The rural worker is not AIDS " The high-risk

The rural worker is not AIDS " The high-risk group "
Staff reporter Zhang WenLing

Will it be noon November 30, one unique the intersection of prevention and the intersection of AIDS and propaganda activity some construction site is launched in Shijiazhuang.

The country takes a photograph of the social investigation result different from people's imagination newly

September of 2004, under developing the support of the bank loan in Asia, of our country the intersection of Yunnan and the intersection of Baoshan and city of west begin to build a about 80 -km-long expressway between Longling county ' Abbreviated as " protect dragon's expressway " ,Have already completed and open to the traffic at present) . The road construction area is about 100 km from Sino-Myanmar border, this a gleam of is endangered one of the most serious areas by AIDS in Yunnan Province, AIDS preventing and controlling situation is very severe. Domestic and foreign research shows, if has not taken the effective prevention intervening measure, the construction of highway will increase some diseases (especially venereal disease, AIDS) too while accelerating local economic development Danger of spreading to the peripheral community.

Protect the potential social dangerous factor which may bring in dragon's road construction in order to reduce, 2005, Yunnan the intersection of provincial government and the intersection of AIDS preventing and controlling and office and Asian Development Bank design first venereal disease and AIDS prevent the control item together - -" protect dragon's expressway venereal disease and AIDS and prevent the project " (call too " The safe and comfortable action of protecting dragons " ),This project is organized by Mary and Stepp world and carried out, Kunming the intersection of medical college and health and Institute for Development Studies take on, supervise, assess collection, arrangement in census data and analyze together with the intersection of Baoshan and the intersection of city and center for disease control.

This investigation is divided into two investigations of base-line and finish line. Nearly 40 members of project team use different sample methods to different crowd's characteristics, the personnel of building site, women engaged in commerciality service in the peripheral bath center, place of entertainment, bar, hotel, cosmetology shop, roadside shop on the way of the highway to building the road, and building site contact close stockaded village engage in farming youth with build the road, the villages and towns work as a temporary labourer in the youth and the middle schools of villages and towns for 16 years old and investigate questionnaire and interview to the 24 -year-old young man near the building site. In order to make the investigation result more convincing, can assess government and other departments and " protect dragon's safe and comfortable action " scientifically Function in this area, this project, still with assuaring the dragon building the road in the expressway the environment is the same, build the road education degree and monthly income of worker general the intersection of characteristic and extremely similar the intersection of Baoshan and the intersection of city and the intersection of Tengchong and county go to the intersection of Burma and Class II highway of Myitkyina, set up control group, it investigation result and assuaring dragon's investigation result of the expressway basically has no difference.

The pleasant one is, the investigation finds: "Protect dragon expressway whom building site close to AIDS and take drug high and getting prevailing, situation that but not found the intravenous injection drugs yet in the building site at present and AIDS spreads. "

"It is not that is minimum that the skilled worker seeks the commerciality possibility of the service, this is information that can be confirmed got in this investigation of ours through the multiple channel. " An investigator of project team says to reporters: "I object to, regard rural worker as dreadful monsters, object to, say rural worker Chengdu go whoring. "

This investigator says, have different colonies in the rural worker too. In the investigation, they worker divide into, come on, investigate by several inferior colony build the road: The intersection of project and administrative staff, supervise, contractor, skilled worker, skilled worker, driver. In the building site, it is not the skilled worker that accounts for most, some of them's worker from the North calls oneself " stupid worker " . They are engaged in digging working manual labor large and simple in intensity such as the cubic meter of stone, choosing the soil, often work overtime, the living condition is arduous, is eating a cauldron of dishes, fifteen six people live in a simple and crude builder's temporary shed less than 20 square kilometers, not only badly paid, but also often can't receive the salary on time.

The intersection of majority and married worker the, wife, around, though someone can say " who want, abstain from eating meat always too, also want to eat some meat or fish " ,But is needed etc. influencing by the income, traffic condition, contacts, few people and commerciality " sex worker " in them The sexual behavior takes place. "Work is so hard every day, where to have that attention to play. Besides, how to afford to consume? Did not earn any money until one day. " A rural worker of some bid section says.

