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1.

Objectives

To estimate the prevalence of HIV and syphilis, incidence of syphilis and to identify the correlates of syphilis infection among heterosexual male attendees of sexually transmitted infection (STI) clinics (MSC).

Methods

A cohort study of one-year duration was conducted in Yangzhou and Changzhou cities in Jiangsu province of China. The baseline survey commenced in June 2009, recruited 1225 consenting adult MSCs (609 in Yangzhou and 617 in Changzhou) through STI-clinic based convenience sampling.

Results

Baseline HIV and syphilis prevalence were 0.49% and 17.29% respectively. Syphilis incidence rate was 7.22 per 100 person-years (6.53 in Yangzhou and 7.76 in Changzhou) during the 6-month follow-up with retention fractions of 27.38% and 35.15% for Yangzhou and Changzhou respectively. Majority of the participants were middle-aged, high school educated, married, living with partners and non-migrants. Very few subjects reported recent and consistent condom-use with regular partners. Although considerable number of MSCs reported recent sexual exposure with female sex workers (FSW) and non-FSW casual partners, the proportion of reported condom use was very low during those exposures. In multivariate analyses higher age, having recent sex with FSWs and being HIV-positive were associated with higher syphilis sero-positivity while higher education was protective. In bivariate analyses, being married, divorced/widowed, official residency of the study cities and non-use of condom with regular partners predicted higher risk.

Conclusions

Considering the potential bridging role of MSCs between high and low-risk populations, effective intervention strategies among them targeting the correlates of syphilis infection are urgently called for in Jiangsu province of China.  相似文献   

2.

Objective

The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China.

Methods

A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening.

Results

17,377 (92.8%) of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73%) of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid) partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4%) had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently) was associated with being divorced or widowed (P<0.05 for single); male gender; shorter duration of stay in Zhejiang; working in factory, market or domestic service (P<0.05 for odd job); having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%–0.06%) and 0.40% (95%CI: 0.31%–0.51%), respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%–0.70%). Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners.

Conclusions

Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant workers in China.  相似文献   

3.

Background

Despite the significance for sexually transmitted diseases (STD) control in East Asia, few studies have examined the relationship between high-risk sexual behavior and condom use. We investigated how three sexually vulnerable groups for STDs show differences in condom use behaviors (CUBs) depending on their STD infection.

Methods

The source of data came from the National Survey for STD Prevalence Rate and Sexual Behavior of the High-Risk Sexual Community. The effects of behavioral determinants on CUBs were estimated by using path analysis models. An 11-item questionnaire assessing subjects’ health risk behaviors, sexual beliefs, sexual risk behaviors, and condom use.

Results

Condom use was higher for men who have sex with men (MSM; n = 108) when they were bisexuals and had high self-efficacy, for Johns (Johns; n = 118) when they had experience of STD infection, and for female sex workers (FSWs; n = 1,083) when they had high self-efficacy, did not engage in drunken sex, and were anxious about infection. Regardless of whether they were infected with STDs, FSWs always used condom when they had high sexual beliefs. On the contrary, Johns exhibited a negative relationship between sexual risk behavior and condom use when they had experience of STD infection. The variable commonly significant to all three groups was the number of sex partners; but it exhibited a positive relationship with MSMs and Johns, and a negative one with FSWs.

Conclusions

CUBs were related to sexual beliefs as well as sexual risk behavior. At the same time, the experience of STD infection mediated the relationship between the two. Therefore, we need to draw social attention to promote safer sex among STD-vulnerable groups.  相似文献   

4.
Sexually transmitted diseases (STD) are very frequent in the whole world. Males who do not use a condom during their sexual relations are at great risk. We report cases of STD during six months of observation, among homosexual/bisexual males who participate in the Project Horizonte. There were 16 cases of genital warts, 6 cases of human immunodeficiency virus infection, 24 cases of unspecific urethritis, 28 cases of herpes simplex virus infection, 30 cases of syphilis, 58 cases of gonorrhea and 84 cases of pediculosis. We concluded that a condom must be used in all sexual relations and new counseling techniques are needed, to avoid this situation.  相似文献   

5.
ObjectiveTo evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM).MethodA cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using “snowball” techniques, and internet advertisements were used to recruit study participants.ResultsOf the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users.ConclusionClub drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM.  相似文献   

6.

