Characteristics of the HIV/AIDS Epidemic in Women Aged 15-49 Years from 2005 to 2012 in China

Objective To describe the characteristics of the HIV/AIDS epidemic in women aged 15-49 years in China. Methods HIV/AIDS cases from 2005 to 2012 that fulfilled the inclusion and exclusion criteria were identified on the Chinese HIV/AIDS case reporting system. Descriptive and spatial analyses were performed. Results A total of 103,559 female HIV/AIDS cases were included in our study. Based on the descriptive analysis, between 2005 and 2012, the proportion of heterosexually acquired HIV infection among women （15-49 years） increased rapidly from 35.8% to 87.4%. Approximately 60% of these cases were infected through non-marital heterosexual contact. Among older women （40-49 years）, a slightly increasing trend was identified. The spatial analysis detected ＇hot spots＇ in the Xinjiang, Yunnan, Sichuan, Guangxi, and Chongqing provinces. The epidemic trends in these areas were predominately driven by heterosexual transmission. Conclusion Non-marital heterosexual contact is a very important factor in the HIV/AIDS epidemic in women aged 15-49 years, and the HIV infection rate in older women is increasing. Several epidemic hot spots were detected in northwestern and southwestern China. Efficient interventions are needed to control the spread of HIV/AIDS among women living in these areas.

Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students

Objective To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model （EPPM）-based integrated model. Methods A total of 3,082 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. Results Among the participants, 2,387 （46.7%） were male, 2,586 （53.3%） were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect （r = 0.23）, perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education （r = 0.40） and intention to engage in premarital sex （r = -0.16）, respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex （intent-to-premarital-sex） had a poor indirect impact on condom-use self-efficacy （total effect was -0.06）. Furthermore, attitude toward HIV health education （r = 0.49） and intent-to-premarital-sex （r = -0.32） had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. Conclusion The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention.