Rural-to-urban migrants and the HIV epidemic in China.

Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.
AIDS and Behavior (Impact Factor: 3.49). 08/2006; 10(4):421-30. DOI: 10.1007/s10461-005-9039-5
Source: PubMed

ABSTRACT China is the next probable frontier for the global HIV epidemic. Central to this anticipated growth of the epidemic is the nation's new and growing population of rural-to-urban migrants. Although there are an estimated 120 million migrants, little information is available about their social and cultural context of their lives in urban areas and their HIV-related perceptions and behaviors. On the basis of the in-depth individual interviews conducted among 90 rural-to-urban migrants in 2 major Chinese cities, Beijing and Nanjing, this qualitative study was designed to explore these issues with a particular focus on their relevance to sexual transmission of HIV. The findings suggest an urgent need for HIV/STI prevention programs that address the cultural, social, and economic constraints facing the migrant population in China.

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    ABSTRACT: In China, there is increasing concern because of the rapid increase in HIV infection recorded over recent years. Migrant workers are recognized as one of the groups most affected. In this study, HIV/AIDS-related knowledge, attitudes, and behavior among unmarried migrant workers in Shanghai are investigated, with the aim of providing critical information for policy makers and sex educators to reinforce sexual health services and sex health education targeting the behavior and sexual health of unmarried male migrants. A cross-sectional survey was conducted among unmarried male migrant workers in Shanghai, China' largest city and housing the most migrants. A self-administered, anonymous questionnaire was used to collect information on knowledge, attitudes, and behavior associated with increased risk of HIV/AIDS. A total of 2254 subjects were questioned, with a response rate of 91.3%. Among those interviewed, 63.5% reported sexual activities. Misconceptions regarding HIV transmission, poor perception of HIV infection, and low use of condoms were not uncommon. Among those who had sexual intercourse, 73.7% had not used condoms in their last sexual intercourse, and 28.6% reported having engaged in sexual risk behavior (defined as having at least one non-regular partner). Multivariate logistic regression analyses identified several indicators of sexual risk behavior, including younger age at first sexual intercourse (OR: 0.67, 95% CI: 0.31-0.91 for older age at first sexual intercourse), more cities of migration (OR: 2.91, 95% CI: 2.17-3.81 for high level; OR:1.15, 95% CI: 1.06-1.29 for medium level), poor perception of acquiring HIV/AIDS (OR:1.52, 95% CI: 1.33-1.96 for unlikely; OR: 2.38, 95% CI: 1.61-3.70 for impossible), frequent exposure to pornography (OR: 0.33, 95% CI: 0.11-0.43 for never; OR:0.69, 95% CI: 0.60-1.81 for less frequently), not knowing someone who had or had died of HIV/AIDS and related diseases (OR: 2.13, 95% CI: 1.70-2.53 for no), and having peers who engaged in sex with a non-regular sex partner (OR: 4.40, 95% CI: 3.37-5.56 for yes). Today, it is necessary to reinforce sex health education among unmarried migrants and sexual health services should target vulnerable migrant young people.
    BMC Public Health 12/2013; 13(1):1152. · 2.08 Impact Factor
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    ABSTRACT: This study examined the prevalence and the determinants of risky sexual behavior (defined as having multiple sex partners and paying for sex) among male rural-to-urban migrants in China. An anonymous questionnaire was used to collect information on socio-demographics, knowledge, attitudes, and behavior associated with increased risk of risky sexual behavior from 4,069 subjects. In total 1,132 (27.8%) participants reported two or more sex partners and 802 (19.7%) participants paid for sex. A considerable proportion (29.6%-41.5%) did not use a condom during risky sexual behavior. Logistic regression analysis revealed that unmarried status (OR: 0.62, CI: 0.42-0.85 for married), earlier age at first sexual experience (OR: 0.67, 95% CI: 0.31-0.91 for ≥22 years old), poor perception of risk of acquiring HIV/AIDS (OR: 1.51, 95% CI: 1.33-1.96 for unlikely; OR: 2.38, 95% CI: 1.61-3.70 for impossible), frequent exposure to pornography (OR: 0.67, 95% CI: 0.60-0.81 for sometimes; OR: 0.31, 95% CI: 0.11-0.43 for never), attitudes toward legalization of commercial sex (OR: 0.39, 95% CI: 0.21-0.59 for no), peer influence (OR: 0.51, 95% CI: 0.27-0.88 for no), and not knowing someone who had/had died from HIV/AIDS (OR: 0.35, 95% CI: 0.20-0.53 for yes) were all significantly associated with having multiple sex partners. Those who paid for sex showed similar findings.
    International Journal of Environmental Research and Public Health 01/2014; 11(3):2846-64. · 2.00 Impact Factor
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    ABSTRACT: Background. Recent studies have indicated towards an increasing burden of HIV/AIDS among older adults. To describe the trend and spatial characteristics of this disease among individuals aged 50 years and above, analysis of data collected during 2005-2012 through the National Case Reporting System (CRS) in China was conducted. Methods. All the identified people living with HIV/AIDS (PLWHA) recorded through the Chinese HIV/AIDS CRS during 2005-2012 were included in the study, excepting the cases without specific spatial information. Trend tests and spatial analyses were conducted. Results. Altogether, information about 73, 521 PLWHA (aged 50 and above) were collected between 2005 and 2012. Three provinces - Guangxi, Henan and Yunnan - accounted for 54.4% of the identified cases during the study period. Compared to 2005, the ratio between residents and migrants among the study population decreased to 40.1% in 2012. Ratio of HIV infected to AIDS patients and the male/female ratio increased gradually among older infected adults. Results of spatial analysis indicate a clustered distribution of HIV/AIDS among older adults across the country. Presence of hotspots was observed in four provinces (Guangxi, Henan, Yunnan, Sichuan) and one municipality (Chongqing). A moving trend towards southern provinces (from central China) was also identified. Conclusions. The number and proportion of HIV/AIDS among older adults have increased during recent years. The infection remained clustered and the hotspots showed movement from central to southern China. A focused intervention strategy targeting the older PLWHA is urgently required in China.
    Clinical Infectious Diseases 04/2014; · 9.37 Impact Factor

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