中华疾病控制杂志

New progress of AIDS epidemiology in China

HE Na

2021, 25(12): 1365-1368, 1480. doi: 10.16462/j.cnki.zhjbkz.2021.12.001

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At the 40^th anniversary of the first global AIDS report, China's HIV/AIDS epidemic presents with new characteristics, and the national goal of anti-HIV/AIDS has also shifted from "the 90-90-90 goal by 2020" to "the 95-95-95-95 goal by 2025". This review briefly summarizes the most recent advances in the epidemiological research of HIV/AIDS in China, aiming to provide insights on the scientific pathways to achieving the national goal of HIV/AIDS prevention and control for the "Fourteenth Five-Years Plan" as well as the hope for "Ending AIDS by 2030".

Based on Lasso-Logistic regression to build a continued drug use risk prediction model for methadone maintenance treatment patients

LIU Xue-jiao, LUO Wei, ZHANG Bo, WEN Pin-yuan, WU Zun-you

2021, 25(12): 1369-1373, 1402. doi: 10.16462/j.cnki.zhjbkz.2021.12.002

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Objective To explore the associated risk factors of continued drug use in methadone maintenance treatment (MMT) patients, and to build a continued drug use risk prediction model. Methods Opioid users who newly enrolled in MMT clinics in Yunnan Province during 2013-2017 were included in the study. We used Lasso regression analysis to screen risk factors for continued drug use. We constructed a prediction model based on screened risk factors above by multivariable Logistic regression analysis. We used bootstrap method to internally validate the model. Further, a nomogram was established to visualize the model. Results Of 7 899 eligible patients, 4 125(52.22%) cases continued to drug use in the first 6 months following enrollment. Nine variables collected at baseline for MMT patients were selected for the prediction model. i.e., male, living alone, unemployed, normal family relationship, bad family relationship, duration of drug use, drug injection behavior in past month, caught by the police in past three months, and criminal behavior in past three months. The model exhibited well discrimination with an area under curve (AUC) of 0.70 (95% CI: 0.69-0.72). Conclusion The model presents good performance in predicting continued drug use risk for MMT newly enrolled patients, which can be used to help clinic staff to find early patients at high-risk of continuing use opioid while receiving MMT service.

Prevalence and correlates of HCV infection among cross-border couples in Dehong Prefecture

YANG Yue-cheng, LI Zi-hui, LI Lin, YE Run-hua, DU Ben-li, WANG Chen-bo, HE Zhi-qun, NIE Yong-ying, LI Wei-mei, WANG Ji-bao, YAO Shi-tang, DING Ying-ying, HE Na, DUAN Song

2021, 25(12): 1374-1379, 1386. doi: 10.16462/j.cnki.zhjbkz.2021.12.003

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Objective To investigate the HCV prevalence and associated factors among cross-border couples in Dehong Prefecture. Methods Information was collected through face-to-face questionnaire survey in this cross-sectional study. The contents of the questionnaire included basic information and 5 ml venous blood of the respondents was collected and sent to HIV confirmation laboratory within 72 hours. Results Among 31 948 participants, HCV prevalence was 2.41% overall, but the prevalence was higher among Chinese natives than foreign spouses [3.42% (518/17 150) versus 1.50% (252/16 798)]. The HCV prevalence was higher in male spouses than female spouses (3.64% versus 1.33%). Prevalence of HCV infection was up to 85.23% among male spouses who were injection drug users, and up to 29.94% among female spouses who had ever have extramarital noncommercial sexual behaviors. In multivariable Logistic regression model analysis, aged ≥30 years, ethnic minorities, history of drug use, extramarital sex, and HIV infection were significantly associated with HCV infection among male spouses, whereas aged ≥30 years, Jingpo ethnic minority, drug user, noncommercial extramarital sex and HIV infection were significantly associated with HCV infection among female spouses. Conclusion The epidemic of HCV among cross-border couples in Dehong is severe, requiring more health education about HCV prevention.

Prevalence and associated factors of multimorbidity among newly reported HIV-positive individuals in Dehong Dai and Jingpo Autonomous Prefecture

MA Zhong-hui, GAO Jie, CAO Dong-dong, YANG Yue-cheng, YE Run-hua, WANG Ji-bao, TANG Ren-hai, HE Na, DING Ying-ying, DUAN Song

2021, 25(12): 1380-1386. doi: 10.16462/j.cnki.zhjbkz.2021.12.004

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Objective To explore the prevalence and associated factors of multimorbidity among the newly reported human immunodeficiency virus (HIV)-positive individuals in Dehong Dai Jingpo Autonomous Prefecture (Dehong). Methods From 1 January 2018 to 30 June 2020, a cross-sectional study was conducted to investigate the multimorbidity burden among newly reported HIV-positive individuals in Dehong. Multimorbidity was defined as the presence of at least two chronic diseases. Results 468 subjects were included, of which 258 (55.1%) were 35- < 50 years old, male to female ratio was about 1.4∶1 and 199 (42.5%) were Han Chinese. Among them, 140 (29.9%) had the multimorbidity. The prevalence of having two, three, four, five, six comorbidities were 19.0%, 8.3%, 1.1%, 0.9% and 0.6%, respectively. The top 5 comorbidities were dyslipidemia, chronic infections, hypertension, anemia and liver fibrosis, accounting for 48.9%, 15.2%, 13.9%, 13.0% and 8.3%, respectively. In multivariate Logistic regression, aged ≥ 50 years old (aOR=4.06, 95% CI: 1.98-8.33, P < 0.001), have history of drug abuse or injection drug use (aOR=2.26, 95% CI: 1.23-4.14, P=0.009) and CD4⁺T lymphocyte counts < 200 cells/μl (aOR=2.03, 95% CI: 1.23-3.37, P=0.006) were significantly associated with the presence of multimorbidity. Conclusions The prevalence of multimorbidity was high among newly reported HIV-positive individuals in Dehong particularly among the elderly, drug users and those with lower CD4 counts. Our data suggested that monitoring and managing multimorbidity should be integrated into regular HIV care.

