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Background: Clients of female sex workers (CFSWs) are at risk for HIV transmission; relevant surveillance and interventions for this vulnerable group are scarce. The China-UK HIV/AIDS Prevention and Care Project launched an enhanced intervention programme involving peer education, seminars, testing services and social gatherings and so forth, and two behavioural surveillance studies (BSS) targeting CFSWs in Suining, Sichuan., Methods: Two cross-sectional BSS (a baseline survey and an evaluative survey) were conducted in September 2005 and May 2006, respectively. In total, 356 and 372 respondents who patronised some low-end sex services were interviewed by peer interviewers. Another triangulation condom audit exercise was conducted in June 2006., Results: Prevalence of respondents using at least one prevention service increased from 50.3% in 2005 to 68.5% in 2006 (AOR = 2.2). Respondents of the evaluative survey compared with their counterparts of the baseline survey had lower prevalence of inconsistent condom users in the last 6 months (44.1% vs 77.0%; AOR = 0.2) and higher prevalence of condom use in the last episode of commercial sex (78.0% vs 41.5%; AOR = 4.9). The triangulation audit showed that condoms were used by 73.8% of CFSWs. The multivariate analysis shows that year of study (OR = 0.3), self-reported sexually transmitted disease symptoms (OR = 2.9), use of face-to-face counselling services (OR = 0.5) and so forth were significantly associated with inconsistent condom use during commercial sex in the last 6 months., Conclusions: Condom use and service use behaviours changed in the study population over a time period when an enhanced intervention programme was implemented. Such effective programmes may be applied to other locations in China.

Objectives: To determine the prevalence and risk factors for chlamydial infection in cross-border truck drivers., Methods: 225 Hong Kong-based cross-border truck drivers were screened for chlamydial infection. Associations between infection and potential risk factors were determined by questionnaire., Results: 8.5% of drivers were positive for chlamydial infection. Of 62% of drivers reporting recent sex with commercial sex workers (CSW), 39% had not used condoms. 75% of drivers with extramarital sex partners (ESP) also frequented CSW and 47% of this group had not used condoms with CSW. 43.3% PCR-positive cases reported symptoms. No risk factor was associated with chlamydial infection after adjustment, although "had sex with ESP" approached significance., Conclusions: The prevalence of chlamydial infection among cross-border truck drivers was not strikingly high, although drivers engaged in sex with both ESP and CSW, with many admitting unprotected intercourse. The findings highlight the importance of promoting safe sex to truck drivers.

Objectives: To investigate changes in HIV-related behaviours among female sex workers (FSW) and associations with services coverage rates., Methods: Behavioural surveillance data from Sichuan, China, were analysed. A mapping exercise was conducted; FSW were recruited from randomly selected sex-work establishments in 19 sites in Sichuan, China, from 2003 (n = 7068), 2004 (n = 6875) and 2005 (n = 6833)., Results: Site variations were substantial. The random effect pooled AOR comparing the prevalence of condom use with regular sex partners, possession of condoms, HIV-related knowledge, HIV antibody testing and services coverage rates in 2005 versus 2003 ranged from 1.42 to 20.35. The 95% CI of these pooled AOR all excluded 1.0; hence rejecting the null hypothesis that such OR were not different from 1.0. Most of the AOR of these evaluative parameters (indicator of improvement) for the 19 individual sites in 2004 and 2005 (vs 2003) were significantly associated with coverage rates (Spearmen correlation coefficients = 0.35 to 0.67, p<0.05)., Conclusions: Improvements were observed in relevant behaviours and coverage rates and the two were associated with each other.

Objectives: To examine the level of discriminatory attitudes towards people living with HIV/AIDS (PLWHA) and factors in association with such attitudes., Methods: A population based cross sectional telephone survey was conducted. A total of 808 Hong Kong Chinese aged 18-50 randomly selected from the general population participated in the study., Results: Around 42% of the respondents exhibited discriminatory attitudes in at least five out of the 20 relevant items. For instance, about 42% would avoid making physical contact with PLWHA; 35% believed that all infected medical staff should be dismissed and about 47% would agree with enacting a law to prohibit PLWHA from visiting Hong Kong. A sizeable proportion of the respondents also hold negative perceptions about PLWHA (for example, 43.7% agreed that the majority of PLWHA are promiscuous, 20.7% thought that PLWHA are merely receiving the punishment they deserve, etc). Multiple regression analysis found that age, HIV related knowledge, the above mentioned negative perceptions about PLWHA, fear related to AIDS, and exposure to HIV related information were independent predictors of discriminatory attitudes towards PLWHA. About 30% would give PLWHA the lowest priority in resource allocation among five groups of patients with chronic diseases., Conclusions: The general public in Hong Kong has formed some negative perceptions of PLWHA. Discriminatory attitudes towards PLWHA are common and cover different aspects of their life. Intervention programmes are warranted and an integrated approach is required.