Background

Sexually Transmitted diseases (STD) syndrome management has been one cornerstone of STD treatment. Persons with STD symptoms in many countries, especially those with limited resources, often initially seek care in pharmacies. The objective of the study was to develop and evaluate an integrated network of physicians, midwives and pharmacy workers trained in STD syndromic management (The PREVEN Network) as part of a national urban community-randomized trial of sexually transmitted infection prevention in Peru.

Methods and Findings

After a comprehensive census of physicians, midwives, and pharmacies in ten intervention and ten control cities, we introduced seminars and workshops for pharmacy workers, and continuing education for physicians and midwives in intervention cities and invited graduates to join the PREVEN Network. “Prevention Salespersons” visited pharmacies, boticas and clinicians regularly for educational support and collection of information on numbers of cases of STD syndromes seen at pharmacies and by clinicians in intervention cities. Simulated patients evaluated outcomes of training of pharmacy workers with respect to adequate STD syndrome management, recommendations for condom use and for treatment of partners. In intervention cities we trained, certified, and incorporated into the PREVEN Network the workers at 623 (80.6%) of 773 pharmacies and 701 (69.6%) of 1007 physicians and midwives in private practice. Extremely high clinician and pharmacy worker turnover, 13.4% and 44% respectively in the first year, dictated continued training of new pharmacy workers and clinicians. By the end of the intervention the Network included 792 pharmacies and 597 clinicians. Pharmacies reported more cases of STDs than did clinicians. Evaluations by simulated patients showed significant and substantial improvements in the management of STD syndromes at pharmacies in intervention cities but not in control cities.

Conclusions

Training pharmacy workers linked to a referral network of clinicians proved feasible and acceptable. High turn-over was challenging but over come.  相似文献   

7.

Background

Social and structural influences of condom negotiation among female sex workers (FSWs) remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines.

Methods

Female bar/spa workers (N = 498), aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use) and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking) associated with condom negotiation, adjusting for individuals nested within venues.

Results

Of 142 FSWs who traded sex in the previous 6 months (included in the analysis), 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment - trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34–49.90), economic environment - sex without a condom to make more money (AOR = 1.52, 95% CI 1.01–2.30), policy environment - sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49–4.48), and individual risk - substance use (AOR = 2.36, 95% CI = 1.28–4.35) were independently associated with FSWs'' lack of condom negotiation with venue patrons.

Conclusions

Factors in the physical, economic, and policy environments, over individual (excepting substance use) and social level factors, were significantly associated with these FSWs'' condom negotiations in the Philippines. Drawing upon Rhodes'' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation for FSWs trafficked/coerced into their work, substance using, and impacted by economic conditions and policies that do not support condom availability.  相似文献   

8.
The paper aims to provide evidence on consistent condom use dynamics among sex workers in Central America between 1997 and 2000, and to examine the most important predictors of use behaviour important for policy and programme interventions in the region. Data on 3500 sex workers, 1500 from 1997 and 2000 from the year 2000, were analysed. The samples represented sex workers in low socioeconomic neighbourhoods who met their clients at known sex establishments or by the roadside. Sex workers were more likely to have used condoms consistently in 2000 than in 1997 (Odds Ratio (OR) = 1.4, p < or = 0.05). Sex workers who discussed condoms with their partners or lovers used them consistently with all clients more than those who did not (OR = 1.3, p < or = 0.10). Knowledge of condom advantages had a positive influence on consistent use. Sex workers who reported using condoms to prevent pregnancy or STDs used them consistently with all clients more than those who did not (OR = 1.2, and 1.3 respectively, p < or = 0.10). The source of condoms is an important predictor of consistent condom use. Sex workers who bought condoms from health establishments or from brothels used them consistently more than those who did not (both OR = 1.3, p < or = 0.10, and p < or = 0.05, respectively). Self-efficacy had a positive effect on consistent condom use. Sex workers who reported that they would use condoms even if clients offered to pay more for unprotected sex used them consistently with all clients more than those who did not (OR = 18, p < or = 0.001). The findings suggest that having condom skill is positively related to condom use. Sex workers who had all four skills used condoms more consistently than those who had none (OR = 1.6, p < or = 0.01). In order to increase consistent condom use and avert more incidences of HIV/AIDS and other STIs, programme interventions need to use the most efficient way to provide quality information, and provide repeated training on condom negotiation and use skills to sex workers.  相似文献   

