knowledge of the disease, and conduct lessons to encourage scientific knowledge of HIV/AIDS. Teachers should also respect OVCs, so that other children will treat them normally. Teachers must lead by example. If teachers respect OVCs, the attitude of the other students will gradually improve.

129(6) Opinions of teachers if the parent(s) of a student is (are) found to have been infected with AIDS, and the school requires that such student provide a blood test report every six months

130Teachers think that this measure is excessive, and will be a blow to OVCs. However, this measure is understandable, since it is for the benefit of the larger student population. Teachers believe that discrimination is also a form of mental isolation.

131(7) Teachers’ Recommendation on the Elimination of Discrimination in School

132Most teachers believe that setting a good example on their part is critical in eliminating discrimination, and has an enormous impact on students and parents. Instead of discriminating against OVCs, teachers should respect OVCs’ right to education, and should care for, sympathize with and help OVCs, as well as live and eat with them. This will inspire people to abandon their discrimination. That said, teachers should also take precautions to protect their own well-being. Thus, AIDS education for teachers must be clear and systematic, and should include measures like emergency tactics.

133For the school, teachers suggested increasing primary and secondary AIDS education. Activities may be organized to promote understanding or educate students about the issue from a human rights perspective.

134In terms of parents, teachers recommend that details about the disease should be more specific, and public coverage must reach the communities to create a caring atmosphere and to inspire society’s acceptance of OVCs.

(IV) Results of Interviews with Persons Living with HIV

1. Overview of Infected Persons Interviewed

135Two groups and a total of six people living with AIDS were interviewed. Each group consisted of three persons. All interviewees were from Henan. Two were male, four female. One was infected through blood transfusion, two through sexual activity, and the mechanism of transmission of the other three was unknown. Also, three were from non-governmental organizations (NGOs) working with AIDS victims, and the other three were “loving mothers” (aixin mama) – special volunteers who take care of children – at a school for OVCs. The four females interviewed have children. One has four children, two of whom were studying in universities in other cities; one has three children, all of whom were attending an OVC school; one has two children, one of whom was in secondary school and the other in high school; one has children but no details were provided. One of the male interviewees was already a grandfather, and the other one lived alone. Interviews with HIV-infected persons reveal how their children were discriminated against.

2. Results of Interviews

136(1) OVCs may face different forms of discrimination in school. For example, parents of schoolmates may forbid their children to play with them. Teachers may fail to understand these children, or even arrange for them to sit at the back of the class. Classmates stayed away and refused to play with them. Discrimination against persons living with HIV exists in different degrees and in different forms. Most forms of discrimination manifest themselves in the following ways: peculiar eye expressions; refusal to eat at the same table with the infected person; refusal to play with children of the infected person; some infected persons and their families moved away after their identities were exposed; children transferred to another school; discrimination of people within the same village who bear the same family name as the infected person; and infected persons were even abandoned by family members. Discrimination is a barrier that prevents many infected persons from taking medical examinations or from revealing their identities.

137(2) Policy enforcement lacks support mechanisms to guarantee the rights of OVCs. The “Four Frees and One Care” and “Two Frees and One Subsidy” policies provide subsidies for OVCs in difficulty. However, application for such subsidies must be submitted through the school, and certain regions provide textbooks printed with the words “This book is provided free by the State.” Procedures such as these will expose the identities of OVCs, and many of these children would rather forego their subsidies than reveal that they are HIV-positive or are from families with persons living with HIV.

138(3) OVCs are usually unwilling to remain in the same school once their identities are exposed. Despite the availability of subsidies if they remain in the same place, many choose to transfer to another school.

139(4) Schools will refuse to accept OVCs on other grounds. The new school may reject the student’s transfer if it comes to know that the transferee or his/her parent is a person living with HIV.

140(5) Parents of OVCs are usually reluctant to reveal the truth of their AIDS infection to their children. However, children will come to know of their parents’ illness as they grow older, and as the family receives frequent telephone calls and visits from officers of relevant government departments. Some know that their parents are sick but do not know what the illness is; others know that their parents are suffering from AIDS, but know little about the disease.

141(6) Impact on the children. Parents of OVCs are worried that their children may not be understood if they attend public schools. Therefore, parents living with HIV send their children to schools for OVCs. Having HIV-infected parents affects the courtships and marriages of the children.

(V) Results of Interviews with OVCs

1. Overview of OVCs Interviewed

142Nine OVCs were interviewed. Five were infected, four were children orphaned by AIDS. Of the five infected children, four were victims of mother-to-child transmission and one was infected through blood transfusion. The children were between the ages of 10 and 15, the mean age being 12.89 ±1.69 years. Six of the interviewees were males and three were females. All were studying at a school for OVCs in Shangshui County, Henan, at levels between primary 3 and 6.

