Commercial Sexual Behaviors Among Male Rural-to-Urban Migrants in Western China: Implications for HIV Prevention

Li, Wen-Wei; Jiang, Junjun; Su, Jinming; Liang, Bingyu; Deng, Wei; Huang, Jiegang; Qin, Bo; Upur, Halmurat; Zhong, Chaohui; Wang, Qianqiu; Wang, Qian; Zang, Ning; Liao, Yulin; Meng, Sirun; Li, Ye; Liang, Hao

doi:10.1177/1010539517709029

Cited by 19 publications

(25 citation statements)

References 23 publications

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“…This appeared to be a positive sign, considering the role of such behaviors in increasing the risk of acquiring HIV and other STIs [43]. We also observed a relatively low percentage of consistent condom use during commercial (40.3%) and non-regular sex (31.1%), similar to the findings of other studies [44][45][46]. Unfortunately, we did not investigate vaginal, oral, and anal sexualities during commercial and non-regular sexes separately.…”

Section: Discussionsupporting

confidence: 83%

Changing Trends of HIV, Syphilis, and Hepatitis C among Male Migrant Workers in Chongqing, China: Nine Consecutive Cross-Sectional Surveys, 2010–2018

Wang

Lu²,

Wu³

et al. 2020

IJERPH

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Background: Male migrant workers (MMWs) have been reported to be vulnerable to human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Chongqing, China is one of the major migration destinations and hotspots of HIV. This study aims to explore the prevalence of HIV, syphilis, and hepatitis C virus (HCV), as well as HIV-related knowledge and behaviors, among MMWs in Chongqing. Methods: Questionnaire surveys were conducted, and blood samples were collected and examined among MMWs selected by two-stage stratified sampling in Chongqing from 2010 to 2018. The Cochran–Armitage trend test was conducted to observe the trends in the prevalence of HIV, syphilis, and HCV, as well as HIV-related knowledge and behaviors. The Chi-square test and Binary Logistic Regression were conducted to observe the distinctions between different groups. Results: The overall HIV prevalence was 0.6% with an increasing trend (0.2% to 0.9%, p < 0.001), whereas the overall HCV prevalence was 0.5% with a decreasing trend (0.5% to 0.4%, p < 0.001). The overall syphilis prevalence was 1.3% in the ≥50 age group, 1.0% in the 30–49 age group, and higher than 0.3% in the 16–29 group (X2 = 19.527, p < 0.001). An uptrend (80.2%–80.6%, p < 0.001) was observed in correct HIV-related knowledge. The 16–29 ((Odds Ratio) OR: 1.575; 95%CI (Confidence Interval): 1.380–1.798; p < 0.001) and 30–49 (OR: 1.697; 95%CI: 1.495–1.926; p < 0.001) age groups had 1.575 and 1.697 times correct HIV-related knowledge more than the ≥50 age group. The proportion of subjects engaged in commercial sex in the past year (7.7%–13.3%, p < 0.001), consistent condom use during this activity (20.5%–54.0%, p < 0.001), and condom use in the last commercial sex (48.6%–72.1%, p = 0.020) were increasing. The risk of engaging in commercial sex in the past year in the 16–29 age group was 0.768 times (OR: 0.768; 95%CI: 0.643–0.917; p = 0.003) less than that in the ≥50 age group. The risk of engaging in non-regular sex in the past year in the 16–29 (OR: 2.819; 95%CI: 2.317–3.431; p < 0.001) and 30–49 (OR: 1.432; 95%CI: 1.184–1.733; p < 0.001) age groups were 2.819 and 1.432 times more than that in the ≥50 age group. The risk of engaging in anal sex in the past year in the 16–29 age group was 6.333 times (OR: 6.333; 95%CI: 1.468–27.327; p < 0.013) more than that in the ≥50 age group. The proportion of consistent condom use during non-regular sex in the past year (10.9%–47.3%, p < 0.001) and condom use in the last non-regular sex (40.8%–71.1%, p < 0.001) increased remarkably. The possibilities of consistent condom use during commercial sex in the past year in the 16–29 (OR: 2.606; 95%CI: 1.847–3.677; p < 0.001) and 30–49 (OR: 1.632; 95%CI: 1.214–2.195; p = 0.001) age groups were 2.606 and 1.632 times more than that in the ≥50 age group. The possibilities of condom use in the last commercial sex in the 16–29 (OR: 1.805; 95%CI: 1.258–2.589; p = 0.001) and 30–49 (OR: 1.360; 95%CI: 1.016–1.821; p = 0.039) age groups were 1.805 and 1.360 times more than that in the ≥50 age group. The possibilities of consistent condom use during non-regular sex in the past year (OR: 1.628; 95%CI: 1.066–2.484; p = 0.024) and condom use in the last non-regular sex (OR: 1.671; 95%CI: 1.148–2.433; p = 0.007) in the 16–29 age group were 1.628 and 1.671 times more than those in the ≥50 age group, respectively. Conclusion: An upward trend of HIV and a downward trend of HCV were observed among MMWs in Chongqing from 2010 to 2018. We also found an increase in commercial sex and inadequate condom use during high-risk behaviors among this population. The overall syphilis prevalence in the middle-aged and elderly groups was higher than in the young group, and elderly MMWs were more likely to engage in unprotected high-risk behaviors. Thus, targeted STI prevention for MMWs in Chongqing, especially those aged 50 years and above, is urgently needed.

