1. Baseline prevalence of HIV/STI and changes resulting from randomized interventions among male and female migrant construction workers in Shanghai, China Liviana Calzavara 1 ; Laiyi Kang 2 ; Hui Fang 2 ; Hongwei Wang 3 ; Lei Xu 4 ; Meixia Yang 5 ; Jinma Ren 2 ; Lucia Light 1 ; Ted Myers 1 ; Qi Chao Pan 2 ; Robert S. Remis 1 ; Sandra Bullock 1 ; and the Canada-China Team 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; 4 Nanhui CDC, China; 5 Xuhui CDC, China. Presented at 6 th IAS Conference on HIV Pathogenesis, Treatment and Prevention Rome, Italy – 17-20, 2011

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 Funding: Teasdale-Corti Global Health Research Partnership Program, (IDRC, CIDA, CIHR and Health Canada) – Grant#103460-045. 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