A bath center " Sex workers " Have verified this statement: "Those people living in above take little money, they can not afford to consume either. What we received are all other guests. "

The reporter sees in " protecting dragon's expressway venereal disease and AIDS to prevent the base-line survey report of the project ", skilled worker to " build the road worker every crowd, happen behavioral proportion with commerciality ' the intersection of sex and worker ' last one year report " China is the lowest, 95.9% people do not have this behavior, 95% of the people have not had sex with provisional companion in one year recently.

A worker says: "Badly off in we house, little,expect family, there are Is, make family day better than a bit, I am more bitter and more tired and perfectly willing too. I will not spend money recklessly, let alone act foolishly. "

Another worker says: "The baby studies and waits for the money, us more bitter more difficult to stop over either babies, I give up all cigarettes, go home in order to bring more money. "

"The serious and objective social investigation result is often different from people's imagination. People always thought the rural worker was that an individual character enlivened the colony, had demand greatly on marriage and sexual life, after leaving one's native place, it is very apt to take place with the sexual behavior outside the wedding before marriage. But actually they have one's own adhering to, the dream and planning of the future. " Professor of Kunming medical college, president of research association of health in Yunnan Province and development would rather say to open.

The sheath is as important as safety helmet

In protecting dragon's investigation in the expressway, the researchers find, build the road in every crowd in the building site, that sought the commerciality service at most is contractor and driver. Its reason is: " the contractor has need of work, a lot of departments should treat with courtesy, such objective conditions as it is relatively independent to also have the economic strength, means of transportation, time, accommodation " ; "Driver's work is freer, the economic income is ensured, is familiar with the surrounding environment, 75.2% driver native, spouse around, have more chances to go out alone, often gather and drink after the work, increase the possibility taking place in high-risk behaviour after drinking even more " .

In the investigation, a contractor complains to the investigator: "Native place to take, remit the money go back often, build the house for the family. Be the intersection of we and, long-term outside, wife around, play with little girl when being lonely, there is a sustenance psychologically. Besides, it is difficult to look for a project now, it please eat, please drink, please play to sometimes want the public relations. Drink, sing and ask the little girl to be accompanied, have atmosphere. "

Whether when the investigator asked this contractor to get and use the sheath, this contractor, hey hey smiled. "The sheath? Have sent? wastes one grade of speech Qu Zhan s of pharmaceutical Yu of Jin and depends on Sha slowly! ?

In recent years, popularizing the sheath has already become an important measure of preventing and curing AIDS, " regulations of AIDS preventing and controlling of Yunnan Province " issued in November of 2006 stipulates: "In population concentration places such as airport, quay, station, building site,etc., set up the sheath and sell facilities. The operator of the public place for money that offers service of getting accommodation, amusing should put the sheath or arrangement sheath to sell facilities in the business place, propagate and popularize the sheath. " But in investigation this, researcher find though great majority build the road the personnel of building site know that use the sheath in surprise, but some people in them do not use the sheath yet while seeking the commercial service. One that is according to contractor and driver,et al., from the report, when they have sex with provisional companion, the sheath insists rate of utilization is very low. Its reason is varied, someone thinks that can confirm " sex workers " by watching Healthy, think without the disease, needn't use the sheath; Someone thinks, there was not a disease without using the sheath in the past, so did not need. More reason is " I am unwilling to use " , " companion has not required the sex " , not " at one's side " Wait, have some reason to " think until venereal disease, AIDS relatively far " , " the rural little girl is safer " . A driver says: "Also used. But sometimes forget to take, does not use. Besides, get along for long time and relatively understand each other, should have no diseases, both sides relatively rest assured. "

"The unprotected sexual behavior will become the spread threat of main venereal disease and AIDS. " An investigator says: "Every crowd in the building site is infected with the risk of venereal disease and AIDS, not merely lie in seeking the behavior of the commercial service to build the road, the more important thing is not to need while seeking the commercial service or can't use the sheath correctly. "

And a troubling one that insist on, use sheath, make the intersection of women and the intersection of commerciality and " sex worker " that link with road construction Fragility increase in dealing with venereal disease and AIDS. One that is with cities and towns li " Sex workers " Compare, " sex workers " of the roadside shop More fragile: It is in large quantity to meet guests, but scarcely prevent the knowledge of AIDS, the sense of self-protection is very deficient.

