Prevalence of HIV, syphilis, HCV and their high risk behaviors among migrant workers in eastern China

Epidemiological characteristics and risk factors of syphilis among blood donors in Huzhou

OBJECTIVE

To investigate the epidemiological characteristics and risk factors for syphilis in Huzhou City, and to provide data to support the design of more effective health counselling and screening measures for blood donors.

METHODS

A retrospective study was conducted to analyse the demographic characteristics and seropositivity of syphilis among blood donors from 2019 to 2021. The differences in the serological status of syphilis among different populations under different demographic factors were compared, and conditional logistic regression analysis was used to identify the risk factors for syphilis.

RESULTS

The seropositivity rate of syphilis among blood donors in Huzhou City was 133/100,000, which decreased year by year. There were significant differences in the syphilis seropositivity rate among different groups in terms of age, education level, occupation, household registration, marital status and blood donation history (P < 0.05). The multivariate logistic regression model showed that all six factors, including age, education level, occupation, household registration, marital status and blood donation history, had significant effects on syphilis infection (P < 0.01), with OR values and 95% CIs of 2. 387 (1.381-4.127), 3.607 (1.609-8.086), 2.784 (1.657-4.679), 5.074 (1.865-13.804), 11.177 (3.481-35.888), and 11.244 (3.940-32.091), respectively.

CONCLUSION

There is room for improvement in pre-donation health counselling and screening of high-risk populations. Timely monitoring and updating of demographic data for specific high-risk populations is essential.

Factors associated with risk behaviours towards hepatitis B among migrant workers: a cross-sectional study based on theory of planned behaviour

OBJECTIVES

Rural-to-urban migrant workers are susceptible to hepatitis B because of lack of self-protection awareness and social support. The aim of this study was to explore the factors influencing risk behaviours for hepatitis B among migrant workers based on the theory of planned behaviour (TPB).

DESIGN

A cross-sectional survey.

SETTING

Chongqing, China PARTICIPANT: Migrant workers PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were the TPB variables. The secondary outcomes were factors explored by logistic regressions which were associated with hepatitis B related risk behaviours and behavioural intentions (BI).

RESULTS

Of 1299 recruited migrant workers, 384 (29.56%) participants undertook risk behaviours related to hepatitis B virus infection in the 6 months prior to the survey, and 1111 (85.53%) migrant workers had the BI of doing so. Of 842 migrant workers who undertook sexual activities, 58.19% did not use condoms. Binary logistic regressions showed that migrant workers who were men (p<0.05), less educated (p<0.01), lacked hepatitis B knowledge (p<0.05) and of a young age (p<0.01), were more intent on conducting hepatitis B-related behaviours. Alcohol drinking (p<0.01) was also positively associated with hepatitis B risk. The scores of TPB variables, including attitude towards behaviour and subjective norms, were positively associated with BI when adjusted for sociodemographics (p<0.001). Meanwhile, experience of behaviour and regret feeling were positively associated with BI and actual behaviours (p<0.01 and p<0.05, respectively).

CONCLUSIONS

A considerable proportion of migrant workers undertake hepatitis B-related risk behaviours, and condoms are seldom used. Health education campaigns targeting the identified TPB variables may play a significant role in improving awareness of hepatitis B prevention among migrant workers, especially for those who are men, younger, alcohol drinkers, less educated and lacking hepatitis B knowledge.

Serosurvey of anti-treponema pallidum (syphilis), anti-hepatitis C virus and anti-HIV antibodies in homeless persons of São Paulo city, southeastern Brazil

