| Objective: To analyze the epidemiological characteristics of HIV/AIDS in Chongqing minority areas,evaluate the intervention effect of expanding publicity and HIV test,explore the model of expanding publicity and expanding HIV test,provide a reference for other areas,provide scientific evidence for developing intervention strategy.Materials and Methods: 1.research methods The method of descriptive epidemiology was used to describe the epidemiological characteristics of HIV/AIDS,a community trial was conducted to evaluate the intervention effect of expanding publicity and HIV test.2.field sites Shizhu,Xiushan,Youyang,Pengshui County were chose as field sites.3.respondents With application of multi-stage sampling method,a questionnaire survey was conducted among 400 medical staff,400 populace,400 STD clinic patients before and after the intervention.The sex ratio is balanced.Baseline survey conducted in January 2014,a survey carried out in January 2016 after the intervention.4.intervention measures expanding publicity: County center for disease control and prevention(CDC)held large street propaganda at least once,media publicity through one of the mass media such as newspaper,Internet and television at least once a month,propaganda for high-risk groups 1 time a month.Town hospitals set up one column each quarter,villages/towns market propaganda at least 1 time a month for AIDS awareness and HIV test strategy.expanding HIV test: Using publicity campaign to build a test atmosphere,improve test intention.Equipping test agency with test equipment,providing fast detection reagent,improving test hardware capability.Each township central hospital established HIV rapid detection points,improved accessibility.Training technicians to make sure every rapid detection point had at least one qualified personne.5.Intervention effect evaluation indicators The indicators on expanding publicity: The proportion of HIV/AIDS awareness,discrimination against HIV/AIDS and the willingness to provide medical services for HIV/AIDS of medical staff.HIV/AIDS awareness,discrimination and extramarital sex of populace.HIV/AIDS awareness,the frequency of condom use in non-regular sex of STD clinic patients.The indicators on expanding HIV test: The number of HIV test points,the number of HIV test and positive,and the source of test sample.6.questionnaire design Questionnaire included general demographic characteristics,HIV/AIDS awareness,HIV test conditions,discrimination,medical staff's willingness of providing medical services for HIV/AIDS,the trust of populace about the township medical institutions carrying out HIV test,the condom use of STD clinic patients with non-regular sex,etc.7.Data collection Epidemic and test database of cases was collected from the national AIDS comprehensive data information system,including the reported cases information whose present address was in Shizhu,Xiushan,Youyang,Pengshui County from January 2003 to December 2014,and the HIV test list from January 2013 to December 2015.The knowledge of AIDS awareness,attitude and behavior of medical staff,populace and STD clinic patients was collected through questionnaire survey before and after the intervention.8.Data processing and statistical analysis Basic database of cases collected from the national AIDS comprehensive data information system were entered into Excel 2007,questionnaire survey data was entered into Epidata 3.1,and data were examined and analyzed by software SPSS 17.0.Results: 1.the status and the trend of HIV/AIDS prevalence By the end of 2014,a total of 636 cases had been reported accumulatively,179 of them were AIDS patients,175 cases died,461 cases were living,the proportion of reported living cases accounts for permanent population is 0.023%.The reported living cases of Xiushan,Youyang,Shizhu,Pengshui County were 152,129,94,86 respectively.In the total of 636 cases,The average age was 38.0±15.1 years old,The ratio of the cases aged from 30 to 49 was 45.0%.Sex ratio was 2.7:1.married people,Junior middle school and primary school education,the occupation with peasant(migrant workers),accounted for 55.3%,73.1%,44.2% respectively,49.7% were minority.The main route was sexual transmission,accounted for 75.2%(Heterosexual and male homosexual transmission of infection accounted for 64.8% and 10.4% respectively),the transmission of injection drug use was decreasing,sexual transmission was on the rise,the proportion of cases aged above 50 years old and the female infected cases were on the rise.2.the intervention effect of expanding publicity After intervention,the total awareness rate of AIDS among medical staff,was increased from 89.1% up to 92.2%,populace,from 48.4% up to 78.3%(2c=74.974,p<0.001),and STD clinic patients,from 69.3% up to 83.9%(=22.809,p<0.001).After intervention,the proportion of HIV test was increased from 43.0% up to 53.6%(2c=8.933,p=0.003),willingness of providing medical services for HIV/AIDS was increased from 90.1% up to 95.0%(2c=10.824,p=0.004)among medical staff.After intervention,the proportion of HIV test was increased from 12.0% up to 19.3%(2c=7.962,p=0.005),the trust on HIV test carrying out by the township medical institutions was increased from 38.3% up to 61.3%(2c=6.220,p=0.045)among populace.After intervention,the condom use of STD clinic patients with non-regular sex in the last time was increased from 67.0% up to 77.4%(2c=5.870,p=0.015),and the proportion of never-use it was declined from 14.7% down to 7.8%(2c=6.673,p=0.036)in the last three months.3.the intervention effect of expanding HIV test After the intervention,the total number of test populace was increased from 68090 up to 219253,the rate of HIV-antibody test was increased from 3.4% up to 11.0%,the positive cases was from 60 to 106,positive rate was from 0.088% to 0.048%(2c=14.234,p<0.001).After the intervention,the number tested by CDC maintain in 5700, positive rate maintain between 0.403% to 0.432%.The number tested by Medical Institutions was increased from 58 800 up to 126 869,the positive cases was from 33 to 61,positive rate was from 0.056% to 0.048%,the difference was not statistically significant.Conclusions: The present prevalence rate of HIV/AIDS is low in Chongqing minority areas,sexual transmission is the major route,report of the epidemic is rising.The total awareness rate of AIDS and rate of HIV-antibody test among medical staff,populace and STD clinic patients were improved,the condom usage of STD clinic patients and the willingness of medical staff providing medical services for HIV/AIDS were increased,the degree of discrimination was reduced owning to the expanding publicity.HIV test work was promoted owning to the strategy of expanding HIV test in Chongqing minority areas. |
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