A Community-based Intervention Study On HIV Voluntary Counselling And Testing Among Migrants In Minhang District Of Shanghai

1.The basic study on HIV voluntary counseling and testing among migrants in Minhang district of ShanghaiObjective To study and evaluate the feasibility of a community-based intervention to promote HIV voluntary counseling and testing on the basis of surveying the related HIV/VCT knowledge and attitudes as well as their willingness to participate in VCT among migrants in Shanghai.Methods Using a quota-sampling strategy,1165,549 and 976 migrants were selected to participate in a cross-sectional survey in Qibao,Jiangchuan and Xinzhuang community of Minhang district.Information about sociodemographic characteristics,mobile experience,HIV related knowledge and attitudes,knowledge and acceptance of VCT and their sexual behavior were collected.Results Most migrants were young,less educated and nearly half were in non-marital state.27.0%of the study participates worked no longer than 6 months in present place.Most migrants were at low awareness of HIV/AIDS knowledge,they knew well in the three ways of HIV transmitting but lacked in the knowledge of mother-to-child transmitting.42.1%of the study participates were willing to working together with HIV-infected.Only 46.5%had heard of VCT,92.1%of the study participants were willing to participating in VCT,but only 40.9%of them choosed to go to CDC for VCT.There was no statistical significance in HIV and VCT knowledge among the migrants in three communities. In sexual behavior,41.3%of the study participates admitted to having pre-marital sexual behavior,7.2%of them have over 2 sex partners in the past one year.The condom using rate is very low among migrants,only 16.0%of them used condom almost every time in the sexual experience in the past one month.Conclusion A comprehensive community mobilization and health education were needed to be implemented among migrants to improve their HIV/VCT knowledge,acceptance of VCT and to eliminate the discrimination to HIV-infected persons.2.Rapid assessment of HIV/VCT community intervention among migrants in Minhang district of ShanghaiObjective To assess the HIV/VCT related knowledge,attitude,behavior and influencing factors on community intervention among migrants and key informants in Minhang district of Shanghai.Method Using a convenience sampling strategy,74 migrants,27 key informants and 20 community service providers were selected to participate in in-depth interview and focus group discussion.The interview guideline mainly focused on the sociodemographic characteristics,mobile experience,HIV risk behavior,HIV/VCT related knowledge,attitudes and behavior,and their demands for community intervention.Results Most migrants were young,less educated,lack HIV knowledge and were likely to take risk behaviors Only one third the migrants know VCT but few of them know the place of VCT or have VCT experience. Nearly half of the interviewees hold an unfriendly and negative attitude towards HIV-infected persons and those who participate in VCT service but most of them welcome HIV prevention and intervention programs in their working place.Conclusions More extensive community mobilizations and appropriate HIV/VCT health education are highly needed.Furthermore,the promotion VCT services and the anti-discrimination education should be reiterated.3.The final study on HIV/VCT community intervention among migrants in Minhang district of ShanghaiObjective To evaluate the effect of a community-based intervention and VCT model through studying the HIV/VCT related knowledge and attitudes as well as their participation in VCT among migrants in Shanghai..Methods Using a same strategy as baseline study,577,434 and 839 migrants were selected to participate in a epidemiological survey in Qibao, Jiangchuan and Xinzhuang community of Minhang district.Additional information like intervention history and VCT data in the past two years were also collected.Results The study participants in the two intervention groups had a beter understanding than the Control group in HIV knowledge,Intervention 1 was especially outstanding in HIV knowledge among them;Comparing the HIV knowledge after intervention,the HIV knowledge rate in seven aspects in the Control group were decreased in the final study;the HIV knowledge rate in ten aspects in the Intervention 1 were increased after intervention except the transmitting way through mother's milk;Only five aspects of HIV knowledge rate in the Intervention 2 were increased while another 6 aspects had not been changed after intervention(P＜0.001);60.1%of the study participants had heard of VCT.49.6%,85.3%and 56.4%of the study participants knew VCT,and 69.0%,94.9%and 86.1%of the study participants were willing to participating in VCT service in the Control group,Intervention 1 group and Intervention 2 group respectively(P＜0.001);The VCT data showed that the number of VCT customers increased from September 2007 and higher than the level of the same period in the year 2006;the number of VCT migrants increased from September 2007 and were very close to the level of the total number of VCT in the same period;the number of VCT migrants in the Intervention 1 group increased obviously from September to Novemember in 2007 and were higher than the level of the Control group and Intervention 2 group.Conclusion The community mobilization,HIV health education and VCT model in the Intervention 1 proved a better effect; Although a lot of work in community intervention had heed done in the Intervention 2 but got mild effect in publicizing the HIV/VCT information to migrants,so an effective and comprehensive community mobilization and HIV health education were advocated to be implemented among migrants to improve their HIV knowledge and acceptance of VCT.