中华疾病控制杂志

The progress and challenges of promoting HIV/AIDS 90-90-90 strategies in China

WU Zun-you

2016, 20(12): 1187-1189. doi: 10.16462/j.cnki.zhjbkz.2016.12.001

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Having 90% of people living with HIV being diagnosed, 90% of diagnosed receiving antiretroviral therapy, and 90% of those on treatment achieving viral suppression are strategies proposed by UNAIDS for ending global AIDS epidemic. The strategies focus on reservoir. It controls HIV spreading by reducing infectiousness of HIV infected individuals via treatment. By the end of 2015, China reached the targets of 68%, 67% and 91% respectively. Revising criteria for treating all HIV infected this year makes 90% treatment target promising. Diagnosing 90% of people living with HIV is the most important and the most difficult target. The strategies are complementary with strategies targeting susceptible individuals. Therefore, they should be used jointly for effectively controlling HIV transmission.

Analysis on effectiveness of immune reconstitution and its influencing factors among HIV/AIDS patients after highly active antiretroviral therapy in Chongqing

YUAN Xin-hao, ZHOU Chao, HE Hai, WU Guo-hui, LUAN Rong-sheng

2016, 20(12): 1190-1193,1198. doi: 10.16462/j.cnki.zhjbkz.2016.12.002

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Objective To understand the effect of immune reconstitution and its influencing factors among HIV/AIDS patients after highly active antiretroviral therapy during 2004 to 2013 in Chongqing City. Methods Data of general information and follow-up of highly active antiretroviral therapy (HAART) among HIV/AIDS patients in Chongqing City were collected from National HAART reporting system, 2-level growth model was used to analyze the long term T-cell counts and its influencing factors. Results 8 991 HIV/AIDS patients were enrolled in HAART in Chongqing, the T-Cell counts at baseline, 6 months and 18 months after HAART were (194.23±123.72), (303.87±159.08), (355.52±174.78) cell/mm³ respectively. The 2-level growth model analysis indicated that T-Cell counts were significantly associated with treatment time, gender, initial treatment age, T-cell counts at baseline, transmission route, marriage, World Health Organization clinical stage, and AIDS-related diseases (all P<0.05). Conclusions The effectiveness of HAART among HIV/AIDS patients in Chongqing is satisfactory. Various factors affect T-Cell counts after HAART, patients should be detected and enrolled earlier.

Drug resistance and its influencing factors in AIDS patients receiving HAART in Harbin

YU Xin, ZHAO Peng-yu, YUE Chao, JIN Gang, WANG Fu-xiang, WANG Bin-you

2016, 20(12): 1194-1198. doi: 10.16462/j.cnki.zhjbkz.2016.12.003

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Objective To investigate the prevalence of HIV-1 drug resistance and related factors in AIDS patients receiving antiretroviral therapy in Harbin. Methods AIDS patients receiving treatment in Harbin in 2015 were chosen for a retrospective study and blood sample collection. The mutation of HIV drug resistance was determined through sequencing pol gene of HIV-1. Results A total of 269 subjects were included in the analysis.The total drug resistance rate was 26.8%.Resistant rate to NRTIs and NNRTIs was higher than that to PIs(χ²=13.430,P<0.001).The single factor analysis found that the influence of initial treatment and treatment time on drug resistance was statistically significant (all P<0.05).There was no statistical significance on the influence of sex,age,transmission route,CD4⁺T lymphocyte count on drug resistance (all P>0.05).As shown by Logistic regression analysis,the relationship of drug resistance with treatment time,the level of CD4 cells and initial treatment had statistical significance. Conclusions The prevalence of HIV-1 drug resistance in AIDS patients receiving antiretroviral therapy was high in Harbin.It is suggested that the patients who were with long treatment regimes should be intensified, so as to reduce the occurrence of drug resistance and the death of AIDS.

Effectiveness of antiviral treatment among HIV/AIDS patients aged above 50 years in Shandong Province

ZHU Xiao-yan, HUANG Tao, WANG Guo-yong, HUANG Peng-xiang, ZHANG Na, LIAO Mei-zhen, TAO Xiao-run, KANG Dian-min

2016, 20(12): 1199-1202,1207. doi: 10.16462/j.cnki.zhjbkz.2016.12.004

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Objective To analyze the results of antiretroviral therapy among HIV/AIDS patients aged above 50 years in Shandong Province. Methods A face-to-face interview was conducted to collect baseline and after treatment data among HIV/AIDS patients aged above 50 years who started antiretroviral therapy in Shandong province during 2003 to 2014. The CD4⁺T cell count and viral load were analyzed to evaluate the effect of antiretroviral therapy. Results Of the 322 patients, 76.7% were male and 23.3% were female. The average age was (56.9±6.4) years old. 63.4% were married or cohabiting. Heterosexual transmission was the major transmission route, accounting for 54.3%.The median of CD4⁺ T cell count was 194.0 (83.5-301.0) on baseline, and there was significant difference in CD4⁺ T cell count among HIV/AIDS patients by different transmission route (H=14.200,P=0.003). CD4⁺ T cell count of different time points after treatment showed differences compared with the baseline data(all P<0.001).The Logistic analysis showed that gender and opportunistic infections status before treatment were the influencing factor of therapeutic effectiveness (all P<0.05). There was no significant difference among the proportion of complete inhibition of virus at different time periods (χ²=2.093, P=0.719). Conclusions The antiretroviral therapy can effectively improve the body immunity, reduce viral load of HIV/AIDS in patients aged above 50 years in Shandong Province.