2. Summary of Results of Interviews

143(1) OVCs have a certain understanding of AIDS.

144(2) OVCs are discriminated against in their original schools (public schools) by teachers, classmates and the parents of classmates. Some gave examples of discrimination: “I was put at the back of the class. I could not see the board”; “Classmates do not play with us. They ignored us”; “Classmates were cold to us”; “Classmates’ parents told them not to play with us”; “The teachers will not be nice (to us) if they know (that we were from a family with persons living with AIDS). They will ignore us, and their facial expressions will change.” OVCs were depressed, but had no one to confide in. Hence, they did not wish to return to their original school.

145(3) Children said that they liked their current school (for OVCs) because “(they) are happy there, and no one discriminates against them,” “the teachers are more caring,” and “they feel better after going (to the school).”

146(4) They believe that “discrimination means no one bothers with them or plays with them, people talk behind their backs and bully them, and boys fight with them.”

147(5) The reason for discrimination is that “people are afraid of being infected.”

148(6) OVCs hope that society and schools can provide assistance, that the school, their schoolmates and relatives will not discriminate against them but will treat them correctly, and that they will receive everybody’s understanding, concern and love.

DISCUSSION

I. Policies

  1. There are laws against discrimination based on HIV/AIDS and laws governing the protection of the right of children to education in China. To some extent, these laws and regulations have been successful in guaranteeing the right of OVCs to education.
  2. Implementation of policy is inconsistent in different areas.
  3. Inadequate support measures and regulatory enforcement of laws and policies.
  4. Low awareness of the laws and regulations among the public. Therefore, greater effort is required in terms of promoting the laws and policies.
  5. Disparity in definition between the law and reality.

II. The Public

149Building a discrimination-free environment in schools depends on the concerted efforts of the government, society, schools and the public (principals, teachers, students and students’ parents). Hence, this study looks at the attitudes of students, parents and teachers, and explores the possibility of creating a caring and discrimination-free environment for OVCs.

1. Positive attitude, such as sympathy and care, of the public (including students, parents, teachers and the general public) towards OVCs

150Our study revealed that the majority of the public is sympathetic to and care for OVCs, and believe that they have the right to education. Between 60.7 percent and 77.6 percent of the public believe that children living with HIV should continue with their studies; between 27.0 percent and 79.0 percent are willing (or allow their children) to attend the same class as OVCs. If an HIV carrier was studying in the same class, most people chose not to discriminate against the person, but to help him/her instead. This indicates that most of the public respect the rights of an infected person, had positive intentions toward infected persons, and are willing to help when they are in need. The attitude and positive intention of this group are essential to the creation of a discrimination-free environment. Thus, people belonging to this group should be given guidance and encouragement.

2. Despite a positive attitude towards OVCs, some members of the public still display attitudes of avoidance and rejection if there is an OVC near them

  • 10 Gregory M. Herek, John P. Capitanio, “Public Rections to AIDS in the United States: A Second Decad (...)

151The results of our study also indicate that 2.7 percent to 35.8 percent of the public have clearly expressed that students living with HIV should not be allowed to go to school, or that they will not (or will not allow their children to) attend the same class as an OVC. Assuming there is an OVC in the same class as their children, 2.5 percent to 13.6 percent of the public exhibit discriminatory behaviour such as demanding that the infected person transfer to another school or class. Hence, in the event of an OVC in the same class, students, parents and teachers will tend to avoid and reject the OVC. Discrimination from various sources remains unavoidable. Our study results are consistent with other local and foreign research results.10

152Common reasons for public discrimination against persons living with HIV and against OVCs.

153By analyzing a single or multiple reasons for discrimination against different groups, and by reading the results of the analysis in tandem with qualitative analyses, we have derived the following key reasons for discrimination:

154(1) Lack of a complete and logical understanding of AIDS.

  • 11 Joint United Nations Program on HIV/AIDS (UNAIDS), Monitoring the Declaration of Commitment on HIV (...)
  • 12 G. M. Herek, J. P. Capitanio, and K. F. Widaman, “HIV-related stigma and knowledge in the United S (...)

155It is important to accurately identify the transmission route of AIDS and differentiate what is right from wrong. For example, believing that AIDS is transmitted by eating at the same table as infected persons will aggravate discrimination against persons with AIDS.11 Results from regression and correlation analyses show that members of the public who received high scores for knowledge (especially non-transmission routes and prevention) tend to have a more positive attitude. This shows that better knowledge can somewhat alter attitudes. When compiling and analyzing the answers to the open-ended questions, we discovered that most of the public was afraid that they (or their children) would be infected. This is revealed by their responses to the statement, “persons living with AIDS should not be allowed to go to school.” Thus, the publics knowledge of AIDS is insufficient to provide them with enough confidence to prevent the transmission of AIDS. Investigations by Herek et al.12 discovered that despite the respondents being very clear about how AIDS is transmitted, very few know of the nontransmission routes. Those who think that AIDS is transmitted through normal daily contact tend to be even more fearful of coming into contact with infected persons. They will also support punitive policies and infringements of the rights of infected persons.