9.
Health providers have played important roles on delivering prevention and care services to control syphilis in China. The current study was aimed to evaluate the performance of different health providers in providing outreach syphilis testing services to female sex workers (FSWs). The current study carried out during April to August 2009 in Liuzhou was aimed to investigate the services delivered by two different types of clinics in China. A total of 1,808 FSWs recruited from sex work venues were included in the study. Prevalence of positive syphilis test (6.4%) among FSWs accessed by the local center for disease control outreach teams (CDC teams) was significantly lower than that (9.3%) among FSWs accessed by the local reproductive health hospital outreach teams (RHH teams). As compared with CDC teams, RHH teams had more FSWs to be successfully referred to the designated STD clinics for further syphilis confirmation and intervention (85.7% vs. 26.7%, P<0.001). These findings indicate that RHH teams may be more efficient than CDC teams to provide outreach-based services to FSWs. Participation of the reproductive health providers or other medical facilities in outreach services to FSWs should be considered in developing intervention programs in China.  相似文献   

10.
Over the last decade, syphilis diagnoses among men-who-have-sex-with-men (MSM) have strongly increased in Europe. Understanding the drivers of the ongoing epidemic may aid to curb transmissions. In order to identify the drivers of syphilis transmission in MSM in Switzerland between 2006 and 2017 as well as the effect of potential interventions, we set up an epidemiological model stratified by syphilis stage, HIV-diagnosis, and behavioral factors to account for syphilis infectiousness and risk for transmission. In the main model, we used ‘reported non-steady partners’ (nsP) as the main proxy for sexual risk. We parameterized the model using data from the Swiss HIV Cohort Study, Swiss Voluntary Counselling and Testing center, cross-sectional surveys among the Swiss MSM population, and published syphilis notifications from the Federal Office of Public Health. The main model reproduced the increase in syphilis diagnoses from 168 cases in 2006 to 418 cases in 2017. It estimated that between 2006 and 2017, MSM with HIV diagnosis had 45.9 times the median syphilis incidence of MSM without HIV diagnosis. Defining risk as condomless anal intercourse with nsP decreased model accuracy (sum of squared weighted residuals, 378.8 vs. 148.3). Counterfactual scenarios suggested that increasing screening of MSM without HIV diagnosis and with nsP from once every two years to twice per year may reduce syphilis incidence (at most 12.8% reduction by 2017). Whereas, increasing screening among MSM with HIV diagnosis and with nsP from once per year to twice per year may substantially reduce syphilis incidence over time (at least 63.5% reduction by 2017). The model suggests that reporting nsP regardless of condom use is suitable for risk stratification when modelling syphilis transmission. More frequent screening of MSM with HIV diagnosis, particularly those with nsP may aid to curb syphilis transmission.  相似文献   

11.
Liao M  Nie X  Pan R  Wang C  Ruan S  Zhang C  Kang D  Fu J  Qian Y  Tao X  Zhao J 《PloS one》2012,7(4):e34085

Background

Routine surveillance using convenient sampling found low prevalence of HIV and syphilis among female sex workers in China. Two consecutive surveys using respondent driven sampling were conducted in 2008 and 2009 to examine the prevalence of HIV and syphilis among female sex workers in Jinan, China.

Methods

A face-to-face interview was conducted to collect demographic, behavioral and service utilization information using a structured questionnaire. Blood samples were drawn for serological tests of HIV-1 antibody and syphilis antibody. Respondent Driven Sampling Analysis Tool was used to generate population level estimates.

