Evaluation Of The Effectiveness Of HIV/AIDS Behavior Intervention Among Nonlocal Construction Workers

Background:In China, construction workers and migrant workers constitute a large proportion of the mobile population which is currently up to about 120 million. The dynamics of the HIV/AIDS epidemic among the mobile population will have significant impact on HIV/AIDS response and socioeconomic development. Therefore, one of the current priorities in response to HIV/AIDS is to explore effective models and operational mechanisms of interventions with the mobile population. A majority of the reported HIV/AIDS cases are among the mobile population. There are several contributing factors spurring on the epidemic of HIV infection among the mobile population, including high mobility, sexually active ages, lack of knowledge about HIV/AIDS, multiple sexual partners, prevalence of high risk behaviors (e.g. commercial sex and drug use), limited social support, lack of basic medical insurance and low income. Construction workers are generally male aged 20-40 with low education levels, mainly junior high school or below. Usually, they congregate together and married ones do not live with their spouses. They have low incomes and mainly come from rural areas, with little knowledge about HIV/AIDS and low rate of condom use in sex outside marriage.China Global Fund AIDS Program Round 5 targets the mobile population, CSW and MSM. According to the results of the baseline survey among ten population groups, the knowledge about HIV/AIDS and the rate of condom use in sex outside marriage are both the lowest among construction workers, respectively 14.6% and 20.1%.Purpose:Construction workers are a key target group of behavioral interventions. Current focuses include understanding the behavioral characteristics of construction workers and their knowledge about HIV/AIDS, evaluating the outcome of existing interventions with construction workers and improving the intervention strategies.Currently,There is no effective intervention model among migrant construction workers. This research is a component of 7 Cities Global Fund AIDS Program Round 5 and combines two surveys and behavioral interventions. Survey results are used to analyze the behavioral characteristics of construction workers and their knowledge about HIV/AIDS. In addition, the outcome of interventions with construction workers is evaluated by comprising results of the two surveys, providing scientific evidence for the development and improvement of behavioral interventions with this group.Results:The knowledge about HIV/AIDS among construction workers increased from 50.9% before interventions to 63.1% after interventions. The proportion of people who are willing to work, live or study with PLHA was used to reflect non-discriminatory attitudes of people towards PLHA. The proportion of survey subjects with non-discriminatory attitudes towards PLHA increased from 14.1% before interventions to 19.1% after interventions.Intervention makes commercial sexual behaviors decrease. The rate decreases from 20.5% before the intervention to 12.7%. The sexual behavior between research objective and the casual sex partner decreases from 10.3% before intervention to 8%. The rate of condom use at last commercial sex increased from 33.4% before interventions to 60.5% after interventions. The rate of consistent condom use during commercial sex in the last years increased from 15.0% before interventions to 29.2% after interventions. The condom use with casual sex partner over last sex increases from 40.2% to 52.0%. This indicats that the intervention over the last year is effective.The accessibility of interventions improved. During one-year implementation, the implementation of various interventions was strengthened in 7 Cities. Compared with 2006, the proportion of survey subjects receiving free condoms and IEC materials in the last year increased significantly. Conclusions:1. According to the evaluation results, the high-risk sexual behavior among the mobile construction workers of seven districts incidence risk.2. The HIV awareness rate clearly increased among the mobile construction workers of study districts. The proportion of Stigma and discrimination against PLWHA gradually descended. The target population reduced high-risk sexual behavior. The rate of using condoms increased in commercial and casual sexual behavior after one year of health education and behavior intervention .3. It is better effect that mobile construction workers were educated by TV, broadcast, newspapers and periodicals, and other IEC materials. They loved to see and hear familiar content and would like to accept the straightaway form.