Background
The increasing trend of the infection of sexually transmitted diseases (STD) including HIV among women in China and their limited access to the scarce STD prevention programme make them vulnerable to the human immunodeficiency virus (HIV) infection. Available information suggests that a vast majority of Hong Kong travellers to the nearest border cities of mainland China do buy sex on an occasional or regular basis. The frequency of consistent condom use is not also very high among them. This has a very serious impact on those partners of the cross-border travellers. To understand the magnitude of the sexual activities in the two border cities of Hong Kong (Shenzhen and Guangzhou), a baseline study was carried out. The aim of this study was to assess knowledge, attitudes and pattern of risk-taking behaviour concerning HIV infection among Chinese women working in different hospitality industries in these two southern Chinese cities.
Methods
Women were recruited from two correctional institutions and were interviewed by trained interviewers between January 1999 and April 1999. A structured pre-tested questionnaire was used for data collection which sought information on demographics, their sexual behaviour and practice, knowledge about AIDS and their perception of risk. Approximate background information of their clients and their attitudes to safer sex was also collected.
Results
A total of 267 women were interviewed of which 32 were not eligible for
the study leaving 235 for analysis. Of the respondents, 71% were below 25
years, most (95%) attained an education to primary (39%) or secondary
(56%) school, 27% were ever smokers, 40% became sexually active before the age
of 18, and 15% were infected with an STD during the previous one year. Although about 80% of the respondents had heard about AIDS, a substantial proportion possessed misconceptions in different aspects of AIDS such as, HIV can be transmitted from shaking hands (15% yes and 39% don't know)) or unprotected sexual intercourse (20% reported no or don't know), and about one-third of the respondents did not know that HIV can be transmitted from mother to her child during pregnancy. Of the respondents 28% had an average of more than 5 sexual partners per week and a substantial proportion (47%) had entertained at least one Hong Kong Chinese client during the week previous to their recruitment to the correctional institute. Condom use
was not common; only 54% and 36% consistently used them with clients and regular sexual partners respectively. Refusal or unwillingness of sexual partners were the main reasons for not using condoms among the
respondents.
Conclusions
Women working in different hospitality industries in these cities should
be encouraged to learn more about the transmission and prevention of HIV/AIDS to reduce the risk of HIV infection among themselves and their clients. A culturally acceptable AIDS education programme, which should also cover negotiation skills with clients, should urgently be developed and delivered to every women working in hospitality industries. This may require greater cooperation from the establishment and local public health officials. On the other hand, Hong Kong travellers who are more likely to buy sex in mainland China should be targeted with rigorous preventive messages. Materials developed for such should be designed in a way which will appropriately promote the perception of risk and create self-awareness among the travelling population.
Reference
Zhang SX, Zhang XY, Abdullah ASM et al. Evaluation of condom use among underground prostitutes and clients in Shenzhen. Journal of China AIDS/STD Prevention and Control 2000; 6:9-11.