ABSTRACT
By the end of 2007, China was home to an estimated 700,000 people living with HIV or AIDS (State Council AIDS Working Committee Office and United Nations Theme Group on AIDS 2008). While statistics appear to indicate a slowdown in new infections, sexual transmission has replaced drug-related transmission to become the dominant route of HIV infection (56.9 per cent of new infections in 2007) and a decisive factor in the future course of the epidemic in China (Merli et al. 2006). In 2007 alone, more than 356,000 cases of gonorrhoea and syphilis were officially reported nationwide, indicating widespread unsafe sex among China’s 1.3 billion population. This, and the spread of commercial sex in China (van den Hoek et al. 2001; Parish et al. 2003; Pan et al. 2004) will likely continue to fuel the epidemic growth of sexually transmitted infections (STIs) and HIV unless effective measures are taken to reduce unsafe sexual behaviours. While the causes of the spread of unsafe sex and HIV transmission are likely
to be complex and multifaceted, increasing rural-urban migration may be one of the main catalysts. Although sources vary, the temporary migrant population, which constitutes the majority of rural-urban migrants in contemporary China, was estimated to have grown from 11 million in 1982 to 79 million in 2000 (Liang and Ma 2004), and most recent national estimates put the number at almost 132 million (NBS 2008). The uprooting of so many men and women may create conditions that are conducive to sexual risk behaviour and the spread of sexually transmitted infections. Indeed, the rapid and continuing spread of HIV in China is arguably best understood in the context of social and economic changes associated with increasing migration in the country (Smith and Yang 2005). Recent research in China has provided empirical evidence for the role
increasing migration plays in the spread of unsafe sex (Anderson et al. 2003; Hu et al. 2006; Yang 2006), but has also suggested significant differences between male and female migrants (Yang and Xia 2008). While most studies have focused on informal, temporary (non-hukou) migration in post-reform China, no research has actually compared it to formal, permanent (hukou) migration. Thus, little is known as to whether rural-urban migration in general or particular types of migration are conducive to unsafe sex and consequently STIs including HIV.
Using the recent migration and HIV literature in China to compare the two types of rural-urban migration, I argue here that the social/residential detachment associated with non-permanent migration is the key mechanism that renders non-permanent migrants more vulnerable to sexual risk behaviour than both long-term migrants and non-migrants.