Homeless persons have been considered as one of the most susceptible populations to sexually transmitted infections. In Brazil, these population experienced an increase of 140% from 2012 to 2020. Accordingly, the present study aimed to assess the seroprevalence of anti-Treponema pallidum, anti-HCV, anti-HIV antibodies, and the risk factors associated with homeless persons in a daytime attendance shelter of São Paulo city during the syphilis epidemic in Brazil. Blood samples of 116 volunteers and epidemiological data were conveniently collected in the shelter from June through August 2018. Detection of syphilis, HCV, and HIV antibodies was performed by chemiluminescent microparticle immunoassay (CMIA). CMIA-reagent samples for anti-T. pallidum antibodies were confirmed by Venereal Disease Research Laboratory (VDRL) non-treponemal test. VDRL non-reagent samples were confirmed by treponemal rapid immunochromatographic test. A rapid immunoblot assay confirmed seropositivity to HIV. Overall, anti-T. pallidum antibodies were observed in 29/116 (25.0%), anti-HCV antibodies in 4/116 (3.4%), and anti-HIV antibodies in 2/116 (1.7%) individuals, both co-infected with anti-T. pallidum antibodies. Associated risk factors for syphilis in homeless persons were being born or previously living in another city (p = 0.043) and becoming homeless due to family conflicts (p = 0.035). Besides homeless vulnerability, worldwide shortage of benzathine penicillin supply and increasing of syphilis testing access through rapid testing in primary health care services may have also impacted disease spreading at the time. The prevalence of syphilis found herein is the highest worldwide to date in this population.

Differences in maternal characteristics and pregnancy outcomes between syphilitic women with and without partner coinfection

BACKGROUND

Partner infection is a significant factor in preventing mother-to-child syphilis transmission. We compared pregnancy outcomes between syphilis discordant and syphilis concordant couples.

METHODS

We conducted a retrospective study among 3076 syphilis-positive women who received syphilis screening together with their partners during pregnancy. Multivariate analysis was used to explore risks for abnormal outcomes in objects correcting for the major covariate factors. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated to compare pregnancy outcomes between syphilis concordant and syphilis discordant couples.

RESULTS

Overall, 657 of the 3076 women were diagnosed with gestational syphilis and had a syphilis-positive partner, giving a partner concordance prevalence of 21.36%. Women in concordant couples were more likely to have higher parity, more children, late antenatal care and syphilis screening, a lower proportion of latent syphilis, and elevated serologic titers than women in discordant couples (P < 0.01 for all). Totally, 10.08% of women had adverse pregnancy outcomes. Multivariate analysis showed partners' syphilis infection (OR_adj = 1.44, 95% CI: 1.10-1.89), untreated pregnancy syphilis (OR_adj = 1.67, 95% CI: 1.15-2.43), and higher maternal serum titers (> 1:8) (OR_adj = 1.53, 95% CI: 1.17-2.00) increased the risks of adverse pregnancy outcomes. Concordance was associated with increased risk for stillbirth (OR_adj = 2.86, 95%CI:1.36-6.00), preterm birth (PTB) (OR_adj = 1.38,95%CI:1.02-1.87) and low birth weight (LBW) (OR_adj = 1.55, 95%CI:1.13-2.11) compared with discordance. Even among treated women, concordance was associated with increased risk for stillbirth (OR_adj = 3.26, 95%CI:1.45-7.31) and LBW (OR_adj = 1.52, 95%CI:1.08-2.14). Among women with one treatment course, the risks for PTB(OR_adj = 1.81, 95%CI:1.14-2.88) and LBW(OR_adj = 2.08, 95%CI:1.28-3.38)were also higher among concordant couples than discordant couples. Nevertheless, there were no significant differences between concordant and discordant couples in risks of stillbirth (OR_adj = 2.64, 95% CI: 0.98-7.05),PTB (OR_adj = 1.15, 95% CI: 0.76-1.74), and LBW(OR_adj = 1.21, 95% CI: 0.78-2.02) among women with two treatment courses.

CONCLUSION

Male partner coinfection increased the risks for stillbirth, PTB and LBW, particularly when gestational syphilis treatment was suboptimal. However, this risk could be reduced by adequate treatment.

Demographic characteristics of transfusion-transmitted infections among blood donors in China

Background

Demographic characteristic surveillance of transfusion-transmitted infections (TTIs) among blood donors is crucial to formulating control strategies and preventing TTIs. This study aimed to investigate the demographic characteristics and social factors associated with TTIs among blood donors from 14 different blood centers or banks in China, covering almost the entire China.

Methods

Demographic information of 1976 blood donations were obtained from the donor databases of 14 blood centers. The results of the samples were confirmed by the National Center for Clinical Laboratories (NCCL).