Results

In 2008 and in 2009, 363 and 432 subjects were recruited and surveyed respectively. Prevalence of syphilis was 2.8% in 2008 and 2.2% in 2009, while no HIV case was found in both years. Results are comparable to those from routine sentinel surveillance system in the city. Only 60.8% subjects in 2008 and 48.3% in 2009 reported a consistent condom use with clients during the past month. Over 50% subjects had not been covered by any HIV-related services in the past year, with only 15.6% subjects in 2008 and 13.1% in 2009 ever tested for HIV.

Conclusions

Despite the low prevalence of syphilis and HIV, risk behaviors are common. Targeted interventions to promote the safe sex and utilization of existing intervention services are still needed to keep the epidemic from growing.  相似文献   

12.
The primary aims of this study were to examine Croatian truck drivers' sexual contact with sex workers, estimate the frequency of condom use, and assess knowledge of HIV/AIDS within this population. The research was conducted from June 14 to September 16, 2005 at customs offices and accompanying parking lots in four Croatian cities. The sample consists of 69 truck drivers. Information about sexual behavior and condom use were gathered by using a semi-structured interview. Knowledge of HIV/AIDS, measured with a self-administered questionnaire, was found to be low. Six respondents (8.7%) had correctly answered all 13 questions. By contrast, 73% of drivers considered themselves well informed about HIV/AIDS, indicating that most drivers overestimate their knowledge. The majority of respondents (n=62) assumed that most of their colleagues engage in sexual contact with sex workers while on the road, although only one third of respondents reported that they personally have paid for sex. All of the respondents who reported engaging in sexual contact with sex workers stated that they always use condoms. Fear of being infected with a sexually transmitted infection was reported as the main reason for condom use.  相似文献   

13.

Background

Accessibility of syphilis testing services is critical in syphilis control programs for female sex workers (FSWs), but few FSWs attend public STI clinics or other testing sites. Introduction of free rapid syphilis testing (RST) into outreach programs for FSWs will help improve test uptake.

Methods

Commercial sex venues were identified in two cities in South China. In cooperation with health advocacy organizations, health outreach teams from local public health or medical facilities approached all types of sex venues in study areas to offer free RST. Acceptability and uptake of RST among FSWs were evaluated.

Results

A total of 2812 FSWs were offered RST and 2670 (95.0%) accepted syphilis testing. 182 (6.8%) FSWs had a positive RST result among whom 136 (74.7%) were willing to attend an STD clinic for confirmatory testing and treatment. More than half (89, 66.4%) of those with syphilis were not willing to notify their sex partners. Multivariate logistic analysis showed that syphilis test uptake was associated with residing in Jiangmen (AOR, 1.78; 95% CI, 1.15–2.77), older age (AOR, 2.11, 95% CI, 1.17–3.79 for age of 31 years or above), and not working at a service venue (AOR, 1.60; 95% CI, 1.10–2.34).

Conclusions

RST at sex venues is well accepted by FSWs when it is integrated into ongoing outreach services. Such programs provide excellent opportunities for expanding syphilis screening efforts among specific subgroups of FSW who are difficult to reach through clinic-based programs.  相似文献   

14.

Objective

This study aims to determine factors associated with levels of condom use among heterosexual Thai males in sex with regular partners and in sex with casual partners.

Methods

The data used in this study are from the national probability sample of the 2006 National Sexual Behavior Study, the third nationally representative cross-sectional survey in Thailand. A subtotal of 2,281 men were analyzed in the study, including young (18–24) and older (25–59) adults who were residents of rural areas of Thailand, non-Bangkok urban areas, and Bangkok. Two outcomes of interest for this analysis are reported condom use in the past 12 months by males in relationships with the most recent regular and casual partners who were not sex workers. Chi-square statistics, bivariate regressions and the proportional odds regression models are used in the analysis.

Results

Condom use for men with their regular partner is revealed to be positively related to education, knowledge of condom effectiveness, and pro-condom strategy, and negatively related to non-professional employment, status of registered marriage, and short relationship duration. Condom use with casual partner is positively determined by education, condom knowledge, non-professional occupation, short relationship duration, and lack of history of paid sex.