156(2) Fear of AIDS.

  • 13 Helene Joffe, Risk and “The Other,” Cambridge: Cambridge University Press, 1999.
  • 14 Yang Ling, Zhu Yawen, Li Jiansheng, “A Review of Research on AIDS Stigma” (“ai zi bing wu mingyaji (...)

157AIDS is a communicable disease with no vaccine at the moment, and has a high mortality rate. Compared to diseases that do not pose apparent threats, AIDS patients tend to face greater discrimination. Study results indicate that most will associate words, such as “death,” “incurable,” “terrifying,” “fear” and “frightful” at the mention of AIDS. The public is worried of getting infected by going to school with OVCs. Despite knowing that the probability of getting infected is small, people do not wish to take the chance. The theory of accusation13 14 interprets the stigma and discrimination faced by AIDS victims as the public’s accusation and fear of AIDS patients. The theory proposes that when people are threatened by AIDS and are situated in a society with a highly dangerous communicable disease, they often direct accusations at other social groups instead of censuring the inner group to which they belong. AIDS stigma and discrimination is a natural emotional response by the public. People try to control risk and to ensure their own safety by accusing the stigmatized group.

158(3) Discrimination against AIDS is, to some extent, discrimination against the perceived wrongful behaviour and morals of the infected party.

159This study reveals that certain members of the public believe that AIDS is caused by immorality, such as drug taking and casual sex. The majority think that infection due to blood transfusion and mother-to-child transmission deserves sympathy, and infection due to drug abuse and casual sex does not. Therefore, we can conclude that people are sympathetic towards the infected persons, and discrimination may be directed at their wrongful behaviour. Such discrimination may spill over to AIDS patients infected through other transmission routes.

  • 15 B. Weiner, “Intrapersonal and Interpersonal Theories of Motivation from an Attributional Perspecti (...)
  • 16 B. Weiner, “A native psychologist examines bad luck and the concept of responsibility,” The moist,(...)
  • 17 Zhou Fanglian, Zhang Aiqin, Fang Lainyi et al., “Responsibility Attribution and Punitive Behaviour (...)
  • 18 Udo, Rudolph, Scott C. Roesch, Tobias Greitemeyer, et al., “A meta-analysis review of helping givi (...)
  • 19 Gisela Steins and Bernard Weiner, “The Influence of Perceived Responsibility and Personality Chara (...)

160Through regression theory and judgment of responsibility, Weiner et al.15, 16 explored cause ascription, judgment of responsibility, and emotional response to events that trigger stigma and repulsion, and the relevant strategies in response to such behaviours. Research by Zhou Fanglian et al.17 has also proved that the public tends to think that public attitudes toward persons living with HIV is related to the cause of a person’s infection. Compared to uncontrollable causes (such as contaminated blood), controllable causes (such as sex and drugs) produce a stronger judgment of fault, more negative emotions, less sympathy, and less willingness to help the infected person.18 19

161(4) Limited knowledge of rights and policies.

  • 20 C. G. Hartell and S. Maile, “HIV/AIDS and Education: A study on how a selection of school governin (...)

162This study shows that the degree of public understanding of rights and policies will also affect the attitude of people towards infected persons and OVCs. Hartell et al. state that the lack of knowledge of AIDS-related laws and policies will not support or protect the rights of infected persons, and discrimination will continue.20 Studies have discovered that the public has little knowledge of the policies on this issue. Therefore, despite the presence of relevant laws, the rights of OVCs may continue to be ignored or even infringed upon. Furthermore, an infected person or patient who has inadequate knowledge of his rights and policies will not be able to take timely advantage of the law in order to protect her own rights.

163(5) Inadequate, inappropriate, and superficial AIDS publicity and education.

164From the feedback through interviews with the public, many felt that the dissemination of knowledge about AIDS is inadequate, that the slogan kind of publicity will not do the job, and that systematic education is necessary. Current publicity focuses on describing AIDS as a disease. For example, telling the public it is a fatal disease exaggerates the outcome of the disease and leads to fear. Very little has been mentioned about the prevention of AIDS, and people do not know how to alleviate their fear. The public also suggested that the content of publicity campaigns should “include more information on prevention, concern and helping people to look at the disease more positively.” The format of the public ads should be more audience-friendly and fun.