Results

Of the 1976 donations, 928 were confirmed as TTI positive (HBV, 309; HCV, 162; HIV, 116; syphilis, 341), while 1048 tested negative. The differences in demographic distribution of TTI positive and negative donations regarding age, previous donation history, occupation, and education were statistically significant (p < 0.001). The factors mentioned above and marital status had associations with TTIs. Among the TTIs, only syphilis was related to ethnicity (adjusted odds ratio [aOR]: 2.309, 95% confidence interval [CI]: 1.378–3.868, p = 0.001), and only HBV positivity was not associated with marital status (HBV, aOR: 0.933, 95% CI: 0.670–1.299, p = 0.681). Gender and education were independent predictors of HIV and syphilis infections (p < 0.05).

Conclusions

Demographic characteristics in this study included age, gender, previous donation history, ethnicity, marital status, occupation, and education, some of which were associated with TTIs. The most susceptible populations for TTIs were unmarried males and first-time donors aged between 26 and 55 years, and blood donors who were workers or company employees with low-educational level. Timely surveillance and updated demographic data on blood donors are critical for blood safety.

HIV Prevalence Among Central American Migrants in Transit Through Mexico to the USA, 2009-2013

HIV prevalence was estimated among migrants in transit through Mexico. Data were collected on 9108 Central American migrants during a cross-sectional study performed in seven migrant shelters from 2009 to 2013. Considerations focused on their sociodemographic characteristics, sexual and reproductive health, and experience with violence. Based on a sample of 46.6 % of respondents who agreed to be HIV tested, prevalence of the virus among migrants came to 0.71 %, reflecting the concentrated epidemic in their countries of origin. A descriptive analysis was performed according to gender: the distribution of the epidemic peaked at 3.45 % in the transvestite, transgender and transsexual (TTT) population, but fell to less than 1 % in men and women. This gender differential is characteristic of the epidemic in Central America. Furthermore, 23.5 % of TTTs and 5.8 % of women experienced sexual violence. The predominant impact of sexual violence on TTTs and women will influence the course of the AIDS epidemic.

Clinical manifestations and treatment outcomes of syphilitic uveitis in HIV-negative patients in China: A retrospective case study

Syphilitic chorioretinitis should be included in differential diagnosis of any form of ocular inflammation. A significantly higher proportion of human immunodeficiency virus (HIV)-positive patients with ocular syphilis as compared to HIV-negative cases have been reported in published studies. However, the clinical signs and symptoms are more insidious in HIV-negative patients who are easily misdiagnosed. We report a series of cases of ocular syphilis and describe the clinical manifestations and treatment outcomes of syphilitic chorioretinitis in HIV-negative patients in China.This was a retrospective case series study. The clinical records of patients with syphilis chorioretinitis were reviewed. Demographic information and findings of fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and spectral domain optical coherence tomography (SD-OCT) were analyzed. All patients received the standard treatment. Ophthalmology examination and laboratory evaluation were repeated every 3 months. All changes were recorded. The treatment was considered successful if the patients had no inflammation in both eyes and rapid plasma reagin titer was negative after therapy.The study examined 41 eyes of 28 HIV-negative patients. The main complaints were blurry vision, floaters, and visual field defect. Twenty-seven eyes presented with panuveitis, and all had posterior involvement, including uveitis, vasculitis, chorioretinitis, and optic neuritis. The most common manifestations were uveitis and retinal vasculitis. Disc hyperfluorescence and persistent dark spots were the most common findings on FFA and ICGA. The ill-defined inner segment/outer segment junction was the most frequent manifestation on SD-OCT. Patients were diagnosed with syphilitic uveitis based on positive serological tests. Best-corrected visual acuity (BCVA) was improved in 34 eyes after treatment. Eleven patients were misdiagnosed before serological tests were performed. The delay in treatment led to long-standing cystoid macular edema and optic neuropathy, which were associated with poor BCVA (P = .037).The common manifestations of syphilitic chorioretinitis were uveitis, retinal vasculitis, and optic neuritis. Further diagnosis should be prompted by FFA, ICGA, and SD-OCT when ocular manifestation is suspected. The standard treatment for neurosyphilis was effective. If patients are presumed to be in low-risk groups such as HIV-negative, delays in diagnosis, and therapy may be likely. It is necessary to reiterate the importance of including syphilis uveitis as a differential diagnosis for any form of ocular inflammations, especially posterior uveitis and optic neuropathy.

