| Objective:To learn about Male floating people's knowledge, attitude and related sexual behavior as well as access to reproductive health service about reproductive health in construction workplace in Chengdu and to explore possible risk factors of knowledge scores, first sexual behavior and unmarried sexual behavior; to evaluate intervention effect of male floating people's knowledge, attitude and related sexual behavior in Chengdu among pre-intervention group, minimal intervention group and extended intervention group.Methods:This study was intervention study using floating people's workplaces as an entry point and adopted community intervention of experiment epidemiology. There were following parts:1) Base line investigation:Before intervention,1924 male construction workers aged 18-35 in 14 selected construction sites were investigated by using the method of Self-administered, Fully interviewer administered or Interviewer administered and Self-administered to complete the pre-questionnaire.2) Evaluation survey:After intervention,1947 male construction workers who aged 18-35 in 14 selected construction sites were investigated by using the method of Self-administered, Fully interviewer administered or Interviewer administered and Self-administered to complete the post-questionnaire. Each questionnaire was carried out rigorous quality control and unified coding. We used EpiData 3.0 statistical software to establish database and two special staff were responsible to enter questionnaires. We accepted clean data by statistical software SPSS 16.0 and then began to analyze results by descriptive analysis, chi-square test and Logistic multivariate analysis.Descriptive analysis included basic demographic characteristics, knowledge assessment about reproductive health, reproductive health service assessment, the attitude analysis of reproductive health, gynecological symptoms and seeking treatment behavior analysis, sexual and contraceptives behaviors, reproductive health services accessibility and so on. Single-factor analysis included knowledge scores, unmarried sexual behavior and age analysis of first sex in different groups. Multivariate Logistic analysis included knowledge scores, unmarried sexual behavior and age analysis of first sexual behavior in different groups.Result:1. Base line survey results of male floating population in Chengdu construction sites:1) Access to reproductive health information and health seeking behavior:604 people received reproductive health knowledge through bulletin board/poster, accounting for 76.9% of respondents; 584 people received reproductive health knowledge through brochures, accounting for 74.3% of respondents; 250 people received reproductive health knowledge through lectures, accounting for 32% of respondents; 326 people received reproductive health knowledge through videos, accounting for 41.8% of respondents; 269 people received reproductive health knowledge through peer education, accounting for 34.4% of respondents; 75 people received reproductive health knowledge through hotline, accounting for 39.6% of respondents. In the past 6 months,110 people had received reproductive health service from hospitals outside of workplaces, accounting for 5.7% (110/1924). In all 202 people with reproductive health/sexual health symptoms,20 people ignored their own illnesses, accounting for 9.9% (20/202); 78 people bought medicines for themselves, accounting for 38.6% (78/202); 51 people went into private clinics, accounting for 25.2%(51/202); only 41 people came to see regular hospital doctors, accounting for 20.3%.2) KAP of reproductive health:In this study there were a total of 14 knowledge questions, Correct answers would get 1 point otherwise wrong answers or not knowing would get 0 points. The full mark was 14 points for every question of 1 point; upper quartile was nine points; median was 6 points; the next quartile was 3 points. Those who got score less than 5 points accounted for 41.6% of the total number; those who got score with 6-10 point accounted for 32.6% of the total number; those who got score more than 10 points accounted for 15.2%. If we presumed 9 point as passing score then we could say less than 8 points (including 8 points) as failure and more than 9 points (including 9 points) for pass. The number of 1396 failed, accounting for 72.6%. Single-factor analysis showed following significant factors:age group (X2=11.297, P=0.001), education (X2=10.575, P=0.002), working time in the factory (X2=9.598, P=0.003), age of working out in the city (X2=9.209, P=0.003), whether having girlfriend (X2=13.699, P 0.001), whether living with his girlfriend (X2=18.056, P= 0.000) and