A Study On The Intervention Of Participatory Health Education On AIDS Among The Rural Out-of-school Youth And Children

BackgroundThe youngsters are one of the groups mostly in need of the prevention of AIDS. According to The World AIDS Report of 2006 released jointly by the Planning Department of AIDS in the United Nations and the World Health Organization, up to 2006, the number of people who got infected with HIV throughout the whole world is 39.5 million, while in 2006 alone, the increased number of HIV positive people was 4.3million, among which the young people aging from 15 to 24 account for 40 per cent. Similarly, the young people composed the majority of the people infected with HIV in china, among whom the rural out-of-school youth and children constituted the particular sector. The rural out-of-school youth and children are referred to as those who dropped out of school after graduation from primary school or junior middle school. Being seperated from school education, these young people enter the soceity by hovering in the margins of society rather than by merging into the mainstream of it due to the limitation of education level. This part of the young people are at the sexually active period of physiological development, therefore they become vulnerable groups liable to infected with AIDS due to the changes in the sexual attitudes and lifestyles.ObjectivesThe present study is aimed at exploring the mechanisms for the participatory health education on AIDS among the rural out-of-school youth and children. On the basis of analyzing the youths'changes in knowledge, attitude and behaviour concerning AIDS after the intervention of participatory health education, the study will evaluate the effect of the implementation of the above mechanisms and then propose the scientific guidance for the prevention and control of AIDS. MethodsThe subjects in the present study are the out-of-school youngsters aging from 15 to 24 from ten natural villages in Tianfu Town of Beibei in Chongqing.By cluster multistage sampling and utilizing the self-designed questionnairs before and after the investigation, the researcher evaluates the process and the effect of the project.ResultsThe survey reveals that the rural out-of-school youths have a low knowledge score about AIDS, that is, they lack of certain knowledge concerning the prevention of AIDS and feel dark about whether the daily contact will result in the transmission of HIV. This particular group of youths has positive attitudes towards premarital sex and over 70 percent of them will accept the sexual demands by the love partners. Most of them hold prejudice toward the infectors and patients of aids virus. Thus, only 14.46 percent of the youths will be willing to keep in contact with the infectors of HIV. Among the unmarried rural out-of-school youngsters, 45.97 percent of them have heterosexual sex, in which the male and the female accounts for 58.99% and 36.91% respectively, showing a significant gender difference. Meanwhile, 21.65% of them use condom and 29.3% of them ( 47 people in total, 41 male youths and 6 female youth) admitted involving in the transaction of money and sex and 4.75% of them (15 people) acknowledged the use of ecstasy and other drugs. Sad to say, these youths are ignorant of the methods of AIDS prevention and control, not even learning about where to get the instructions on sex, contraception and the testing of AIDS. Even worse, they seldom ask the people they trust for the suggestions on the concerned health problems. No wonder they seldom exchange views concerning sex and reproductive health with their parents or partners.After the intervention of health education on AIDS: knowledge score of HIV/AIDS of rural out-of-school youth and children increased from 57.9% to 82.36%( p<0.01);the rate of willing to communicate the HIV infector or AIDS patients increased from 14.46% to 67.936%;the willingness of accepting cigarettes from schoolmates decreased from 93.00% to 54.36% and willingness to accept gifts from strangers out of courtesy decreased from 79.87% to 55.34%;embarrassment of offering to use condom decreased from 77.33% to 39.04;condom use in the latest sexual intercourse increased from 28.76% to 61.63% and regular use of condom in sex increased from 23.29% to 45.93% (p<0.01); the number of people willing to have HIV testing at the disease control department increased from 1.25% to 23.13% (p<0.01).ConclusionsThe rural out-of-school youths are at high risk of being infected with HIV. Utilizing the participatory method to carry out health education on AIDS for them can effectively increase the knowledge score; change the attitudes and behaviour concerning AIDS. But to implement the long-term behaviour change needs persistent promoting activity and community support.Suggestions1. It is urgent to improve and implement the school health education policies and systems and to spread knowledge and skills about AIDS prevention in junior high school so as to increase the youths'knowledge score of the threats of AIDS.2. It is essential to reinforce the supervisor over the management of the internet cafe and other entertainment places for the sake of purifying the social surroundings and creating civilized atmosphere for the youths'growth.3. It is necessary to strictly regulate tobacco and alcohol sales and carry out the policy of denying the juvenile the purchase of tobacco and alcohol. We should advocate a healthy lifestyle, which consists of no smoking and moderate alcohol. At the same time we can multiply cultural life in the rural communities so as to provide more options for recreational activities for the youths.4. It is of great need to set up consultation telephone, internet, and clinics for the youths, especially for the rural out-of-school youths and provide targeted and personalized services concerning reproductive health and AIDS prevention.5. We should enhance the publicity about AIDS and correct people's misconceptions about HIV infectors and AIDS patients and eliminate the obstacles of taking advantage of the related service.6. On top of the health education on AIDS among the rural out-of-school youths, it is important to improve their production skills and provide or introduce more job opportunities so as to increase their income. In return, it provides an essential financial basis for the rural out-of-school youths to utilize the service more effectively.