The association between human perceived heat and early-stage syphilis and its variance: Results from a case-report system

BACKGROUND

The relationship between temperature and syphilis is poorly understood despite clues and suggestions from previous studies. We examined the association between human perceived temperature (humidex) and the relative risk of early-stage syphilis in the most affected area of China, as well as its variance across social-economic status and age groups.

METHODS

Information regarding early-stage (primary and secondary) syphilis cases reported to the China Case Report System between 2005-2013 from Guangdong province was analyzed in this study. Weather data were obtained from the National Meteorological Information Center. Distributed lag nonlinear models were applied to assess the relationship between humidex and the relative risk of early-stage syphilis. Results were further stratified by social-economic status and age groups.

RESULTS

The relative risks of early-stage syphilis mainly increased with increased humidex, and were elevated when the humidex was around 30 or greater than 38. The humidex-RR association for the 15-40 age group was similar to the scenario pooled across the age groups, particularly in the Pearl-River Delta Region. The relative risk of syphilis in the elderly for the non-Pearl-River Delta Region did not show a clear change with humidex, whereas that in the Pearl-River Delta Region substantially increased, particularly when humidex was above 25.

CONCLUSIONS

Human perceived temperature was positively related to the relative risk of early-stage syphilis. People in the Pearl-River Delta Region tended to be more sensitive, with relative risk elevated at potential comfortable times or under excessively hot conditions. The vulnerability of the elderly in the Pearl-River Delta Region is concerning.

Facilitating and Inhibiting Factors of Sexual Behavior among Migrants in Transition from Mexico to the United States

INTRODUCTION

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is one of the most prevalent infectious diseases in the border region of Mexico due to the flow of migrants under desperate conditions, encouraging casual and unprotected sex. Since this has become a binational public health problem, it is important to understand the factors that predict these sexual behaviors. The aim of the current study was to investigate the facilitators and inhibitors of transition in the sexual behavior of migrants from two border regions on the Mexico-United States (US) border.

METHODS

This was a predictive and cross-sectional study. A sample of 256 migrants in shelters for migrants on the border between Mexico and US were selected through systematic random sampling. Predictor variables investigated for effect on the safe sexual behavior (SSB) of the migrant were reasons for having sex; sexual attitudes; sexual machismo; knowledge about HIV; access to health services; and social discrimination.

RESULTS

The sample was predominantly male (89.5%), with 46.1% reporting being single. The average age was 33.38 years (SD = 9.73) and the average number of years of education reported was 8.05 (SD = 3.37). A permissive sexual attitude and sexual machismo both correlated with condom use (r_s = 0.130, p < 0.01 and r_s = -0.174, p < 0.01, respectively). Regression analysis showed that a permissive sexual attitude decreased the practice of safe sex (β = 0.17, t = 4.16, p < 0.001), as did sexual machismo (β = -0.28, t = -4.83, p < 0.001) and HIV knowledge (β = -0.11, t = -2.62, p = 0.006).

DISCUSSION

It was found that access to health services did not influence the SSB of migrants, as suggested by the literature. However, a permissive sexual attitude, sexual machismo, and HIV knowledge were all variables capable of predicting SSB. It is recommended that the study is extended to study migrant populations from other parts of the border, as well undertaking as a qualitative approach to explore new variables.

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.

Clinical manifestations and cerebrospinal fluid status in ocular syphilis in HIV-Negative patients

Background

Syphilis with ocular involvement has reemerged as a critical health problem. The aim of the present study was to explore the clinical manifestations and cerebrospinal fluid (CSF) status in ocular syphilis in human immunodeficiency virus (HIV)-negative patients.

Methods

The clinical records of patients with ocular syphilis presenting to the Shanghai Xuhui Central Hospital in the period from January 2011 to December 2012 were retrospectively reviewed.

