Epidemiological Survey On HIV/STDs Infections To Miners In Yunnan Province

Background146 intravenous drug users were infected HIV in Ruili city where is in the southwest of Yunnan Province in 1989.After 1995, HIV was gradually extended to every state in Yunnan and prevalenced among drug users.Along the channels of the illegal drug traffic,HIV was spread out rapidly to Xinjiang,Guangxi,Xichuan and other provinces.Those years,with the rapid development of economic,a lot of floating population such as workers,travllers swarm into Yunnan.Under the influence of special border geography setting and minority custom and culture,these people are fragile to infect HIV easily.Gejiu city which is at southwest of Yunnan,is not only the center for economic,culture and politic of Honghe state,but also famous for its mines of stannum and coloured metal.So extraneous miners make the most part of the floating population every year,who are frequent at floating,low education level.Most of them are male.They stay out for a long period to earn money away from their home .Hard work,bad habitation,and strong sexuality make miners have more high risk activiyies relative with venereal disease and HIV infection,such as having several sexual partners,wenching,drug use,etal.In the research,we chose miners in Gejiu as the subjects to carry on cross-sectional surveys in order to know the situation of HIV/STD infections. Objective1. To investigate the miners HIV infectious rate and risk factors.2. To investigate the miners syphilis infectious rate and risk factors.3. To investigate the miners herpes simplex virus infectious rate and risk factors.4. To investigate the miners gomococcal infectious rate and risk factors.5. To investigate the miners choamydiae infectious rate and risk factors.6. Compare the miners knowledge level of AIDS between Round 1 survey and Round 2 survey, so that to provide the scientific basis to practice the intervention.MethodIn the first round survey,from December 2005 to January 2006,526 male miners from five different mining district were recruited as samples for a cross-sectional survey for HIV-1,syphilis,herpes simplex virus type 2,gonorrhea,Chlamydia. In the second round survey, from March 2006 to June 2006,1804 male miners from five different mining district were recruited as samples for a cross-sectional survey for HIV-1,syphilis,herpes simplex virus type 2,gonorrhea,Chlamydia. Before the survey carried on,all the investigators had received specialty training.Face to face questionnaire interviews were conducted anonymously.Blood specimens were collected to test for HIV-1(ELISA initial screening, WB confirmation), syphilis antibody (RPP initial screening,TPPA confirmation),HSV-2 IGg(ELISA initial screening),and urine samples to test for morphine(ACON MOP). The testing results were feedback to the subjects four weeks after the tests,and the post-test counseling were initiated simultaneously.The data was analyzed via SPSS 12.0.Logistic regression was used to analyze the HIV and STDIs associates risk factors.Chisquare test was applied for the comparison between frequency and proportion of the HIV/AIDS knowledge.Result and disscusion1.The aggregate HIV/STDs infectious rate of the miners in round 1 and round 2 was respectively 18.3% and 15.4%,which were both higher than the average infectious rate of Chinese.In the first round survey multivariate Logistic regression model showed that risk factors were significantly associated with sexual behavior (OR=51.74 , 95%CI: 6.84~391.23),having 2 to 9 sexual partners(OR=2.06,95%CI: 1.14~3.72), having mare then 10 sexual partners (OR=5.73 , 95%CI: 3.01~10.90).In the second round survey multivariate Logistic regression model showed that risk factors were significantly associated with low education level below primary school (OR=1.55,95%CI: 6.84~391.23), minority (OR=1.86,95%CI:1.38~2.49), non-excavation worker (OR=1.81,95%CI: 1.25~2.63),drug useage (OR=4.31 , 95%CI: 1.57~11.79), sexual behavior(OR=2.05,95%CI: 1.17~3.58), engagement in prostitution(OR=1.75,95%CI: 1.29~2.37).Minorities are more unrestricted on sexual life than the Han nationality.There were more miners who were minorities had experience with sex and went whoring than those who were the Han nationality.When they went whoring, the minorities miners used less condoms than the Han