Conclusion

The national survey emphasized the importance of risk perceptions and condom motivations variables in explaining condom use among men in Thailand. These factors include not only education and knowledge of condom effectiveness and pro-condom strategy but also types of partners and their relationship context and characteristics. Program intervention to promote condom use in Thailand in this new era of predominant casual sex rather than sex with sex workers has to take into account more dynamic partner-based strategies than in the past history of the epidemics in Thailand.  相似文献   

15.

Background

A comprehensive, HIV prevention programme (Projet Sida1/2/3) was implemented among female sex workers (FSWs) in Cotonou, Benin, in 1993 following which condom use among FSWs increased threefold between 1993 and 2008 while FSW HIV prevalence declined from 53.3% to 30.4%.

Objective

Estimate the potential impact of the intervention on HIV prevalence/incidence in FSWs, clients and the general population in Cotonou, Benin.

Methods and Findings

A transmission dynamics model parameterised with setting-specific bio-behavioural data was used within a Bayesian framework to fit the model and simulate HIV transmission in the high and low-risk population of Cotonou and to estimate HIV incidence and infections averted by SIDA1/2/3. Our model results suggest that prior to SIDA1/2/3 commercial sex had contributed directly or indirectly to 93% (84–98%) of all cumulative infections and that the observed decline in FSWs HIV prevalence was more consistent with the self-reported post-intervention increase in condom use by FSWs than a counterfactual assuming no change in condom use after 1993 (CF-1). Compared to the counterfactual (CF-1), the increase in condom use may have prevented 62% (52–71%) of new HIV infections among FSWs between 1993 and 2008 and 33% (20–46%) in the overall population.

Conclusions

Our analysis provides plausible evidence that the post-intervention increase in condom use during commercial sex significantly reduced HIV prevalence and incidence among FSWs and general population. Sex worker interventions can be effective even in medium HIV prevalence epidemics and need to be sustained over the long-term.  相似文献   

16.

Introduction

Condom promotion among female sex workers (FSWs) is a key intervention in India’s National AIDS Control Program. However, there is limited understanding of how FSWs negotiate condom use with male clients, particularly in the context of their mobility for sex work. The objective of this study is to examine the factors associated with the mobile FSWs’ ability to refuse unsafe sex and successfully negotiate condom use with unwilling male clients.

Methods

Data for 5498 mobile FSWs from a cross-sectional survey conducted in 22 districts of four states in southern India were analyzed. Questions assessed FSWs’ ability to refuse clients unprotected sex, convince unwilling clients for condom use and negotiate condom use in a new location. Logistic regression models were constructed to examine the association between socio-demographics, economic vulnerability, sex work practice, and program exposure and condom negotiation ability.

Results

A majority of FSWs (60%) reported the ability to refuse clients for unprotected sex, but less than one-fifth reported the ability to successfully convince an unwilling client to use a condom or to negotiate condom use in a new site. Younger and older mobile FSWs compared to those who were in the middle age group, those with longer sex work experience, with an income source other than sex work, with program exposure and who purchased condoms for use, reported the ability to refuse unprotected sex, to successfully negotiate condom use with unwilling clients and to do so at new sites.

Conclusion

FSWs need to be empowered to not only refuse unprotected sex but also to be able to motivate and convince unwilling clients for condom use, including those in new locations. In addition to focusing on condom promotion, interventions must address the factors that impact FSWs’ ability to negotiate condom use.  相似文献   

17.
The HIV prevalence and incidence among men who have sex with men (MSM) in China are high. Unprotected anal intercourse (UAI) with a regular male sex partner (RP), a significant predictor of HIV sero-conversion, was high yet under-emphasized among MSM having RP (MSMRP). The present cross-sectional survey interviewed 307 HIV negative MSMRP recruited through convenient sampling from multiple sources, including venue-based outreaching, online recruitment, and referrals made by peers, in Beijing and Chengdu, China. Among MSMRP, the prevalence of UAI with RP in the last three months was 52.4%. The results of the multivariate analysis showed that trust and intimacy within the relationship with RP and presence of clinical depression symptoms were positively associated with UAI with RP in the last three months. Other associated scalar factors derived from the Theory of Planned Behavior were related to perceptions on condom use, including positive attitudes toward condom use (a negative association), subjective norm of the perception that MSM do not usually use condoms during anal intercourse with RP (a positive association), perceived behavioral control over condom use with RP (a negative association), and behavioral intention to use condoms with RP in the coming three months (a negative association). It is seen that MSMRP were at high risk of HIV/STD transmission. The associated factors hence involved those related to perceptions about condom use, mental health, and interpersonal relationship. Future interventions should take these multi-dimensional factors into account. In particular, future research to test the efficacy of couple-based interventions that include mental health elements needs to be conducted, as trust and intimacy within the relationship were associated with UAI among MSMRP, and mental health problems may exist for both the MSMRP and their RP.  相似文献   