The survival analysis in 7 255 AIDS patients on antiretroviral therapy in Liaoning Province in 2003-2015

YAO Shu-jie, LV Ya-ni, WANG Li, YAO Wen-qing

2016, 20(12): 1203-1207. doi: 10.16462/j.cnki.zhjbkz.2016.12.005

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Objective To analyze the survival rates of AIDS cases receiving Highly Active Antiretroviral Therapy (HAART) and related factors. Methods A retrospective cohort study was conducted to analyze the related factors among 7 255 HIV/AIDS patients who had been treated with HAART in Liaoning province from 2003 to 2015. The life table method was used for survival rate analysis, and Cox proportional hazard model was performed to identify the factors associated with survival time. Results Among 7 225 HIV/AIDS patients, the 1, 3, 5 and 6-12 year actuarial survival rates were 97%, 95%, 93% and 92% respectively after HAART. There were 269 cases of HIV/AIDS related death after HAART, and the total case fatality ratio was 1.99/100. As to mortality risk, the group aged from 30 to 59 years(HR=0.330,95%CI:0.203-0.538) and older than 59 years (HR=0.569,95%CI:0.395-0.820) were lower than the group aged younger than 30 years; the group educated as middle school (HR=0.503,95% CI:0.324-0.780), high school, technical secondary school (HR=0.284,95% CI:0.200-0.405), junior college and much higher(HR=0.254,95% CI:0.169-0.381) were lower than the groups educated as primary school and much lower. Meanwhile the mortality rate was related to the pathway of infection:the rate of the heterosexual transmission group was lower than that of the homosexual transmission group (HR=0.540, 95%CI:0.383-0.763), the rate of the group which the baseline CD4⁺T cell counts ≥200 μl was lower than that of <50 μl (HR=0.316,95% CI:0.201-0.499), and the rate of the group that BMI ≥24.0 kg/m² was also lower than that of <18.5 kg/m² (HR=0.459,95% CI:0.344-0.611). Conclusions The antiretroviral therapy of HIV/AIDS patients in Liaoning province are effective and stable, and have high 5-year survival rate; the early standard treatment is effective measure to reduce the mortality risk and improve the survival rate.

Analysis on antiretroviral therapy effect and influencing factors among adult HIV/AIDS patients in Yining

ZHANG Yu, JI Er-gao, DOU Zhi-hui, WANG Xue-min, LIU Li-rong, XU Bi-xin, ZHENG Wei-wei

2016, 20(12): 1208-1211. doi: 10.16462/j.cnki.zhjbkz.2016.12.006

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Objective To analyze the antiretroviral therapy(ART) effect and influencing factors among adult human immunodeficiency virus(HIV)/acquired immune deficiency syndrome (AIDS) patients in Yining. Methods Monitoring data of adult patients receiving ART were collected from the national antiretroviral therapy reporting system. Retrospective study was conducted and Logistic regression method was applied to analyze the influencing factors. Results A total of 3 740 cases were enrolled in this study. Heterosexual infection and drug infection accounted for 46.3% and 32.0%, respectively, the median of baseline CD4⁺T lymphocyte count was 278(170,395) cells/μl. The virological inhibition rate were 70.4%(1 568/2 228), 64.4%(1 695/2 631), 66.3%(1 590/2 400), 70.1%(1345/1919) and 73.6%(550/747) at 6,12,24,36,60 months after ART, respectively, rate at 12 months was the lowest (all P<0.05). Multivariate analysis showed that in different duration of treatment(12,36 and 60 months after ART), dose missing was the risk factor of virological failure, adjusted odds ratio(AOR) (95% CI) were 3.581(2.943-4.357), 2.496(1.957-3.182) and 3.137(1.969-4.998), respectively. Injecting drug use (AOR=1.544, 95% CI:1.164-2.048) and baseline CD4⁺T lymphocyte count (cells/μl)<200(AOR=1.371, 95% CI:1.086-1.731) were the risk factors of virological failure at 12 months after ART. Conclusions The rate of virological failure among patients received ART in Yining was high. Dose missing was the main risk factor. The adherence education and dose guidance should be strengthened among patients injecting drug or with lower baseline CD4⁺T lymphocyte count, and the treat ability in the township treatment institution should be improved to get a better virologic suppression effect.

