Politics of Public Health
Feel free to email me (chchliu@ucsd.edu) if you cannot access or want to discuss my articles.
Politics of the Covid-19
It’s (not) the flu: Expertise and the Covid-19 Pandemic in China, Hong Kong, and the United States. in progress. (with Larry Au and Zheng Fu) |introductory essay on Items|
HIV/AIDS and Socio-political structures
“Red is not the only color of a rainbow”: The making and resistance of the “MSM” subject among gay men in China. Social Science & Medicine. 2020. Winner of the Martin Levine Paper Award (American Sociological Association). |download| |abstract|
Beyond Clinical Trials: Social Outcomes of Structured Stakeholder Engagement in Biomedical HIV Prevention Trials in China. Culture, Health & Sexuality. 2019. |download| - |abstract|
Transplantation or Rurality? Migration and HIV Risk among Chinese Men who have Sex with Men in the Urban Areas. Journal of International AIDS Society. 2018; 21(1): e25039. |download| - |abstract|
Methods: In July 2016, MSM ≥16 years old currently residing in one of eight urban cities in China were recruited for an online cross‐sectional survey, which collected information on socio‐demographics, sexual behaviours, HIV care‐seeking behaviours, and healthcare utilization. Based on a question about residency status, each participant was classified as an urban local resident, urban transplant, or rural transplant. Multivariable multinomial logistic regression was used to examine the associations between risky behaviours and healthcare utilization among these three groups.
Results: Among 2007 MSM, the proportion of local, urban transplant and rural transplant were 32% (648/2007), 24% (478/2007), and 44% (881/2007), respectively. Compared with urban local resident MSM, urban transplant MSM were more likely to have ever tested for HIV (adjusted odds ratio (aOR) = 1.39, 95% confidence interval (CI): 1.08 to 1.80). Compared with urban transplant MSM, rural transplant MSM were less likely to have utilized any governmental sexual health services in the past three months (aOR = 0.75, 95% CI: 0.60 to 0.93), ever tested for HIV (aOR = 0.77, 95% CI: 0.61 to 0.96), ever initiated antiretroviral therapy (ART) (aOR = 0.16, 95% CI: 0.05 to 0.52), and ever purchased sex (aOR = 0.57, 95% CI: 0.38 to 0.85). No other significant differences were found in sexual behaviours among three groups.
Conclusions: The widely used local/migrant categorization obscures important differences in HIV risk present between urban/rural subgroups among them. Previous studies of HIV risks in Chinese “migrant” may have failed to consider the role of structural factors such as discrimination or barriers to healthcare when interpreting their findings of higher HIV prevalence in this population. Low ART uptake among rural transplant MSM in this study is particularly concerning and underscore the need for HIV‐related interventions tailored for this group.
Community Engagement in Sexual Health and Uptake of HIV Testing and Syphilis Testing among MSM in China: A Cross-sectional Online Survey. Journal of the International AIDS Society. 2017; 20(1):21372. |download| - |abstract|
Introduction: HIV and syphilis testing rates remain low among men who have sex with men (MSM) in low‐ and middle‐income countries (LMICs). Community engagement has been increasingly used to promote HIV testing among key populations in high‐income countries, often in settings with stronger civil society. This study aimed to assess socio‐demographic, behavioural, and community engagement factors associated with HIV and syphilis testing among MSM in China.
Methods: MSM ≥16 years old who had condomless sex in the past three months were recruited nationwide to complete a cross‐sectional online survey in November 2015. Data were collected on socio‐demographics, sexual behaviours, HIV testing, syphilis testing, and community engagement in sexual health. We defined community engagement in sexual health using six items assessing awareness and advocacy of sexual health programmes. The underlying factor structure of a 6‐item community engagement scale was determined through exploratory factor analysis. Univariate and multivariable logistic regressions identified correlates of HIV and syphilis testing.
Results: 1189 MSM were recruited. 54% (647/1189) of men had ever tested for HIV and 30% (354/1189) had ever tested for syphilis. Factor analysis suggested three levels of community engagement (minimal, moderate, and substantial) and this model explained 79.5% of observed variance. A quarter (26%, 312/1189) reported none to minimal engagement, over one half (54%, 644/1189) reported moderate engagement, and a fifth (20%, 233/1189) reported substantial engagement. Multivariable logistic regression showed that MSM with greater community engagement in sexual health were more likely to have ever tested for HIV (substantial vs. no engagement: aOR 7.91, 95% CI 4.98–12.57) and for syphilis (substantial vs. no engagement: aOR 5.35, 95% CI 3.16–9.04).
Conclusions: HIV and syphilis testing are suboptimal among MSM in China. Community engagement may be useful for promoting testing in China and should be considered in intervention development and delivery. Further research is needed to better understand the role of LMIC community engagement in HIV interventions.
Sexuality and Subjectivity
Light and Shadow: Gay Bar as a Space of Consumption. West Journal. 2016; (2): 70-74. (in Chinese: “明”与“暗”:作为消费空间的同性恋酒吧) |download| - |abstract|
Stereotype and Masculinity: A Gender Perspective to Review the Male Nurse. Sexuality Research in China. 2016; 2(1): 362-374. (in Chinese: 刻板印象与男性气质——性别视角下的男护士) |download| - |abstract|
English Abstract: With the development of the society and the nursing profession, male nurses are gradually becoming active in the profession that was once considered to be only women. From the theoretical perspective of sociology and gender studies, this paper, after two months of participatory observations of two hospitals and in-depth interviews with 26 relevant individuals, thoroughly examine the most stereotypical advantages and disadvantages associated with male nurses - The "great strength" and "not careful enough." This paper finds that the advantages and disadvantages of this kind of gender-based stereotypes highlight the important role of male nurses in special departments, but they are not conducive to the stability and development of their identity as a nurse, which also makes them fall into deeper self-doubt and discipline. This article also examines how male nurses reconstruct and display their identity and masculinity through the strategical display/hide information.
Meaning World and Subjective Construction of an Anti-Masturbation Community: A Sociological Investigation (in Chinese: 戒色者的意义世界与主体建构——对一个网络社群的社会学研究). |abstract|
English Abstract: The harmlessness of moderate masturbation has long been confirmed from the perspective of “biological science”. However, in recent years, the discourse of "anti-masturbation" have been greatly affected in China, and its followers have reached more than one million. However, current literature lacks attention to this very strange issue. Through in-depth interviews with several “anti-masturbation” practitioners and discourse analysis of the online community, this paper explores how the community uses traditional, religious, nationalism and other elements to frame the issue of masturbation and the social relations associated with it. The discourse of masturbation carries out the subject construction. While practitioners reflexively reshapes their self-identity and life trajectory, and then practices the alternative meaning world.