Challenges of Integrating HIV Prevention and Treatment in China's Border Mountain Regions: A Grounded Theory Study

Background HIV remains a critical global public health challenge, with 39 million people living with HIV as of 2022 and over 40.4 million lives lost to the epidemic. In China, the burden is similarly significant, with over 1.33 million HIV cases reported as of 2024. The challenges are particularly acute in western regions like Yunnan Province, which face resource limitations, socio-demographic disparities, and a high prevalence of HIV among ethnic minorities. Objectives This study examines the challenges in HIV/AIDS diagnosis, treatment, and prevention across various institutions in Yunnan Province, including government bodies, hospitals, disease control centers, and primary healthcare institutions. It aims to provide insights for optimizing prevention and treatment strategies in areas with ethnic minorities and impoverished mountainous regions. Methods This study employs Grounded Theory to examine the systemic, socio-demographic, and cultural barriers to integrating HIV prevention and treatment in M City, a resource-limited border region in Yunnan Province. Data were collected through semi-structured interviews with 23 participants, including individuals living with HIV, village doctors, healthcare providers, and policymakers, to gain a comprehensive understanding of the challenges in HIV management. Results The study identifies several critical barriers to integrating HIV prevention and treatment. Patients’ low health awareness, poor medication adherence driven by stigma, weak family support, and high-risk behaviors such as low condom use and migration significantly exacerbate transmission risks. Village doctors face logistical challenges and stigma in conducting follow-ups, while hospitals are overburdened with insufficient staff and resources to manage increasing patient loads. Additionally, weak inter-agency collaboration and inadequate referral mechanisms hinder coordinated care and timely interventions. The burden of managing comorbidities and ART-related complications, including osteoporosis and liver dysfunction, further strains the under-resourced healthcare system. These challenges collectively underscore the urgent need for integrated, multisectoral solutions. Conclusion This study highlights the complex challenges in HIV prevention, treatment, and integration in economically underdeveloped regions, emphasizing the need for improved patient awareness, healthcare system efficiency, and cross-institutional collaboration. Future research should focus on multi-center, longitudinal studies and real-world implementation to refine and scale the integration model for sustainable HIV care in these regions.