ABSTRACT
This chapter considers whether better understanding the role of certain social inequalities, especially income inequalities, may help explain China’s rapidly growing and evolving HIV/AIDS epidemic. Such understandings are important, as they may inform policy of the broader structural responses needed to combat an HIV/AIDS crisis and point to the type of governance mechanisms that are most suitable. There is little evidence, despite the scaling up of responses after the 2003 SARS epidemic, that Chinese policy makers have yet appreciated the magnitude and impact of these forces. Instead, a focus on information and education campaigns, following mainstream policy, appears to be the primary response. A range of studies, however, produced by researchers in a variety of disciplines using very different methods, now argues that a number of social and economic inequalities have a strong impact on population health [for some popular examples see Farmer (1999) and Wilkinson (2005)]. It is of particular importance that income inequality, given its rapid increase in China, has been found to have a strong association with population health in the both the developed and developing world (Pei and Rodriguez 2006: 1069; Wilkinson and Pickett 2006). As well as this and of great relevance to the current study at hand and the Chinese HIV/AIDS epidemic, recent empirical evidence also finds an extremely robust association between HIV/AIDS prevalence both income and gender inequalities (Drain et al. 2004; Talbott 2007; Nepal 2007; Crosby and Holtgrave 2003). Other studies, using different approaches (involving less quantitative analysis) make rather similar observations on the relationship between income and gender inequalities and HIV/AIDS epidemics (Barnett and Whiteside 2002; Kalipeni et al. 2004).
