HIV Assessment in Fuyang, Anhui Province, China

This study has been completed.
Sponsor:
Information provided by:
National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:
NCT00094354
First received: October 16, 2004
Last updated: March 26, 2009
Last verified: January 2009
  Purpose

The purpose of this study was to examine the needs, concerns, stigmas, and social networks of HIV infected former plasma donors (FPDs) and their relatives in Fuyang, Anhui Province, China. Interviews and focus groups were used to collect data in preparation for a future, larger behavioral study for HIV infected individuals in China.


Condition
HIV Infections

Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: A Qualitative Study for the Development of an Intervention Among HIV-Positive Former Plasma Donors (FPDs) in Fuyang, Anhui Province, China

Resource links provided by NLM:


Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Enrollment: 111
Study Start Date: October 2004
Study Completion Date: April 2006
Primary Completion Date: March 2005 (Final data collection date for primary outcome measure)
Groups/Cohorts
1
HIV-infected FPDs
2
Family members of HIV-infected FPDs
3
Local healthcare workers
4
Villagers not related to an HIV-infected individual

  Hide Detailed Description

Detailed Description:

The HIV epidemic in China has reached a phase of exponential growth. Among the infected are former commercial plasma donors (FPDs) in rural communities, who became infected through contaminated blood collection equipment. This study examined the needs, concerns, stigmas, social networks, and discrimination among HIV infected FPDs and their families. The study was designed to provide preliminary information and help prepare for the implementation of a second study, which evaluated community based intervention on quality of life of HIV infection villagers and HIV-related stigma.

Four groups of people were enrolled in this study: HIV infected FPDs; family members of HIV infected FPDs; local healthcare workers; and other villagers not related to an HIV infected individual. Participants were recruited based on sampling framework which stratified potential participants by gender, age, and place of residence. Selected study participants from all four groups had in-depth, one-on-one interviews approximately 2 to 3 hours in length. The interviews were taped and transcribed, and the transcriptions were coded with respect to responses. In addition, there were 2 separate focus groups; one for local healthcare workers and a second for other villagers not related to an HIV infected individual.

Information was collected from 111 participants through face-to-face, in-depth interviews (FFI) and focus group discussions (FGD). FFIs were held with 20 HIV+ FPDs, 20 family members, 20 villagers from HIV-negative households and 20 local health workers. A further 31 participants participated in four FGDs; two each with villagers from HIV-negative households and local health workers, respectively.

Main findings

  1. HIV testing and disclosure: Most of the interviewed HIV+ FPDs were tested when the local CDC went to their villages and offered testing. Most of their spouses were also tested. Villagers usually knew who is HIV+ in their village because there have been confidentiality issues in the notification process and because they see who is seeking AIDS-related healthcare or getting assistance from the government's HIV/AIDS care and support programs.
  2. Discrimination and stigma: There have been no acts of physical violence as a result of discrimination or stigma. Acts of discrimination included being deliberately ignored, both by other villagers and their families. Stigma associated with HIV/AIDS includes imminent death, loss of labor and family economy, and bad reputation. The severity of stigma/discrimination is inversely related to the prevalence of HIV in a village.
  3. Psychological status: The ART program has improved people's outlook on life, however many remain pessimistic about their health, economic situation and future.
  4. HIV knowledge: Almost all the interviewees had heard of HIV/AIDS and knew the three main transmission routes (i.e. blood, sex, mother-to-child), however there were some misconceptions about transmission and prevention.
  5. Sexual behavior: Most of the HIV+ FPDs reduced their frequency of sex, and some even stopped having sex, after they learned their sero-status. Extra-marital sex was rare. HIV+ FPDs rarely used condoms before they knew they were positive. While they reported that they now use condoms every time they have sex, some of them do not use condoms correctly.
  6. Healthcare seeking behavior: After the introduction of the Four Free and One Care program, HIV+ FPDs tended to seek health services in HIV-designated hospitals/clinics because they provide financial support for medications. Despite the subsidies, many still found healthcare unaffordable. A minority forgot to take or could not adhere to their regimen at first, however this situation was very much improved by regular home visits by local health workers.
  7. Social network and support: Social networks among HIV+ FPDs have been formed as a result of daily life, work and medical treatment. However the networks vary. In Funan, a stable network has been formed among HIV+ people who know each other quite well because they live close to each other and were together when selling blood, seeking medical care after being informed of their HIV+ status and participating in AIDS-related programs. In Yingzhou, PLWHAs have less contact with each other, partly because they do not have a fixed treatment place. They do, however, have some opportunities to meet and chat with each other.
  8. Perceived needs: Participants were keen to learn more about HIV in general and in particular about treatment. They also desire more opportunity for communication to help them deal with the stress and pressure they experience. Family member recognized the need for some kind of intervention to help their HIV+ relatives.
  9. Economic situation: HIV+ individuals are the main income earners for their household, however most are not fit enough for jobs in the cities and rely on crops as their main source of income. People in Yingzhou are generally better off than people in Funan. A large proportion of the family income is spent on healthcare for the HIV+ family member.
  10. Modality of intervention: Participants' opinions on AIDS-related programs varied widely. HIV+ participants indicated their willingness to participate in any kind of AIDS-related programs. Group activities seemed to be acceptable. It was suggested that groups be divided by gender; that activities be held in a nearby or convenient location; that the intervention be scheduled during the off-season for farming; and that village leaders or doctors act as the contact persons for AIDS-related programs.
  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

