Sexual behavior of migrant workers in Shanghai, China

Low Behavioral Intention to Use Any Type of HIV Testing and HIV Self-Testing among Migrant Male Factory Workers Who Are at High Risk of HIV Infection in China: A Secondary Data Analysis

This study investigated the prevalence of and factors associated with behavioral intention to take up any type of HIV testing and HIV self-testing (HIVST) in the next six months among male migrant workers, who were at high risk of HIV infection, in Shenzhen, China. This was a secondary data analysis. A total of 363 subjects who had sexual intercourse with non-regular female sex partners and/or female sex workers in the past six months were selected. Logistic regression models were fitted for data analysis. About 16.5% of participants reported having used HIV testing in their lifetime and 12.7% for HIVST. Among the participants, 25.6% and 23.7% intended to take up any type of HIV testing and HIVST in the next six months, respectively. Significant factors associated with the behavioral intention to take up HIV testing and HIVST included individual-level factors based of the Health Belief Model (e.g., perceived benefit, perceived cue to action, perceived self-efficacy) and interpersonal-level factors (e.g., frequency of exposure to health-related content or HIV and STI-related content on short video apps). This study provided practical implications for designing interventions to increase the uptake of HIV testing and HIVST among migrant workers.

The Perpetrator-Victim Relationship: An Important Clue in Understanding Intimate Partner Homicide in China

Intimate partner homicide (IPH) is a global public health issue that has serious consequences for an individual's health. Whereas prior research has made some progress analyzing the perpetrator-victim relationship in understanding the dynamics of IPH, research set in the context of China in this field using the perpetrator-victim relationship as a focal variable in analyzing IPH is still lacking. The current study addresses this gap and builds on existing research by exploring the significance of the perpetrator-victim relationship in order to facilitate a deeper understanding of IPH in China. After examining 979 IPH criminal judgments, the findings revealed that the perpetrator-victim relationship is an important clue in understanding IPH in China today. By analyzing the correlation between intimate relationships as a focal variable and other variables such as IPH characteristics and risk factors, it is possible to understand the prevalence of IPH in China in greater detail. Irrespective of the kind of relationship between the perpetrator and victim, the findings revealed that most of them come from lower socioeconomic backgrounds, have no previous history of intimate partner violence, and are not satisfied with their marriages. Although research has provided detailed explanations, the perpetrator-victim relationship remains neglected, especially in the context of research on contemporary China. The findings showed that over half of the perpetrators and victims had intimate relationships with people outside their marriages. This may be the main reason for the rapid increase in the number of instances of IPH, which seems to be in tandem with China's rapid modernization and urbanization.

Intermittent Needs for Family Planning among Women with an Internal Migrant Husband in Bangladesh: A Qualitative Study

Bangladesh is one of the major labour-exporting countries in the world, with large-scale labour migration flows occurring both internationally and domestically. Spousal separation due to migration has the potential to disrupt women’s ability to use contraception in line with their reproductive goals. This qualitative study complements the 2014 Bangladesh Demographic and Health Survey (BDHS) data; we conducted in-depth interviews with a sub-sample of 23 BDHS respondents whose husbands stayed elsewhere but returned at least once a year to Barisal Division, Bangladesh. The study explores how husbands’ migration patterns influence couples’ fertility intentions, contraceptive decision-making and behaviour, and unintended pregnancies. Results showed that contraceptive use was high among the study participants, with nearly all couples using some method to avoid pregnancy – usually pills and condoms. However, the use was episodic and inconsistent, reducing effectiveness. Experiences of side effects were commonplace, which contributed to this pattern of inconsistent use: women used pills only during the duration of their husband’s visits. Half of the informants experienced unintended pregnancies either due to the inconsistent use of pills or other method failures. The study findings indicate that women with migrant husbands need family planning education related to their particular circumstances and access to a wider range of family planning choices. Quality counselling should respect women’s experiences with side effects and include thorough discussion of viable alternatives.

