| Objectives To increase the knowledge related to HIV/STDs, the skill to refusing sexual behavior and risky sex behavior, the utilization of legal health service among migrant female adolescent via the intervention of social network.Methods The females, who were younger than 25 years old, unmarried, moved in from the rural, and worked in Hefei were recruited to be participants in interview. Among them 15, 10 and 11 participants recruited from one factory, six restaurants and six entertainment venues respectively. After informed consent, participants were interviewed according to the same interview outlines and the interview were recorded. The contents of the interview involved the sociodemographic characteristics, social network, the status of sexual behavior, reproductive health, knowledge related to HIV/STDs and condom usage, demand for health service, as well as working time. Each interview lasted about an hour. The records of the interviews were transformed into word file by one investigator and were checked by another investigator to conform the consistency between the original records and final word files. The criterion was established for data selection, and then targeting contents were choosen based on interview clues.A total of 457 females who aged 16 to 24 years old and met for criterion of including above were recruited by convenience sampling. Among them 175, 138 and 144 participants were recruited from one factory, six restaurants and six entertainment venues respectively. After informed consent, a survey was self-administered to determine the status of sexual behavior, knowledge related to HIV/STDs and condom usage, self-efficacy of refusing sexual behavior and condom use, social capital, social network, depressive symptoms, as well as prevalence of HIV/syphilis. Additionally, 5 ml blood specimens of each participants was collected to test for HIV snd syphilis anti-body. EpiData 3.0 software was used to established a data-base. T-test, Chi-Square test, logistic regression analysis were applied to detect risk factors of sexual behavior and risky sexual behavior.Based on survy above, intervention was conducted among migrant femal adolescents in Hefei. Among eligible migrant feimales in the thirteen study sites, 53 peer educatiors (15, 23,15 participants in factory, restaurants and entertainment venues respectively) were recommended by participants. All participants were divided into 53 groups and 8-12 of them in each group. The members of the group had good relationship with peer educatior who was in charged of the intervention in the group. Baseline was self-administered to all participants before intervention. Peer educators were trained with four intervention session, one session in every two weeks, and they teached all the members in their groups with what they learned from the intervention. Assessment was conducted after two weeks of intervention. Effectiveness of behavior intervention was determined by comparing baseline with assessment of knowledge related to HIV/STDs, prevalence of sex behavior and condom usage, rates of utilization of legal health service.Results Totally, 36 migrant female adolescent who were 17 to 24 years old were recruited to participate in in-depth interview. The social network of participants mainly consisted of peer worked together and were from the same rural area. Of them, 17 participants reported sexual behavior and some of them had unprotective sex who worked in restaurants and entertainment venues. Only four participants reported condom use in their first intercourse. Their knowledge related to HIV/STDs was low and leaned from peers, broadcast and TV as well. Eleven participants reported reproductive infections (mainly colpitis, 5 times at most) and pregnancy (4 times at most). Some of participants ever utilized illegal health service. Participants in factory thought 6:30-8:00 PM on Saturday night was the best time to conduct intervention. Participants in restaurants hoped the intervention would conducted during 2:00-4:30 PM on work day. Participants in entertainment venues thought 3:30-5:00 PM on Saturday or Sundy would be best for intervention.The prevalence of sexual behavior and risky sexual behavior were 35.2% (161/457) and 43.5% (70/161). The percentages of females who reported sexual behavior in factory, restaurants, entertainment venues were 5.1%, 20.3% and 86.1% respectively (Linear-by-Linear Chi-Square, P<0.05);The percentages of participants who reported condom use everytime, sometime, nerver when they had intercourse in the last two month were 11.2%, 32.3% and 56.5% among 161 participants who had sex behavior (Linear-by-Linear Chi-Square, P<0.05). Logistic regression analysis demonstrated that working in entertainment venues could increase the risk of having sexual behavior which was 41 times of participants working in factory ( OR=41.612,95 %CI:12.331~140.422); Being older ( OR=2.692,95%CI: 1.273~5.689) were associated with high risk of sexual behvior. Knowledge of HIV/STDs and condom usage (OR=1.213,95%CI: 1.127～1.305), having high score of organizational density and characteristics (OR=1.207, 95%CI:0.999～1.458), having high score of exlusion of neighbourhood (OR=1.197, 95%CI: 1.000~1.434), having high score of the trust and cooperation of neighborhood ( OR=1.202,95%CI: 1.034～1.398) could not decrease the risk of sexual behavior. Protective factors of sexual behavior were self-efficacy of sexual behavior (OR=0.799,95 % CI:0.725~0.881), solidarity of neighborhood (OR=0.892,95%CI: 0.836~0.951), having larger social network (OR=0.868,95%CI: 0.767~0.981) and the density of sicoal network more than 0.7 (OR=0.389, 95%CI: 0.182~0.829).working in cities over 2 years (OR= 2.476, 95%CI: 1.081~5.673) could increase the risk of risky sexual behavior. Having high score of the trust and cooperation of neighborhood(OR=1.187, 95%CI: 1.014~1.391) could not decrease the risk of sexual behavior. The risky sexual behavior decreased with being older(OR= 0.384, 95%CI: 0.145~1.012), high score of self-efficacy of condom usage(OR=0.803, 95 % CI: 0.732~0.882), high score of organizational density and characteristics(OR= 0.743, 95%CI: 0.576~0.959) and exlusion of neighbourhood(OR= 0.785, 95%CI: 0.625~0.988), as well as density of social network more than 0.7 (OR= 0.192, 95%CI: 0.080~0.459).Of 457 participants, 338 participants were followed up at assessment after two weeks of intervention finished. Analysis showed that intervention increased the knowledge related to HIV/STDs, condom use correctly among participants in factory, restaurants and entertainment venues (baseline 8.03±4.77, 12.59±5.78 and 20.49±4.29, follow-up 22.10±6.16, 22.23±6.39 and 22.71±4.99, P<0.01); The intervention could increased self-efficacy of condom use of participants in factory and restaurants (baseline 11.42±4.77,11.30±4.01; follow-up 14.22±4.26, 12.84±4.49, P<0.01); The rates of condom usage were increased in the last two month intercourses, the last intercourse, the last two intercourses and the last three intercourses among participants in restaurants( baseline 33.3%,48.1%,37.0%,29.2%; follow-up 62.9%,74.3%,71.9%,61.3% , McNemar Chi Square, P <0.01); There were no changes of condom use among participants in factory and entertainment venues. The intervention Improved the rates of HIV/AIDS consultation of participants in factory, restaurants and entertainment venues (baseline 0.6%,1.4% and 17.4%, follow-up 10.9%, 10.2% and 42.9%, P <0.01), and the rate of HIV testing (baseline 1.7%, 0.7% and16.0%, follow-up 14.3%, 22.7% and 41.3%, P <0.01).Conclusions The intervention based on social network among migrant female adolescent was effective which has increase the condom use, the knowledge related to HIV/STDs and the utilization of legal health service.
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