165(6) Discrimination may arise from improper media reporting.

166AIDS-related reporting by the media should avoid using descriptions that may lead to discrimination, such as differentiating between “not innocent” infected persons from “innocent” persons, or using words such as “high risk group” or “AIDS orphan.” The media should also refrain from disclosing the identities of OVCs or any information that may lead to speculation of an OVC s identity. An OVC’s right to education may be prejudiced, or there may be greater discrimination, if his/her privacy cannot be guaranteed.

3. Anti-discrimination characteristics of students, parents and teachers

167(1) Students’ positive attitude increases with their level of study. Compared to students who have not been educated, those who have been educated tend to be more positive. AIDS-prevention education for primary students should be stepped up.

168Results of our study show that anti-discriminatory behaviours amongst students are related to their education status. A higher education level is correlated with a greater tendency towards anti-discriminatory behaviour. As such, discriminatory behaviour is more apparent among lower level students. Also, our qualitative analysis has found that discrimination among primary students stem from their ignorance of AIDS. Their discrimination is not directed only at AIDS victims, but any student who is different, such as one who gets poor grades or has unusual looks, etc., will be treated differently. This could be related to their lack of rational thinking and the lack of understanding of the concept of equality. This is why OVCs may face a certain degree of discrimination in primary school.

169Additionally, educated students scoring higher in anti-discriminatory behaviour indicate that education produces significant results in establishing anti-discriminatory behaviour. Thus, this study reveals that it is necessary to provide elementary education on AIDS prevention. The content may be simpler, since the aim is to allow elementary school students to have a basic understanding of AIDS, so that they will not fear or discriminate against AIDS victims. Education will also teach them self-protection skills, and will instil in them the spirit of humanity, and respect for people and for equality. Teachers who were interviewed also believed that AIDS education for primary and secondary students should be augmented. The Outline for AIDS Prevention Education for Primary and Secondary Students, issued by the Ministry of Education in 2003, provided that secondary schools should organize six periods of AIDS prevention education lessons, and four periods in high school. There is no specific requirement for primary school. Anti-discrimination education is required for high schools, but no provision for the same is set forth for secondary schools. Therefore, we recommend that AIDS education should commence at the primary level, and anti-discrimination education should be included at the secondary level.

170(2) In relative terms, discrimination among parents is greater; parents have to balance their children’s safety and morality.

171Our study has found that parents who are agreeable to having their children study in the same class as children whose parents are living with AIDS account for only 40.3 percent. This percentage is lower than those of children (58.9 percent) and teachers (79.0 percent). The percentage of parents who will allow their children to study in the same class as students living with AIDS is only 32.6 percent, which is also lower than that of students (49.7 percent) and teachers (62.0 percent). 13.6 percent of parents selected the option, “demand that the infected person transfer to another school or class.” This is a higher percentage than that of students (6.7 percent) and teachers (2.5 percent).

172Some students believe that the main source of discrimination comes from parents, because of their concern and care for their children. Teachers interviewed also believed that schools have difficulty accepting OVCs mainly because of parents. Many parents simply cannot accept an OVC studying in the same class as their child. Interviews with persons living with AIDS and OVCs also indicate that other parents will tell their children not to play with the children of persons with AIDS.

173From responses to open-ended questions in the questionnaire, parents revealed that many of them were in a dilemma, and are caught between their children’s safety and their own sense of morality. Parents are worried that their children lack the ability to protect themselves, and that they will be infected with AIDS. Thus, despite the low risk of infection, parents are not willing to take the risk.

174(3) Discrimination by teachers against OVCs is relatively less, and most teachers are aware that they should set an example in the creation of an anti-discriminatory education environment. However, teachers think that the school’s acceptance of OVCs will generate tremendous pressure.

175Based on the study results, teachers’ discrimination is comparatively less than the other groups. Results of interviews with teachers also indicate that they believe that OVCs have the right to education, and that teachers have the responsibility and duty to help and protect these children. Teachers realize that their own behaviour is an important example for students and parents. However, teachers also believe that they will be under tremendous pressure if there is really an OVC in class, and that it is necessary to communicate with other teachers and parents. Students may not accept an OVC in class. From our quantitative analysis, we also found that 10.5 percent of the teachers have made it explicit that they did not wish to have an AIDS-infected student in their class. A small number have also selected the discriminatory option, “demand the infected person to transfer to another school or class.” Interviews with infected persons and OVCs indicate that some teachers exhibit discriminatory attitudes. Such discriminatory attitudes may be more prominent in rural areas. Therefore, one of the things we must do is improve AIDS and anti-discrimination education for teachers to create a caring and discrimination-free environment. On the other hand, teachers hope that their education can be more systematic and clear, such as teaching them how to deal with situations involving OVC students.

