Willingness to Participate in HIV/STD Prevention Activities among Chinese Rural-To-Urban Migrants

Abstract

Data from 4,208 migrants aged 18-30 years old in Beijing and Nanjing, China, were analyzed to examine the correlates of willingness to participate (WTP) in HIV/STD prevention intervention activities among Chinese rural-to-urban migrants. Overall, 83.3% of the respondents would be willing to participate. Increased WTP was associated with employment in the industrial sector (OR = 1.59, 95% CI: 1.11-2.29), migrating to cities to learn more about the outside world (OR = 1.31, 95% CI: 1.08-1.59), prior experience with health maintenance (OR = 1.36, 95% CI: 1.11-1.66), higher level of HIV/AIDS awareness (OR = 1.16, 95% CI: 1.02-1.31), and perceived severity of risk behaviors (OR = 1.32, 95% CI: 1.04-1.68). Decreased WTP was associated with increased involvement in health risk behaviors (OR = 0.50, 95% CI: 0.35-0.73), increased perceptions of peer risk involvement (OR = 0.81, 95% CI: 0.68-0.98), perceived intrinsic rewards for risk behaviors (OR = 0.81, 95% CI: 0.68-0.96) and perceptions of HIV-related stigma (OR = 0.68, 95% CI: 0.53-0.89). The high level of WTP suggests that HIV/STD prevention activities are acceptable among rural-tourban migrants. Their awareness of HIV/AIDS should be increased and HIV-related stigma should be reduced to increase the level of WTP. Recruitment and retention of individuals with high-risk behavior in prevention activities will be critical and challenging.Population mobility has been identified as a major risk factor for HIV/STD infection and transmission in many developing countries, including China (Bloom, Urassa, Isingo, Ng'weshemi & Boerma, 2002;Hope, 2000;Zhang & Ma, 2002 For any successful intervention, a prerequisite is that adequate numbers of individuals are willing to participate in it. Estimates of willingness to participate (WTP) will help researchers to determine the feasibility of prevention intervention program. Identification of associated factors may help to develop effective strategies to address those factors in the design and planning to increase WTP and, consequently, to improve participation rates.The issue of WTP in HIV-related programs was first addressed among intravenous drug users (IDUs) in the United States in the late 1980s (Magura et al., 1989;Marlink et al., 1987). During the past 2 decades, a growing number of studies addressing this issue have been reported among diverse populations, including men who have sex with men (MSM), bisexual men, pregnant women, and STD patients. Level of willingness and possible correlates (e.g., demographic characteristics, HIV/AIDS knowledge, health behaviors, and self-perceived susceptibility) have been examined in these studies. A broad range of willingness levels was reported among these varied populations. For example, among IDUs in methadone clinics, one study reported a WTP rate of 85% (39/46) for voluntary HIV testing, whereas another study found only a WTP rate of 38% (114/300) (Magura et al., 1989;Marlink et al., 1987). An international survey among pregnant women in 13 cities from nine developing countries r...

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