Survival analysis on the influencing factors of the mortality of TB/HIV co-infectious patients during the anti-tuberculosis treatment period in Yunnan Province

YANG Rui, QIN Yu-bing, SU Wei-wei, ZHANG Li-fang, XU Lin

2016, 20(12): 1212-1215,1226. doi: 10.16462/j.cnki.zhjbkz.2016.12.007

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Objective To analyze the influencing factors of the mortality of Mycobacterium tuberculosis and human immunodeficiency virus (TB/HIV) co-infection patients during the anti-tuberculosis treatment period. Methods The mortality of TB/HIV co-infection patients was compared with that of ordinary TB patients by 1:1 cohort study method during the anti-tuberculosis treatment period. Then, the influencing factors of the mortality for the TB/HIV patients. Results The mortality rate of the TB/HIV co-infection patients and ordinary TB patients were 6.60% and 0.43%, respectively. Cox regression analysis was carried out and showed that the degree of patients, clinic delay time and level of CD4⁺cell counts were main risk factors for the TB/HIV co-infection patients (all P<0.05). The mortality rate of the critically patients were 2.049 times more than that of other patients, the death risk of patients with visit delay for 14 days or more was 1.521 times compared with patients who delayed less than 14 days. The death risk of patients with CD4⁺ cell counts <50 p/μl was 2.943 times compared with the patients with CD4⁺ cell counts of 50 p/ul or more. In addition, the beginning time of antiviral therapy and whether to accept antiviral therapy were also influential factors. Conclusions Through early detection, providing standardized treatment in time and giving antiviral therapy to eligible persons as soon as possible, the survival rate could be improved, risk of death could be reduced, and the life of TB/HIV co-infection patients could be saved.

A survey on drug-resistance gene mutations in HIV-1 strains in Wuxi City

YUAN Rui, CHENG Hao, CHEN Lu-si, JI Ya-yong, XU Fan-fan, ZHANG Xuan, WANG Bei

2016, 20(12): 1216-1220. doi: 10.16462/j.cnki.zhjbkz.2016.12.008

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Objective To understand the prevalence of HIV-1 drug resistance (DR) mutations among HIV-1/AIDS patients in Wuxi City. Methods 343 blood samples of human immunodeficiency virus 1 (HIV-1)/acquired immunodeficiency syndrome (AIDS) patients were collected from October 2012 to June 2013.DNA were extracted from provirus. After partial pol gene amplification and sequencing, all sequences were evaluated for DR mutations using the Stanford University Algorithm (http://hivdb.stanford.edu). Results Eventually, 279 sequences of HIV-1 pol region were successfully amplified and sequenced. DR-related mutations were identified in 36 of the 279 viral sequences. Among drug-naive and treated individuals, the rate of HIV-1 drug resistance was 1.8% (4/220) and 16.9% (10/59), respectively. The major DR-related mutations caused high-level resistance and/or intermediate-level resistance, including D30N, L90M, K65R, M184I/V, K103N and Y181C. The others caused potential low-level resistance and/or low-level resistance. Conclusions The current HIV-1 drug resistant strains transmission is at low prevalence level in Wuxi City. The main causation which lead to DR-relate mutations is drug-induced mutation. However, cross resistance and transmission of HIV-1 DR strains suggest that DR surveillance should be strictly performed.

The influence of opiate abuse on the expression of IFN-α, ISG56 and MxA in peripheral blood mononuclear cells of patients infected with HIV

JIANG Jun-jun, LI Xu, LIAO Yan-yan, WEI Fu-mei, PAN Pei-jiang, LIANG Bing-yu, HUANG Jie-gang, SU Jin-ming, LI Yu, CHEN Hui, YE Li, LIANG Hao

2016, 20(12): 1221-1226. doi: 10.16462/j.cnki.zhjbkz.2016.12.009

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Objective To detect the effect of opiate abuse on HIV replication and the possible mechanism by analyzing the expression ofinterferon-α(IFN-α), interferon stimulated gene 56 (ISG56) and myxovirus resistance protein A (MxA) in peripheral blood mononuclear cells(PBMCs) among human immunodeficiency virus (HIV) infected patients with or without opiates abuse. Methods A total of 200 subjects were randomly recruited from methadone treatment and voluntary HIV counselling and testing centers, and were divided into four groups:Opiate+HIV+, Opiate-HIV+, Opiate+HIV-, and Control. A questionnaire was used to collect data on demographic characteristics. Plasma and PBMCs were isolated from blood samples of the subjects. The expression of IFN-α, ISG56 and MxA level in PBMCs were analyzed by RT-PCR,western blot and ELISA. Results There were no significant differences in gender, age, nationality, domicile, marital status, education level and occupation, and other demographic characteristics among four groups (all P>0.05). Among HIV-1-infected subjects, RNA and protein level of IFN-α, ISG56 and MxA in Opiate+HIV+group were lower than those in Opiate-HIV+ group (all P<0.05). Conclusions Opiate abuse may suppress the antiviral responses of IFN-α, ISG56 and MxA to promote HIV-1 replication.

