Evolution of HIV/AIDS Prevention and Control Policies in China: A Grounded Theory Approach

Objective: This study aims to provide a theoretical foundation for the development and practical application of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) prevention and control policy systems in China by scrutinizing, analyzing, and synthesizing the evolution of Chinese policies in this domain. Methods: Utilizing grounded theory, we employed NVivo12 software to perform text content analysis, mining, and coding classification, along with visualization techniques, on policy texts sourced from Chinese government platforms, including the official website of China's State Council. We considered four analytical dimensions - time, subject, type, and object. Results: The National Health Commission and the State Council emerged as the primary entities engaged in policymaking for HIV/AIDS in China. We identified four distinct stages in the evolution of these policies, culminating in a novel 'sun -shaped' HIV/AIDS prevention and control policy network model with an emphasis on 'knowledge, attitude, and practice' at its nucleus, which aligns with national conditions and societal progress. Furthermore, the focal groups of these policies have been dynamically refined and updated over time. Conclusions: Our findings introduce a 'sunshaped' HIV/AIDS prevention and control policy network model specific to China. We observed a conceptual policy shift towards prioritizing overall human health rather than confining the focus to disease treatment. Additionally, in light of China's growing elderly population, the imperative to address HIV/AIDS prevention and control among older adults is an issue that warrants increased attention. which is caused by the human immunodeficiency virus (HIV), represents a significant threat to both global public health and societal progress, as this infectious disease imperils the well-being and development of human populations (1-3). In China, the HIV/AIDS epidemic remains a critical concern, with the burden of prevention and control presenting a substantial and ongoing challenge (4). While policy and regulation serve as crucial tools for governmental and administrative bodies tasked with managing AIDS, the literature has not adequately provided a systematic analysis of China's national HIV/AIDS prevention and control policies across various stages of their implementation. Prior research has tended to concentrate on aspects such as epidemiology, antiviral strategies, sentinel surveillance, key demographics, and legal frameworks. Studies that address HIV/AIDS policy frequently employ a traditional chronological analysis, which often suffers from issues of timeliness and scope. Consequently, a deeper investigation into the underlying patterns and logical progression of policy evolution in the context of HIV/AIDS prevention and control is warranted. A comprehensive review and analysis of the development of HIV/AIDS prevention and control policies in China over the last four decades would not only facilitate a retrospective assessment of policy efficacy but also assess the scientific rigor and practicality of their implementation. Such an analysis could provide an invaluable foundation for the ongoing advancement and sustainability of HIV/AIDS prevention and control strategies at both the national and regional levels.