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• Migrant HIV risk in China
  Joseph D Tucker
  Published on: 8 March 2006

• Published on: 8 March 2006

  Migrant HIV risk in China

  • Joseph D Tucker, physician

  Dear Editor,

  The article on HIV and syphilis among migrants in eastern China (1) sheds light on a very important topic of great public health import – to what extent will the enormous rural to urban migration happening across China affect sexual behaviors, STI risk, and HIV transmission. However, there are several important caveats that were not discussed in this paper that should be considered.

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  Dear Editor,

  The article on HIV and syphilis among migrants in eastern China (1) sheds light on a very important topic of great public health import – to what extent will the enormous rural to urban migration happening across China affect sexual behaviors, STI risk, and HIV transmission. However, there are several important caveats that were not discussed in this paper that should be considered.

  First, the individuals included under the umbrella of the term “migrant” are far too numerous and heterogenous to comprise a single sexual risk-taking profile. Rural to urban migrant workers in China number number over 100 million, and include populations like PhD graduates traveling to urban areas to take teaching positions in addition to female sex workers. Although subsets of migrants (e.g, young, poor, unmarried females who work in salons) may have increased sexual risk, the broader groups encompassed by the terms migrant or migrant worker are too large for meaningful prevention or intervention efforts.

  Second, one does not need to invoke comparisons of African nations or other regions to understand that some subsets of rural to urban migrants in China likely have increased sexual risk taking and higher STI/HIV prevalence compared to their rural or urban counterparts. Behavioral (2,3) and serologic (4) studies suggest that sexual risk taking is increased among some groups of migrants, including women. Both sexes are part of China’s rural to urban migrants, and there are plausible social explanations for both male and female subsets of migrants to have increased sexual risk, including: 1) migrants are away from their “home town” and the social structures and cultural norms that curb commercial sex interactions in rural areas; 2.) migrants lack access to reliable STI/HIV testing and reproductive health services; 3.) poor rural to urban female migrants with limited education have problems finding official jobs, but can earn money by selling sex; 4.) China’s eastern urban regions have higher STI seroprevalence than most rural areas, making sex in urban areas potentially more risky. Understanding the sexual risk and STI/HIV dynamics of China’s migrants requires studies that compare these groups to their rural and urban counterparts. It is encouraging that some small studies of migrants in China have revealed low STI and HIV prevalence,(1,5) but more work needs to be done among high risk subsets of migrants to understand STI/HIV risk and guide prevention efforts among these vulnerable groups.

  References

  1. Hesketh T, Li L, Ye X, Wang H, Jiang M, Tomkins A. HIV and syphilis in migrant workers in eastern China. Sex Transm Infect 2006; 82:11-14.

  2. Hong Y, Stanton B, Li X, Yang H, Lin D, Fang X, et al. Rural-to- Urban Migrants and the HIV Epidemic in China. AIDS Behav 2006; 19: 1-10.

  3. Li X, Stanton B, Fang X, Lin D, Mao R, Wang J. HIV/AIDS risk behavior and perception among young rural-to-urban migrants in China. AIDS Educ Prev 2004; 16: 538-56.

  4. Liu H, Li X, Stanton B, Liu H, Liang G, Chen X, et al. Risk factors for sexually transmitted disease among rural-to-urban migrants in China: implications for HIV/sexually transmitted disease prevention. AIDS Patient Care STDs 2005; 19: 49-57.

  5. He N, Detels R, Zhu J, Jiang Q, Chen Z, Fang Y, et al. Characteristics and sexually transmitted diseases of male migrants in a metropolitan area of Eastern China. Sex Transm Dis 2005; 32: 286-92.

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  Conflict of Interest:
  None declared.

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