The investigation finds, though the boss tells these women to use the sheath, in the sex trade, but because many kinds of factors have not used the sheath finally. For example: " whether in passive status, unwilling guest with but also unable to persuade in oneself " ; " person running into the frequent visitor and liking oneself " ; Do not " think there is AIDS in the locality, do not quite get the possibility of AIDS " ; " guests add the money " ; " believe oneself is healthy, will not be infected " .

In addition, the investigation also finds, building the highway increases peripheral community villagers and works as a temporary labourer, sells the agricultural byproducts, chance to hire out house nearby, have raised local villagers' income, has driven the development of the local service industry, catering trade, also driven the development of different places of entertainment on the way, has presented the phenomenon that the place of entertainment follows highway. Because the traffic came as to convenient, a large number of nonlocal personnel, made greater change has taken place in such aspects as thought, idea, behavior of associating to local young peopled.

In the youth of community investigated, young man and students outside school are nearly of the same age, but by contrast, the young man outside school deals with the respect to show at venereal disease and AIDS even more fragily. For example, the young man outside school is 45.4% from the youth of stockaded village of incidence who reports the premarital sex, the youth of villages and towns is 36.8%, students report by oneself the incidence of the premarital sex is 12.5%, the young man outside school is 3~4 times of the students', and their sexual behavior does not often have any protective measure. The local traditional idea does not think young people should have a sexual behavior before marriage, let alone use the sheath, this has become one of the reasons that influences the sheath to release, get, use.

According to the investigation, most community youth knows the sales outlet of the sheath is hospital, birth control organization, pharmacy and private clinic, the place where they would like to buy the sheath most is hospital, pharmacy and adult's health product shop, only a few community youth mentions the selling machine automatically of the sheath. And sets up the sheath and sell some as to the selling machine in the installation sheath of the community automatically, most interviewed community young men all agree. And the person that does not agree to thinks, the open sales of the sheath diminishes the local social conduct.

"What the building constructor paid close attention to even more is that the progress of building the road and workers are safe, wear safe items such as the safety helmet,etc. and is rooted in the hearts of the people in the building site. And the sheath should be listed in safe knowledge education like safety helmet, could make, prevent and cure the intersection of venereal disease and AIDS to be work easy to implement and make a practice of. " Would rather say to open.

Venereal disease and AIDS of medical worker at the basic level have deficient knowledge

The ones that made people feel surprised are, the investigation finds, all medical organizations at the basic level of the community on the way of building site of highway investigated though the diagnosis that has been offering venereal disease treats the service, but venereal disease and AIDS of the administrators and medical workers of these organizations have quite deficient knowledge, unnecessary medicines and make a diagnosis apparatus, even does not know they can play an important role in the AIDS prevention work of venereal disease.

The target of medical organization at the basic level who the project team investigates is that one grade of hospitals, state-run clinic, clinic and family at village level at county level in the township make a diagnosis in the centre, and private clinic and pharmacy. These medical organizations do not basically understand how to meet and examine AIDS people, but can offer service of making a diagnosis and giving treatment in basic venereal disease. The larger one is health clinics in towns and townships, individual clinic and the street, rural clinic that venereal disease connects the examining amount, meet, examine the intersection of venereal disease and patient, range from several people to more than 100 people one year, and different medical organization the intersection of venereal disease and kind examined to connect have different. Closer individual clinic and what the residential district, rural clinic are met and examined of building site are mostly venereal disease patients building the road in the building site before building the road. And the villages and towns farther from the building site, venereal disease patients are mostly temporary workers going out here or strangers that worked as a temporary labourer in the locality.

However, in these medical organizations at the basic level, except that the health clinics in towns and townships can do several simple venereal diseases to measure, other medical organizations basically can't measure venereal disease, the doctor's diagnosis to venereal disease patient mainly depends on the medical history and checks the body.

The investigation finds, the relevant knowledge of staff member's venereal disease and AIDS of medical matters at the basic level is deficient, 20% of the medical workers can't choose the full name of AIDS correctly, people that knowledge of protecting to the diagnosis, treating the measure, job of AIDS etc. chooses correctly do not have many.