miners.All of those made minorities miners have more chances to infect with STD.Compared non-excavation workers with excavation workers,the former had higer socioeconomic class than the later.They did not need to work as hard as the excavation workers.So more money and time they could spent on prostitutes.Miners who were lower at education level used less condoms when had sex with prostitues,which made them easier to infect with STD.2. The HIV infectious rate of the miners in round 1 and round 2 was respectively 0.6% and 0.7%. In the second round survey multivariate Logistic regression model showed that risk factors were significantly associated with drug useage (OR=38.93,95%CI: 9.04~167.67), with more than 11 prostitutes in the past twelve months(OR=16.77,95%CI: 1.94~145.23).Most of miners came from the other areas,which made them more unstable.Because of their long time leaving home and the physiological need could not be satisfied with,they went whoring more than usual.Most of miners were low at education level .They were lack of knowledge of AIDS, for some of this,they used less condoms when had sex with prostitues. So they were prone to infect with HIV.3. The syphilis infectious rate of the miners in round 1 and round 2 was respectively 1.4% and 1.8%,which were both higher than the average rate of Chinese.The HSV-2 infectious rate of the miners in round 1 and round 2 was respectively 13.3% and 9.5%.In the first round survey multivariate Logistic regression model showed that risk factors were significantly associated with minority(OR=2.38,95%CI: 1.36~4.18). In the second round survey multivariate Logistic regression model showed that risk factors were significantly associated with less than 30 years(OR=2.24,95%CI: 1.54~3.24), minority (OR=2.24,95%CI: 1.54~3.24), low education level below primary school (OR=1.66,95%CI: 1.13~2.44), non-excavation worker (OR=2.15,95%CI: 1.39~3.33) engagement in prostitution (OR=1.96,95%CI: 1.36~2.82).The result shows that HSV is mainly transmitted by sex.4. The gomococcal infectious rate of the miners in round 1 and round 2 was respectively 0.8% and 0.2%. In the second round survey multivariate Logistic regression model showed that risk factors were significantly associated with more than 1 prostitutes in the past twelve months(OR=4.38 , 95%CI: 1.45~13.21). Gomorrhea is the predominance STDs in Yunnan province,which has high infectious rate among male. So it is necessary to educate miners on knowledge of prevention of STD.5. The choamydiae infectious rate of the miners in round 1 and round 2 was respectively 5.0% and 4.8%. In the second round survey multivariate Logistic regression model showed that risk factors were significantly associated with minority (OR=1.73 , 95%CI: 1.06~2.83), having 2 to 9 sexual partners (OR=2.16,95%CI: 1.35~3.45).It is more popular with minorities miners to have multiple sex partners than the Han miners.This phenomena may be determinated by nationality trait that the minorities are more unrestricted with sex behavior.It is tend to infect with CT more easily when have 2 to 9 sex partners than to have more than 10 sex partners.Maybe this is caused by the enhanced immunity ability.6. The HIV/AIDS knowledge of the miners was no significantly different between the twice surveys (χ2 =1.55,P=0.213).Interview miners who have heard of AIDS.Only'Whrther he or she is patient suffered AIDS if he or she looks health?'was significantly different between the twice surveys(χ2 =11.45,P=0.003).Miners know part of the knowledge of AIDS and they have misunderstanding with some of it.So it is important to educate them further to a nicety7. Miners got the knowledge on HIV/AIDS mainly through TV,chatting with friends,propaganda materials and pamphlets. So those means should be used when propagandize AIDS,which could improve the efficiency.Conclusion1. Miners have higher HIV/STDs, HIV, HSV-2, syphilis, gomococcal, and choamydiae infectious rate than general population.2. Most Miners are low at education level, and have more sexual partners and prostitution behaviors than general population.Some of them are drug-users,and have shared syinges with others.3. Miners obtain AIDS knowledge from TV, friends chatting, propaganda materials and pamphlets most, but they only grasp some of it.We should propagandize them according to their weekness.