Sexual Risk Behaviors, HIV Prevalence and Access to Reproductive Health Services Among Young Women Migrant Workers in the Industrial Zones in Vietnam

Background: Young migrant workers working in the industrial zones (IZ) in low and middle-income countries are at risk for HIV and other sexually transmitted diseases. This study examines the sex-related risks of young women migrant workers in the IZ in Vietnam. Materials and Methods: This cross-sectional survey was conducted among 1,061 young migrant women working in the IZ park in Hanoi, Vietnam. Multivariate logistic regression analysis was used to identify factors associated with HIV testing and condom use at last sex. Results: A total of 1,061 young women migrant workers completed the survey in which 652 participants consented to take the initial rapid HIV test. All but one participant tested negative indicating a HIV prevalence of 150 (95% CI: 27-860) per 100,000 population among this population. There were no differences in sexual behavior, use of sexual and reproductive health services, HIV knowledge, perceived HIV risk or alcohol use between those who were HIV tested and those not tested. Single participants reported high rates of first sex while living in the IZ and high rates of condom use during the first-time sex, however, they had low levels of condom use at last sex. While the majority of married participants used the SRH/HIV services, nearly 80% of the single participants who reported having sex never used SRH/HIV services since living in the IZ. However, single participants were over 4 times more likely to use condoms at last sex compared to married participants (OR = 4.67; 95%CI = 2.96-7.85). Participants with vocational school or higher education was more likely to use condom (OR = 2.19; 95%CI = 1.05-4.57). Neither HIV knowledge or alcohol use were associated with condom use. Conclusions: Although HIV prevalence is very low among young women workers in the IZ in Vietnam, a significant number of them engaged in risky sexual behavior and low levels of condom use at last sex as well as low level of using SRH/HIV services highlights a need to develop interventions that provide tailored-made and cultural appropriate SRH education for unmarried female migrant workers to prevent risky sexual behaviors, sexually transmitted diseases and unwanted pregnancy.

The Risk of HIV/STDs Infection and Transmission Among Never-Married Male Migrants in China: Is Risk Attributable to Bachelorhood or Migration?

In the context of sex-ratio imbalance and rural-to-urban migration in China, never-married male migrants may become a vulnerable group as well as a bridge population that facilitates HIV/STDs transmission. It is still not clear, however, whether increased HIV/STDs transmission risk can be attributed to bachelorhood, migration, or both. This study identified the contributions of bachelorhood and migration to an increased risk of HIV/STDs infection, as well as the risk of HIV/STDs transmission across populations and regions. Data were from a cross-sectional questionnaire survey, in which 180 never-married non-migrant males in rural areas, 558 never-married male migrants, and 302 married male migrants in urban areas of China were interviewed in 2017. Results showed that never-married male migrants are more likely to engage in commercial sex and unsafe sex than never-married non-migrant males, and their likelihood of engaging in unsafe sex was also higher than married male migrants. Although never-married male migrants were less likely to have multiple sex partners than married male migrants, they were more likely to have multiple sex partners and sex partners from different regions than never-married non-migrant males. These findings indicate that both migration and bachelorhood increase the risk of HIV/STDs infection for never-married male migrants, and migration also increases the risk of HIV/STDs transmission across populations and regions.

The Mediating Role of Loneliness Between Social Support and Depressive Symptoms Among Chinese Rural Adolescents During COVID-19 Outbreak: A Comparative Study Between Left-Behind and Non-left-behind Students

Introduction: The COVID-19 pandemic has greatly impacted people's life across the globe. In a public health crisis, rural adolescents are more prone to mental health problems. The current study aimed to investigate the prevalence of depressive symptoms among Chinese rural adolescents during the COVID-19 outbreak, and examine the association between perceived social support and depressive symptoms and its underlying mechanisms. Method: Perceived Social Support Scale, UCLA Loneliness Scale, Patient Health Questionnaire-9 were administrated to 826 rural adolescents from Anhui Province, China, amid the COVID-19 crisis. Mackinnon's four-step procedure was employed to examine the mediating effect, while Hayes PROCESS macro was utilized to test the moderated mediation model. Results: The results showed the rate of depressive symptoms among rural adolescents in China was 77.6% during the outbreak of COVID-19. Female left-behind students and non-left-behind students from disrupted families experienced more depressive symptoms (all P < 0.05). Loneliness mediated the association between perceive social support and depressive symptoms and the indirect effect was stronger in left-behind adolescents in comparison to non-left-behind adolescents during the COVID-19 pandemic. Conclusion: Depressive symptoms are extremely prevalent among Chinese rural adolescents during the COVID-19 outbreak, and perceived social support plays a protective role against depressive symptoms. Chinese rural adolescents, especially left-behind students, could benefit from the interventions aimed at enhancing the perceived social support and reducing loneliness during the COVID-19 pandemic.