Factors associated with HIV infection among family members and friends of people living with HIV/AIDS

ZENG Cheng-bo, ZHANG Han-xi, CAI Wei-ping, SUN Yi-peng, CHEN Ting-ting, GUO Zi-han, ZHU Ya-jing, GUO Yan

2016, 20(12): 1227-1230,1235. doi: 10.16462/j.cnki.zhjbkz.2016.12.010

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Objective To explore the current status and related factors of human immunodeficiency virus (HIV) infection among family members and friends of people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA). Methods Cross-sectional study by convenience sampling was adopted and family members and friends of PLWHA were recruited from the infection department of Guangzhou No.8 People's Hospital from March to June 2013. Self-designed questionnaire was used in this face-to-face survey. Results Among 192 family members and friends of PLWHA, 86.5% (166/192) were family members. The rate of HIV infection was 36.5% (70/192). Multivariate Logistic regressions analysis indicated that being married or in sexual relationship (OR=4.464, 95% CI:2.128-9.366), homosexuality or bisexuality (OR=4.523, 95% CI:1.676-12.209), and drug use (OR=6.755, 95% CI:1.720-26.528) were risk factors of HIV infection while emotional closeness (OR=0.229, 95% CI:0.097-0.539) was a protective factor. Conclusions Spouses or sexual partners of PLWHA had a higher probability of engaging in sex behaviors with PLWHA and were therefore at a higher risk of HIV infection than other relatives. However, spouses or sexual partners who were emotionally close to PLWHA had lower risks of HIV infection than their counterparts. Homosexuality/bisexuality and drug use still were risk factors of HIV infection. Further studies on the relationship between emotional ties with PLWHA and HIV infection of other relatives and friends except spouses or sexual partners are needed.

Molecular characterization of HIV-1 infection among men who have sex with men in Huai'an

YAN Qing-li, YANG Peng-fei, FAN Wei, XING Ya-dong, LIU Chun-cheng, GUO Hong-xiong, HE Nan-jiang, YAO Hai-bo

2016, 20(12): 1231-1235. doi: 10.16462/j.cnki.zhjbkz.2016.12.011

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Objective To gain more insights into genotype and evolutionary characteristics of HIV-1 infection among men who have sex with men (MSM) in Huai'an,Jiangsu. Methods Local confirmed cases in Huai'an were collected. HIV-1 env genes were amplified by nested reverse transcription polymerase chain reaction (RT-PCR)from (RNA) DNA, followed by sequencing and molecular evolutionary analysis. Results The distribution of HIV-1 infection genotypes among MSM were as follows:CRF01-AE(68.21%, 118/173),CRF07-BC(16.76%, 29/173),CRF08-BC(0.58%, 1/173),CRF55-01B(1.16%, 2/173) and B (13.29%, 23/173). Comparison of env gene sequences indicated that the HIV-1 strains circulating in Huai'an had high nucleotide identity with strains in Yunnan, Liaoning, Guangxi, Jiangsu and Hunan and clustering with their subtypes together on the phylogenetic tree. Overall, 58 haplotypes of CRF01-AE genotype were defined among individuals and CRF01-AE genotype of Huai'an isolates were equipped with a high haplotypic diversity index (0.999) and low nucleotide diversity index (0.150) also indicated the high genetic diversities. Conclusions HIV-1 genotypes are diverse in Huai'an. CRF55-01B was firstly detected among MSM in Huai'an. CRF01-AE is the dominant epidemic sub-type in MSM.

Investigation of high-risk sexual behavior and STD/AIDS prevalence among men who have sex with men in Tongling

ZHU Ren-min, HAN Cong-ming, WANG Dao-fa, LIU Yan, HUANG Yong, HE Yi-xin

2016, 20(12): 1236-1239. doi: 10.16462/j.cnki.zhjbkz.2016.12.012

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Objective To understand the status of high-risk sexual behavior and STD/AIDS infection among men who have sex with men (MSM) in Tongling City, and to provide scientific basis for the intervention of MSM population. Methods MSM were recruited by respondent-driven sampling (RDS), QQ network recruitment and regularly male outreach activities. Questionnaire was employed to collect demographic information and investigate AIDS awareness as well as high-risk sexual behaviors. 5 ml of peripheral blood were collected for detecting HIV antibody and syphilis antibody. Results 101 MSM with an average age of (24.8±6.2) were investigated. The majority of MSM were unmarried, well-educated, employees. The awareness rate of AIDS was 95.0%. The awareness rate of condom usage was higher among subjects with 75.2% of which giving correct answers to all 6 questions. The average age of the first sexual behavior was (19.4±2.8) years old, and 71.3% of subjects had male partner for the first sexual behavior. 88.1% of MSM had homosexual behavior in the past 6 months, among which only 64.0% used condoms consistently, 36.0% of them only used condoms occasionally. Moreover in 62 blood samples, the positive rate of HIV and syphilis was 6.5% and 1.6% respectively. Conclusions The positive rate of HIV is high among MSM in Tongling city. While the rate of condom usage is also low in homosexual behavior. Therefore, instant intervention to MSM population is critical for AIDS prevention.

