HIV/AIDS Behavioral Interventions in China: A Literature Review and Recommendation for Future Research

Abstract

In the past two decades, China has witnessed an alarming increase of HIV/AIDS epidemic. Meanwhile, a number of HIV prevention interventions have been conducted. This study reviews existing studies in literature on behavioral interventions on HIV/AIDS in China. Of 25 studies we identified, most have been concentrated in South and South–West China, mainly targeting injection drug users and female sex workers. The most commonly used intervention strategy was individual-oriented HIV-related knowledge education and behavioral skill training. All studies reported positive intervention effects including improved HIV-related knowledge, increased condom use, reduced needle sharing, and reduced STI. Literature also suggests a lack of intervention among other at-risk populations such as MSM, migrant workers, and non-injecting drug users, lack of studies with rigorous evaluation design, inadequate follow-up, limited outcome measurement, and lack of multi-faceted structural interventions. The existing intervention studies document strong evidence of controlling HIV/AIDS epidemic through effective behavioral intervention. More efforts are needed to control the growing HIV/AIDS epidemic in China. Future studies need to employ more rigorous methodology and incorporate environmental or structural factors for different populations at risk of HIV infection in China.

HIV risk and sexual health among female migrants in China

“…A systematic review of HIV prevention programs in China identified a growing body of individual-level behavioral interventions delivered in clinical settings and high-risk venues, and noted an emerging interest in workplace interventions (Hong and Li, 2009). Differences in HIV risk according to workplace settings call for the development of tailored workplace interventions.…”

The Effect of a Structural Intervention for Syphilis Control Among 3597 Female Sex Workers: A Demonstration Study in South China

“…This study represents a marked departure from earlier FSW interventions in China by virtue of its higher recruitment rate, improved retention, measurement of syphilis and HIV incidence, and oversampling of FSWs from low-tier sex venues [3,[18][19][20]. One study reported approaching 13 785 FSWs but enrolling only 977 (7.1%), [18] making our enrollment rate of 49.3% (3597 of 7297) a substantial improvement.…”

“…First, whereas most traditional FSW interventions have focused on condom use and increasing individual HIV knowledge, [20] this community structural intervention focused on creating mutual trust and sustainable connections between sex venues and STI clinics. Especially in local contexts where private clinics may not have standardized STI services or licensed doctors, [22] re-establishing trust and relationships with local standardized STI clinics may have been a powerful force in preventing syphilis.…”

Sexual Communication, Safer Sex Self-Efficacy, and Condom Use Among Young Chinese Migrants in Beijing, China

“…Most of the HIV prevention interventions in China focus on improving HIV knowledge, awareness of HIV, attitudes towards condom use, and condom use (Hong & Li, 2009), few emphasize improving the assertiveness and the frequency of communication about condom use among target audience (Zhang, Li, Shah, Baldwin, & Stanton, 2007). It is important to understand the characterisitcs of assertive sexual communication of Chinese migrants so that variations in safer sex negotiation skills can be discovered.…”