HIV and sexually transmitted disease prevalence, risk behaviors, and stigma against people living with HIV/AIDS among migrant women living in Shanghai, China

Shanghai is one of the largest metropolitan areas in the world. Known as a city with vast job opportunities, more and more rural migrants, including women, are seeking employment there. It is estimated that as more than 5 million migrants are currently living in the 19 districts of Shanghai. Along with the economic boom, however, the HIV and STD epidemics continue to worsen in Shanghai. By the end of 2008, there were 3,747 reported cases of HIV in Shanghai, and the proportion of HIV infections transmitted heterosexually is constantly increasing.;This was a community-based, cross-sectional study conducted among 601 female migrants living in three communities in Xuhui district, Shanghai, in 2008. An anonymous questionnaire-based interview was carried out to examine their HIV/AIDS and STD-related knowledge, attitudes and beliefs, stigma against people living with HIV/AIDS (PLWHA), and sexual behaviors. Blood samples were collected to determine the prevalence of STDs and HIV. The prevalence of HSV-2, syphilis, and HBsAg were 12.5%, 1.1%, and 7.9%, respectively. Only one woman was HIV-positive. The prevalence of any one of the four STDs was 19.7%. The prevalence of STDs was higher among older female migrants with low levels of education and short duration in Shanghai. Living alone, working at entertainment venues, smoking, having multiple sex partners, and being very young at sexual debut were risk factors for STDs. Their levels of stigma against PLWHA were high. Over half of the participants had stigmatizing and/or discriminatory attitudes. Female migrants with less knowledge of HIV/AIDS, who were older, had lower levels of education, and had resided in Shanghai relatively longer were more likely to have stigma against PLWHA. Participants who reported having premarital sex and/or multiple sex partners were less likely to discriminate against PLWHA.