Health Education Of Aids Knowledge On The Migrant Workers In Zhengzhou City And Evaluation On It's Effect

Since the reform and opening policy, migrant workers have become a new occupational population. Generally, they work in one city but don't have the registered permanent address of there. With the acceleration of the urbanization process, the number and the frequency of floating population in major cities in China have constantly increased. Most of them are young and prone to high-risk sexual behavior because they are in the period of stronger sexual desire and far away from home. This population is very difficult to manage because of the large population and migration. So migrant workers have been identified as one of vulnerable population of HIV infection. The 2/3 of HIV-infected persons are migrant workers are in Shanghai, Shanxi and Zhejiang. And the number of infections increases year by year. The economic level of Zhengzhou City is at the middle of national level. Census data of Henan Province in 2000 show that the urban resident population is about 2,590,000, where migrant workers are about 530,000, accounting for 20%. In 2007, the number of urban residents is 3.09 million. The number of migration workers is about 100 million, accounting for 33% of the resident population. Most of them are the employee from entertainments and service industries, such as beauty salon, nightclub / KTV, bars, hotels, restaurants, supermarkets, food factory, construction industry, and so on. In recent years, there is an increasing trend of the proportion of the migrant workers in the total population. Migrant workers are not only vulnerable groups of AIDS, but also the main vehicle for the spread of AIDS.In recent years, the health education interventions of AIDS / STD are always carried out in college and middle school students, drug abuse inmates, sex workers and other high-risk groups, but few in migrant workers. So we designed an evaluation of the effect of multiple-intervention on AIDS related knowledge, attitude, and practice (KAP) in order to guide future health education on migrant workers. Theresearch field is Zhongyuan District, and the subjects are the migrant workers inZhengzhou. And the results will provide a theoretical basis and new ideas about AIDSprevention and treatment for other areas.Methods723 migrant workers were chosen from 7 entertainments and 10 serviceindustries in Zhongyuan district of Zhengzhou city, from March to April, in 2008.Multiple-interventions such as health education of AIDS, sending condoms andhandbook of AIDS knowledge, and face-to-face consulting services were carried out.Then awareness rate of AIDS knowledge, function and usage of condom use wereevaluated before and after Multiple-interventions.Results1. The demology characteristics of migrant workersThe Minimum age was 13.9, and the maximum age was 54.3, the average age was 23.6±7.3. 303 (41.9%) of them were male, 420 (58.1 %) of them were female. The proportion of bachelor, married, cohabit/divorced/separated was 68.3%, 28.6% and 3.1% individually. The educational level of migrant workers was lower. The proportion of middle school or below accounted for 95.3% of the total.2. Knowledge of AIDS among migrant workersThe awareness rate of AIDS knowledge was 42.6% before intervention and99.2% after multiple-interventions. The difference was significant,χ~2 =405.5( P<0.01) . The correct rate of each item was enhanced at least 10%. The score of AIDS knowledge was 4.9±1.9 before intervention and 7.9±0.5 after intervention. The difference of knowledge score was also significant, t =42.7, P <0.01. 3. The attitude of migrant workers to AIDSBefore intervention, 55.0% participants thought the identity of AIDS patients should be open, 18.4% showed they will refuse to keep contracting with AIDS patients, 44.1% were willing to eat with AIDS patients together. After intervention, 58.2% participants thought that the identity of AIDS patients should be made public, the rate that participants will refuse to keep contracting with AIDS patients was decreased to 8.2%. The rate that participants who were willing to eat with AIDS patients together was increased to 82.7%.4. Condom use in sex behavior(1) The incidence of unmarried sex behavior: 176 participants among the 494 unmarried participants had experienced sex behavior before marriage, the rate of unmarried sex behavior was 35.6%.(2) Condom use in sex behavior: 404 (55.9%) of the participants had experienced sex behavior. The rate of using condom in sex behavior was 68.1%.(3) The intention rate of using condom: Whether before or after the multiple-interventions, gender was not the influencing factors of wearing condom.χ~2=1.05, P=0.592(before intervention),χ~2=2.66, P =0.625(after intervention).Before intervention, the intention rate of using condom among female sex workers was significantly higher than that of the migrant worker who didn't engage incommercial sex service,χ~2=15.89, P <0.001. While after the multiple-interventions,the rate between two kind of population were same,χ~2=1.82, P =0.402. Whether before or after the multiple-interventions, educational level were not the influencing factors of wearing condom,χ~2=7.91, P=0.245 (before intervention) ,χ~2=9.66,P =0.140 (after intervention)(4) The opinion about the function and usage of condom: Before intervention, 71.6% of the participants knew that condoms can prevent sexually transmitted diseases, while after intervention, this rate was enhanced to 98.2%. And the rate of choosing "read time of validity of condom, discharge bubbles beside the condom, distinguish the face or inverse of condom, or don't use the same condom repeatedly" were 69.8%, 55.3%, 75.6% and 3.3% individually, and after the intervention, the corresponding rate was enhanced to 97.6%, 92.8%, 90.6% and 94.6%.Conclusions1. The awareness rate of AIDS knowledge among migrant workers was very little before multiple-interventions. Multiple-intervention is an effective measurement to enhance the level about AIDS knowledge.2. Most of the migrant workers don't know how to use condom correctly. Multiple-intervention is an effective way to teach them how to wear condom correctly.3. The unmarried sex behavior, and unprotected sex behavior is higher among the migrant workers. The Government should continue to strengthen the function and use condom, especially strengthen the supervision to entertainment professionals, urge them to form a good sex habit, so as to avoid the spreading of AIDS from high-risk groups to the general population.4. Although multilple-intervention on migrant workers is an effective way to improve the level of AIDS knowledge and make them form good sex habit, this kind of intervention model should be adjusted basing on the character and work place of study population. For example, handing out the condom and one-to-one consulting are good models in the femal sex workers. Only in this way, can the intervention be more effective.