availability of reproductive health knowledge in past 6 months (X2=34.945, P=0.000).Multivariate-factor logistic analysis showed following significant factors:work-months in the construction (OR=2.172), age of working out in the city (OR=1.043); age group (OR=0.582), whether living with girlfriend together (OR=0.628), availability reproductive health knowledge (OR=0.0.568) in nearly 6 months.71.7% of people thought that we should distribute free condoms to unmarried young people; 35% of people could talk freely with friends and family about sexual health topics; 41.8% of subjects could freely talk with the doctor about sexual and reproductive health topics slightly, accounting for 41.8%; 629 people would not contact with colleagues with sexual transmitted disease, accounting for 32.7%; 710 people would isolate colleagues with sexual transmitted disease, accounting for 36.9%; 44.1% of subjects did not choose to contact colleagues who were infected with HIV; 50.5% of subjects isolated colleagues infected with HIV.In all 1924 subjects,1427 people had sexual behavior, accounting for 74.2%; 497 had non-sexual behavior, accounting for 25.8%. The first sexual behavior age younger than 19 years old accounted for 27.5%, upper quartile was 22 years old; median was 20 years old; lower quartile was 19 years old. In all of 1412 people who responded to whether having sexual behavior in the last 3 months,842 had sexual behavior in the last 3 months, accounting for 59.6%(842/1412); main sexual partners of 128 subjects prepared to pregnant, accounting for 6.7% of respondents (128/854); 69 or their sexual partners had been neutered, accounting for 3.6% of all respondents(69/850). Last year,160 people made their girlfriends unintended pregnancy, accounting for 11.4% of all respondents (160/1407); 143 people made their girlfriends abortion last year, accounting for 7.4% of all respondents (143/1268); in past 3 months,153 people had sexual intercourse with more than 1 sexual partner, accounting for 8.0% of all respondents (153/1412); 202 people had prostitution behavior once, accounting for 10.5% of all respondents (202/1408); in the past 3 months,108 people had sexual intercourse, accounting for 5.6% of all respondents (108/1122); 76 people used condoms when prostitution, accounting for 37.6%(46/202). There were 803 unmarried subjects, accounting for 41.7%; 315 unmarried subjects had sex, accounting for 39.2%. Single factor analysis would be carried out to whether having sexual behavior of the unmarried and results showed following statistical significant factors:education level (X2=4.564, P=0.035), age group (X2=49.954, P=0.000), knowledge (X2=21.164, P=0.000), whether having girlfriend (X2=143.449, P=0.000). Multivariate Logistic analysis showed that:Reproductive health knowledge (OR=0.519) might be unmarried sexual protective factor; whether having girlfriend (OR=6.418) might be unmarried sexual behavior risk factor.There were 1335 subjects who had first sexual behavior younger than 24 years of age, accounting for 69.4% of all sample size. Single factor analysis would be carried out to had first sexual behavior younger than 24 years of age and there were following statistical significant factors:whether having girlfriend (X2=635.947, P=0.000), whether getting reproductive health information nearly 6 months (X2=50.968, P=0.000), whether avoiding to contact with HIV infected persons (X2=8.293, P=0.002), whether using condoms (X2 =4.677, P=0.033), reproductive health knowledge score (X2=10.078, P= 0.001). Multivariate Logistic analysis showed that whether having girlfriend (OR=0.395) and reproductive health knowledge (OR=0.682) might be protective factors; whether living with his girlfriend (OR= 2.692) and whether accessing to reproductive health information (OR=1.794) might be risk factors.There were 748 subjects who had first sexual behavior younger than 20 years of age, accounting for 38.9% of all sample size (748/1924). Single factor analysis would be carried out among first sexual behavior younger than 20 years old and there were following statistical significant factors: whether having girlfriend (X2=111.667, P=0.000), age of first working out (X2=3.154, P=0.044), distributing free condoms to unmarried people (X2=29.599, P=0.000), isolating colleague with sexual transmitted diseases (X2=6.863, P=0.009), isolating colleague with HIV (X2=20.581, P=0.000) use of contraceptives (X2=18.573, P=0.000), whether using condoms in the past 3 months (X2=4.096, P=0.026), whether using condoms every time when sexual life (X2=8.836, P=0.004). Multivariate Logistic analysis showed that The younger when they worked out, it was easier for them to have sexual life less than 20 years old. 596 people had used contraception, accounting for 70.1% of all respondents (596/850); 588 people had used contraception in last 3 months. 