III. OVCs

1. OVCs face different degrees of discrimination in school

  • 21 UNICEF China HIV/AIDS Program, Booklet on the Psychosocial Care of AIDS Orphans and Vulnerable Chi (...)

176During interviews with infected persons and OVCs, we discovered that OVCs face varying degrees of discrimination from teachers, classmates and parents of classmates. Discrimination manifests itself in different forms, such as having to sit in the last row in class, being ostracized and rejected by classmates, having classmates’ parents tell their children to not play with them, etc. OVCs usually prefer not to continue their education in the same school as soon as their identities are revealed, even though they will receive subsidies if they stay in that school. Most prefer to transfer to another school, or even move out of the community. However, in the process of their transfer, the new school may find other reasons to reject them if it comes to know that the child is an infected person or comes from a family with an infected person. Furthermore, State subsidies may not benefit them, since they will need to apply for such subsidies through the school, and the village committee at the school; the applicant’s family’s domicile will also assess the application, and put up in the public notice before the subsidy can be disbursed. In certain areas, subsidized students would receive books printed with the words, “This book is provided free by the State.” This makes it difficult to protect the privacy of OVCs, and they face discrimination in school. Discrimination is traumatic to OVCs, and will result in anxiety, fear and a sense of hopelessness. Their grades will deteriorate, they will begin to detest school, refuse to socialize with people or will socialize only with people who have had similar experiences (other OVCs), or even drop out of school.21

2. The stigma experienced by OVCs is stronger than the stigma perceived by the public

177Hence, OVCs choose to stay away from the school environment to avoid or reduce discrimination.

  • 22 B. E. Berger, C. E. Ferrans, F. R. Lashley, “Measuring stigma in people with HIV: Psychometric ass (...)

178According to studies by Berger et al,22 the stigma felt by OVCs is the perception by persons with HIV of the actual or possible social deprivation (incomplete acceptance by society, or rejection by society); of limitation or deprivation of opportunities (e.g. housing, employment or medical treatment); and of negative changes in social identity (how they are perceived by others). The stigma felt by OVCs is affected by two factors: the infected person’s perception of social attitudes, and his personal knowledge. Perceived stigma can lead to different outcomes, such as change in self-image, emotional response toward the discriminator, concealment of illness or escaping from society to avoid or reduce discrimination. In our study’s stigma questionnaire, the attitude scores of OVCs in aspects such as emotional response and education are lower than those of students and parents. Hence, it indicates that OVCs have stronger stigma. For variables such as “It is safe for the child to play with Xiaoli” in Case 1 and “Xiaolang will threaten the health of other students if he remains in the school,” all reveal negative scores for OVCs. This indicates that they (infected persons’ personal knowledge) also believe that it is unsafe to be with HIV-infected persons and children orphaned by AIDS. At the same time, the scores for attitudes, such as emotional response, awareness of rights, and education, that they experience were lower than the actual attitudes of parents (infected persons’ perception of social attitudes). This may be the initial feeling. OVCs may opt to escape from their present school to avoid or reduce discrimination because of the presence of stigma. For the question, “Hopefully, a special school will be built, so that Xiaolang can go to school with children of similar circumstances” in the stigma questionnaire, OVCs obtained negative scores. This indicates that they agree to the building of a special school. This could be a means of escapism for them, and a means for them to avoid or reduce discrimination.

3. The public and OVCs hope to see special schools for OVCs built

179During group interviews with students, some students said that a special school should be built, so that all OVCs can be put in the same school. The same findings were obtained in the analyses of the responses from students, parents and OVCs in the stigma questionnaire and through interviews with OVCs. Restrictions imposed in an educational setting (e.g., segregation), is one of the indicators that determine if discrimination exists in the education sector under the Protocol for the Identification of Discrimination against People Living with HIV by UNAIDS. Many students in the groups interviewed think that building a special school is discrimination against OVCs. However, at this stage, when social discrimination is not eliminated, children studying in public schools will have to deal with different forms of discrimination. This discrimination is extremely detrimental to the physical and mental development of OVCs. They may develop various psychological problems, such as lacking a sense of security, solitude, unwillingness to study, feelings of inferiority, depression, anxiety, anger, and the feeling of being insignificant. As such, it may be a better option to build a special school at this point. The problem is that, in the special school, the students’ standard of education is much lower than children of the same age due to the lack of education resources, poor teaching facilities, as well as insufficient teachers and their limited abilities. On the one hand, special care centres and schools must be established; on the other hand, more has to be done to enable public schools to create a caring and discrimination-free environment for OVCs, so that all students are able to return to society, be respected, and will not be discriminated against, marginalized or ostracized.