Survey on risk of HIV-sexual transmission from HIV-positive men who have sex with men to their male primary sexual partners through unprotected sexual behaviors

LIU Nai-peng, CHEN Fang, ZHANG Yue, WANG Xiao-dong, ZHOU Yi, XIAO Jian, LIU Xiao-yu, WANG Wei, ZHANG Hong-bo

2016, 20(12): 1240-1243,1248. doi: 10.16462/j.cnki.zhjbkz.2016.12.013

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Objective To investigate the risk of HIV-sexual transmission to primary partners among HIV-positive men who have sex with men(MSM) who engaged in unprotected sexual behaviors and to determine the contributions of its factors to HIV transmission risk. Methods Participants were recruited by "snowball" sampling in Shanghai and Chengdu of China. The survey was administered face-to-face by well trained staff in a confidential room. All participants completed questionnaire anonymously. Results Approximately 26.9 percent (83/308) of participants had the sexual transmission risk to their primary partners. The results of multiple Logistic regression showed that HIV-sexual transmission risk among participants who were diagnosed HIV infection within one year was 3 times(OR=0.34,95% CI:0.15-0.79) and 6 times(OR=0.17,95% CI:0.06-0.49), respectively, than that of the ones diagnosed between 1-2 years and more than 3 years. Furthermore, disclosure of HIV infection to their family and all their primary sexual partners were protective factors for the HIV-sexual transmission risk, OR=0.24 (95% CI:0.10-0.55) and OR=0.04 (95% CI:0.01-0.13) respectively. In addition, the risk of HIV-sexual transmission to primary sexual partners among participants who looked for sexual partners by internet increased 3 times of that among participants by other ways(OR=0.33,95% CI:0.14-0.78). Conclusions HIV-sexual transmission risk between HIV-positive MSM and their male primary sexual partners could accelerate HIV spread among MSM, thus, intervention practice of early ART, sexual partner notification and family disclosure, as well as new media intervention are urgently needed.

A study on convenient condom access and HIV prevention

ZENG Xiang, DOU Qian-ru, BAO Yu-gang, ZHANG Yan-hui, TAN Hong-zhuan

2016, 20(12): 1244-1248. doi: 10.16462/j.cnki.zhjbkz.2016.12.014

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Objective To analyze the unprotected sexual behavior and condom use rate among sexually transmitted HIV-positive patients,imitating the effectiveness of improving condom access on preventing HIV transmission through sexual behaviors. Methods A survey was conducted among sexually transmitted HIV-positive patients using questionnaires to collect general information during the last 6 months before notification of HIV infection. Effectiveness of improving condom access on preventing HIV transmission was estimated by mathematical models. Results Among total subjects, the condom use rate was only 36.4%. During the last 6 months before notification of HIV infection, 63.6% never used condoms, 14.8% sometimes used, 9.6% often used, and only 12.0% insisted on using condoms. The reasons why subjects did not insist on using condoms were different, with 30.9% didn't obtain condoms timely when they had unprotected sexual behaviors. As expected, the occurrence of unprotected sexual behaviors and new cases of HIV infections were decreased by 13.79% and 10.92%, respectively, by improving the condom access. Conclusions Providing access to condoms in public places would reduce HIV transmission.

Analysis of the trend of HIV/AIDS related risk behaviors and HIV/AIDS infection among peasant-workers

ZHAI Jing, LI Xue-hua, NIU-Jin, XIAO Min-yang, LUO Hong-bing, HUANG Li-hua, CHEN Zhi-juan, LI Hong-yuan, ZHONG Li-dong, JIA Man-hong

2016, 20(12): 1249-1252,1256. doi: 10.16462/j.cnki.zhjbkz.2016.12.015

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Objective To understand the trend of HIV/AIDS knowledge, risk behaviors and HIV/AIDS prevalence among peasant-workers. Methods Fixed location continuous sampling method was used. Questionnaire survey and HIV antibody test were carried out among peasant-workers from 2012 to 2014 in Dali city. Sample size was 400 per year. Results The rate of HIV/AIDS knowledge for peasant-workers increased from 79.8% to 98.5%(χ²=80.17,P<0.001). Multivariate analysis showed that education level, whether received AIDS intervention services and age were independent factors for AIDS knowledge. There was no trend change about the rate of consistent condom use with sex workers in 2012-2014(r=-0.238,P=0.149). The rate of consistent condom use with casual sexual partners were 28.6%,46.4% and 56.3%, respectively. The rate of consistent condom use with spouses increased slightly from 4.8% to 6.3%(r=0.048,P=0.031). From 2012 to 2014, HIV prevalence rate was 0.0%, 0.0% and 0.5%, respectively. Conclusions Behavior intervention among peasant-workers has made some progress, but the rate of condom use is not satisfactory. Special attention should be paid to the increasing trend of casual sex behavior. Further effort should be focused on multi-sector cooperation, increasing coverage of comprehensive intervention and HIV testing service, especially among older and lower education background peasant-workers.