Sexual network and condom use among male migrants in the context of China's gender imbalance

In the context of China's gender imbalance, this study addresses the characteristics of sexual networks and their association with condom use in a sample of 713 male migrants (aged 28-64) who have rural hukou (household registration) in China. Descriptive statistics, univariate analyses, and multilevel random intercept models were used to investigate the characteristics of sexual networks and their associations with condom use. We found that age, marital status, type of sex partners, support (the main help given to each sex partner by the participant), type of sexual intercourse, and stability of sexual relationships were associated with condom use. The sexual networks were mainly composed of sex partners of similar age (58.46%), unmarried people (50.53%), and regular partners (49.38%). Married male migrants were more likely to use condoms with casual partners; unmarried male migrants were less likely to use condoms in emotional and stable relationships. Variation in individual factors, sex partners, and sexual relationship characteristics contribute to participation in condomless sex by male migrants. HIV prevention strategies should target unmarried male migrants and their casual sex partners by increasing their awareness of the risk of HIV transmission and the availability of free condoms.

Comparative Circulation Dynamics of the Five Main HIV Types in China

The HIV epidemic in China accounts for 3% of the global HIV incidence. We compared the patterns and determinants of interprovincial spread of the five most prevalent circulating types. HIV pol sequences sampled across China were used to identify relevant transmission networks of the five most relevant HIV-1 types (B and circulating recombinant forms [CRFs] CRF01_AE, CRF07_BC, CRF08_BC, and CRF55_01B) in China. From these, the dispersal history across provinces was inferred. A generalized linear model (GLM) was used to test the association between migration rates among provinces and several measures of human mobility. A total of 10,707 sequences were collected between 2004 and 2017 across 26 provinces, among which 1,962 are newly reported here. A mean of 18 (minimum and maximum, 1 and 54) independent transmission networks involving up to 17 provinces were identified. Discrete phylogeographic analysis largely recapitulates the documented spread of the HIV types, which in turn, mirrors within-China population migration flows to a large extent. In line with the different spatiotemporal spread dynamics, the identified drivers thereof were also heterogeneous but are consistent with a central role of human mobility. The comparative analysis of the dispersal dynamics of the five main HIV types circulating in China suggests a key role of large population centers and developed transportation infrastructures as hubs of HIV dispersal. This advocates for coordinated public health efforts in addition to local targeted interventions.IMPORTANCE While traditional epidemiological studies are of great interest in describing the dynamics of epidemics, they struggle to fully capture the geospatial dynamics and factors driving the dispersal of pathogens like HIV as they have difficulties capturing linkages between infections. To overcome this, we used a discrete phylogeographic approach coupled to a generalized linear model extension to characterize the dynamics and drivers of the across-province spread of the five main HIV types circulating in China. Our results indicate that large urbanized areas with dense populations and developed transportation infrastructures are facilitators of HIV dispersal throughout China and highlight the need to consider harmonized country-wide public policies to control local HIV epidemics.

How Bachelorhood and Migration Increase the HIV Transmission Risk Through Commercial Sex in China?