Results

The median age of 25 HIV-negative patients with ocular syphilis was 53 years, 18 patients (72.0 %) were males and 7 (28.0 %) were females. None of them self-identified themselves as men who had sex with men (MSM). The ocular lesions included: uveitis (13 cases), optic neuropathy (6 cases), retinal vasculitis (5 cases), retinal detachment (3 cases), and neuroretinitis (4 cases). Serum toluidine red unheated serum test (TRUST) titer ranged from 1 to 512, with a median of 64. Overall, 18 (72.0 %) of the 25 patients had abnormal CSF results, 15 (60.0 %) CSF samples had elevated white blood cell counts, 13 (52.0 %) had elevated protein levels, and 9 (36.0 %) had reactive CSF Venereal Disease Research Laboratory (VDRL) test, respectively. Mann–Whitney U tests showed higher serum TRUST titer (>32) correlated with the abnormal CSF results.

Conclusions

The demographic characteristics of patients with ocular syphilis in this study were different from previous reports. The study showed a high CSF abnormal rate in HIV-negative patients. The recommendation for CSF examination from all patients with ocular syphilis, including HIV-negative cases, is strongly supported by the present data.

Effectiveness of treatment to improve pregnancy outcomes among women with syphilis in Zhejiang Province, China

OBJECTIVES

To determine the effectiveness of treatment in improving pregnancy outcomes among women with syphilis.

METHODS

This is a retrospective study based on the provincial prevention of mother-to-child transmission of syphilis database. All women with syphilis with singleton pregnancies were recruited. We evaluated their pregnancy outcomes by group-specific analyses according to their treatment time and adequacy.

RESULTS

The syphilis prevalence among pregnant women was 0.3% (4214/1 338 739) in Zhejiang Province, China, during 2013-2014, considering all live births and abortions. Women with singleton pregnancies (3767) were included in the study, including live births and stillbirths (≥28 weeks). The treatment coverage for all women with syphilis was 80.2% (3022/3767), and 68.2% (2062/3022) of the women were treated adequately. Of 745 infants born to untreated pregnant women with syphilis, 1.2% manifested pneumonia, 2.7% asphyxia, 1.6% birth defects, 3.8% congenital syphilis (CS), 14.2% were preterm, 10.1% had low birth weight (LBW) and 3.1% experienced perinatal death. The risks of asphyxia (OR=2.7), CS (OR=3.1), preterm birth (OR=1.5), LBW (OR=1.9) and perinatal death (OR=3.1) were much higher in infants born to mothers treated inadequately than from those treated adequately. Moreover, mothers with syphilis who initiated treatment in the third trimester suffered an increased risk for asphyxia (OR=3.0), CS (OR=6.0) and LBW (OR=1.7) compared with those who initiated treatment in the first trimester.

CONCLUSIONS

Early and adequate treatment could improve the adverse pregnancy outcomes among women with syphilis.

Unsafe sexual behaviour in domestic and foreign migrant male workers in multinational workplaces in Jordan: occupational-based and behavioural assessment survey

OBJECTIVES

To examine the prevalence of unsafe sexual behaviour, sexually transmitted infection (STI)-related knowledge, health and work-related conditions, and correlates of practising unsafe sex among domestic and foreign male workers in multinational workplaces in Jordan.

DESIGN

Cross-sectional behavioural assessment survey.

SETTING

Multinational workplaces in Jordan.

PARTICIPANTS

230 Jordanian and 480 foreign male workers aged ≥ 18 years who had worked in a Qualified Industrial Zone (QIZ) for 12 months or more.

OUTCOMES

The primary outcome was the prevalence of practising unsafe sex. 'Unsafe sex' was defined as sex with a non-regular sexual partner with inconsistent condom usage.

RESULTS

Overall, 74.3% of workers reported lifetime sexual experience. The proportion of lifetime unsafe sex was similar among domestic (31.8%) and foreign (35.6%) workers. Of those, 59.2% of domestic and 68.1% of foreign workers started practising unsafe sex after joining the QIZ. Rates of lifetime unsafe sex were significantly higher among those who had their sexual debut after joining the QIZ in domestic (aOR, 2.2, 95% CI 1.1 to 4.4) and foreign workers (aOR, 2.4, 95% CI 1.4 to 4.1). Among the domestic workers, being 18-24 years old (aOR, 4.9), unmarried (aOR, 4.8), working in the QIZ for 5-8 years (aOR, 5.0), sometimes/frequently shopped with foreign workers (aOR, 2.1) or were current/ex-alcohol drinkers (aORs, 3.4) were independently significantly associated with higher odds of practising unsafe sex.