Proportion and influencing factors of delay on HIV diagnosis among newly reported HIV-infected Myanmar patients in Dehong area of Yunnan Province in 2015

LI Lin, YANG Yue-cheng, CAO Yan-fen, TANG Ren-hai, YE Run-hua, YANG Shi-jiang, YAO Shi-tang, WANG Ji-bao, ZHANG Yu-cheng, DUAN Song, HE Na

2016, 20(12): 1253-1256. doi: 10.16462/j.cnki.zhjbkz.2016.12.016

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Objective To investigate the proportion and influencing factors of delay on HIV diagnosis among newly reported HIV-infected Myanmar patients in Dehong area of Yunnan Province in 2015. Methods Sociodemographic characteristics, routes of infection and other information of interest for newly reported HIV/AIDS Myanmar patients in Dehong area were collected through the National Information System for Comprehensive AIDS Prevention and Control. Results Among 526 patients, 110(20.9%) were subject to late HIV diagnosis. Multivariable Logistic regression analysis showed that patients aged 25-34 (OR=2.72, 95% CI:1.33-5.56, P=0.006) or ≥35 years old (OR=4.93, 95% CI:2.29-10.63, P<0.001) were more likely to be diagnosed later than those age < 25 years old. Patients from medical institutions (OR=3.15, 95% CI:1.48-6.71, P=0.003), voluntary counseling and testing clinics (OR=5.48, 95% CI:2.66-11.31, P<0.001) and those spouses or sex partners with positive HIV(OR=3.08,95% CI:1.47-6.44,P=0.003) had higher proportion of delayed diagnosis compared with detained people. Conclusions The proportion of delayed diagnosis among newly reported HIV-infected Myanmar patients in Dehong area is relatively high in 2015. HIV testing should be scaled up among Myanmar people so as to detect HIV infection early and provide antiviral therapy in time.

Sentinel surveillance among female sex workers in Wuwei City Gansu Province from 2011 to 2013

WANG Xiang-shang, WANG An-hui, He Xin-sheng, LIU Yuan, YAN Yong-ping

2016, 20(12): 1257-1260,1269. doi: 10.16462/j.cnki.zhjbkz.2016.12.017

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Objective To investigate the awareness of HIV/AIDS related knowledge, high-risk sexual behaviors and influencing factors among female sex workers (FSWs) in Wuwei city and to provide evidence for making intensive intervention policy for FSWs. Methods According to the national acquired immune deficiency syndrome (AIDS) sentinel surveillance protocol, questionnaire survey and serological detection were conducted among FSWs in Wuwei city from 2011 to 2013. Results Total 1 200 FSWs were included in the analysis and the awareness of HIV/AIDS related knowledge among FSWs was 89.8% (1 077/1 200). The awareness of HIV/AIDS related knowledge among FSWs from 2011 to 2013 were 97.0% (388/400),90.8% (363/400),81.5% (326/400) respectively (χ²=52.88,P<0.001). The rate of consistent condom use during the last month among FSWs in 2011-2013 were 93.0% (372/400), 83.0% (332/400) and 75.0% (300/400), respectively (χ²=47.61,P<0.001). No HIV positive cases were detected among FSWs. The positive rates of syphilis and anti-HCV were 2.9%(35/1 200) and 2.3%(27/1 200). Multivariate Logistic regression analysis showed that the awareness of HIV/AIDS related knowledge, education level, grade of sex trade sites, age and diagnosis of sexual transmission disease during last 12 months were associated with persist condom use in the last month among FSWs. Conclusion Compared to 2011, the rates of HIV/AIDS related knowledge awareness and consistent condom use in the last month among FSWs were decreased in 2013. More enhanced propaganda interventions should focus on FSWs in low and middle class sex trade sites in Wuwei city.

Sentinel surveillance of AIDS among 400 commercial sex clients in Liuzhou City in 2015

YU Tao, YANG Yan-zhen, WANG Jun-lin, WANG Xiu, DENG Chen-chen, FAN Yin-guang, YE Dong-qing

2016, 20(12): 1261-1264. doi: 10.16462/j.cnki.zhjbkz.2016.12.018

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Objective To explore infection situation of human immunodeficiency virus among 400 commercially sexual clients from Liuzhou and factors targeting the use of condoms, and to provide references for further work. Methods A total of 400 clients from Liuzhou were randomly enrolled for anonymous questionnaires. Peripheral blood samples were collected for detection of antibodies of human immunodeficiency virus (HIV). Treponema pallidum and hepatitis C virus. Results All clients were recruited from low entertainment places The rate of whole AIDS knowledge awareness was 93.3%. The rate of not using condom during commercial sex in the past time and year were 5.2% and 13.5%, respectively. The main reason was "non-comfortable". Multivariate Logistic regression analysis showed that age(OR=0.434, 95% CI:0.261-0.721,P=0.001) and the accepted detection of HIV (OR=2.103, 95% CI:1.064-4.158,P=0.032) were protective factors of persistent condom use in commercial sex in the past year; the positive rate of antibodies for human immunodeficiency virus (HIV). Treponema pallidum and hepatitis C virus were 1.3%,3.8% and 0.5%, respectively. Conclusions Most of clients from Liuzhou city are elderly adults. Both the low use of condom with female sex worker and the high rate of HIV infection play potential risk roles in the transmission from high risk population to general population. Therefore, targeted measures need to be taken in order to prevent the spread of HIV.