In China, the serious involuntary bachelorhood due to sex ratio imbalance in decades is expected to dramatically increase the spread of HIV through heterosexual contact. However, the higher HIV transmission risk and its correlates among never married men in rural China are not well understood. This study explored whether and how bachelorhood and migration increased the HIV transmission risk through commercial sex. By combining two cross-sectional survey data from never married men in rural areas and male migrants (including both married and unmarried men) in urban areas, a total of 1030 participants who were never married and age 28 and above or married male migrants were included in this study. The results show that both bachelorhood and migration put the never married male migrants at particularly higher HIV transmission risk by increasing both the possibility of engaging in commercial sex, and the frequency and inconsistency of condom use in commercial sex. Selection bias into marriage and neighborhood characteristics associated with exposure to commercial sexual risk may partly explain why male migrants that never married had a higher commercial sex related risk than that of married male migrants and never married non-migrant males.

Changing Trends of HIV, Syphilis, and Hepatitis C among Male Migrant Workers in Chongqing, China: Nine Consecutive Cross-Sectional Surveys, 2010-2018

Background: Male migrant workers (MMWs) have been reported to be vulnerable to human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Chongqing, China is one of the major migration destinations and hotspots of HIV. This study aims to explore the prevalence of HIV, syphilis, and hepatitis C virus (HCV), as well as HIV-related knowledge and behaviors, among MMWs in Chongqing. Methods: Questionnaire surveys were conducted, and blood samples were collected and examined among MMWs selected by two-stage stratified sampling in Chongqing from 2010 to 2018. The Cochran–Armitage trend test was conducted to observe the trends in the prevalence of HIV, syphilis, and HCV, as well as HIV-related knowledge and behaviors. The Chi-square test and Binary Logistic Regression were conducted to observe the distinctions between different groups. Results: The overall HIV prevalence was 0.6% with an increasing trend (0.2% to 0.9%, p < 0.001), whereas the overall HCV prevalence was 0.5% with a decreasing trend (0.5% to 0.4%, p < 0.001). The overall syphilis prevalence was 1.3% in the ≥50 age group, 1.0% in the 30–49 age group, and higher than 0.3% in the 16–29 group (X² = 19.527, p < 0.001). An uptrend (80.2%–80.6%, p < 0.001) was observed in correct HIV-related knowledge. The 16–29 ((Odds Ratio) OR: 1.575; 95%CI (Confidence Interval): 1.380–1.798; p < 0.001) and 30–49 (OR: 1.697; 95%CI: 1.495–1.926; p < 0.001) age groups had 1.575 and 1.697 times correct HIV-related knowledge more than the ≥50 age group. The proportion of subjects engaged in commercial sex in the past year (7.7%–13.3%, p < 0.001), consistent condom use during this activity (20.5%–54.0%, p < 0.001), and condom use in the last commercial sex (48.6%–72.1%, p = 0.020) were increasing. The risk of engaging in commercial sex in the past year in the 16–29 age group was 0.768 times (OR: 0.768; 95%CI: 0.643–0.917; p = 0.003) less than that in the ≥50 age group. The risk of engaging in non-regular sex in the past year in the 16–29 (OR: 2.819; 95%CI: 2.317–3.431; p < 0.001) and 30–49 (OR: 1.432; 95%CI: 1.184–1.733; p < 0.001) age groups were 2.819 and 1.432 times more than that in the ≥50 age group. The risk of engaging in anal sex in the past year in the 16–29 age group was 6.333 times (OR: 6.333; 95%CI: 1.468–27.327; p < 0.013) more than that in the ≥50 age group. The proportion of consistent condom use during non-regular sex in the past year (10.9%–47.3%, p < 0.001) and condom use in the last non-regular sex (40.8%–71.1%, p < 0.001) increased remarkably. The possibilities of consistent condom use during commercial sex in the past year in the 16–29 (OR: 2.606; 95%CI: 1.847–3.677; p < 0.001) and 30–49 (OR: 1.632; 95%CI: 1.214–2.195; p = 0.001) age groups were 2.606 and 1.632 times more than that in the ≥50 age group. The possibilities of condom use in the last commercial sex in the 16–29 (OR: 1.805; 95%CI: 1.258–2.589; p = 0.001) and 30–49 (OR: 1.360; 95%CI: 1.016–1.821; p = 0.039) age groups were 1.805 and 1.360 times more than that in the ≥50 age group. The possibilities of consistent condom use during non-regular sex in the past year (OR: 1.628; 95%CI: 1.066–2.484; p = 0.024) and condom use in the last non-regular sex (OR: 1.671; 95%CI: 1.148–2.433; p = 0.007) in the 16–29 age group were 1.628 and 1.671 times more than those in the ≥50 age group, respectively. Conclusion: An upward trend of HIV and a downward trend of HCV were observed among MMWs in Chongqing from 2010 to 2018. We also found an increase in commercial sex and inadequate condom use during high-risk behaviors among this population. The overall syphilis prevalence in the middle-aged and elderly groups was higher than in the young group, and elderly MMWs were more likely to engage in unprotected high-risk behaviors. Thus, targeted STI prevention for MMWs in Chongqing, especially those aged 50 years and above, is urgently needed.

