Social Epidemiologic Study On HIV/AIDS In A Village Of Henan Province

Objectives: (1) To investigate the epidemiologic status of HIV/AIDS in a representative village of Henan Province, and analysis its social determinants; (2) To describe the impact of HIV/AIDS on children in life, education and social psychology; (3) To develop the instrument "perceived discrimination of HIV/AIDS affected children" based on the theory of social psychology.Methods: A represenfive HIV/AIDS prevalent village----Shuihuang village, Weishi County was selected as the study field. Combined with qualitative and quantitative methodology were utilized to collect data. Based on grounded theory, semi-structured and unstructured individual focus interviews, stakeholder interviews and focus groups were used in qulitafive study to collect data. Psychometric features proved scales were used to examine anxiety, depression, perceived discrimination of HIV/AIDS affected children in quanititative study.Using the "Family Information Instrument", collected information on family, members, income, ever blood donating and infection situation of every family in Shuihuang Village. Using the "Demographic Data Forum", we interviewed every individuals with HIV/AIDS, explored their disease, treatment, and its impact. For the HIV/AIDS affected children, applying the instruments to measure the extends of anxiety, depression, perceived discrimination and behavior of HIV/AIDS affected children. In addition, focus group interiviews were conducted among teachers, students, selective residents, stakeholders, and leaders of schools and village."Scale on perceived discrimination of HIV/AIDS affected children" was developed by interviewing children affected by HIV/AIDS. The internal consistency reliability and construct validity were examined among 229 subjects.Results: There are 2335 residents in Shuihuang Village and among them, 107 are with HIV/AIDS. The prevalence is 4.6%. Among the HIV positive, 96.3% was infected through illegal blood donation. Ninety-five (88.8%) are AIDS patients and 90 received free HAART.The social epidemiological study found that social factors, such as government advocation, economic profit, illegal blood collection, collective behavior, traffic convenience, social network with blood buyer, low educational level and family pressure were relevant to the HIV/AIDS epidemic in Shuihuang Village. In turn, the prevalence of HIV/AIDS has impacted the health status, health service, SES, family and community interaction, stratification and other social conditions in the village.HIV/AIDS affected children in several aspects. In life, the substance condition is terrible and they have to take heavy family responsibility. In education, the rate of drop-out among HIV/AIDS affected children is higher than that of the unaffected children (p＜.05). The difference in performance is not significant. Comparing with the norm, HIV/AIDS affected children face more anxiety(46.1%), depression(2.9%), behavior problems (26.3%). The mean score on perceived discrimination is 79.2±18.69 (total: 120). The most perceived discrimination were "Others fear us to transmit the disease" (2.4±0.96), "Classmates treat me different as they know my situation" (2.39±0.76), "Others taboo us" (2.39±0.92)。"Perceived Dsicrimination Scale for Children Infected/Affected by HIV/AIDS" is consisted of 40 items. Through factor analysis, five factors were resulted: behavior rejection, anxiety, disgusting, teacher effects and neighborhood effects. The internal consistency for reliability of Cronbach'sαtotal score, factor 1to 5 are 0.948, 0.930, 0.926, 0.867, 0.836, 0.853. Test-retest reliability is 0.812.Conclusion: The prevalence rate of HIV/AIDS in Shuihuang Village is 4.6%, 65 times higher than the Chinese population prevalence rate. The infectors are majority of the blood donors in 1990's. HIV infection is caused by blood donation. The HIV prevalence has impact on health, medical situation, economic status, family and social relationship. The children also affected on fife, education, and social psychology by HIV/AIDS. The preliminarily developed scale "Perceived Dsicrimination Scale for Children Infected/Affected by HIV/AIDS" has good reliability and validity.