The psychological and social support status of people living with HIV/AIDS in Wuxi

ZHOU Jin, CHENG Hao, XU Fan-fan, ZHANG Xuan, ZHU Jing, WANG Bei

2016, 20(12): 1265-1269. doi: 10.16462/j.cnki.zhjbkz.2016.12.019

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Objective To investigate the psychological and the social support status of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), and to analyze factors which influenced their psychological and social support status in Wuxi. Methods A total of 110 people diagnosed with HIV-positive were recruited in this cross-sectional study. A questionnaire which included 90 Symptom Checklist (SCL-90) and Social Support Rating Scale (SSRS) was answered by participants. Results The number of SCL-90 screening positive participants was 66(60.00%), and the total and subscale mean scores were higher than those of norm of China (all P<0.001). Social support total and subscale scores were less than those of norm of China (all P<0.05). And the subjective score had difference in different ages and marital status (all P<0.05). Correlation analysis found that total social support score was negatively correlated with total and subscale mean scores except the mean scores of somatization, obsessive-compulsive and others (all P<0.05); objective support score was negatively correlated with total mean score and subscale mean scores of interpersonal sensitivity, depression, anxiety and phobic anxiety (all P<0.05); subjective support score was negatively correlated with total mean score and subscale mean scores of interpersonal sensitivity, depression, anxiety, anger/hostility, paranoid ideation and psychoticism (all P<0.05); there was no significant correlation between the utilization of supports and all mean scores on the SCL-90 (all P>0.05). Conclusions There are many psychological problems among people living with HIV/AIDS in Wuxi, and their social support total and subscale scores were generally low. They should experience more mental health counseling and psychological services, and be given more social support, especially objective support and subjective support.

Influence of follow-up intervention on social support and medication compliance for HIV/AIDS patients

YANG Yong-guang, LIANG Shu-ying, LIU Yang, GUO Xiao, SUN Liang, LI Zi-zhao, WANG Chong-jian, WANG Yu-ming

2016, 20(12): 1270-1273. doi: 10.16462/j.cnki.zhjbkz.2016.12.020

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Objective To evaluate the effect of follow-up intervention on HIV/AIDS patients. Methods Stratified random sampling method was used to investigate HIV/AIDS patients from the five demonstration city in Henan Province. Baseline and follow-up survey were conducted among participants to analyze the social support and the adherence to highly active antiretroviral therapy (HAART). Results A total of 911 and 860 HIV/AIDS patients were included by the baseline and follow-up survey, among each 798 and 795 participants received HAART. The total social support scores of the baseline and follow-up survey on HIV/AIDS patients were (38.64±7.87) and (40.36±7.45), respectively, and significant differences were found (t=4.486,P<0.001). The total score of social support and its all dimensions in the following-up survey were higher than those of the baseline survey (all P<0.05). The patients adherence to HAART before and after the follow-up intervention, the significant differences were found between better medication compliance and poor medication compliance (χ²=20.648,P<0.001). Conclusions Follow-up intervention could significantly improve the social support and the adherence to HAART, and the higher social support could enhance the medication compliance.

Loss to follow-up over the first five years and its influencing factors in the cohort of sero-negative spouses of HIV-infected individuals in Dehong Prefecture, Yunnan Province

ZHANG Yu-cheng, CAO Yan-fen, YANG Yue-cheng, TANG Ren-hai, YANG Shi-jiang, LI Lin, YAO Shi-tang, YE Run-hua, WANG Ji-bao, DUAN Song, HE Na

2016, 20(12): 1274-1277,1298. doi: 10.16462/j.cnki.zhjbkz.2016.12.021

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Objective To explore the factors influencing the loss to follow-up over the first five years among seronegative spouses of HIV-infected individuals in Dehong Prefecture, Yunnan Province. Methods A total of 1 110 HIV seronegative spouses were recruited in 2009, social-demographic characteristics and HIV/AIDS related information were collected, follow-up survey was conducted every year till the end of 2014.COX proportional hazards regression model was used to analyze risk factors of loss to follow-up. Results Among total 1 110 seronegative spouses recruited, HIV seroconvertion was developed in 37 subjects with a total incidence rate of 0.92 per 100 person years. 1 015(91.4%) had at least one follow-up visit, however, 227 lost to follow-up at the end of 2014, contributing to a rate of 5.66 per 100 person years. four subjects and 129 seropositive subjects died, 63 divorced. The retention rate was 58.7%(652/1 110) at 5 years. Of all sero-negative spouses who needed follow-up, 74.2% (652/879) performed follow-up visit. COX proportional hazards regression model showed that the risk factors of loss to follow-up were living in Ruili (HR=1.83,95% CI:1.16-2.87,P=0.009) or Mangshi (HR=1.90,95% CI:1.23-2.93,P=0.004), male (HR=1.74,95% CI:1.27-2.38,P=0.001) and having sero-positive spouses not under anti-retroviral therapy (ART) (HR=4.39,95% CI:3.21-6.02,P<0.001). Conclusions Living in Ruili or Mangshi, male and having seropositive spouses not under ART are risk factors of loss to follow-up. To maintain a high retention rate, the institute of HIV/AIDS prevention and control in Dehong prefecture should pay more attention to these influencing factors in the future work.