Characterizing Unsafe Sexual Behavior among Factory Workers in the Context of Rapid Industrialization in Northern Vietnam

Industrial workers or factory workers, especially migrant workers, have been found to be vulnerable populations at risk of sexually transmitted infections (STIs). However, there has been a gap in literature regarding health behaviors of migrant factory workers. We conducted a cross-sectional study among 230 factory workers in Hanoi and Bac Ninh cities in Northern Vietnam from July to September 2018 to identify sexual risk practices and related factors among migrant and nonmigrant factory workers. Information collected regarding sexual behavior included the number of sexual partners in the previous 12 months and whether they used condoms in their last sexual intercourse. Two-thirds of participants reported having no sexual activity in the last 12 months, and there was a low percentage of participants using condoms in their last sexual intercourse. Being female, living with spouses/partners, and being a nonimmigrant had a negative association with the lack of using condoms in the last sexual intercourse with casual partners/sex workers, as opposed to having mobility and self-care problems and identifying as a binge drinker. Therefore, workplace-based prevention programs focusing on providing tailored sexual health education and promoting condom use among industrial workers, especially those who are immigrant or migrant workers, in Vietnam should be emphasized.

Short-term acceptability of the Woman's Condom and influencing factors among internal migrants in China

Background

The Woman’s Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman’s Condom and influencing factors among internal migrants.

Methods

A longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects.

Results

Three-level model analysis revealed statistically higher short-term acceptability of the Woman’s Condom among subjects who lived in Shanghai (β = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (β = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (β = − 1.69, t = − 7.55, p < 0.01) and lower educational attainment (β = − 2.30, t = − 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (β = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants’ acceptability of the Woman’s Condom would significantly increase over time (β = 1.09, t = 5.54, p < 0.01).

Conclusions

The findings indicate that the Woman’s Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women’s Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.

Social capital, migration stress, depression and sexual risk behaviors among rural-to-urban migrants in China: a moderated mediation modeling analysis

Background: Few studies have examined the complex relationship of migration stress and depression with sexual risk behaviors among migrants. The relationship between migration stress and sexual risk behaviors may be mediated by depression, and the mediation process may be modified by social capital. The study aims to investigate this moderated mediation mechanism among rural-to-urban migrants. Methods: Data were collected from rural-to-urban migrants in China. Migration stress, depression, and social capital were measured with validated scales and used as predictor, mediator and moderator, respectively, to predict the likelihood of having sex with risk partners. Mediation and moderated mediation models were used to analyze the data. Results: Depression significantly mediated the migration stress-sex with risk partner relationship for males (the indirect effect [95%CI] = 0.36 [0.08, 0.66]); the mediation effect was not significant for females (0.31 [-0.82, 0.16]). Among males, social capital significantly moderated the depression-sex with risk partner relation with moderation effect -0.12 [-0.21, -0.04], -0.21 [-0.41, -0.01] and -0.17 [-0.30, -0.05] for total, bonding and bridging capital respectively. Conclusion: Social capital may weaken the association between migration stress and sexual risk behavior by buffering the depression-sexual risk behaviors association for males. Additional research is needed to examine this issue among females.

Pattern of sexual behavior among people in a rural area of Bihar: A qualitative study on wives of migrant workers

Background:

Population mobility and migration are important processes of human life. It affects broad range of sociocultural parameters. Mobility increases personal interaction and exposure to sexual partners from high-risk group. Although traditional Indian value prohibits premarital or extramarital sexual activities, but this aspect has not been explored in migrant workers.

