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Open Access Research article

Acquired immunodeficiency syndrome/human immunodeficiency virus knowledge, attitudes, and practices, and use of healthcare services among rural migrants: a cross-sectional study in China

Ying Wang1, Christopher Cochran2, Peng Xu3, Jay J Shen2, Gang Zeng3, Yanjun Xu1, Mei Sun1, Chengyue Li1, Xiaohong Li1, Fengshui Chang1, Jun Lu1, Mo Hao1* and Fan Lu3*

Author Affiliations

1 Research Institute of Health Development Strategies, Fudan University, 130 Dong An Road, Shanghai 200032, China

2 Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada, 4505 Maryland Parkway, Las Vegas, NV, USA

3 National Center for AIDS Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, China

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BMC Public Health 2014, 14:158  doi:10.1186/1471-2458-14-158

Published: 13 February 2014

Abstract

Background

Today’s rapid growth of migrant populations has been a major contributor to the human immunodeficiency virus (HIV) epidemic. However, relatively few studies have focused on HIV/acquired immunodeficiency syndrome (AIDS)-related knowledge, attitudes, and practice among rural-to-urban migrants in China. This cross-sectional study was to assess HIV/AIDS-related knowledge and perceptions, including knowledge about reducing high-risk sex.

Methods

Two-phase stratified cluster sampling was applied and 2,753 rural migrants participated in this study. An anonymous self-administered questionnaire was conducted in Guangdong and Sichuan provinces in 2007. Descriptive analysis was used to present the essential characteristics of the respondents. Chi-square test and multiple logistic regression models were performed to examine the associations between identified demographic factors and high-risk sex, sexually transmitted disease (STD) symptoms, and access to HIV screening services among the seven types of workers.

Results

58.6% of participants were knowledgeable about HIV/AIDS transmission, but approximately 90% had a negative attitude towards the AIDS patients, and that 6.2% had engaged in high-risk sex in the past 12 months. Logistic regression analysis revealed sex, marital status, income, migration and work experience to be associated with high-risk sex. Among the 13.9% of workers who reported having STD symptoms, risk factors that were identified included female gender, high monthly income, being married, daily laborer or entertainment worker, frequent migration, and length of work experience. Only 3% of migrant workers received voluntary free HIV screening, which was positively associated with monthly income and workplace.

Conclusions

HIV/AIDS knowledge, attitudes, and practices among rural migrants in China remain a thorny health issue, and use of healthcare services needs to be improved. Low levels of education and knowledge regarding HIV/AIDS among housekeepers and migrant day laborers result in this population likely being engaged in high-risk sex. Government programs should pay more attention to public education, health promotion and intervention for the control of the HIV/AIDS epidemic in China.

Keywords:
China; AIDS/HIV; Knowledge, Attitude and Practice (KAP) study; Rural migrant workers; High-risk sexual behavior; Health services use