| BackgroundThe pandemic of AIDS has aroused extensive concern in the governments and modern society. Due to the FSW's low utilization of condoms, low popularity rate of control knowledge of AIDS, limited coverage of intervention and serious situation of prevention and treatment, in China sexual transmission is the main rout of transmission within following years. The act of AIDS Prevention and Treatment, issued by state in 2006, requires that take comprehensive intervention of AIDS to high risk group for HIV infections and provides beneficial legal safeguard and guide to action for AIDS prevention and control measures. Taking comprehensive intervention measures on FSWs is one of the important contents.Since the intervention on FSWs in mini-type entertainment venues is just at the beginning, the research is still at the exploration stage. Some negative factors such as high density of mini-type entertainment venues, rapid shifting crowd, dim consciousness of preventing disease and lack of support form society also brought severe challenges to AIDS prevention and control. This research is aimed to investigate the mechanism of effective intervention carried on mini-type entertainment venues in Hongkou district and the practice form of AIDS's prevention and control among the high risk group in the basic units.ObjectTo explore the comprehensive intervention methods, which is suitable for the local, and aim to preventing AIDS for FSW's worked in mini-type entertainment venues. To reduce the infection rate and risk of HIV transmission among the target group and provide experiences and countermeasure for sustainable development of research which is promoted in the other district of the city.MethodThe study was based on the one-year integrated application of intervention such as face to face education, peer education, promoting the usage of condoms, providing referral service and VCT service, which had been carried on FSWs in Guangzhong community in Hongkou district. To evaluate the effects of AIDS intervention by setting the transverse contrast, face to face questionnaire and serological investigation. To understand the effect of intervention on the serum level and the changes in knowledge and behavior of the target group. Before the intervention, the baseline survey on 244 FSWs from 126 Mini-type entertainment venues.was conducted. After intervention, the baseline investigation on 360 FSWs from 136 Mini-type entertainment venues was analyzed. The Epi info3.5.1 was used to analyze statistical data. The investigation index included the awareness rate of the AIDS transmission and prevention, the rate of correct answer, condom promotion rate, accessibility of medical care and infection rate of HIV/syphilis.Resulta. The FSWs in mini-type entertainment venues in Hongkou district were all widespread immigrants, who came from 21 provinces(autonomous regions and municipalities directly governed by Central Government). With the characteristic of mobile,61.1% FSWs' working time was less than 1 year,36.4% less than 6 months.b. Social-demographic characteristics of FSWs were elder, mainly married, low educational level and financial weakness.c. The baseline investigation showed that the total knowledge rate about AIDS of FSWs was 34.4%.20.1% of FSWs used condom for every sexual act,32.8% used condoms during the latest sexual act. HIV infection rate among FSWs was 0, and the prevalence rate of syphilis was 4.1%. It was necessary to carry out the intervention measures for preventing AIDS among FSWs.d. Through the practice of intervention with policy advocated, utilizing several methods, to build the network of comprehensive intervention for goal of increasing FSWs'awareness and skill of preventing AIDS with the platform including health, family planning department and community, based on entertainment venues.e. The total knowledge rate about AIDS of target group was 78.2% after intervention, obviously higher than control (P<0.01),and experimental group gained more comprehensive knowledge than the control. The awareness rate of target group with different financial state and different working times in various venues was significantly higher than control (P<0.01). Except for group under 20 years old, awareness rate of all age groups with intervention is obviously higher than control (P<0.01).The never usage rate of condoms while having sexual act in the latest month was 43.1%, significantly lower than that of in the control (P<0.01). The condom promotion rate of intervention group in the latest month was 42.1%, obviously higher than that of control (P<0.01).No significant difference of the never condom usage rate was found between the under 20 years old group, above 40 years old group, financial difficulties group, working time more than1 year group, none awareness of AIDS group and control group. The consciousness of hospitalizing is significantly higher than that of control (P<0.01). No significant difference of syphilis's and HIV infection rate between the intervention group and control group.ConclusionBy conducting comprehensive intervention for AIDS prevention among mini-type entertainment venues in Hongkou district Shanghai, to advocate further intervention policy among AIDS high risk group, improve cooperation mechanism between various departments, and stable intervention team. The awareness rate of AIDS among the target group was obviously increased. The knowledge for AIDS among target group was more comprehensively. The condom use has remarkable improved, and correct hospitalizing idea has been informed. The intervention has produced a marked effect.Suggestiona. Enforce the public health duty for management of floating population and play the support role in the health department. By establish the examination and assessment system and communication system, carry out the strategies and programmes of public health.b. The intervention for the places of entertainment, which act as AIDS prevention education, be integrated with routine job. Using the daily work related network, provide the mutil-channel intervention on target group and further enforce the cooperation between various departments.c. According to FSWs'healthy requirement in mini-type entertainment venues, to establish the "2+1" intervention pattern with General Practitioner service team dominant combining with community workers and peer educators. Lighten the pressure of human resource short on intervention for the high risk group, improve general level of intervention. |
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