November 30, 2006 - Over recent years, the map of the spread of HIV/AIDS in China can be closely matched to that of transportation development. The infrastructure network has been shown to be one of the main “transmitters” for HIV/AIDS. A clear focus is on the roads, which carry the majority of goods and people, targeting truckers, construction workers, migrant laborers, and sex workers at truck-stops. The Hubei Provincial Communications Department wantedto ensure that the migrant workers and local residents received proper education about the dangers of HIV/AIDS and about how to mitigate the related risks.  | Spread of HIV/AIDS in China over the years:
(a) 1985
(b) 1989
(c) 1995
(d) 1998
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For the past 18 months the World Bank has conducted an intensive HIV/AIDS education and testing program under the Hubei Shiman Expressway Project. “The construction workers are almost exclusively males below the age of 40 with junior high school education. They are away from their families for 300-350 days a year and many engage in risky behavior. When we started the project we found that only 16 percent were even aware of how HIV/AIDS was transmitted,"said Chris Bennett, the World Bank program manager. So far, over 25,000 copies of information materials have been shared with 11,000 construction workers and local villagers, many training courses delivered, and almost 1,000 people have been tested for HIV/AIDS and 1,700 for sexually-transmitted diseases (STDs). Already the project has begun to show positive results in terms of behavioral changes which will reduce the risk of contracting HIV/AIDS and the stigma attached to it. To date, the number of STD cases has declined significantly, by 29 percent in 2005 and 35 percent in 2006. No new HIV/AIDS infections have been detected among the target communities. Moreover, general awareness about HIV/AIDS has increased among the workers and local residents. Simple, low-cost education activites that use existing resources The program was then implemented on the China Fifth Inland Waterways Project, also located at the HIV/AIDS hotspot of Hubein, and the Third Jiangxi Highway Project. Additional funding is currently being sought to implement the strategy on other projects.  | To date, the number of STD cases has declined significantly, by 29 percent in 2005 and 35 percent in 2006.
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The regional transport program has been proactive in trying to tackle the HIV/AIDS epidemic. The program has adopted a regional HIV/AIDS strategy which proposes to include specific HIV/AIDS intervention programs as part of all new projects. The proposed model supports the provider(s) –government agencies, NGOs, consultants– in delivering a consistent education program. The focus is on incorporating simple – but effective – low-cost information activities that can be readily implemented on transport projects using resources already available. The recent mainstreaming of “HIV clauses” into the Bank’s standard work bidding documents is helping with this effort. To complement these activities, the Hubei Provincial Communications Department suggested organizing a seminar as an opportunity to share experiences to date, and to decide how to move forward with improving the education programs. In late October, over 60 international HIV/AIDS experts, Chinese government officials, as well as transportation and health sector professionals got together to examine ways to raise awareness about HIV/AIDS among transport workers at the seminar that the Bank co-sponsored. The seminar participants identified a number of ways to improve the effectiveness of future HIV/AIDS education activities in China, including: - Provide additional training to the primary project staff for better results;
- locate HIV/AIDS educational materials and condom distribution sites in locations other than the managers’ offices, to provide better accessibility to the construction workers;
- develop peer education among the workers with appropriate compensation, and make the workers in charge of the distribution of condoms and educational materials;
- get the project owners and the management officials at construction sites to be more supportive and discourage negative attitudes towards the intervention program;
- clearly define responsibilities and obligations of the contractors to ensure that they are active participants of the program;
- extend the Bank’s initiative on HIV/AIDS interventions through standard clauses to all construction projects in China; and
- extend the HIV/AIDS awareness of the construction workers to bring about “behavioral change” in order to lower high risk behavior and HIV/AIDS/STD incidents.
Professor Xi’en Guifrom Zhongnan Hospital of Hubei’s Wuhan University and one of China’s top HIV/AIDS researchers and educators, has been requested to prepare guidelines on ‘HIV/AIDS Prevention in Communication Programs’ to be used by the Communication Departments. The guidelines will specify the respective responsibilities and obligations of the transport sector and the health sector, and describe how to evaluate the outcomes of prevention efforts. “Project safety should not only refer to construction safety, but also to the general health of construction workers,”he observed.
See also:
Transport in East Asia and Pacific HIV/AIDS in East Asia and Pacific |
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