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High-risk Establishments and Women’s HIV Prevention in Southern China
Research Method: Intervention Research
Principal Investigators: Margaret R. Weeks, Ph.D., PI (ICR), Susu Liao, Ph.D., Co-PI (Peking Union Medical College)
Grant: National Institute on Mental Health
Partners: Department of Epidemiology, Peking Union Medical College (PUMC), Chinese Academy of Medical Sciences (CAMS), Hainan Province Centers for Disease Control (CDC), Guangxi Province CDC
Dates of Study: 2007-2012

In the past two decades in China, HIV/AIDS and STD rates have been rising, particularly among women. Though HIV/AIDS campaigns have been launched for years by the Chinese government, the population's knowledge of HIV/AIDS is limited and perception of risk is extremely low. Additionally, social stigma associated with an HIV-positive diagnosis generates reluctance to access testing, treatment, or information on prevention. The lack of knowledge and prevention models is combined with a shift in social and economic structures, significant increase in migration of young men and women from rural areas to development zones, and changing gender norms, leading to increased drug use and female prostitution in both rural and urban areas, and increased risk for HIV/STD infection. Innovative and multiple HIV/STD prevention approaches, including women-controlled methods, are desperately needed.


A previous ICR study, Microbicide and Female Condom Acceptability for HIV/STD Prevention Among Female Sex Workers in Southern China, provided formative data, trained local researchers, and built relationships that will assist project staff to conduct an intervention testing the acceptability of female condom use in sex establishments in 2 provinces in southern China. A significant component of the study was the transfer and sharing of technologies of research methodologies among the international team of research collaborators, and from the research institutes in the U.S. and China to the local partner organizations in each of the study sites. High-risk Establishments and Women’s HIV Prevention in Southern China will build on this data to test an intervention promoting female condom use among commercial sex workers and the proprietors of the establishments in which they work.

Project Goals and Objectives
To assess the number and nature of sex-work establishments in these towns, and the stability and social dynamics within these establishments that affect delivery and testing of a site-base intervention to promote FC use for HIV prevention
To assess factors associated with HIV risk and use of female and male condoms for HIV prevention among women who work within these establishments
To develop, pilot, conduct a process evaluation, assess short-term efficacy and potential sustainability of, and manualize a site-based, multi-level (individual, site, community) intervention conducted in these establishments to promote the FC for HIV/STD prevention
To explore factors likely to explain: a) variation in feasibility, acceptability, and fidelity of intervention delivered in different establishments and different towns, and b) variation in short-term efficacy and sustainability of the intervention among women in different establishments and different towns.
Staff Contact:
Margaret R. Weeks, Ph.D.,
Principal Investigator
Associate Director, ICR


Project Staff:
ICR
Margaret R. Weeks, Ph.D., Principal Investigator

Jianghong Li, M.D.

Co-Principal Investigator, Statistician

Maryann Abbott

Project Director

Jennifer Dunn

Ethnographer

PUMC
Susu Liao, Ph.D.,
Co-Principal Investigator

Jingmei Jiang, Ph.D.

Biostatistician

Fei Li, Ph.D.

Ethnographer

Hainan CDC

Qiaya He

Site Director

Bin He

Project Site Coordinator

Guangxi CDC

Wei Liu

Site Director

Yuejiang Zhou

Project Site Coordinator
Project Details
In each town we will use intensive ethnography to assess the characteristics and dynamics of sex workers and sex-work establishments, as well as the feasibility, process, and outcomes of the intervention conducted in those establishments. We will conduct cross-sectional surveys of sex workers in all 4 towns at three time points (baseline, 6 and 12 months post-baseline) for comparative analyses to assess town-level, sex-work establishment, and individual-level characteristics associated with HIV risk and prevention and outcomes of the intervention. Qualitative and quantitative data will be triangulated to build the strongest assessment of characteristics that affect risk and intervention outcomes and to provide the most comprehensive analysis of factors that enhance or impede use of the FC and other prevention measures by women in these establishments. Development and testing of the FC intervention has significant public health implications because of its potential for reducing sexual HIV transmission in this high-risk population and in the broader population of their sexual networks.

Link to Research Methods page

Links to Other Projects
Microbicide Acceptability to Prevent HIV in High-Risk Women
Female Condom Use in High Risk Women as Predictor of Microbicide Readiness

Links to External Sites
John E. Fogarty International Center for Advanced Study in the Health Sciences
Peking Union Medical College
Chinese Academy of Medical Sciences