Methods:

It was a qualitative study based on indepth interview of participants. The participants were wives of migrant workers. Indepth interviews were conducted by two female field interviewers recruited for the study. A total of 24 study subjects were recruited for the study. An indepth interview guide was prepared which mainly focused on sexual behavior, including premarital, marital, and extramarital, quality of marital relationship, gender roles, peer networks, substance abuse, work-related activities, etc., The transcripts were analyzed in NVIVO and themes were generated.

Results:

The premarital sex was more common in boys than girls. It is more common in the same age group and has increased in the recent years. Various reasons were cited in relation to premarital sex in rural areas like love affair, delayed marriage, watching bad movies, bad company, allurement for gifts money, etc., Some women had opinion that males belonging to affluent and powerful families had tendency to enjoy sex with other women within and outside village. The major themes which emerged from the study were the sexual activity, type of sexual partners, reasons for multiple sexual partner, and risky and nonrisky sexual activity.

Conclusion:

The findings of the study provided insights to design and conduct a larger and more representative quantitative study among the wives of migrant workers to understand the dynamic combination of biomedical, behavioral, and sociocultural factors that may influence transmission of infection within marriage.

Impact of worker emigration on HIV epidemics in labour export areas: a molecular epidemiology investigation in Guangyuan, China

We aimed to investigate the molecular epidemic characteristics and viral transmission patterns of HIV-1 in a typical labor export area, Guangyuan city, China. Based on conducting phylogenetic trees and molecular transmission networks, a phylogenetic analysis was performed on HIV-1 pol sequences obtained from 211 migrant-history workers, 83 non-migrant-history individuals, and 21 migrant-history unknown individuals between January, 2012 and February, 2017 in Guangyuan city. Phylogenetic analysis revealed that CRF07_BC (48.3%, n = 152) and CRF01_AE (33.3%, n = 105) were the dominant strains in Guangyuan city, and circulated by multiple lineages with various epidemic characteristics. Geographic network analysis showed that Guangyuan city-related sequences with 20.3% CRF07_BC and 28.3% CRF01_AE were linked to that of other provinces, compared to that with 1.7% CRF07_BC and 5.0% CRF01_AE in cities of Sichuan. Molecular transmission network analysis further illustrated that migrant-history workers linked more sequences from other provinces than non-migrant-history individuals in both CRF07_BC (29.3% versus 0.0%, P = 0.013) and CRF01_AE (40.5% versus 10.0%, P = 0.001) networks. Our results highlighted that migrant-history workers in recent year played a vital role in fueling HIV-1 epidemic in Guangyuan city. Molecular transmission network analysis could be a useful approach for disclosing the transmission mechanism of HIV, which should be used in prevention and intervention efforts.

'Unqueer' kinship? Critical reflections on 'marriage fraud' in mainland China

This article explores the controversial kinship practice in mainland China of 'gay' men marrying unwitting women. It questions the 'marriage fraud' discourse that condemns the men involved while pitying their wives, or tongqis. Taking an ethnographic approach, this article considers the major flaws of this popular discourse: the idealized-package of marriage-love-sex, the oft-neglected difficulties of living outside marriage, and most importantly, the essentialization of homosexuality. It also examines the im/possibility for married 'gay' men to be honest in their marriages. Finally, it cautions that honesty, if used as a decontextualized ethical yardstick for queer kinship, may obscure the racist and homophobic prejudices that exist both outside and inside queer communities. Accordingly, this article proposes that we shift to 'opacity' as an epistemological, methodological and ethical parameter that radically queers kinship (studies).

