Prevalence of HIV, Syphilis, HCV and Their High Risk Behaviors among Migrant Workers in Eastern China

Xiaohong Pan,Rongbin Yu,Ning Wang,Xin Chen,Yingying Zhu,Qing Wang,Jing Su,Hui Zheng,Zhihang Peng,Joan A Caylà

doi:10.1371/journal.pone.0057258

Xiaohong Pan, Rongbin Yu + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0057258

Copy DOI

Abstract

ObjectiveThe goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China.MethodsA cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening.Results17,377 (92.8%) of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73%) of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid) partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4%) had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently) was associated with being divorced or widowed (P<0.05 for single); male gender; shorter duration of stay in Zhejiang; working in factory, market or domestic service (P<0.05 for odd job); having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%–0.06%) and 0.40% (95%CI: 0.31%–0.51%), respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%–0.70%). Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners.ConclusionsMuch greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant workers in China.

Highlights

Concurrent with the rise in international population mobility, over the past 30 years HIV has spread from high-risk nations to countries all over the world [1,2,3]
Previous surveys in China suggested that a large number of migrants were willing to be tested for HIV/sexually transmitted diseases (STDs) [18,19], and 4,293 VCT(voluntary counseling and testing) clinics had been established throughout the country by the end of 2007 [20], migrants still have less access to HIV/STD tests and treatment due to their low awareness of VCT services and their subjection to a household registration system in which migrant workers are not entitled to social security or medical benefits [20,21]
Most previous epidemiologic and behavioral surveys of HIV/ STDs in China have focused on migrant MSM, migrant female sex workers or migrant workers working in a certain occupation with a small sample size, but were rarely based on a large samples that included almost all subgroups of migrants in eastern China where there is a large assemblage of this group [22,23,24]

Summary

Introduction

Concurrent with the rise in international population mobility, over the past 30 years HIV has spread from high-risk nations to countries all over the world [1,2,3]. Internal migrants potentially facilitate HIV and sexually transmitted diseases (STDs) transmission between rural and urban populations through their annual return to their home villages [5,6,7]. Many social and economic elements in China facilitate the spread of HIV/AIDS through sexual transmission. These elements can include the prevalence of STDs [10,11] and the rate of population mobility [12,13]. Most previous epidemiologic and behavioral surveys of HIV/ STDs in China have focused on migrant MSM, migrant female sex workers or migrant workers working in a certain occupation with a small sample size, but were rarely based on a large samples that included almost all subgroups of migrants in eastern China where there is a large assemblage of this group [22,23,24]

Methods

Results

Conclusion