RECOMMENDATIONS

1801. Improve support measures for enforcement of laws and policies, and increase regulatory enforcement. Implementation of care policies depends on contact with persons living with HIV/AIDS. If protection of the privacy of infected persons and their family members is neglected during policy implementation, the benefits of care and support policies will not be enjoyed by their intended recipients, and may even lead to discrimination. Therefore, putting in place the necessary support measures for law and policy enforcement will better protect the rights of infected persons and their family members. Furthermore, issuing of relief materials and resources should be subject to more stringent regulatory management in order to ensure that all relief materials are given to the infected persons and their family members.

1812. Where possible, discrimination should be defined and discriminatory behaviour prohibited under the law. This will better protect the rights of persons living with HIV/AIDS and of OVCs, and will be conducive to the creation of a discrimination-free environment.

1823. Government authorities should increase publicity surrounding laws and policies, and on HIV/AIDS and anti-discrimination education. Insufficient awareness of AIDS-related laws and regulations will undermine anti-discrimination efforts. The government has announced a series of policies, such as the “Four Frees and One Care” policy, which were, to a certain extent, effective at ensuring the rights of OVCs to education. However, our study has shown that public awareness of these policies is low. Therefore, the focus must be on building awareness of laws and policies. Knowledge of HIV/AIDS is required for anti-discrimination. The government is responsible for disseminating educational information on HIV/AIDS and anti-discrimination.

1834. Recommend to the Ministry of Education to include HIV/AIDS education at the primary level and anti-discrimination education at the secondary level. Specifically, to revise the Outline for AIDS Prevention Education for Primary and Secondary Students to include clear provisions that include AIDS-prevention education in primary schools, and anti-discrimination education in secondary schools. Although there is antidiscrimination education in secondary schools in some areas, the Outline should provide the authority to this requirement binding. This way, secondary students will have a definite understanding of the significance of anti-discrimination in AIDS prevention.

1845. Regulate media reports to ensure that reporting is scientific and objective, and that the opinions contain healthy guidelines for the public. Most students, parents, teachers and the general public obtain their knowledge of HIV/AIDS from mass media. Thus, the media’s perspective will affect the attitude of the public towards HIV/AIDS. Besides ensuring scientific and objective reporting, media reports should be positive and audience-friendly. This will help eradicate fear and inspire an anti-discrimination attitude.

1856. The school and the community should target HIV/AIDS and anti-discrimination education and publicity at parents and teachers. The attitudes of parents and teachers cannot be neglected if discrimination against OVCs is to be discouraged, and if the right of OVCs to education is to be protected. Even if schools have accepted these children, parents may apply pressure on the school and demand that OVCs transfer to another school. Teachers may also refuse to teach OVCs. Therefore, schools must encourage publicity and education on HIV/AIDS, and aim anti-discrimination programs at teachers and parents. For example, the “Hand in Hand” (xiao shou la da shou) initiative, where pertinent information is disseminated to parents by the school or through the parents’ group at an opportune time, should be encouraged. There must be different forms of publicity, such as inviting expert speakers to give special talks, field visits to institutions where AIDS patients and OVCs congregate, or invite persons living with AIDS to talk about their own experiences. This will allow parents and teachers to truly understand the experiences of persons living with HIV/AIDS, and to improve empathy so that their fear of AIDS will be eliminated over time.

1867. Use teachers as living examples to create a discrimination-free education environment. During our interviews with teachers, many of them realized that their behaviour is critical. Teachers must serve as role models in the elimination of discrimination against OVCs and to promote their right to education. Teachers’ behaviour directly affects the students and their parents. Teachers who respect and care for OVCs will provide positive and constructive guidance for students. Teachers must communicate with parents who fail to understand the reasoning behind this behaviour.

  • 23 Liu Jitong, “Policy Recommendations for the Welfare Building of AIDS Orphans and Vulnerable Childr (...)

1878. Increase psychological care for OVCs, help them to get to know themselves, and encourage them to express their own emotions. To achieve this, there must be intensive research into the type of psychological care suitable for the Chinese socio-cultural tradition, and to ensure that OVCs will have good psychological health and sound character development.23

Notes

1 Joint United Nations Program on HIV/AIDS (UNAIDS). Protocol for the Identification of Discrimination Against People Living with HIV, 2000.

2 http://www.unchina.org/unaids/documentpercent201ink.htm.

3 B. E. Berger, C. E. Ferrans, and F. R. Lashley. “Measuring Stigma in People with HIV: Psychometric Assessment of the HIV Stigma Scale,” Research in Nursing and Health, 2001, 24, 518-529.

