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China faces a rapidly emerging HIV epidemic and nationwide resurgence of sexually transmitted infections associated with a growing sex industry. Community empowerment and capacity building through community-based participatory research partnerships show promise for developing, testing, and refining multilevel interventions suited to the local context that are effective and appropriate to address these concerns. However, such efforts are fraught with challenges, both for community collaborators and for researchers. We have built an international team of scientists from Beijing and the United States and collaborating health policy makers, health educators, and care providers from Hainan and Guangxi Province Centers for Disease Prevention and Control and the local counties and towns where we are conducting our study. This team is in the process of testing a community-wide, multilevel intervention to promote female condoms and other HIV prevention within sex-work establishments. This article presents lessons learned from our experiences in the first two study sites of this intervention trial.

New interventions to reduce HIV and sexually transmitted infections (STI) among female sex workers are introduced into the context of women’s existing prevention beliefs and practices. These indigenous practices affected implementation of our program to introduce female condoms to women in sex-work establishments in southern China. We used ethnographic field observations and in-depth interviews to document common prevention methods women reported using to protect themselves before and during intervention implementation. Individual, sex-work establishment, and other contextual factors, including sources of information and social and economic pressures to use or reject prevention options, shaped their perceptions and selection of these methods and affected adoption of female condoms as an additional tool. Efforts to improve uptake of effective prevention methods among low-income sex workers require attention to the context and spectrum of women’s HIV/STI prevention practices when introducing innovations such as female condoms, microbicides, pre-exposure prophylaxis pills, and others, as they become available. [ABSTRACT FROM AUTHOR]

Objective: To understand the positive rates of hepatitis B surface antigen (HBsAg) and surface antibody (anti-HBs) among adults aged ≥18 years in communities in Chaoyang district, Beijing., Methods: HBsAg and anti-HBs were tested with ELISA reagents for participants in the Community Diagnosis Survey (3 000 person were sampled in each community according to the age and sex distribution of the residents) in all 42 communities in Chaoyang district by Beijing Center for Disease Control and Prevention (CDC) and Chaoyang CDC. The data of 35 communities in which at least 1 000 adults were tested were analyzed., Results: A total of 78 100 adults were tested for HBsAg and anti-HBs in the 35 communities. The crude positive rate of HBsAg was 2.24% (95% CI: 2.13%-2.34%). The highest age-specific HBsAg positive rate was 3.00% (95% CI: 2.56%-3.44%) for those aged 40-44 years and the lowest age-specific HBsAg positive rate was 1.69% (95% CI: 1.29%-2.09%) for those aged 18-24 years, respectively. A obvious difference in community- based HBsAg positive rate was founded with the highest of 10.68% (95% CI: 9.43%-11.94%) and lowest of 0.24% (95% CI: 0.13%-0.38%). HBsAg positive rate was significantly lower in local residents than in participants with household registered in other provinces (1.97% vs. 2.98%, P<0.01), but the sex specific difference in HBsAg positive rate was relatively smaller (2.45% in males and 2.07% in females, P<0.01). The multivariate logistic regression analysis showed that age, community, occupation, residence status and sex were all associated with positive rate of HBsAg (P<0.01). The overall positive rate of anti-HBs was 30.85% (95% CI: 30.53%-31.18%), and the highest was 38.10% in age group 18-24 years (95% CI: 36.58%-39.61%) and the lowest was 28.88% in age group 75- years (95% CI: 27.62%-30.15%), respectively. Up to 67.02% of the subjects were both HBsAg and anti-HBs negative (95% CI: 66.69%-67.35%), and the age specific difference was not significant. But significant differences in anti-HBs positive rate and the negative rate of both HBsAg and anti-HBs were found across communities., Conclusion: The overall positive rate of HBsAg was at a moderate low level among adults in Chaoyang, but the age specific positive rate was high in the middle-aged and the population specific positive rate was high in participants with household registered in other provinces, therefore, the prevention and control of hepatitis B in Chaoyang should be focused on the middle aged people and participants with household registered in other provinces. The community specific differences in the positive rate of HBsAg and anti-HBs across communities need to be further studied.

The Health Station of the First Inner Ward, Peiping, was open in 1925 as a community health care institution of Peiping Health Bureau, sponsored and operated by Peking Union Medical College (PUMC) established in 1921. It was a unique demonstration project to provide the community with medical and prevention service, to implement an extraordinary educational internship of preventive medicine for PUMC students and other doctors and nurses all over the country; and to conduct applied research on the community residents'disease prevention and health promotion. Guided by the prevention thought advocated by John B. Grant, the first Chairperson of the Department of Public Health, PUMC, the station created a variety of innovative programs such as prevention-oriented public health nursing for the residents and school students, maternal and child health programs, and family health records and residents' vital surveillance statistics. The station operated for 26 years and made a significant influence on the contemporary public health in China through its unparalleled prevention education and training program and its innovative community health care demonstration. As one of the examples, it inspired the thought of primary health care raised by WHO several decades later. It provides us definitely beneficial learning as nowadays we reform health system in China.