| Background and objective:Kokang region is located in a HIV high prevalence area in China-Myanmar border where planting opium long time ago and has a large number of drug-used population affected by HIV, however, the HIV epidemic and related high risk behavior is rarely reported in that place. Selected labor camps’ reeducation as respondent. In order to understand the related high risk behavior, the factors lead to these high-risk behaviors, and the infection status of HIV among high risk persons in the mean time. To provide the basis for the establishment of HIV detection system covering the Kokang region, and prevent the further spread of AIDS epidemic in China -Myanmar border areas.Methods:The research was divided into two stages, the first stage was the quantitative study. Since Nov.2013, selected two labor camps which the high risk population were affected by the HIV is more concentrated in Kokang region adjacent to the Zhenkang county,Yunnan province, China as study sites(Yang Longzhai labor camp and Man Dongba farm labor camp). Signed a cooperation agreement with the Kokang health department at first, and all person in labor camps accepted informed consent, then selected this person were included in a survey. Used the retrospective investigation, the method of purposive sampling, a self-designed questionnaire, including demographic data, high risk behaviors and characteristics before into labor camps, AIDS related knowledge awareness, accepted what kind of HIV related service before into labor camps and HIV related services needs. Used EIA and SD two rapid tests for HIV detection, and laboratory confirmation for the positive ones. With double parallel input data in EpiData3.1 database and 10% randomly selected for review. The data was analyzed by SPSS17.0.The second stage was the qualitative part. Based on the first stage of data analysis, designed the outline of interview. In Apr.2014, interviewed survey 5 respondents and 2 management staffs in those camps. The content included the living environment of these high risk population affected by HIV before into labor camps, factor related HIV risk behaviors, the way of HIV infection, and the most urgent need of HIV prevention related services.Results:Total 277 target population were included the survey, all were male; the youngest was 16 years old and the oldest was 64 years old, mean age 34.73 ± 9.494, in 31-40 age are majority, having 102 people (36.8%);Survey on ethnic distribution, mainly is Han, accounting for 77.3%, the rest are Dai, Wa and other minorities; in cultural degree distribution, primary school and below accounted for 82.4%, a total of 228 people; 134 of them were married (48.4%); for the former occupation,165 (59.6%) were farmers,35 people (12.6%) unemployed; were found 44 HIV positive people, accounting for 15.9% of all respondents.109 people had been injecting drug use before into camp, accounted for 39.4% of respondents.31 (28.4%) in the last 6 months before into camp has repeated use of needle; 33 (30.3%) in the last 6 months before into camp share needles with other person,19 of them (57.6%) needle sharing partner were from Myanmar,11 people (33.3%) needle sharing partner were from Chinese,3 people (9.1%) both has China and Myanmar partner, according to the different distribution of the nationality of the companion P>0.05, the difference was not statistically significant; 26 people (23.4%) in the last 6 months before into camp were share diluted drug container. In these different types of drug addiction inmates,28 (25.7%) also had two different kinds of intravenous drug abuse, and three different types of injection drug taking a total of 14 people (12.8%); the presence of drug injection behavior person HIV infection rate compare with the others shows that P<0.001, the difference was statistically significant.245 people has sexual partners before into camp, a total of 88.4%; types of sexual partners including spouses, fixed sexual partners, casual sex partners and sex workers, the spouse and fixed with the majority,191 people (78%) had only one kind of sexual partner, a total of 54 people (22%) had 2 or above kinds of sexual partners; 149 (60.8%) in the last 6 months before into camp has risk sexual behavior,; 109 of them (44.5%) only having Myanmar sexual parents.49 people (20%) only having Myanmar sexual parents,26 people (10.6%) both having China and Myanmar sexual partners. According to the different nationalities were compared with P<0.001, the difference was statistically significant; The survey into the high risk sexual behavior, 21 people infected with HIV (47.7%),. And other subjects in the number of people infected with HIV was 23 (52.3%). Compare with high risk sexual behavior of HIV infection rate and other personnel, P> 0.05, the difference was not statistically significant.Grouped by the existence high risk behavior of these people in the last 6 months before into camp, and analysis the relationship between the HIV infection rate and the high risk behavior. Results show that both injection drug and high risk sexual behavior have influenced the HIV infection rate, OR=3.782/1.233.Investigation on the survey involved three questions relate on high risk behavior and HIV infection, the total awareness rate was 65.8% (the total number/total number of items answered correctly); 130 people three answer were right (46.9%); in each question, the highest rate is:If will be infected with HIV when share needles with HIV positive (71.1%); the lowest rate was:If will be reduce the risk of HIV transmission when use of condoms every time (58.1%). Among them, only to answer 1 questions were 46 (16.7%),54 (19.5%) out of 2 questions,3 questions were answered correctly in 130 people (46.9%),47 people in each 3 questions were not correct (17%).By understanding the HIV/AIDS related services in six aspects of clean needles, methadone treatment, peer education, free condoms, AIDS counseling, HIV/STD publicity propaganda materials, the survey found that the both six service acceptance rate was lower than 40%, the highest one for free condom (39.4%), and the lowest is the MMT(24.9%). Among them, the people has never received any service of 85 people (30.7%), received 1-3 services with 121 people (43.7%), received more than 3 services have 71 (25.6%).By Logistic regression analysis, demographic characteristics, HIV/AIDS related knowledge and the related service receiving before into the camp both have different influences on high risk behavior among these people, increase the risk of HIV infection, had become an important reason for HIV detection rate high.Conclusions and advises:The reeducation in the labor camp in Kokang region exists repeated use, sharing of needles, sharing diluted drug container and unsafe sexual behavior associated with HIv infection, also has a higher rate of HIV infection in the population. These high risk behaviors are closely related by HIV/AIDS related knowledge and awareness is low, and poor acceptance of related services, had become a serious threat to the health of people at high risk of courage. At the same time, this high risk groups’partner both from China and Myanmar during their sharing needles or unsafe sexual behavior phenomenon is obvious. Implications of cross-border circulation of HIV/AIDS infection in China Myanmar border area.In view of the above phenomena, proposed to strengthen the prevention and control of high risk HIV publicity and training, to provide MMT, clean needles and condoms and comprehensive intervention services. Especially in the HIV affected area, to improve the HIV related knowledge for reeducation, to reduce risk behaviors, provide the corresponding treatment services for HIV positive ones, through the comprehensive intervention reduced the HIV spread in Kokang high risk populations. In addition, in order to reduce the risk of international spread of HIV in China and Myanmar border area, suggested that the Chinese relevant departments to strengthen cooperation with Kokang region, with output more mature and effective control strategy, capital, technology and experience to reduce the rate of HIV infection in high risk groups, to help build the HIV sentinel surveillance in Myanmar Kokang domestic community, understand the epidemiological characteristics of HIV in different populations and different location,. To provide related services to help protect the Kokang local people’s health services, and effectively curb the spread of AIDS in China and Myanmar border area. In order to ensure the full implementation of the national "along the way" strategy. |
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