HIV-infected former plasma donors (FPDs) , family members of HIV-infected FPDs, local healthcare workers and villagers not related to an HIV-infected individual in Fuyang, Anhui Province, China

Criteria

Inclusion Criteria for HIV Infected Villagers:

  • HIV infected
  • Between 20 and 59 years of age
  • Living in Funan County or Yingzhou District, Fuyang, Anhui Province, China
  • Married
  • Former plasma donor

Inclusion Criteria for Family Members of HIV Infected Villagers:

  • HIV uninfected
  • Living in Funan County or Yingzhou District, Fuyang, Anhui Province, China
  • Parent, spouse, brother, sister, or child of HIV infected participant of the study
  • Aware of participating family member's HIV-positive status

Inclusion Criteria for Local Health Workers:

  • Doctor, nurse, or other village health worker in Funan County or Yingzhou District, Fuyang, Anhui Province, China
  • Working at county or township hospital or clinic in study villages in either Funan County or Yingzhou District, Fuyang, Anhui Province, China

Inclusion Criteria for Villagers Who Are Not From Households with an HIV Infected Participant:

  • HIV uninfected OR unknown HIV status
  • Between 18 and 59 years of age
  • Living in Funan County or Yingzhou District, Fuyang, Anhui Province, China
  • Not a family member of someone who is HIV infected

Exclusion Criteria:

  • Traveled outside of Funan County and Yingzhou District, Fuyang, Anhui Province, China for more than 6 months in the year prior to study entry
  • Permanent disability such as deafness, serious mental illness, or mental retardation that may interfere with participation in the study
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00094354

Sponsors and Collaborators
Investigators
Study Chair: Zunyou Wu, MD, PhD Division of Health Education and Behavioral Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention
Study Chair: Mary Jane Rotheram-Borus, PhD Division of Social and Community Psychiatry, Neuropsychiatric Institute, University of California, Los Angeles
Study Chair: Jie Xu, MD, MS, MPH Division of Health Education and Behavioral Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention
  More Information

Additional Information:
Publications:
Responsible Party: Rona Siskind, DAIDS
ClinicalTrials.gov Identifier: NCT00094354     History of Changes
Other Study ID Numbers: CIPRA CH 002A, CIPRA, Project 2
Study First Received: October 16, 2004
Last Updated: March 26, 2009
Health Authority: United States: Federal Government

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
HIV infected former Plasma Donors
Needs assessment
HIV-related stigma and discrimination
In-depth interview
Focus Groups

Additional relevant MeSH terms:
HIV Infections
Acquired Immunodeficiency Syndrome
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Slow Virus Diseases

ClinicalTrials.gov processed this record on July 22, 2014