“New barefoot Doctors”: How social workers navigate HIV care and structural marginality in Yi ethnic minority communities

Social workers play a critical yet underexamined role in HIV prevention and treatment in China's remote ethnic minority regions. Drawing on ethnographic fieldwork conducted between 2024 and 2025 in two Yi-autonomous mountain townships, this study examines how social workers navigate structural inequality and constraints within HIV care. This study identifies three interrelated agentic practices. First, women's healing workshops provide spaces that empower widowed women living with HIV through relational and cultural forms of support. Second, social workers advance drug assignment by advocating for simplified antiretroviral regimens, negotiating flexible dispensing arrangements, and translating biomedical knowledge into locally meaningful terms. Third, social workers engage in emotional stabilization and decriminalizing care, softening surveillance-oriented governance through ethical discretion and relational mediation. Framing as “new barefoot doctors,” social workers enact relational, structural, and institutional forms of agency that repair inequities and humanize HIV governance. The findings highlight the importance of culturally embedded, equity-oriented social work in advancing humane and effective HIV care in marginalized settings.