Rural-to-urban migrants are at high risk of sexually transmitted and viral hepatitis infections in China: a systematic review and meta-analysis

Abstract

BackgroundRapid economic development in urban China has led to a mass migration of surplus rural residents into urban areas for better employment opportunities. This study aims to identify prevalence levels and risks of sexually transmitted infections (STIs) and hepatitis among the rural-to-urban migrant population in China.MethodsChinese and English literature databases were searched for studies reporting prevalence of HIV, STIs and viral hepatitis among rural-to-urban migrants in China between 1990 and 2013. The estimates were summarised through a systematic review and meta-analysis. The risks of infection were compared between migrants and the general Chinese population.ResultsWe identified a total of 411 eligible studies. The prevalence of HIV, syphilis, gonorrhea, genital warts and HCV among migrants were 0.23% (0.20-0.27%), 0.69% (0.57-0.84%), 2.18% (1.30-3.64%), 1.54% (0.70-3.36%) and 0.45% (0.31-3.65%), representing 4.0 (3.1-5.2), 1.9 (1.1-3.0), 13.6 (5.8-32.1), 38.5 (15.7-94.5) and 3.8 (1.9-7.3) higher odds of infection than among the general population. Construction workers, long-distance truck drivers and migrant women through marriage were migrant subgroups that were highly susceptible to STIs and hepatitis. HIV prevalence among migrant pregnant women (0.10%, 0.02-0.49%) was significantly higher than that of pregnant women in the general Chinese population (OR = 7.7, 3.4-17.4). However, no significant differences were observed in STIs and hepatitis between overall female sex workers (FSWs), men who have sex with men (MSM) and drug users (DUs), and the corresponding subgroups with a migratory background.ConclusionsRural-to-urban migrants have a higher risk of STIs and hepatitis than the general Chinese population, but a migratory background does not increase the infection risks of STIs and hepatitis in FSWs, MSM and DUs.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-490) contains supplementary material, which is available to authorized users.

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“…The speedy economic growth in China over these years is rapidly inducing a series of socioeconomic changes, including the over 200 million rural-to-urban migrants who move to and temporarily live in cities with the intention to grasp better employment opportunities (Zou et al, 2014). This urban migration combined with an expanding trend in young couples of living separately from their parents, giving rise to the ‘empty nest’ phenomenon, is common not only in rural areas but also in urban cities, with a prevalence rate of 31.8% in 2010 (Liu et al, 2015; Liu and Guo, 2008; Zou et al, 2014). The ‘empty nest’ is negatively associated with life satisfaction, and ‘empty nest’ elders manifest a higher incidence of depression and loneliness, and have an urgent need for geriatric care services, especially home care (Liu et al, 2015; Liu and Guo, 2008).…”