| 1.Background and ObjectiveHIV infections rise dramatically in Asia in recent years, Asia is becoming one of the most plagued areas in the globe following North America and Africa, especially in Southern and Southeastern Asia adjacent to China. Estimations show that by the end of 2007, approximately 700,000 were HIV positive since the first case was reported in 1985; thereof 85,000 are AIDS and 39,000 deaths. China's HIV epidemic remains one of low prevalence overall, but with the huge population base; the practical number of HIV infections has already ranked the 2nd place in Asia and fourteenth in the world. Epidemic of HIV infection is sliding into the critical phase of sharp expansion. The damage and loss to community and economy are deteriorating day after day. Effective control of AIDS spread has developed the most pressing endeavor in the public health in China.The data of epidemic situation in 2007 demonstrated that sexual transmission accounts for 56.9% of HIV infection. Sexual transmission is taking the place of blood donation and transfusion as the primary transmission route. AIDS sentinel surveillance indicated HIV infection rate in sexual workers had run up from 0.02% in 1996 to 1.0% in 2004. Consequently, to deter prevalence of HIV infection among common mass, it is imperative to advertise the knowledge of AIDS treatment and prevention as well as carry out intervention action to the service misses in house of recreation. All data from domestic and abroad established that it could reduce effectively and productively the rate of HIV infection to perform health education of AIDS and intervention on sexual women workers.2.Subject and MethodAll commercial entertainment places in Shangcheng District of Hangzhou with undercover sexual transactions were the selections of intervention locale. Some of service women workers who had sex trades were the subjects of intervention. The convenient sampling was employed; the individuals with oral informed consent and inclusion criteria were recruited into the study.Scene investigation of the study was divided into two stages to implement. Investigation contains two parts, one is questionnaire; the other is blood collection. After the baseline data gathered, one year tenure of behaviors intervention was carried out. The measures comprised community intervention, outreach service, partner communications, text message notice and reference service of medical treatment. Terminal investigation was accomplished at the end of study.257 questionnaires out of baseline investigation and 262 questionnaires out of terminal investigation were applicable.Database was created with EpiData2.0 and the data were analyzed by SPSS 13.0.3.Results3.1. Intervention Effect3.1.1 Acknowledgement of AIDS among sex workers pre and post intervention8 items are set up in the study; the awareness of AIDS related information among sex workers in post intervention is higher than counterpart in preintervention (x2=30.86, p<0.01).3.1.2 Comparison characteristic of sex activity between before and after interventionRate of condom usage of investigational subjects in the very recent time:pre and post intervention were 70.5% and 88.9% respectively. Post intervention is higher than preintervention (x2=27.31, p<0.01).Rate of condom usage of investigational subjects:pre and post interventions were 25.81% and 63.42% respectively.25.81% of the subjects in very recent month insisted wearing condom in each time during intercourse before intervention; however, the rate ran up to 63.42% after intervention. There exists the significant difference in statistics.The usage of condom among remarriage or cohabitation subjects:the usage of condom in last time during intercourse with spouse or partner after intervention is greater than that before intervention (x2=55.77, p=0.000). The frequency of condom donning pre and post intervention has significant difference (x2=74.41, p＜0.01).3.1.3 Drug use before and after interventionThe rate of drug usage shows no difference between two intervention actions. 3.1.4 STD related symptoms and medical help seekingNo statistical significance in STD related symptoms has been found (x2=0.05, p=0.82)。The proportion of taking medical service from STD of specialty hospital and general hospital for the STD associated symptoms between terminal investigation and baseline investigation shows no significant difference. But the proportion of taking medicines by selves after intervention descends more significantly than that of before intervention (79.35%vs23.71%, p<0.01), however, the proportion of seeking treatment from private clinic as well as women and children hospital ascends tremendously.3.1.5 Acceptance of service related to AIDSAfter intervention, the proportion of acceptance of condom, mate communication, STD check-up, consultation with AIDS, AIDS assay in subjects significantly increases in comparison with that before intervention. But the rate of acceptance of AIDS pamphlets and leaflets has no changes.3.1.6 Primary source of acquired information on AIDSThe proportion of acquired AIDS related information from television, paper media and billboard before intervention is significantly higher than that after intervention, on the contrary, the proportion of acquired related knowledge from broadcast, friends, professional staffs, consultation and free available promotional documents after intervention is much higher statistically than that before intervention.3.1.7 Lab assay results267 respective blood samples were collected during baseline and terminal investigation. HIV antibody, Syphilis antibody, HBsAg and HCV were assayed, the results were all negative. There also no significant difference of the positive rate of four indicators found between two interventions.3.1.8 Reference service to medical treatmentIn the procedure of this study,12 cases of syphilis were referred to professional medical treatment.3.2. Analysis the factors that impact on the score of knowledge of prevention and treatment of AIDSMultiple factors including locale, age, marriage, residence, education and the approach to acquire information on AIDS were analyzed. It shows that education is positively correlated with score of knowledge of AIDS (OR=1.91, P＜0.05); In comparison with other accessible approaches, the score acquired from promotional materials on AIDS is high (OR=2.41, P<0.05).4.Conclusion4.1 The high risk activities of HIV infection prevail in the entertainment places in Hangzhou.4.2 The population who work in the above locales possess the high potential risk of HIV infection.4.3 Our study demonstrates that the series of intervention measures such as community intervention, outreach advertisement, partner communications, consultation face to face and text message notice are practical and effective. Potential infection candidates could be screened out earlier by this approach.4.4 Suggest applying this approach to the whole municipal city. |
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