CONCLUSIONS

A significant proportion of domestic and foreign male workers had been practising unsafe sex. The findings indicated that not only foreigners but also domestic male workers associating with foreign workers are at high risk of unsafe sex. Tailored interventions to promote safer sex in multinational workplaces in Jordan are needed.

HIV/AIDS-related knowledge and behaviors among rural married migrant women in Shandong Province, China: a comparison study

Migrant women in China are disproportionately affected by HIV/AIDS. This study described HIV/AIDS-related knowledge and behaviors among married migrant women in Shandong province in comparison to non-migrant local women and identified factors associated with HIV testing history and extramarital sex among married migrant women. A probability-based sample of 1,076 migrant and 1,195 local women were included in the analyses. Compared to local women, married migrant women had lower levels of HIV/AIDS knowledge and were more likely to have had premarital sex, extramarital sex, history of sexually transmitted diseases, and drug use. Less than a quarter of migrant women used condoms consistently in extramarital sex. Only 31.0 % of married migrant women had ever tested for HIV, and the rate of premarital HIV testing was very low. Multivariable analysis showed that married migrant women with a history of extramarital sex were more likely to be from Yunnan province, be living in Yantai city, be in their first marriage, have lower family income, have poor relationship with spouses, use drug, have a history of sexually transmitted diseases, and have lower social support. Our findings provide further evidence that married migrant women are at higher risk for HIV infection and that targeted interventions need to be developed for this population.

The increase of sexually transmitted infections calls for simultaneous preventive intervention for more effectively containing HIV epidemics in China

OBJECTIVE

To identify the priority public health challenges with respect to the development of multipurpose prevention technologies in China.

DESIGN

Review of published literature, databases of state and local disease control agencies and unpublished data relating to HIV and other sexually transmitted infections (STIs).

SETTING

China.

POPULATION

General and migrant populations.

METHODS

Review of published data, government reports and databases of China Disease Control agencies, and our unpublished studies.

MAIN OUTCOME MEASURES

Reported STI incidence, particularly HIV, syphilis, chlamydia and genital herpes, and the migrant population with respect to disease transmission.

RESULTS

We found that the reported STI incidence increases along with that of HIV and showed significant geographic overlap with HIV. Economic migrant workers may facilitate the spread of STIs, including HIV.

CONCLUSIONS

To more effectively contain the HIV epidemic, it is imperative to develop preventive measures to simultaneously target HIV and other STIs. We recommend that the development of multipurpose prevention technologies in China should target HIV and STIs.

Factors associated with HIV testing among male motorbike taxi drivers in urban Vietnam

Using the Attitude-Skills-Knowledge (ASK) model, this study examined the prevalence of, and factors associated with, human immunodeficiency virus (HIV) testing among male motorbike taxi drivers (MMTDs). In a cross-sectional design, using quantitative approaches, 291 MMTDs were recruited from 135 sites across 13 districts in Hanoi, Vietnam, for a face-to-face interview. Applying the ASK model modified as a central theory, logistic regression was used to identify determinants of HIV testing. Although many MMTDs engaged in multiple risk behaviours for HIV, only 20.6% had been tested for HIV during the past 12 months. The tested model included one factor of the ASK model, HIV prevention knowledge (adjusted odds ratio [AOR] = 4.76; 95% confidence interval [CI] = 2.12-10.7) and five additional factors: being married (AOR = 3.13; 95% CI = 1.25-4.78), preferring sex with men or with both men and women (AOR = 8.72; 95% CI = 1.48-51.5), having lower number of lifetime sex partners (AOR = 0.66; 95% CI = 0.49-0.88), higher number of past year sex partners (AOR = 2.97: 95% CI = 1.21-7.31) and discussing condom use when having sex with partners (AOR = 0.08; 95% CI = 0.01-7.31). This modified ASK model provided better fit than the ASK model, as it explained more variance in HIV testing (47 vs. 29.8%). Recognising factors associated with HIV testing among MMTDs enables us to create suitable public health intervention strategies.

