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a lack of trained staff and facilities and the predominance of supply and demand reduction approaches

widespread injecting culture supported by traditional approaches to public health lack of low threshold friendly services available to vulnerable communities including drug users

very limited knowledge of young people about drugs and drug-related harm

condom use among vulnerable population is low

condom supply in the countryside is limited.

considerable stigma associated with drug use.

Discussion and Conclusions

(a) Concept of vulnerability and vulnerability to HIV/AIDS in particular

‘Vulnerability of migrants’ is clearly a complex and contested issue. Many migrants appear to be in vulnerable situations but in reality they may be less vulnerable than they were in the regions that they originated from. ‘Vulnerability’ needs to be dissected into various elements, as some aspects may improve with migration while others could deteriorate. An index of vulnerability is perhaps one way of thinking about the component parts.

Vulnerability Index for Migrants = Economic security + Social status + Emotional security + Health protection

Vulnerability to HIV/AIDS falls under the latter, health protection. It is of particular importance because it can be anticipated — if people, and migrants in this case, engage in particular behaviours or activities known to increase the risk of contracting HIV/AIDS. Migrants’ heightened vulnerability is due to the fact that the situation they face after migration may lead them to engage more readily in risky behaviours.

The size of the mobile population is increasing within China and the increase is expected to continue in the future. Above all, the fact is clear that the population of migrants or travellers, both within a country and across borders, is of an age that is most active in social, economic, as well as sexual activities, and they often live in isolated, marginalised and ostracised situations. With little knowledge of HIV/AIDS or how to prevent it, they are open to contracting the virus, which is beginning to spread in China.

Little information is available on cross-border movements out of China but returning Chinese workers are beginning to return with the virus. The itinerant traders and travellers who visit China’s border cities may increase the spread of the virus through their visits to sex workers and drug-related activities. North Korean refugees are potentially at very grave risk of contracting and spreading the virus as they are forced

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