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Section: Discussionsupporting

confidence: 83%

Changing Trends of HIV, Syphilis, and Hepatitis C among Male Migrant Workers in Chongqing, China: Nine Consecutive Cross-Sectional Surveys, 2010–2018

Wang

Lu²,

Wu³

et al. 2020

IJERPH

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“…The rst reason is that this group are sexually active and had insu cient education. According to the literature [7,9], more than 63% of factory workers were under the age of 35 and more than 44% had less than junior high school education. The second reason is the high prevalence of high-risk sexual behaviors.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

Chen¹,

Luo²,

Meng

et al. 2020

Preprint

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Background: Factory workers in low- and middle-income countries (LMICs) are vulnerable to HIV transmission. Interventions are needed to prevent HIV in this population. We systematically reviewed published literature on the efficacy of various HIV interventions in reducing stigma, risk behaviors and HIV transmission among factory workers.Methods: A systematic review was performed using predefined inclusion and exclusion criteria. Four databases (PubMed, PsycINFO, Scopus and EMBASE) were searched for relevant publications between January 1, 1990 and December 31, 2018. Two independent reviewers assessed the methodological quality of studies.Results: Thirteen articles were included, with 2 randomized controlled trials and 11 cohort studies. Five interventions and their combinations were summarized. Educational intervention increased condom use and reduced the use of recreational drugs and alcohol before sex. Community intervention that proactively provide HIV counselling and testing (HCT) services could increase the detection rate of HIV and other sexually transmitted diseases (STDs). Lottery intervention increased HCT uptake and decreased HIV public stigma. Education combined with community intervention reduced the proportion of workers with casual sex and enhanced HIV knowledge. Peer education combined with community intervention increased the proportion of workers who were willing to take their partners to HCT. Policy intervention combined with peer education enhanced HIV knowledge, perceived condom accessibility and condom use with regular partners.Conclusions: Various interventions improved HIV knowledge, decreased HIV stigma and reduced HIV-related risk behaviors among factory workers in LMICs. The combination of multiple interventions tended to achieve better efficacy than a single intervention. Persistent combination interventions are essential to address HIV in this population.

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“…The large numbers of migrant workers, tourists, students play a "bridge"for the HIV/AIDS transmitting. 14 With the implementation of testing-based prevention for infectious diseases (HIV, HBV, HCV and Syphilis) for pregnant women, 15 before operation, interventional examination or treatment, the testing and confirmed cases for HIV increase yearly in China. 12,16 In addition, substantial intervention initiatives, such as "Four Free One Care" 17 and "prevention of mother-to-child transmission (PMTCT) programme", 18 have been introduced since 2003. which result in an obvious decrease in the proportion of HIV cases attributed to vertical transmission in China.…”

Section: Discussionmentioning

confidence: 99%

Shift in New HIV/AIDS Epidemic and Factors Associated with False Positives for HIV Testing: A Retrospective Study from 2013 to 2018 in Xi’an, China

Wang

Zhang

Ruan

et al. 2019

Preprint

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Objectives: In the study, firstly, the epidemic characteristics of new HIV/AIDS were investigated in order to provide evidence for the targeted interventions; Secondly, the major factors of false positives (FP) for HIV testing were also determined. Methods: A retrospective review was performed in a teaching hospital in Xi’an between 2013 and 2018. The overall characteristics and epidemiological trends of new HIV/AIDS were described. Moreover, the distributions of FP cases in the gender, age and department were analysed, and the major factors of FP were determined by the Pareto analysis. Results: During the study, a total of 469 new HIV/AIDS were diagnosed, with an increasing prevalence from 0.0626% in 2013 to 0.0827% in 2018. Of them, the majority occurred in the Hans (99.57%), males (88.50%), people aged 21-50 years (76.97%), migrants (60.98%) and sexual contact route (88.70%). A rapid increase in the annual number of new HIV/AIDS and multiple routes of HIV transmission were found. The epidemic showed increasing trends in groups of young individuals, students and homosexual mode, however, a downward trend in the percentage of injecting drug use was also observed. 67.81% of FP cases were over 50 years old. The departments of oncology, obstetrics, hepatobiliary surgery, nephrology, cardiology and infectious disease were major factors of FP by Pareto analysis. Conclusions: The HIV/AIDS epidemic in Xi’an is still evolving, therefore, effective strategies, appropriate education and scaling up HIV testing should be developed to control the spread of the epidemic. In addition, old adults and specific departments were associated with FP.

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Commercial Sexual Behaviors Among Male Rural-to-Urban Migrants in Western China: Implications for HIV Prevention

Cited by 19 publications

References 23 publications

Changing Trends of HIV, Syphilis, and Hepatitis C among Male Migrant Workers in Chongqing, China: Nine Consecutive Cross-Sectional Surveys, 2010–2018

Changing Trends of HIV, Syphilis, and Hepatitis C among Male Migrant Workers in Chongqing, China: Nine Consecutive Cross-Sectional Surveys, 2010–2018

Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

Shift in New HIV/AIDS Epidemic and Factors Associated with False Positives for HIV Testing: A Retrospective Study from 2013 to 2018 in Xi’an, China

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