Rural-to-urban migrants are at high risk of sexually transmitted and viral hepatitis infections in China: a systematic review and meta-analysis

Background

Rapid economic development in urban China has led to a mass migration of surplus rural residents into urban areas for better employment opportunities. This study aims to identify prevalence levels and risks of sexually transmitted infections (STIs) and hepatitis among the rural-to-urban migrant population in China.

Methods

Chinese and English literature databases were searched for studies reporting prevalence of HIV, STIs and viral hepatitis among rural-to-urban migrants in China between 1990 and 2013. The estimates were summarised through a systematic review and meta-analysis. The risks of infection were compared between migrants and the general Chinese population.

Results

We identified a total of 411 eligible studies. The prevalence of HIV, syphilis, gonorrhea, genital warts and HCV among migrants were 0.23% (0.20-0.27%), 0.69% (0.57-0.84%), 2.18% (1.30-3.64%), 1.54% (0.70-3.36%) and 0.45% (0.31-3.65%), representing 4.0 (3.1-5.2), 1.9 (1.1-3.0), 13.6 (5.8-32.1), 38.5 (15.7-94.5) and 3.8 (1.9-7.3) higher odds of infection than among the general population. Construction workers, long-distance truck drivers and migrant women through marriage were migrant subgroups that were highly susceptible to STIs and hepatitis. HIV prevalence among migrant pregnant women (0.10%, 0.02-0.49%) was significantly higher than that of pregnant women in the general Chinese population (OR = 7.7, 3.4-17.4). However, no significant differences were observed in STIs and hepatitis between overall female sex workers (FSWs), men who have sex with men (MSM) and drug users (DUs), and the corresponding subgroups with a migratory background.

Conclusions

Rural-to-urban migrants have a higher risk of STIs and hepatitis than the general Chinese population, but a migratory background does not increase the infection risks of STIs and hepatitis in FSWs, MSM and DUs.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2334-14-490) contains supplementary material, which is available to authorized users.

A cross-site intervention in Chinese rural migrants enhances HIV/AIDS knowledge, attitude and behavior

Background: With the influx of rural migrants into urban areas, the spread of HIV has increased significantly in Shaanxi Province (China). Migrant workers are at high risk of HIV infection due to social conditions and hardships (isolation, separation, marginalization, barriers to services, etc.). Objective: We explored the efficacy of a HIV/AIDS prevention and control program for rural migrants in Shaanxi Province, administered at both rural and urban sites. Methods: Guidance concerning HIV/AIDS prevention was given to the experimental group (266 migrants) for 1 year by the center of disease control, community health agencies and family planning department. The intervention was conducted according to the HIV/AIDS Prevention Management Manual for Rural Migrants. A control group of migrants only received general population intervention. The impact of the intervention was evaluated by administering HIV/AIDS knowledge, attitudes and sexual behavior (KAB) questionnaires after 6 and 12 months. Results: In the experimental group; 6 months of intervention achieved improvements in HIV/AIDS related knowledge. After 12 months; HIV/AIDS-related knowledge reached near maximal scores. Attitude and most behaviors scores were significantly improved. Moreover; the experimental group showed significant differences in HIV-AIDS knowledge; attitude and most behavior compared with the control group. Conclusions: The systematic long-term cross-site HIV/AIDS prevention in both rural and urban areas is a highly effective method to improve HIV/AIDS KAB among rural migrants.

Blood safety and availability: continuing challenges in China's blood banking system

Social and economic development, along with increased health care coverage, has caused a sharp increase in the clinical demand for blood in China. Whole blood collection has increased rapidly in the past decade but has failed to keep pace with the ever-increasing demand. Overall, the country's blood safety has been improved with 99% of whole blood donations collected from voluntary unpaid donors. However, the unmet clinical demand for blood and the increasing incidence of human immunodeficiency virus and syphilis in the general population pose new challenges to China's blood banking system. To ensure a safe and adequate blood supply, continued efforts are required to recruit and retain a sufficient number of low-risk voluntary blood donors, improve donor prescreening and blood testing process, ease donor restrictions, and strengthen patient blood management.