As to some AIDS preventive treatment knowledge, many medical workers have a mistaken idea too. If the mosquito can transmit AIDS to bite, nearly 1/ 3 of the medical workers can't answer correctly. Some doctors think " The afterflush of sexual intercourse " With " use contraceptive for external use " Can prevent AIDS.

"Though the knowledge is often involved in the masses propagate, and can see in the poster, but these medical workers do not understand yet, it has relation that this is not probably strong with their consciousness against AIDS. " An investigator tells reporters. They find in the investigation, most medical workers at the basic level have not met and examined AIDS people, only the extremely individual doctor meets and examines AIDS people during receiving a training. While mentioning AIDS, though mostly express sympathy on AIDS people and person living with HIV/AIDS, but still think " Too terrific " , " fear " ,Even a few medical workers think " serve you right, is not worth sympathizing with " ,"Should make all peoples once, draw blood, check, will isolate after finding the person suffering from AIDS, do not let them transmit AIDS " .

"These medical workers criticize the morals that the patient make, has influenced the view that they prevent and control to AIDS. " This investigator says.

The interviewees all mind one's own health

"Don't think rural worker some uncouth fellow, healthy and safe and apathetic to a own one. " Open, would rather say to reporter according to observation of them, majority it bes coolies to be whether technical staff lie in a own one to be healthy and safe very much in fact, a lot of people had a meal and only inserted the dish that just served the desk each time in them, later only had a meal, they fear to be infected with hepatitis B.

"Besides hepatitis B, such as they ask me, whether diabetes will be infected if they also fear a lot of diseases. " Would rather say to open.

The investigation reveals, every crowd in the building site nearly all hears of venereal disease, know the spread route of venereal disease too to build the road, still can say the names of a few kinds of venereal diseases, but know little about ABC of AIDS. Supervise, contractor and the intersection of great majority and pair in the worker " Whether one can find out from appearance he suffers from AIDS " The answer of this question is " Can't know " . Hear of philtrum of AIDS in great majority, know spread of AIDS route whether blood propagate with " play with with those women " only generally Will spread, there are few people who will know mother-to-baby transmission route. In addition, build the road the intersection of building site and person mostly think the measure which prevent AIDS is not to take drug, but the majority are right " Do not inject the drugs, not share the needle to take drug " Method very clear; Most people think " Don't act foolishly " Also means to prevent AIDS, to " use the sheath prevent from AIDS " Understanding fuzzy.

Watch on understanding depth and broadness of AIDS knowledge, the administrative staff of the project and supervising better, it is not that a skilled worker is the worst. The administrative staff can obtain the knowledge of AIDS through TV, newspaper, magazine, network,etc., but not the skilled workers, especially workers of the tunnel project, class three rotates, it is the physical power that live, very arduous, amateurish life, mainly in order to read newspaper, chat for main fact, knowledge come from the intersection of mouth and mouth according to legend mainly. In them, nonlocal workers are better than local workers, the workers of the Han nationality are better than the workers of ethnic minority.

When hearing the investigator can explain health knowledge for everybody, the personnel of building site express the great interest to build the road. A worker says: "Nobody has told us, does not know how to deal with, will infect to hear of sneezing too, fear to have it very much. We want someone to say something about very much. " A contractor says too: "Diseases in the society are many now, we do not know either how to prevent, nobody says too. If you can come to say something about the best. "

The investigation reveals, every crowd at the building site knowledge explain and propaganda materials release and the intersection of sheath and releasing, health consultation and special technical training,etc. have a greater demand to serve to intervene to AIDS, a few people obtain sheath, lubricant, venereal disease, make a diagnosis serving and special skills training once only in the they. Most people express on the building site the service hoped to obtain in the following two years is " Explain the AIDS preventive treatment knowledge of venereal disease " , " offering the sheath and lubricant " .

