| AIDS that caused by HIV is a emerging infectious disease. Since the first case reported in 1981, Its spread and damage has become the most important public health and social problem all over the world. Currently, the main HIV transmission route is through injecting drug use, however, there is a emerging trend that the proportion of sexually transmitted HIV infections is increasing. The rapid growth of sexually transmission is mainly due to renascence of sex industry and the boom of FCSW from 1980s. Data from national sentinel surveillance shows that the prevalence rate among FCSWs increased from 0.02% to 0.94% between 1996 and 2005. Intervention works targeted to FCSWs is consided as a key to control the spread of AIDS.Unlike other infectious diseases, behavioral factor act as a crucial role when HIV infected. In order to control the spread among FCSWs, the first thing is to change their risk behaviors. We have to understand the situation and influencing factors of such risk behaviors; besides, we need to creat conditions and settings to promote the behavior modification. In this regard, it's urgent to develop some theories which are scientific, general and experience confirmed to help us understand and promote the AIDS prevention behavior. Unfortunatelly, few studies focused on such field and intervention based on intervention theory even less. Enforcing intervention theory study and exploring sutiable theory for specific high risk population is on the top of agenda in China.Prevention and intervention should start from analyzing influencing factors. At present, statistical methods widely used in behavior research include multiple linear regression, principal component analysis, factor analysis and logistic regression etc. However, these methods have their limitations as follow when applying to data about behavioral problems: (1) can't handle two and more dependent variables; (2)multi- collinearity between independent variables is unresolved; (3)not able of dealing with immeasurable variables; (4)measure error and their correlation is thoughtless.Structural equation modeling (SEM) is a combination of two important statistical techniques, i.e. factor analysis and path analysis. It treats observation variables as the indications of latent variables and permits the existence of measure error in both two variables. It's capable to study the manifest variables as well as the latent variables, the direct effects as well as the indirect effects. With the requirement of intervention practice and the development of relevant behavior theories, SEM has became one of the hot research area due to its unique advantages.Objective:1. By means of SEM to develop a causal relationship model for AIDS prevention behaviors among FCSWs in Jinan city. After model estimation, modification and assessment, to come up with an optimum model to comfirm the applicability of IMB model.2. Based on the final model, to ascertain the influencing factors of AIDS prevention behavior. Analyzing direct and indirect effects of information, motivation and behavioral skills on prevention behavior and provide scientific reference for succedent intervention.3. To explore a reliable pattern to analyze behavior problems using latent variable analysis methods. To enrich relative intervention theories for combating AIDS and provide methodological referrence for behavior theory study.4. To probe into the feasibility and efficiency of IMB based intervention.Method:FCSWs are recruited from several entertainment venues in Jinan urban area using convenience sampling method. Self-compiled scale is used to collect relevant information required by IMB model.Using Lisrel 8.7 to perform SEM analysis. After model estimation, modification and assessment, to come up with an optimum model to study the relationship of each components of IMB model.Result:Total of 158 FCSWs were recruited from 28 entertainment venues, form which 156 valid questionnaires were collected. In terms of demographical character, Most of FCSWs in this research were young people aged between 18 and 25 and the average age is 23. Low educational background and spinsterhood were two primary characters. The people from other proviences accounted for a large contribution (52%) , especially from three Northeastern Provinces of China.Their knowledge about AIDS was incomprehensive, especially the knowledge about how to effectively prevent AIDS. In regard to prevention motivation, their perception of risk and social support were in low level; prejudice against condom use was prevalent. For behavioral' skills, FCSWs were in short of the negotiation skills to persuade guests to use condoms. Their physical skills to use condom was also worrying with few of them could use it correctly. In the recent month, The rate of condom use was 32.05% (50/156) . The rate of condom use in the recent time was 66.03% (103/156) .Based on IMB model, we set a initial model at the beginning. Then according to Goodness of Fit Statistics, standard residual, modification index and estimation value of parameter, a series of pruning and modifying was conducted. In this process, standard coefficient, chi-square value, GFI,AGF,CFI,RMSEA etc. were used to assess the current model. When dealing with nested models, Likelihood ratio test was performed to determine the optimum model. Finally, we got the final model and its GFI,AGF,CFI,RMSEA were 0.884, 0.956, 0.977, 0.0796 respectively, which indicated the well fit.The final model showed that both information and motivation can affect prevention behavior via behavioral skills. The information's direct effect on prevention behavior was insignificant while the motivation got a strong influence on prevention behavior. Information's effect on behavioral skills were almost equal to the motivation's but the later's effect on prevention behavior was much greater. The standard coefficient illustrated as follow: Information's direct effects on behavioral skills and prevention behavior were 0.503 and 0.327 respectively; Motivation's direct effects on behavioral skills and prevention behavior were 0.510 and 0.369 respectively; Motivation's total effect on prevention behavior was 0.7 and behavioral skills' direct effect on prevention behavior was 0.650.Conclusion:1. Low motivation and behavioral skills level are showed in FCSWs in Jinan which explains the low rate of condom use.2. The main influencing factors of prevention behaivor among FCSWs are motivation and behavioral skills, while the information's effect is weak.3. Structural equation modeling which is considered as the organic combination of mathematical knowledge and speciality knowledge possess many advantages compared with conventional statistical methods when handling data from behavior research. But it has its own limitations and shortages. For example, the theoretical model and definition of the latent variables in this study are based on subjective assumption in terms of relevant theory. When drawing any conclusions, being prudential is preferred.4. IMB theoretical model was proved according to this study which illustrates us that only knowledge intervention can't promote behavior change. An integrated manner that covers information, motivation and behavioral skills should be adopted when conducting behavior intervention.
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