Presented at 6 th IAS Conference on HIV Pathogenesis, Treatment and Prevention

1. Baseline prevalence of HIV/STI and changes resulting from randomized interventions among male and female migrant construction workers in Shanghai, China LivianaCalzavara1; Laiyi Kang 2; Hui Fang 2; Hongwei Wang 3; Lei Xu4; MeixiaYang 5; JinmaRen2; Lucia Light 1; Ted Myers 1; Qi Chao Pan 2; Robert S. Remis1 ; Sandra Bullock 1; and the Canada-China Team Presented at 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention Rome, Italy – 17-20, 2011 1 CIHR Social Research Centre in HIV Prevention, Dalla Lana School of Public Health, University of Toronto, Canada; 2 Shanghai Municipal Center for Disease Control and Prevention, China; 3 Huangpu CDC, China; 4Nanhui CDC, China; 5Xuhui CDC, China.

2. Objectives • To determine the prevalence of HIV/STI among migrant workers and • Assess the effectiveness of three levels of interventions in reducing new infections

3. Methods – study population & design Randomized controlled intervention trial 18 construction sites selected in 3 districts in Shanghai, China Participants randomly selected from employee lists 1,871 participants (Refusal rate = 0.3%) Data collection – June to December 2008 Interviewer-administered surveys at baseline and 3 and 6 months post-intervention Blood an urine tested for HIV & STI testing (i.e., Syphilis, Chlamydia, Gonorrhea). Counselling and treatment provided 3 educational interventions randomly administered among work sites in each district • Intervention groups • 1. Pamphlet • 2. Pamphlet, posters & videos • 3. Pamphlet, posters, videos & group counseling & one-on-one counseling

4. Interventions Slogan: For safety wear a helmet. For good health wear a condom Graphic Text: Safety Message: Building a city takes a lot of hard work; preventing AIDS is even more important. Photo: Lu Liang, Shanghai AIDS Prevention Spokesperson

5. Results, Conclusions & Implications Rates of HIV/STI among migrant construction workers in Shanghai remain low and comparable to those found 5 years ago None tested HIV+ Challenge common belief that migrant workers are sources of STI and a bridge of infection between rural and urban areas Incident infections were largely among those who only reported sexual contact with a spouse It is possible that many of the spousal and other primary partner infections are the result of re-infection by the same partner, since treatment rates were low, even though free to participants

6. Results, Conclusions & Implications – cont. Intervention was not shown to be protective of infection; however, it was focused primarily on infection via casual partners and paid sex, and not on infection by spousal partners Educational and treatment interventions should target STI infection in primary/regular partners (i.e. spouse or primary girlfriend/boyfriend), as “traditional” HIV and STI risk behaviour is not as common as predicted among migrant construction workers Important to stress the relevance of following treatment protocols, and consider offering treatment to spouse/partner of to ensure that STI not passed back and forth between partners

7. Acknowledgments • Study participants, managers and officials at the construction sites • Study staff and collaborating organizations including the: • Shanghai Municipal Bureau of Health • Shanghai Municipal Center for Disease Control and Prevention, China • Dalla Lana School of Public Health, University of Toronto, Canada • Faculty of Law, Queen’s University, Canada • Regent Park Community Health Centre, Canada • Shanghai Academy of Social Sciences, China • Bureau of Health, Shanghai, China • Huangpu, Xuhui, and Nanhui Centers for Disease Control and Prevention • and Community Health Center, Shanghai, China • Toronto General Hospital • Canadian HIV Initiative Program • Canada-China Project Investigators Funding: Teasdale-Corti Global Health Research Partnership Program, (IDRC, CIDA, CIHR and Health Canada) – Grant#103460-045.