The Research On HIV Prevalence And Life Quality Status Among Left-Behind Women At High HIV Epidemic Rural Areas InYunnan

ObjectivesTo understand the status of HIV infection, high risk behaviors, life quality, social support and related risk factors among left-behind women (LBW), to provide scientific evidence for HIV prevention and control, and for improving life quality among LBWs.MethodsAcross-sectional investigation method was taken in this study. HIV testing and questionnaire investigation was conducted at Dehong and Lincang prefecture. The sample size was 500 cases. Probability Proportionate to size sampling method was used. HIV antibody was tested by collecting blood and questionnaire was finished face to face by household survey. The questionnaire of AIDS awareness and risk behaviors was designed based on "sentinel surveillance of AIDS", which came from Chinese center for disease control and prevention.36-Item short health survey form came from Boston health research was used for life quality survey. Social support rate scale made by XIAO Shuiyuan was used for social support investigation. Qualitative investigation of WLBs and workers was conducted face to face for 30-40 minutues in an independent room. The software of epidata3.1 was used for data type-in and SPSS22.0 was used for data statistical analysis.ResultsA total of 500 pieces questionnaire were finished and all of that were valid, the effective rate was 100%. We conducted qualitative interviews among 30 WLBs and 10 workers, the total case was 40.The total rate of HIV infection among LBWs was 8.2%(41/500). The rate of HIV infection among LBWs whose husband taking drug was 22.7%(30/132).The rate of HIV infection among other LBWs (Women did not take in drug addiction and husband did not too) was 2.8%(10/363). The rate of HIV infection among WLBs was 20.0%(1/5), for who was take in drug addiction, but husband did not take drug.Multi-factor logistic regression analysis showed the risk factors of HIV infection included who was minority, widowed,whose husband was addicted into drug using and taken into custody, left behind longer than 2 years, did not undstand the knowledge of AIDS (P<0.05)The rate of AIDS awareness among LBWs was 71.0%(355/500). The LBWs had multi-sex partner accounted for 28.6%(143/497). The rates of condom use of casual sex behavior and commercial sex behavior were 20.7%and 58.3%(χ2=8.65, P<0.01). The rate of drug abusing among LBWs was 1.4%(7/500). The rate of acceptance to AIDS intervention among LBWs was 67.4%(337/500).The total score of SF-36 among WLBs was 62.58±14.24, the physical health score (PHS) was 64.04+16.55. The mental health score (MHS) was 69.89±16.53. Eight dimensions score were lower than the score of general population in China. Social function (SF) had highest score. The total score of SSRS was 40.88±5.91, the score was positive correlation with score of SF-36.The dangerous factors for lower score of SF-36 included who was older than 35 years old, under junior high school, being left behind more than 2 years, the score of SSRS was lower and HIV test was positive (P<0.05) The dangerous factors for lower score of PH included:who was older than 35 years old, who was under junior high school, divorced or widowed, the score of SSRS was lower and HIV test was positive (P<0.05). The dangerous factors for lower score of MH included who was under junior high school, living in divorce or widowhood, left behind more than 2 years, the score of SSRS was lower and HIV test was positive (P<0.05)ConclusionsHigh rate of HIV infection, low rates of AIDS awareness, high rate of multi-sexual partners and low rates of condom use were found among LBWs at high HIV prevalence areas in Yunnan province. High rate of HIV infection was related to minorities, marriage status, the reason and the time of being left behind, the status of AIDS awareness and spouse weather belonged to drug addiction. We should step up publicity in the future to provide the awareness of AIDS at communities. We need improve the intervention caverage, pay more attention to WLBs who taking multi-sexual behavior and whose spouse was taking drug. We need strengthen the work of drug control and prevent HIV transmission between spouse. We should strengthen the intervention among those LBWs who was belonged to minority, who was left-behind for long time, who was widowed, who had bad awareness of AIDS and had poor life quality.There was poor life quality among LBWs. We should strengthen cooperation among departments to provide care and support by the leading and ublicity of policy, we need innative the development modle too. We should develop agricultural modernization for reducing labor burden. In addition, Employer should incentive employees to strengthen the communication with LBWs, and to provide support to employees for retrunning home.