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.

Dissemination and uptake of HIV/STD preventive interventions in American Indian and Alaska Native communities: a case study.

Objectives: HIV and sexually transmitted diseases (STDs) are serious health conditions among American Indian and Alaska Native (AIAN) populations, especially youth. However, few sexual risk reduction evidence-based interventions (EBIs) have been implemented by AIAN-serving organizations. This project sought to identify and assess the parameters facilitating the uptake and use of EBIs in order to strengthen opportunities for sustainability and improved sexual health among AIANs.Design: Guided by Rogers' theory of diffusion of innovation, we conducted a survey with a national sample of stakeholders involved with sexual health and well-being of AIAN youth (N = 142). We collected surveys for nine months beginning September 2010 and analyzed data in 2014 and 2015. We assessed respondents' perceptions of factors that might facilitate or hinder the use of a sexual risk reduction EBI, called RESPECT, in their communities. We regressed the scale of likely program uptake (alpha = 0.88) on each of five measures of perception of diffusion and uptake: trialability (extent new program can be altered), relative advantage (more advantageous than current program), observability (impact of program), complexity (difficulty of implementation), and compatibility (consistent with community values and practices).Results: Trialability (p = .009), observability (p = .003), and compatibility (p = .005) were found to be significantly related to program uptake in the adjusted model. Standardized betas showed that compatibility ranked highest of the three, followed by trialability and observability.Conclusions: For AIAN-serving organizations and AIAN communities, demonstrating trialability, compatibility, and observability of a sexual risk reduction EBI in specific cultural settings may increase likelihood of implementation and sustainability.

Development and effectiveness of a mobile phone application conducting health behavioral intervention among men who have sex with men, a randomized controlled trial: study protocol.

BACKGROUND: Behavioral intervention is a key approach to HIV prevention among men who have sex with men (MSM). Widespread use of mobile phones provide us with novel opportunities to decrease HIV infection and transmission of MSM. The objective of the study was to design and develop a mobile phone application (app) aims to conduct behavioral intervention to MSM and to evaluate the efficacy of the app-based intervention compared to usual care, to analyze cost-effectiveness and mechanism of the intervention. METHODS: This study involves 2 phases, phase 1 use qualitative method and phase 2 is a randomized controlled trial lasting for 18 months, they will be conducted in Chagnsha, Hunan Province, China. Phase 1 is to design and develop the app, procedures including retrieval of domestic apps related to prevention and treatment about HIV and sexually transmitted diseases (HIV/STDs), personal interviews with MSM about preferences and functional needs of the HIV prevention app, multidisciplinary experts focused group discussions of the app, software engineers' development and users test of the app will be performed. In phase 2, we will recruit 800 MSM by cooperating with the local center of disease control and prevention and nongovernmental organizations, and divide them into intervention and control group evenly. Intervention group participants will receive app-based HIV prevention. Control group participants will be provided with usual care including HIV/STDs knowledge brochure and free voluntary counseling services. Data will be collected at baseline, 6, 12 and 18 months since subject's participation. Effectiveness of the intervention includes HIV/STDs infection rates, adherence to regularly HIV testing, sexual risk behavior, consistent condom use and relative risk of HIV infection. Cost-effectiveness will be analyzed by decision-analytic modeling, and mechanism analysis of this app-based intervention will be performed by path analysis. DISCUSSION: This will be the first study of its kind in China to develop an app and implement app-based HIV prevention intervention among MSM. It is of great potential to determine whether app-based intervention is a cost-effective way to decrease HIV infection among MSM and explore intervention mechanism with an accurate method. TRIAL REGISTRATION: Chinese Clinical Trial Register ( ChiCTR-IOR-15006724 ). Registered 10 July 2015.

Experiences of HIV/STD Providers in New York State During Hurricane Sandy: Strengths, Challenges, and Recommendations.

OBJECTIVES: The aim of this study was to assess strengths and challenges experienced by HIV/STD providers in providing care during the response to Hurricane Sandy (Sandy) in New York State, and their recommendations for future preparedness. METHODS: A mixed methods approach, including a focus group (n = 3), interviews (n = 3), and survey (n = 31) of HIV/STD providers, was used. Key words identified by means of open coding methodology from collected data were organized into strengths, challenges, and recommendations and then grouped into federal and study-associated preparedness capabilities. RESULTS: Key words were organized into 81 strengths (38.8%), 73 challenges (34.9%), and 55 recommendations (26.3%). Services most interrupted during Sandy were related to HIV/STD outreach and education. While providers reported challenges with external agency communication, the ability to still connect clients to needed resources was reported as a strength. Strengthening partnerships with federal, state, and local agencies was among the major recommendations made by these providers. CONCLUSIONS: This study presents unique information about challenges experienced by HIV/STD providers in providing services during a natural disaster and the use of national public health emergency preparedness capabilities to address and overcome those challenges. Lessons learned and recommendations regarding inter-agency communications emerged as an important priority during a natural disaster to minimize or reduce service interruption.