332 people had used rhythm, accounting for 56.5 (332/588); 134 people had used withdraw, accounting for 22.8%(134/588) 75 people had used emergency contraception, accounting for 12.8 (75/588); 35 people had used condoms, accounting for 6.0%(35/588); 12 people had took oral contraceptives, accounting for 2.0%(12/588).In last 3 months,265 people had used condoms, accounting for 44.8% of all respondents (265/591); in last 3 months,117 people had used condoms every time, accounting for 41.2 of all respondents%(117/284); 10 people had used the same condom repeatly, accounting for 3.5% of all respondents (10/284); in last 3 months,153 people received free condoms, accounting for 25.9% of all respondents (153/591).2. Evaluation survey results of male floating population in Chengdu construction sites:1) Effect evaluation of reproductive health knowledge and health seeking behavior:in past 6 months, whatever minimal or extended intervention group, there was significant difference among intervention group and pre-intervention group. The four parts were as followings: contraception and family planning information (P1=0.000, P2=0.000, P3=0.000); sexual information (P1=0.000, P2=0.000, P3=0.000); where to access reproductive health (P1=0.000, P2=0.006, P3=0.003). The same as reproductive health service (X2=34.514, P=0.000) between pre-intervention and post-intervention.2) Effect evaluation of reproductive health KAP:In all of 7 questions about attitude of reproductive health, there was significant difference among intervention group and pre-intervention group (P1=0.000, P2=0.000, P3=0.000) except 1 question.In all of 1947 subjects in post-intervention,1416 subjects had sexual behavior once, accounting for 72.7%(1416/1947); 709 subjects had first sexual behavior less than 20 years old, accounting for 36.4%(709/1947); 1357 subjects had first sexual behavior less than 24 years old, accounting for 69.7%(1357/1947); in last 3 months,957 had sexual behavior once, accounting for 67.6%(957/1416); main sexual partners of 286 subjects intended to be pregnant, accounting for 60.0%(520/866); in last 3 months,6 subjects had used the same condom repeatedly, accounting for 1.5%(6/404); 366 subjects received free condom, accounting for 40.7%(366/899); female partners of 118 subjects had unwanted pregnancy, accounting for 8.3%(118/1416); in last 3 months,136 subjects had sexual behavior with more than one partner, accounting for 9.6%(136/1416); 219 subjects visited prostitute, accounting for 15.5%(219/1416); in last 3 months,60 subjects visited prostitute, accounting for 27.4%(60/219); 123 subjects used condom when visiting prostitute, accounting for 56.2%.There was significant difference between pre-intervention and post-intervention of male floating people in Chengdu construction sites (X2=19.319, P=0.000).The same as intending to be pregnant (X2=9.695, P=0.002), contraception with sexual partner (X2=18.625, P=0.000) and receiving condom in last 3 months (X2=34.519, P=0.000). As for contraception frequency, the proportion of always using and often using contraception in post-intervention was higher than that in pre-intervention (X2=29.708, P=0.000).There was significant difference between pre-intervention and post-intervention on where to receive free condom (X2=80.369, P=0.000). Last year, the rates of unwanted pregnancy and induced abortion declined a little and there was significant difference between pre-intervention and post-intervention (X2=435.434, P=0.000). There was significant difference on visiting prostitution in last 3 months and using condom when prostitution among pre-intervention group, minimal intervention group and extended intervention group.Conclusion:1. The post-intervention effect of reproductive health knowledge acceptance and reproductive health service acceptance were better than pre-intervention.2. The post-intervention effect of correct rate of reproductive health and sexual health related knowledge was better than pre-intervention. However, the effect of minimal intervention group was better than extended intervention group.3. The attitude change of post-intervention effect was better than pre-intervention but extended intervention group was not better than minimal intervention group. 4. Intervention effect was not very distinct. However, the post-intervention effect of health seeking behavior, contraception behavior, prostitution behavior, and condom usage was better than pre-intervention. |
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