| Objectives:To explore the characteristics of HIV-related high risk behaviors after informed HIV positive among people living with HIV and AIDS aged 50 and above,and to understand the level of social support,and social service demand of this population. To explore the possible influence factors of conducting continuous high risk behaviors.To provide recommendation on policy development of improving risk behavioral intervention and follow-up service for this population.To further improve the life quality of HIV/AIDS aged 50 and above, and reduce the possible secondary HIV transmission caused by this populationMethod:This study was cross-sectional study, and both quantitative and qualitative investigations were conducted to collect data. Fixed place continuous sampling method was used to draw samples.Uniformed questionnaire and social support revalued scale were adopted in quantitative study. Face to face interview was conducted for respondents in order to collect the HIV basic knowledge,HIV-related risk behaviors,level of social support and the social support demand situation of PLWHA aged 50 and above.Qualitative interview was conducted for those respondents who admitted having continuous high risk behaviors during quantitative study, for HIV negative spouses and doctors who are charge of follow-up services for PLWHA,to explore possible reasons of having continuous HIV-related risk behaviors after informed HIV positive. Epidata3.1 software was used for data input and SPSS 17.0 software was used for data analyze.Results:(1).Demographic characteristics:450 PLWHA aged 50 and above were investigated.The number of male was 317,female was 133, and sex ratio was 2.38:1.The mean age was 61.16±7.63.The main nationality was Han. Marital status were mainly in marriage, secondly divorce and widow/widowhood.309 respondents were rural residents and 141 were urban residents. The respondent’s overall education level and income were low. Heterosexual transmission was their main route of HIV infection.(2). Continuous high-risk behaviors in recent half year:41.2%(122/296) of the infected patients who were married had sex within marriage in recent half year. The rate of condom use with spouses was 66.4%(81/122). The rate of condom use between HIV positive spouse (50.8%) was significantly lower than that of serum disaccord spouses (84.2%).8.9%(28/313)of male infected patients reported having commercial sex behaviors in recent half year, significantly lower than that of 65.5% (205/313) before they were informed HIV status. The rate of condom use in commercial sex behaviors was 17.9%(5/28).7.1%(32/450) of the infected patients reported having temporary sex behaviors in recent year, lower than that 26.2% (118/450) before they were informed HIV status. The condom use in temporary sex behaviors was 18.7%(6/32). The rate of commercial sex behaviors in urban male infected patients was 13.4%(19/115), much higher than that of in rural male infected patients 4.5%(9/198)(χ2=11.715,p<0.05).4 female respondents were admitted that they provided commercial sex service before they were informed having HIV infection, and they stop commercial sex practice once they know their HIV status. Homosexual sex behavior was not found in this survey.(3). The influencing factors of the occurrence of high-risk behaviors after the infection of HIV were analyzed using Logistic regression. The risk factors of the occurrence of sex outside marriage included:male, relatively young (50-59 years old), urban residents, relatively high income and lack of family and social support. The risk factors of not using condoms by HIV infected patients during sex included:low educational level, rural residents, relatively high income and lack of family and social support.(4). Social support and service needs:The average scores of three dimensions of social support was 29.34±6.330. The score was both lower then normal population and HIV positive population.The main needs for service among elderly PLWHA were life assistance, medical assistance, and social care, support and acceptance.Conclusions:The rate of high risk behaviors among aged PLWHA was significantly reduced after HIV status inform, but some respondents still practice continuous high risk behaviors.The related influence factor of continuous risk behaviors were associated with age, education level,types of sex partners,family income,family and social support, individual risk behavior assessment should be carried out during routine follow-up service. Right and obligation education of PLWHA, well-directed sexual health education and behavior change communication should be strengthened for elder PLWHA..Especial attention should be given to families that both husband and wife are HIV positive,and to individuals that relatively younger,have higher income,and have continuous high risk behaviors.PLWHA aged 50 and over were lack of social support,and support coming from outside was deficiency. Social discrimination still exits to some extent.Grassroots community should enrich spiritual and cultural activity.Family members and local community should be encourage to provide care and support service to elderly population, including life assistance,medical service and social care and support.Public security sector should conduct comprehensive measures to reduce commercial sex activities outside the entertainment places. |
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