Risk factors for HIV infection among 15 to 25-year-old rural unmarried Yi adolescents in an ethnic minority region of China

We aimed to analyze factors related to human immunodeficiency virus (HIV) infection among 15 to 25-year-old rural unmarried Yi adolescents in Liangshan Yi Autonomous Prefecture from 2011 to 2016, and to investigate the relationship among the HIV-related risk factors.Three sites (Butuo, Zhaojue, and Ganluo counties) with a Yi population were selected from 2011 to 2016 in Liangshan prefecture. We used questionnaires to investigate demographic and behavioral characteristics and performed HIV testing. Logistic regression analysis and multiple correspondence analysis (MCA) were used to analyze the data.A total of 6311 qualified rural unmarried Yi adolescents were involved in this study, with an HIV infection rate of 4.18% (264/6311). Logistic regression analysis indicated that males (OR = 1.56, 95% CI = 1.17-2.08), illiteracy (OR = 2.70, 95% CI = 1.79-4.08), primary school education or below (OR = 1.62, 95% CI = 1.12-2.36), history of out-migrating for work (OR = 1.58, 95% CI = 1.18-2.13), and injecting drug user (IDU) (OR = 6.42, 95% CI = 3.06-13.46) contributed to the risk of HIV infection. MCA revealed a strong interrelationship between the following risk factors and HIV infection: aged 23 to 25 years, IDU, history of out-migrating for work, and ever having sexual behaviors.HIV infection among 15 to 25-year-old rural unmarried Yi adolescents in Liangshan is a serious issue. MCA and logistic regression analysis can be used to assess the relationship between risk factors for HIV infection.

Mitigating circumstances: A model-based analysis of associations between risk environment and infrequent condom use among Chinese street-based sex workers

Background

Little is known about how freelance street-based sex workers navigate condom use while soliciting. Traditional behavioural model may fail to account for the complex risk environment that most street-based sex workers work within. We examine first the association of self-efficacy and the infrequent condom use, then we investigated the roles of clients and venues frequented on this association.

Method

Using a purposive chain-referral sampling method, we surveyed 248 street-based sex workers in Shanghai. The survey focused on sex workers HIV risk factors, sex work patterns, HIV knowledge, and related HIV self-efficacy. Clients types and behaviours, and characteristics of the venues frequented by these commercial sex workers were also collected. We conducted a series of multiple logistic regression models to explore how the association between a sex worker’s self-efficacy with infrequent condom use change as client and venue characteristics were added to the models.

Results

We find that within the basic model, low self-efficacy was marginally associated with infrequent condom use (54.9% vs. 45.1%, AOR = 1.70, 95% CI = 0.95–3.03). As client- and venue- characteristics were added, the associations between self-efficacy and condom use were strengthened (AOR = 2.10 95% CI = 1.12–3.91 and 2.54 95% CI = 1.24–5.19 respectively). Those who reported middle-tiered income were more likely to report infrequent condom use compared to their peers of high income (AOR = 3.92 95% CI = 1.32–11.70) whereas such difference was not found between low income and high income sex workers. Visiting multiple venues and having migrant workers as clients were also associated with infrequent condom use.

Conclusion

Our findings suggest sex worker’s self-efficacy matters in their HIV risk behaviours only when environment characteristics were adjusted. Risk environment for street-based sex workers are complex. Programming addressing behavioural changes among female sex workers should adopt holistic, multilevel models with the consideration of risk environments.

Influence Factors of Sexual Activity for Internal Migrants in China

Background

Sexual frequency is associated with the quality of life. China’s internal migrants that are sexually active are more likely to participate in sexual behavior. However, less work has been undertaken to assess the sexual frequency and its predictors in migrants.

Aim

This study seeks to explore which factors were related to sexual frequency in migrants and how the association varies with different levels of sexual frequency.

Methods

A total of 10,834 men and 4,928 women aged 20–49 years from 5 cities in China were enrolled by multi-stage sampling during August 2013–August 2015.

Outcomes

Sexual frequency among migrants was determined by asking: How many times have you had sexual intercourse with a man/woman in the past 30 days?

