Study On Tntervention Effect In High-Risk Population Of HIV/AIDS In A City

Objectives:This article aims to find out the status and trends of high-risk behaviors related to AIDS in the target groups through systemic and continual surveying high-risk population of commercial sex workers (CSW) and injecting drug users (IDU); we carried out a series of intervention activities among them and compared their knowledge and behavior related AIDS with respective lengthways. Thus we can more initiatively and accurately evaluate the impact of local high-risk population, and predict the epidemic trend of local AIDS. In addition, this research can provide basic information for the government policy-makers in developing and improving HIV/AIDS prevention and control strategies and form a feasible and ease-handled intervention model for similar areas.Methods:Behavior survey had been carried out between CSW and IDU in the city from 2007 to 2009 according to behavioral research method with "The national venereal monitoring work related documents and technical plan" and combined the local actual condition, then the work of comprehensive behavior interventions and monitoring would have been launched in this area. All the activities in pilot sites had been conducted according to the scheduled scheme and had been rigorously controlled in quality.Results:1. HIV testing results were negative in samples of CSW from 2007 to 2009; but there were 1.39%,2.57% and 4.25% of CSW who infected with syphilis.1.50% of CSW infected HCV in 2009. One person of IDU was found infect with HIV in 2007, HIV antibody positive rate was 0.28%. The year of 2008 and 2009,we found no one of IDU infected HIV disease, but 1.96%,2.26% and 3.54% of the three years'IDU who infected with syphilis; 24.24% of IDU infected HCV in 2009.2. Through the health education propaganda, these two types of high-risk population has been aware of more elementary knowledge about AIDS, but for the knowledge still needs be further consolidated and improved, especially to the total rate which reflects comprehensive knowledge of HIV/AIDS to be grasped by them. CSW's total AIDS awareness rate were 66.9%,70.8% and 84.8% from 2007 to 2009, the Chi test to three samples resulted inχ2=35.79, P=0.000, the difference was statistically significant. IDU's total AIDS awareness rate were 68.6%,77.3% and 88.6% from 2007 to 2009, theχ2 test to three samples resulted inχ2=44.85, P=0.000, the difference was statistically significant. The total AIDS awareness rate of the tow types of high-risk population was increasing year by year.3. Through health education and behavior intervention, the effect of CSW's high-risk behavior has been changed. We should make the downward trend and keep it. The rate of condom use "last time" when CSW has sex with their sexual partners has increased from 67.8% in 2007 to 89.3% in 2009 which was statistically significant (P=0.000) after a series of activities. But the rate of condom use "last month" in the three year from 2007 to 2009 was respectively 49.7%,60.5% and 69.8%(P=0.000). There is still considerable part (more than 40% CSW on the average) that exposed unprotected sex intercourse, meanwhile, the network of CSW proliferated high-risk behavior still exists.4. Since intervention activities such as peer education, methadone and needle exchange and so on been carried out, IDU had had less high-risk behaviors than before. The rate of share needles "last time" when IDU injected drug had dropped from 23.8% in 2007 to 5.9% in 2009 (P=0.032), and "last month" had also descended from 31.0% in 2007 to 11.8% in 2009 (P=0.007), the difference of which two were both statistically significant (P<0.05). The rate of condom use "last time" when IDU has sex with their sexual partners is 7.7%,10.6% and 13.1%, the difference was statistically significant (P=0.003).Conclusion:1. Data has showed there is some effect in CSW's behavior change by intervention activities. But because population's great mobility and other factors caused the proliferation of high-risk behavior network, we should draw up stronger and more pertinence intervention programs to behavior changes, but also strengthen the intervention.2. Data has showed there is some effect in IDU's behavior change, the rate of needle sharing has declined significantly and the rate of condom use has climbed not much but little by intervention activities, which suggest us adjust the idea of IDU's intervention, such as improving the quality of needles exchange service and accessibility. Injecting drug use commercial sex hybrid IDU will be the key intervention group in planning.3. The quality of STD service must be further improved so that the high-risk population of AIDS will be rightly led to seek doctors. We should provide standard treatment of sexually transmitted diseases for them, promote social integration-disintegration, improve the medical personnel understanding, strengthen the training of medical personnel, and encourage voluntary consultation testing what is necessary.