4 Y. Yang, K. L. Zhang, K. Y. Chan, et al., “Institutional and structural forms of HIV-related discrimination in health care: a study set in Beijing,” AIDS Care, 2005, 17 (supplement 2): S129-S140.

5 State Council Working Committee to Combat AIDS, Report on the 2005 Declaration of Commitment on HIV/AIDS, 2005

6 State Council Working Committee to Combat AIDS, the UN Theme Group on HIV/AIDS in China, Joint Assessment of HIV/AIDS Prevention, Treatment and Care in China (2007), 2007.

7 China Ministry of Health, UNAIDS, World Health Organization, China AIDS Epidemic and Prevention Progress 2005, 2006.

8 http://www.ha.xinhuanet.com/add/zfzx/2007-09/10/content_l1102468.htm.

9 http://www.cqjlp.gov.cn/zwgk/3884.htm.

10 Gregory M. Herek, John P. Capitanio, “Public Rections to AIDS in the United States: A Second Decade of Stigma,” American Journal of Public Health, 1993, 83, p. 574-577; Ma Yinghua, Hu Peijin, Chen Yichen, “A Study on the Needs for Education in AIDSRelated Knowledge, Attitude, Behaviour and Health of Secondary Students and Teachers in Yunnan Province” (“Yunnan sheng zhong xue shengyu jiao shi dui ai zi bing xiang guan zhi shi, tai du, xing wei he jian kang jiao yu xu qiu de yan jiu”), Chinese Journal of Public Health, 1999, 15 (6), p. 541-544; Yan Jingyi, Xu Liuchen, Yang Yulin, “Behavioural Analysis on the Knowledge of and Attitude towards AIDS for 5870 Secondary and University Students in Shandong Province” (“5870 ming da zhong xue sheng ai zi bing zhi shi tai du xing wei fen xi), Chinese Journal of School Health, 2006, 27(2), p. 163-165; Li Guiyin, Chu Tianxin, He Xiong et al., “Investigation on the AIDS Knowledge, Attitude and Behaviour of Parents of Secondary and High School Students,” Chinese Journal of Public Health, 2006, 22 (8), p. 899-900.

11 Joint United Nations Program on HIV/AIDS (UNAIDS), Monitoring the Declaration of Commitment on HIV/AID, Guidelines on Construction of Core Indications. Geneva, Switzerland, 2005, 7.

12 G. M. Herek, J. P. Capitanio, and K. F. Widaman, “HIV-related stigma and knowledge in the United States: Prevalence and Trends, 1991-1999,” American Journal of Public Health, 2002, 92 (1), p. 371-377.

13 Helene Joffe, Risk and “The Other,” Cambridge: Cambridge University Press, 1999.

14 Yang Ling, Zhu Yawen, Li Jiansheng, “A Review of Research on AIDS Stigma” (“ai zi bing wu mingyajiu ping shu), Journal of Northwest Normal University (Social Sciences), 2007, 44 (4), p. 59-63.

15 B. Weiner, “Intrapersonal and Interpersonal Theories of Motivation from an Attributional Perspective,” Educational Psychology Review, 2000, 12 (1), p. 1-14.

16 B. Weiner, “A native psychologist examines bad luck and the concept of responsibility,” The moist, 2003, 86 (1), p. 996-1010.

17 Zhou Fanglian, Zhang Aiqin, Fang Lainyi et al., “Responsibility Attribution and Punitive Behavioural Response of University Students towards Person Living with AIDS” (“da xue sheng dui ai zi bing huan zhe de ze ren gui yin ji cheng jie xing wei fan ying”), Psychological Science, 2005; 28(5), p. 1216-1219.

18 Udo, Rudolph, Scott C. Roesch, Tobias Greitemeyer, et al., “A meta-analysis review of helping giving and aggression from an attributional perspective: Contributions to a general theory of motivation,” Cognition and Emotion, 2004 18(6), p. 815-848.

19 Gisela Steins and Bernard Weiner, “The Influence of Perceived Responsibility and Personality Characteristics on the Emotional and Behavioral Reactions to People with AIDS “ Journal of Social Psychology, 1999, 139(4), p. 487-495.

20 C. G. Hartell and S. Maile, “HIV/AIDS and Education: A study on how a selection of school governing bodies in Mpumalanga understand, respond to and implement legislation and policies on HIV/AIDS,” International Journal of Education Development, 24(2004), p. 183-199.

21 UNICEF China HIV/AIDS Program, Booklet on the Psychosocial Care of AIDS Orphans and Vulnerable Children, Beijing: Peking University Medical Press, 2005, p. 20-27.

22 B. E. Berger, C. E. Ferrans, F. R. Lashley, “Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale,” Research in Nursing and Health, 2001, 24, p. 518-529.

