Study On The Strategies Of AIDS Behavior Intervention In Gender Perspective Among Wives Left Behind In Rural Areas Of China

Objective This study aimed to measure the level of HIV-related knowledge and discrimination attitudes against PLWHA among wives left behind (WLB) and wives of non-migrant men (WNM) in rural areas with former commercial blood donors, China. In rural areas of China where commercial plasma donation used to be common, and little is known about sexual behaviors and condom use among WLB by migrating husbands and WNM. This study investigated sexual behaviors and condom use among married women in rural areas of China. To find effective intervention strategies to prevent and treat AIDS among WLB,two different intervention measures based on the prevalence of AIDS, AIDS-related knowledge, attitude, behavior (KAB) and related risk factors among WLB were developed and implemented and the intervention effect was evaluated.Methods Cluster sampling was used and Xingtang and Tianqiao in Linquan County and Shibali and Shijiuli in Qiaocheng district in Bozhou city in Anhui Province were selected as investigation sites and a cross-sectional study was carried out. The AIDS intervention activities in gender perspective were applied among the rural left-behind women aged 18 to 49 in the two towns in Linquan, while the AIDS intervention activities in non-gender perspective were applied in the two towns in Linquan.A cross-sectional study was carried out when the two intervention activities were over.Data was analyzed by the statistical software SPSS, mainly by descriptive analysis and Chi-square test. Data were independently entered twice and checked by Epidata 3.1 software and then transformed into a Statistical Package for the Social Sciences (SPSS) data file and analyzed using the SPSS version 10.1 for Windows, SPSS Inc, Chicago, IL. Data were evaluated in frequency and percentages ratios, and using Chi-square (χ2) and t-tests. The significance level was defined asα= 0.05. Univariate and Multivariate analysis were performed to estimate factors associated with HKS and DAS. No-conditional multi-Logistic regression analysis was used to analyze the correlation for multiple sexual partners.Results Mass media was the major sources of the total respondents'information about HIV/AIDS. The total rate of questions about knowledge about HIV/AIDS answered correctly was 50.13%. Compared to wives of non-migrant men, left behind wives had lower HKS (P=0.009), with HKS being 14.50 (standard deviation (SD) 5.335) vs. 15.22(SD 5.493), respectively. Higher education level and family income per capita were positively correlated with higher HKS, while older age was negatively associated with higher HKS. The total DAS among the total respondents was 10.49(SD 7.170). Compared to wives of non-migrant men, left behind wives had similar DAS, with DAS being 10.93 (SD 7.062) vs. 10.30(SD 7.210), respectively. Older age were positively correlated with higher DAS, while lower education level and HKS were negatively associated with higher DAS. The results showed that WLB had a significantly lower mean frequency of sexual intercourse with their husbands in the previous month, a higher rate of multiple sexual partners, a higher rate of self-reported HIV infection, and a lower rate of condom use when compared to WNM. Also, HIV-infected WLB infected by their husbands had multiple sex partners and did not use condoms consistently. In the research of intervention, the AIDS intervention without gender perspectives obtained good results, after intervention the correct answere rates of the rural left-behind women on the AIDS general knowledge, transmission knowledge, nontransimitted knowledge and the knowledge about condoms were generally increased by 16.5%, 8.3%, 26.1% and 10.7% respectively than those before intervention, the attitudes towards PLWHA showed a slight change, but the high-risk behavior remained largely unchanged, the condom use rate and VCT utilization ratio had no significant difference (P>0.01) before- and after intervention; however the results obtained after the intervention in gender perspective were even more obvious than those obtained without gender perspective, after the intervention in gender perspective the increasing ranges of the correct answere rates of the rural WLB on the AIDS general knowledge, transmission knowledge, nontransmitted knowledge and the knowledge about condoms were 2.3, 2.2, 2.2 and 2.1 times respectively than those without gender perspective; the change extent of attitudes towards PLWHA by the intervention in gender perspective brought in a generally more obvious result than that without gender perspective, at the same time the high-risk behavior went down as well as the condom use rate and the VCT utilization ratio increased.Conclusion There were widespread misconceptions about HIV infection and routes of HIV non-transmission, and their discrimination attitudes against PLWHA were very common among the respondents. Rural women need more HIV/AIDS knowledge to correct their misconceptions about HIV infection and transmission, and HIV-related discrimination reduction should be an important component of HIV prevention approaches. This research provides additional insight that may be used to develop effective HIV prevention strategies in rural areas of China. The intervention effects on the rural left-behind women by the AIDS intervention measures in gender perspective were more obvious than those without gender perspective. The intervention results indicate that the AIDS intervention measures in gender perspective are good methods for the rural WLB to prevent AIDS and it is quite necessary that the female AIDS prevention and intervention measures should be designed in gender perspective. Our experiences have important reference value to the prevention and control against AIDS/HIV in other areas.