Investigation On Knowledge And Behavior Of HIV Voluntary Counseling & Testing Among Different Population In Guangzhou

Objective:It is over 20 years since HIV occurred. Updated by Dec 2005, there are 40.3million People Living with HW/AIDS (PLHA) estimated around the world, including4.9 million newly infection in 2005. Because of odd social & behavior characteramong the high risk population involved with HIV, stigma and discrimination usuallyhappen on HIV, thus make people hesitate to attend HIV counseling and testing. Also,many people have poor self-perception of susceptibility to HIV infection and be notwilling to have a HIV test. The majority of PLHA have yet not known their infection.Voluntary Counseling & Testing (VCT) is a service that help people to make asmart and reasonable decision as the HIV testing is concerned, the decision making isself finished by the clients and all of the information of the service should be kept insecret. VCT is aimed at helping people to know their susceptibility to HIV andinitiating the reasonable testing in order to acquire appropriate health caree.Additionally, counseling can act as behavior changing communication, then helppeople to promote there healthy behavior.The action of VCT is based on the people's recognizant perception of HIV andVCT, that is to say, the image and satisfaction of the VCT service are related with therecognitive perception. Therefore, This investigation is aim to describe the demandand action of VCT among different population as well as exploring the relevantfactors. According to the epidemic and control, the targeted participants consist ofgeneral population and high risk population such as Female Sex Workers (FSW) andInjecting Drug Users (IDU). It is equal to acquire VCT for the general populationexcept for the factor under investigated, the outcome should sum up the action ofVCT and it's relevant factors thus provide supportive information for the strategymaking. On account of the social behavior character and surveillance & interventionamong high risk population, the outcome should analyze the readiness of VCT andthe effect of VCT thus to provide supportive for the implementation style making. Because of the scattering and floating living of FSW, field education andoutreach service are the key ways of intervention, then the key point under discussionis the readiness of the VCT via outreach among FSW. Since it is hard to call up theIDU in community, detox and MMT (Methadone Maintenance Treatment) clinic arethe two main sites to conduct behavior changing communication, then the key pointunder discussion is the psycho-behavior changing around the action of counselingamong IDU.Methods:Counseling & Testing is one kind of heath behavior, therefore it's mechanism isbased on the theory of health psychology and behavior. Context of investigationshould include the knowledge and behavior of HIV/AIDS besides demographiccharacter such as gender and education etc, which is composed of knowledge ofAIDS transmission, care and treatment, control and prevention, worry of AIDSepidemic, AIDS stigma, self-efficacy of HIV, high risk behavior and self perceptionof susceptibility of HIV infection.Participants recruitment is carried out by different means according to the spotsituation, which describe the condition and circumstance of VCT implementation.The recruitment is including termed routine sampling at VCT clinic for VCT clients,continuous sampling in 4 blocks for residents, convenience sampling at 2entertainment centers for FSW and termed routine sampling at a detox for IDU.Investigation is conducted and finished in a period in which meet a fair situation ofeconomy and culture, and the investigation time of high risk population iscompressed in 3 months to avoid the repeating recruitment.Data is collected by face-to-face questionnaire and recorded by Excel 2000.Datacollation is done by the investigators from the 4 sites, quality assessment &management are done by the supervisor. Data analysis is done by SAS 6.12 usingdescript statistics and Logistic regression model. Descript statistics is includingunivariate analysis, t-Test, wilcoxon-Test, frequency analysis and spearmancorrelation. Logistic regression model is used to explore the relevant factors to thereadiness, action & effect of VCT, which is only expected to describe not causationbut relationship, so the cue from outcome is bi-orientated, thus multiple-factoranalysis is done without single-factor analysis.Result:VCT meet with higher level comparing with the general population as for theknowledge on transmission (Z=3.24314, P=0.0012) and worry of epidemic (Z=1.92708, P=0.0540). Among people involved with risk behavior for HIV, there are 4predominant factors to action of VCT including sex (OR=0.051, 95%CI=0.016～0.158), knowledge on transmission (OR=0.082, 95%CI=0.009～0.746), self-efficacyof HIV (OR=0.308, 95%CI=0.103～0.916) and worry of AIDS epidemic(OR=0.634, 95%CI=0.420～0.958). Among the FSW, it is fairly high as for the knowledge on transmission,especially the sex-born transmission. Ninety-five ninety percent of the FSW usedcondom on the last sexual intercourse, and 81.1%used constantly in the last 5 sexualintercourses. There are some relationship between self-perception of susceptibility ofHIV infection and the age of first sexual intercourse (OR=0.685, 95%CI=0.576～0.816), reproductive health (OR=0.628, 95%CI=0.381～1.037) as well as the imageof danger as for the sex-born transmission of HIV (OR=0.534, 95%CI=0.408～0.698).FSW with high self-perception of susceptibility are not willing to field freecounseling & testing, the majority of readiness has involved with unprotected sexualintercourse (OR-0.248, 95%CI=0.062～0.982).Among the IDU, Only 55.4% can correctly describe the HIV transmission, andsome have low image of danger as for needle sharing. Twenty-four ten percent hadmore than one time HIV voluntary counseling. Needle sharing in the last 6 months(OR=0.142, 95%CI=0.050～0.399) and last time (OR=2.258, 95%CI=0.946～5.392) of drug using can strengthen the self-perception of susceptibility of HIVinfection, which can promote the HIV voluntary counseling. Participants involvedwith HIV voluntary counseling meet with a fairly higher image of danger as forneedle sharing (OR=5.030, 95%CI=1.787～14.160) , and reduce the needle sharingin the last 6 months (OR=0.091, 95%CI=0.024～0.349) .Conclusion:Somewhat all of the different population should be integrated into the generalpopulation, therefore, it is the baseline to explore the relevant factors to the action ofVCT in the community. Since AIDS Knowledge, worry of epidemic and self-efficacyof HIV act as the positive factors to the action of counseling & Testing, it is the keypoint to highlight the epidemic, clarify the transmission and introduce the solution forAIDS treatment & prevention as the promotion of VCT is concerned.As for FSW, Self-perception of susceptibility of HIV infection would fade withthe safe sex, also reduces image of danger as for the sex-born transmission of HIVwhich can trouble the maintenance of safe sex. Readiness of field free counseling &testing is decided by the recent unprotected sexual intercourse. Thus outreach offield counseling and reasonable testing as well as behavior changing should be putinto ample implementation, which make up the poor voluntary of the FSW andprovide some convenience.IDU meet with lower level of AIDS knowledge with frequent needle sharingwhile have fairy high Self-perception of susceptibility. It may be related with healthbelief and unorganized effect. Needle sharing can strengthen the self-perception ofsusceptibility and initiate the HIV voluntary counseling, which can help the IDU toclarify the HIV transmission and promote the safe injecting drug using. HIV VCT canprovide effective behavior changing and also should be conducted via outreachservice and peer education.