Objective: This study was conducted in order to determine the prevalence of men having sex with men (MSM) and their HIV related behaviours and attitudes among Chinese men in Hong Kong., Methods: A large scale, random, population based, anonymous telephone survey of 14 963 men between the ages of 18-60 was conducted. The overall response rate was approximately 57%., Results: Of the respondents, 4.6% had ever engaged in MSM activity. In the 6 months preceding the survey, 2.0% had engaged in MSM behaviours (active MSM) and 0.5% reported having engaged in anal sex MSM behaviours. Among anal sex MSM, consistent condom use was 42.9% with male non-commercial sex partners and even lower with male commercial sex partners (35.7%). Approximately 11% of anal sex MSM and 4.1% of the non-anal sex MSM had contracted an STD in the last 6 months. The prevalence of HIV testing was only 20.6% among anal sex MSM and 11.9% among non-anal sex MSM., Conclusions: Active MSM in Hong Kong are at high risk of HIV infection. The belief of low vulnerability to HIV is prevalent among active MSM in Hong Kong with only 2.0% believing that their chances of HIV infection as being "very likely."

Objective: Reporting bias due to social desirability is an important consideration in carrying out surveys on sensitive issues. The study compared the frequency of self reported sensitive behaviours and response rates between the conventional "telephone interviewer method" (TIM) and a combined interviewer and computerised data capturing method (telephone interviewer and computerised questionnaire method, or TICQM)., Methods: A total of 580 males and 582 females were recruited and randomly assigned to either of the two methods in a cross sectional study. The overall response rate was about 51.6%., Results: While the two methods both had high completion and low item non-response rates, the TICQM respondents reported higher frequencies of sensitive risk behaviours. Sexually active female respondents interviewed by the TICQM were more likely to report that their sex partners were their steady boyfriend, instead of their husband; and were also more likely to admit that they had had "one night stand" experiences or had undergone an HIV antibody test, when compared with their counterparts in the TIM group. Similar contrasts were observed for sexually active male respondents, that the TICQM group were more likely to report that they had had sexual intercourse with female sex workers or non-regular sex partners. Sex differences in the strength of association were observed between some studied behaviours (for example, HIV testing and substance abuse) and modes of data collection., Conclusion: The choice of data collection method has a significant impact on the results of sensitive studies; special attention should be given to designing the study and interpreting the results.

Aims: Patients' knowledge and participation in their care are important in prevention of blindness from common eye diseases such as cataract, glaucoma, and age related macular degeneration (AMD). The aim of this study was to measure knowledge of these conditions in the Hong Kong Chinese population., Methods: Subjects aged 40 and above in the Shatin district of Hong Kong were randomly selected as part of a larger study of causes of adult visual loss. The subjects received eye examinations in which the primary cause of visual disability was recorded. The respondents were asked by trained interviewers in a standardised fashion about their knowledge of cataract, glaucoma, and AMD. Their answers were rated for accuracy by a senior ophthalmologist., Results: Out of the 2538 eyes examined, 7.0% had visual acuity less than 6/18. Fully 69.6% of the visual disability for those aged 60 or above was caused by cataract, AMD, or glaucoma. Awareness of cataract in particular was high, in that over 90% of respondents had heard of it. However, only 22.9% of them could describe cataract symptoms correctly, and these percentages were even lower in glaucoma (10.2%) and AMD (<1%). Over 40% of subjects did not know that surgery was an appropriate treatment for cataract., Conclusion: This sample of the Hong Kong Chinese population had limited knowledge of common eye diseases. Educational programmes to enhance public awareness may be needed to improve the effectiveness of health promotion and thus prevent unnecessary blindness.