An investigator tells reporters, the commerciality " sex worker " AIDS knowledge troubling. "AIDS? Having it is saided, how on earth but can not know, only hear that very terrible. " A " sex worker " Say to the investigator. Some people even think wrongly in them " The afterflush of sexual intercourse " , " use antiinflammatory agent " , " it is ill to see him " Can all achieve the goal of preventing. Though they know that want to use the sheath, most people do not know in them where to get the free sheath.

This investigator says, with women's commerciality " sex worker " It is relatively great to link up the difficulty, should keep in touch with them alone by way of role playing at the very beginning. As indicating to them after the identity explain the one's purpose in coming, they will demonstrate that impatient, turn on the television, put very loud sound. But after some knowledge and information that they do not know that the investigator says, their attitude will change, even listen to the investigator explaining absorbedly. "They would like to know oneself engaged in trade this what loss does it can bring to one's own health in fact, can still get married and bear the healthy child in the future? "

"In all personnel who we visited, all express active demand and great interest to health education and reproduction teaching service, the medical personnel of the medical organization at the basic level hopes to obtain relevant training in respects such as making a diagnosis and giving treatment, consultation and health education of venereal disease,etc. too. " Would rather say to open: "Different crowds along the line of the building site of the highway have serious fragility to deal with the respect at venereal disease and AIDS, seem very important to prevent from intervening project activity. ' protect dragon's safe and comfortable action ' may be said that provides timely help. "

It is obvious to produce effects

Relatively show through the result that investigate of base-line investigation and finish line, through the intervention of more than one year, through " safe and comfortable action of protecting dragons " Resultant of forces of the project and government of Baoshan, no matter assuare the dragon builds the road in the building site and rises in the dense highway and builds the road in the building site in the expressway, AIDS preventing and controlling has made the exciting result:

Assuare dragon expressway build the road building site every great to transmit route, know rate and the intersection of AIDS and key correct understanding rate of knowledge improve to some extent to 3 AIDS crowd; Every crowd reduces from the dangerous sexual behavior incidence of the report to some extent compared with before, the emergence proportion of the provisional sexual behavior of the contractor, driver, skilled worker drops greatly, contractor and temporariness accompany and take place 22.7% that the rate of the sexual behavior is investigated by the base-line to reduce to 4 that investigated finish lines. 5%, skilled worker is recent year and " sex worker " The rate insisting on using the sheath when the sexual behavior takes place is by 6. 7% rise to 65%.

Rise dense highway build the road building site every crowd after not knowing, having HIV find voluntarily free, the proportion of person who wants to measure increases, seek the proportion of number of people that HIV measures voluntarily and rise to some extent than the previous year one year later, it is the largest with the contractor's rising proportion, rises to 90.9% from 70%.

The sum of preventing Erik from, working as the government " The safe and comfortable action of protecting dragons " The key crowd paying close attention to, the researchers see joyfully, and " protect dragon's safe and comfortable action " in government and other departments Act on down,women" worker " AIDS preventive treatment knowledge last improvement, be lasted emergence of protected sexual intercourse at the same time. Among them, " sex workers " of women of the roadside shop Change getting more obvious particularly,its AIDS knowledge level raise greatly, the using proportion of the sheath obviously increases too.

In addition, the youth of community along the line of the highway has improvement to a great extent to the correct understanding rate of the relevant knowledge of AIDS, the investigation reveals, the youth of community has accompanied taking place with temporariness in one year recently the proportion of the sexual behavior is reduced to some extent than before intervention, the sheath rate of utilization at the time of the sexual behavior is improved to some extent than before intervention for the first time.

And the medical worker not only the relevant knowledge of AIDS is improved a lot, also the obvious change takes place in the attitude towards AIDS patient of venereal disease, hold to the infeted " The fear " The proportion of medical worker of the attitude drops from 20.3% to 1.4%.

The health of Kunming medical college and Tang SongYuan, associate professor of Institute for Development Studies, point out, AIDS is not only a medical question, but also a public problem of management. It needs a great deal of departments of the whole society to work, need the government, enterprise, non-governmental organization, community, not include the infeted, patient and expert with the crowd to prevent and cure AIDS, there are joint efforts and participation of the international organization. Only rationally the organization mobilizes social resources, could prevent and cure AIDS and this disease of hindering the human social development effectively.

The rural worker is not AIDS " The high-risk group "