Results

In this study, sexual frequency with an average age of 38.28 years was 5.06 (95% CI 5.01–5.11) time per month. Negative binomial showed that male gender, younger age, earlier age of sexual debut, masturbation, more knowledge of sexual and reproductive health, longer time together with a spouse, and higher school education and incomes were predictors of increased sexual frequency in migrants. Communicating with sexual partners frequently had the largest effect on sexual frequency compared with occasional communicating (β = 0.2419, incidence rate ratio = 1.27, 95% CI 1.23–1.31). In the quantile regression, months of cohabitation (β = 0.0999, 95% CI 0.08–0.12), frequent sexual communication (β = 0.4534, 95% CI 0.39–0.52), and masturbation (β = 0.2168, 95% CI 0.14–0.30) were positively related to lower levels of sexual frequency. Interestingly, migrants who had low and high sexual frequency would be affected in opposite directions by the knowledge of sexual and reproductive health.

Clinical Translation

Clinicians can more understand the relationship between sexual frequency and its factors that can as the symptom basis of sexually-related diseases.

Conclusions

The present findings indicate that specific demographic, socioeconomic, and epidemiological characteristics influenced sexual frequency among migrants. Sexual communication as the largest effect predictor to sexual frequency should be paid more attention to, to improve sexual activity of migrants.

Zhang J, Wu J, Li Y, et al. Influence factors of sexual activity for internal migrants in China. J Sex Med 2018;6:97–107.

Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015

Background

Yi people make up about 50% of the population in Liangshan Prefecture, Sichuan Province, China, but accounted for 88.07% of new HIV cases in the prefecture from 2011 to 2013. This study evaluated HIV prevalence in pregnant women of Liangshan Prefecture using HIV sentinel surveillance (HSS) data over the period of 2009 to 2015.

Methods

Xichang, Zhaojue County, and Butuo County were selected as HSS sites. We investigated the temporal trends in HIV prevalence in these areas, and the association between demographic and behavioral characteristics and risk of HIV infection.

Results

Data on a total of 2797 pregnant women in Xichang and 3983 pregnant women in Zhaojue and Butuo was collected for the period 2009 to 2015. There was a fluctuating HIV prevalence among pregnant women of Xichang, with a rate of 0.75% in 2015 (χ²_trend = 2.27, P = 0.13). HIV prevalence among pregnant women of Zhaojue and Butuo was consistently high, varying between 3.4% (9/267, 2011) and 10.3% (82/796, 2012) over the period of 2010 to 2015 (χ²_trend = 0.12, P = 0.73). In Xichang, we found that Yi ethnicity (OR = 11.37, 95% CI = 2.92–44.25) and a husband who used drugs (OR = 32.13, 95% CI = 5.33–193.67) were significantly associated with HIV risk in pregnant women. For Zhaojue and Butuo, we observed that pregnant women had a higher risk of HIV infection when they were over 30 years old (OR = 1.72, 95% CI = 1.17–2.52), when they had a higher number of previous births, when their husbands had a history of migrating for work (OR = 1.56, 95% CI = 1.16–2.08), and when they had a history of other sexually transmitted infections (OR = 2.19, 95% CI = 1.16–2.08). Compared to those with a primary school education or below, pregnant women with a secondary or high school education level had a lower risk of HIV infection (OR = 0.28, 95% CI = 0.09–0.89).

Conclusion

Our results indicate that there is a serious HIV epidemic among pregnant Yi women, especially for those with less education, more past births, or a husband with a history of out-migrating for work or STD infection.

Commercial Sexual Behaviors Among Male Rural-to-Urban Migrants in Western China: Implications for HIV Prevention

Rural-to-urban migrants are at high risk of HIV infection. The goal of this survey was to explore the commercial sexual behavior and condom use among male rural-to-urban migrants in western China. A cross-sectional survey on male rural-to-urban migrants in western China was conducted. Among all the subjects surveyed, 140 (7.4%) had commercial sexual behavior, which is associated with being aged older than 24 years, being of Han or other ethnic minorities, being divorced, separated, or widowed, having experienced drug abuse, having had heterosexual behavior, having had casual sexual partners, having had sex with a homosexual, and being from Xinjiang. A total of 31.4% of them never use condoms when buying sex. Not using condoms is associated with being from Chongqing, having a high school or above education, and having commercial sex monthly. Commercial sexual behavior and not using condoms are common among male rural-to-urban migrants in western China. Strategies and appropriate education should be developed to prevent HIV transmission due to high-risk sexual behaviors.