18.
This study sought to assess the prevalence of consistent condom application on male clients by female sex workers (FSWs) in Armenia and its association with demographic, psychosocial and behavioural factors. In this cross-sectional study, 120 street-based FSWs aged 20-52 completed an interviewer-administered questionnaire. The primary outcome measure was consistent application of condoms by FSWs on their male clients. A total of 21.7% of participants reported consistently applying condoms on clients. Logistic regression analysis demonstrated that higher condom use self-efficacy (Adjusted Odds Ratio, AOR=1.1; p=0.01), lower perceived condom use barriers (AOR=0.9; p=0.04) and not using douching as a method to prevent STI/HIV (AOR=4.8; p=0.04) significantly predicted consistent condom application. Higher HIV/AIDS knowledge was a marginally significant predictor of condom application (AOR=1.3; p=0.05). Future interventions should address these modifiable factors to encourage FSWs to apply condoms on clients themselves, which may reduce condom failure and exposure to HIV transmission.  相似文献   

19.
Results of HIV sentinel epidemiological surveillance among sex workers in Osh city in 2005 are presented. Prevalence of HIV-infection, HCV-infection and syphilis among sex workers was 2%, 5.5%, and 15.5% respectively. The reasons of high prevalence of HIV-infection were: unprotected sex (17.9 - 53.5%), presence of sex transmitted diseases (43%) and injecting drug users (7%). The level of awareness about modes of HIV transmission and measures for protection is relatively low (54.8% and 42% respectively) and not enough for the change of behavior.  相似文献   

20.
Due to their geographical mobility and long periods of separation from intimate partners, migrant workers are at increased risk for a variety of sexually transmitted infections (STIs) including HIV/AIDS. This study sought to investigate patterns in HIV/AIDS related knowledge, attitudes and sexual behaviour in migrant workers in Croatia. In 2003, 566 male migrant workers were recruited during regular required medical examinations and surveyed at seven locations throughout the country. Each participant was asked to complete a self-administered KABP (sexual knowledge, attitudes, beliefs and practices) questionnaire. The average age of respondents was 38.2 years and the majority worked as seafarers (77.3%) and construction workers (20.5%). Only 18.5% of respondents were able to correctly answer all 13 questions assessing knowledge of HIV/AIDS. Seafarers reported higher levels of knowledge than did construction workers. The average respondent reported having had two sexual partners in the last 12 months, with slightly over half of the respondents (55.3%) reporting condom use at their last intercourse with a casual partner. One fifth of the respondents (20.3%) who reported having had intercourse with a sex worker during the last year reported not using condoms at last intercourse. The number of sexual partners was correlated with age, marital status, faith in God, and personal HIV risk assessment. Attitudes toward condom use, co-workers' HIV/AIDS concerns and the duration of migrant status (within the last two years) were shown to be significant correlates of condom use at last intercourse with a casual partner. The effect of HIV/AIDS related knowledge on analyzed behaviors did not reach statistical significance. Inadequate patterns of migrant workers' condom use, gaps in knowledge about HIV transmission and modes of protection, as well as widespread ignorance regarding available anonymous HIV testing found by this study suggest a critical need for expert intervention to avert the potential for an increase in new HIV/AIDS cases. A coordinated, systematic campaign for HIV/AIDS prevention among Croatian migrant workers should focus on increasing peer communication about HIV/AIDS, especially among younger migrant workers, and on reducing the frequency of sexual risk taking.  相似文献   

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