23 Liu Jitong, “Policy Recommendations for the Welfare Building of AIDS Orphans and Vulnerable Children,” China Social Welfare, 2007 (9), p. 19-21.

Table des illustrations

Titre Table 1: Public Understanding of the Relation between AIDS and Morality, and the Lives of Infected Persons
URL http://books.openedition.org/uop/docannexe/image/1174/img-1.jpg
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Titre Table 2: Public Compassion towards Persons Living with AIDS infected through Different Transmission Routes
URL http://books.openedition.org/uop/docannexe/image/1174/img-2.jpg
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Titre Table 3: Public’s Attitude towards School Education for OVCs
URL http://books.openedition.org/uop/docannexe/image/1174/img-3.jpg
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Titre Table 4: Public’s Attitude towards Hypothetical OVCs
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Titre Table 5: Public Attitude on the Right to Education
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Titre Table 6: Public Attitude towards the Privacy of Persons Living with HIV
URL http://books.openedition.org/uop/docannexe/image/1174/img-6.jpg
Fichier image/jpeg, 186k
Titre Table 7: Understanding and Ranking of the Unjustifiability of the Various Attitudes towards Persons Living with HIV
URL http://books.openedition.org/uop/docannexe/image/1174/img-7.jpg
Fichier image/jpeg, 261k
Titre Table 8: Stigma of Students, Parents and OVCs towards Persons Living with HIV
URL http://books.openedition.org/uop/docannexe/image/1174/img-8.jpg
Fichier image/jpeg, 357k
URL http://books.openedition.org/uop/docannexe/image/1174/img-9.jpg
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Titre Figure 1: Behaviour Intention Box Plot of Different groups towards Persons Living with HIV
URL http://books.openedition.org/uop/docannexe/image/1174/img-10.jpg
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Titre Figure 2: Emotional Response Box Plot of Different Groups towards Persons Living with HIV
URL http://books.openedition.org/uop/docannexe/image/1174/img-11.jpg
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Titre Figure 3: Behaviour Response Box Plot of Different Groups towards Persons Living with HIV
URL http://books.openedition.org/uop/docannexe/image/1174/img-12.jpg
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Titre Figure 4: Disclosure of Illness Box Plot of Different Groups towards Persons Living with HIV
URL http://books.openedition.org/uop/docannexe/image/1174/img-13.jpg
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Titre Table 9: Sense of Humiliation of Students, Parents and AIDS-affect Children toward Children Orphaned by AIDS
URL http://books.openedition.org/uop/docannexe/image/1174/img-14.jpg
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URL http://books.openedition.org/uop/docannexe/image/1174/img-15.jpg
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Titre Figure 5: Emotional Response Box Plot of Different Groups towards Children Orphaned by AIDS
URL http://books.openedition.org/uop/docannexe/image/1174/img-16.jpg
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Titre Figure 6: Rights Awareness Box Plot of Different Groups towards Children Orphaned by AIDS
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Titre Figure 7: Attitude to Education Box Plot of Different Groups towards Children Orphaned by AIDS
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Deputy Director at the Institute of Child and Adolescent Health at the Peking University. In addition, she is an Associate Professor, a part-time consultant for the UNICEF Office for China on life skills and education, a Councilor for the Ministry of Education’s National Teacher Training Centre for AIDS Education, the National Program Consultant for the Children and Youth Science Centre, a member of the Experts Committee of the China Children’s and Teenagers’ Safety-Health Growth Plan, and a Councilor for the Association of Smoke and Health. Ma’s research focuses on health education in school, with a particular focus on education for AIDS prevention and life skills development. As a core research member, she has participated in developing the Thematic Education Guidelines for HIV/AIDS Prevention Education for Primary and Secondary School Students of the Ministry of Education and has conducted research for the Thematic Education Wall Map for HIV/AIDS Prevention Education. She is also the chief editor for several teaching materials on AIDS prevention, and has published several academic papers about school health education on AIDS prevention and life skill education in national journals

Holds a Bachelor’s in preventive medicine from the Soochow University (2005) and a Master’s in child and adolescent health from Peking University (2008). Her research interests are focused on child and adolescent development and health education on HIV/AIDS in schools

Graduated from the Department of Public Health, Peking University in 1981 with a Doctor of Medicine degree. Her major research focus has been on HIV/AIDS and health education in schools

Holds a Bachelor’s in Chemical and Biomolecular Engineering from the Hong Kong University of Science and Technology. Her research interests are focused on health development of school adolescents. In 2006 she was nominated to be the “Unite for Children, Unite against AIDS” Youth Ambassador for UNICEF and the Youth League

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