Syphilis infection status and the associated factors among partners of married syphilis-infected pregnant women in Shenzhen

WU Xiao-bing, HONG Fu-chang, PENG Dong-yu, ZHANG Chun-lai, TANG Fen, LAN Li-na, FENG Tie-jian, YANG Ying-zhou

2016, 20(12): 1278-1281,1285. doi: 10.16462/j.cnki.zhjbkz.2016.12.022

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Objective To investigate syphilis infection status among partners of married syphilis-infected pregnant women, and analyze the associated factors from the perspective of both pregnant women and their partners. Methods Follow-up survey and contact tracing were conducted among married syphilis-infected pregnant women diagnosed from 2008 to 2011. Both toludine red unheated serum test (TRUST) and treponema pallidum particle agglutination (TPPA) were applied to partners attending antenatal care clinics. Structural questionnaires were used to collect information. Binary logistic regression model was applied to analyze the factors associated with partners' syphilis infection. Results Totally 2 261 pairs of married syphilis-infected pregnant women and their partners were recruited. Based on laboratory record, 528 partners were with positive results for both TRUST and TPPA (23.35%), and 129 partners were with positive results for only TPPA (5.71%), thus syphilis infection rate among partners were 29.06% (657/2 261). The partners were more likely to have syphilis infection when pregnant women were with TRUST titers ≥1:8, were with diagnosis of early syphilis or had received adequate treatment before pregnancy (all P<0.05). The partners had higher risk of syphilis infection when they had lower education level, or had multiple sex partners (all P<0.05). Conclusions Syphilis infection rate among partners of married syphilis-infected pregnant women is high. Pregnant women's levels of TRUST titer and disease stage as well as partners' sexual behaviors were important factors associated with partners' syphilis infection.

The situation analysis of community-based organizations providing HIV testing services in Yunnan Province

YANG Yan-ling, JIA Man-hong, MA Yan-ling

2016, 20(12): 1282-1285. doi: 10.16462/j.cnki.zhjbkz.2016.12.023

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Objective To understand the human immunodeficiency virus (HIV) testing provision of community-based organizations (CBOs) in the 3rd round China-care program in Yunnan Province and provide suggestions for HIV testing promotion. Methods Data was collected by online questionnaires and analyzed with SPSS 19.0. Results 50 CBOs participated in the 3rd round China-care Program in Yunnan Province.100.0% (50/50) could provide referred HIV testing services. 64.0%(32/50) of them could provide HIV testing service, 81.3%(26/32) could provide blood HIV rapid testing services and 53.1%(17/32) could provide oral fluid HIV rapid testing services. All 32 CBOs received HIV rapid testing training. 40.0%(20/50) of CBOs could provide HIV rapid testing. The attitudes for HIV rapid testing services in different Health departments were significantly different (χ²=15.309, P=0.004). Conclusions It is important for CBOs to provide HIV rapid testing service and identify HIV infections. Thus, it is necessary to strength potentials of CBOs in providing HIV rapid testing service in the 3rd round China-care program in Yunnan Province. Providing HIV rapid testing service and behavioral intervention at the same time could extend coverage of HIV testing.

Research progress on direct-acting antivirals usage for HCV mono-infection and HCV/HIV co-infection

LIU Hang, GUI Xi-en, HO Wen-zhe

2016, 20(12): 1286-1291. doi: 10.16462/j.cnki.zhjbkz.2016.12.024

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In the past several years, research on the development of new drugs for treatment of hepatitis C virus infection has made a breakthrough. A number of basic and clinical studies have proven that direct-acting antivirals (DAAs) that target specific viral proteins are highly effective in treating HCV with a sustained viral response (SVR) as high as >90%. However, HCV/HIV co-infected individuals have not been able to receive the effective treatment with DAAs due to a number of factors. This paper briefly describes the classification, mechanisms and results of clinical studies on DAAs. In addition, the paper introduces the research on the development of host-targeting agents (HTAs), and treatment of DAAs for HCV/HIV co-infected individuals.

Application and problems of the qualitative research method in AIDS research

DAI Se-ying, SHEN Zhang-wei, CHENG Xiao-li

2016, 20(12): 1292-1295. doi: 10.16462/j.cnki.zhjbkz.2016.12.025

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Qualitative research is a common method for sociology and anthropology, its core characteristic is highlighted in the humanistic care and respect. It could explore some sensitive problems in a way that is deeper and humanized, could learn some deeper problems, and could obtain the information which quantitative research method could not get. AIDS is a disease that is closely related with social factors and individual behavior, and these social factors and individual behavior are affected by many factors such as ethnic, culture, environment and custom. Therefore, in order to explore this complicated and sensitive issues, to gather the sensitive information that is related with social factors and individual behavior, the qualitative research is increasingly applied in the related research of AIDS. This paper mainly introduces the application and problems of the qualitative research method in AIDS research in our country.

Analysis of sentinel surveillance of AIDS among female sex workers in Liuzhou City from 2009 to 2015

LIU Xue-mei, FENG Xian-xiang, YANG Yan-zhen, SHAN Gui-su, ZHONG Xiang-hai, QIN Yu-duo, FAN Yin-guang, LI Ming-qiang

2016, 20(12): 1296-1298. doi: 10.16462/j.cnki.zhjbkz.2016.12.026

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2016, 20(12): 1299-1300. doi: 10.16462/j.cnki.zhjbkz.2016.12.027

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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