| Objectives. To identify the prevalence of HIV infection and sexual behaviors among rural residents in areas with many former plasma donors (FPDs) in rural China.; Methods. A cross-sectional survey was conducted among rural residents 25--55 years old in 40 villages randomly selected from villages with many FPDs in rural north Anhui, China. A structured questionnaire was anonymously administered face-to-face, and a venous blood specimen collected for HIV testing.; Results. Subjects (1997) were interviewed and tested for HIV. HIV prevalence was 10.8%, with 15.2% among FPDs and 4.9% among non-FPDs. Among FPDs, plasma donation frequency, spouse being HIV-positive and male gender were associated with HIV infection. Among non-FPDs, spouse being HIV-positive and having multiple sexual partners were associated with HIV infection. Within marriage, the condom use rate was 5.9%. Younger age, education, using other contraceptives, awareness of AIDS and condoms, and HIV testing behaviors were associated with condom use. Only 0.5% of participants used condoms when having sex with girlfriends/boyfriends, but 23.5% of the male participants used condoms when having sex with sex workers. The proportion having more than one sexual partner was 3.1%. Being male, younger age, having other jobs in addition to farming, negative attitude toward HIV positive people and being HIV positive were associated with having multiple sexual partners. Most of the boy/girlfriends were from the local rural areas (87.5%), and 51.9% of the sex workers visited by our study participants were in urban areas and 2/3 of the sex workers visited by the HIV positive participants were in urban areas.; Conclusions. The prevalence of HIV infection is high. The HIV/AIDS epidemic has spread to non-donors primarily through sexual transmission. Low condom use rate with spouse and other sexual partners promotes HIV sexual transmission. The sexual mixing pattern and the low condom use rate, especially among the HIV positive people, further indicate that HIV sexual transmission is unavoidable. Promotion of condoms with all partners and limiting the number of sex partners, are urgently needed to stop further spread of HIV. The program should include general HIV/AIDS education and voluntary counseling and testing (VCT) promotion. |