Associations of resting heart rate and dyslipidemia with prehypertension and hypertension among HIV/AIDS patients

HE Chun-yan, CHEN Xiao-xiao, FENG Cheng, WANG Miao-chen, LIN Hai-jiang, HE Na, DING Ying-ying

2021, 25(12): 1387-1392, 1397. doi: 10.16462/j.cnki.zhjbkz.2021.12.005

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Objective To assess the associations of elevated resting heart rate (RHR) and dyslipidemia and their interactions with prehypertension and hypertension among HIV/AIDS patients. Methods A cross-sectional assessment was conducted among 1 645 HIV/AIDS patients over 30 years old from the baseline survey of Comparative HIV and Aging Research in Taizhou (CHART) between 2017 to 2019. Multinomial Logistic regression model was used to assess the factors associated with prehypertension and hypertension. Multiplicative model was used to explore the interaction between elevated RHR and dyslipidemia. Elevated RHR was defined as > 90 beats/min; dyslipidemia was defined as elevated total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) or decreased high-density lipoprotein cholesterol (HDL-C) levels. Results Among 1 645 HIV/AIDS patients, prevalence of prehypertension and hypertension were 42.8% and 28.1%, respectively. 15.8% (260/1 645) of the subjects had elevated RHR, and 59.2% (974/1 645) had dyslipidemia. After adjusting for age, sex, body mass index, waist to hip ratio and TC, elevated TG and elevated RHR were independently associated with prehypertension (aOR=1.56, 95% CI: 1.14-2.13, P=0.005; aOR=1.60, 95% CI: 1.06-2.43, P=0.026) and hypertension (aOR=1.94, 95% CI: 1.37-2.75, P < 0.001; aOR=1.95, 95% CI: 1.20-3.18, P=0.007), and there was a negative multiplicative interaction between elevated TG and elevated RHR with prehypertension (P=0.017) and hypertension (P=0.032). No interaction was observed between abnormal TC, LDL-C, HDL-C and elevated RHR on prehypertension and hypertension. Conclusion Elevated RHR and elevated TC are independently associated with prehypertension and hypertension in HIV/AIDS patients. The negative interactions between elevated RHR and elevated TC on prehypertension and hypertension suggest that faster RHR is likely to reduce the threshold for TG levels to cause hypertension. Further studies are needed to reveal the underlying mechanism between RHR, TG and hypertension.

Depression status and its influencing factors of lesbians in China

WANG Li-yin, DING Chang-mian, GUO Meng-lan, WEI Li-qing, XIAO Chen-chang, YAN Hong, LI Shi-yue

2021, 25(12): 1393-1397. doi: 10.16462/j.cnki.zhjbkz.2021.12.006

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Objective To investigate the depression status of lesbians in China, and to explore the related factors of depressive symptoms, so as to provide suggestions for better health management for lesbians. Methods An online questionnaire survey was conducted among lesbians from July 1, 2018 to December 30, 2018. The distribution of lesbian depression was described. Chi-square test and two independent samples T test were used for univariate analysis. Logistic regression analysis model was performed to analyze the factors influencing depressive symptoms. Results 56.1% of lesbians had symptoms of depression. The results of the research showed that lesbians who lived with female friends (OR=0.399, 95% CI: 0.182-0.872, P=0.021), had a higher level of social support (OR=0.953, 95% CI: 0.926-0.980, P=0.001) and mental resilience (OR=0.934, 95% CI: 0.895-0.975, P=0.002) were less likely to get depressed. However, lesbians from ethnic minorities (OR=5.849, 95% CI: 1.474-23.206, P=0.012) were more likely to suffer from depression compared with Chinese Han lesbians. Adverse childhood experiences (OR=1.317, 95% CI: 1.065-1.628, P=0.011) were risk factors of depression. Conclusions The incidence of depressive symptoms is high among lesbians in China, and attention should be paid to the psychological health status of sexual minorities. The positive effects of social support needs to be taken seriously to promote their mental health.

Survey of physical and mental health among middle-old aged female HIV/AIDS patients in North Anhui Province

XIAO Yong-kang, XU Zeng-hui, LIU Ai-wen, JI Guo-ping

2021, 25(12): 1398-1402. doi: 10.16462/j.cnki.zhjbkz.2021.12.007

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Objective To investigate the physical and mental health status of middle-old aged female human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in northern Anhui Province, and to provide scientific basis for the care and support for the HIV/AIDS patients and the promotion of the quality of life in the future. Methods Using the method of cluster random sampling, 521 female HIV/AIDS patients aged ≥ 40 years and their neighbors were investigated in 8 villages from March 2018 to February 2019. The questionnaire included social demographic characteristics, physical health and mental health status, etc. Results A total of 495 subjects were included in the final analysis. The proportion of two-week prevalence was 45.8% and the proportion of annual hospitalization was 36.2% in patients, which were higher than those in the control group (all P < 0.05). There were statistical differences in sleep quality, appetite, vision, hearing and movement of legs and feet between the two groups (all P < 0.05). The detection rate of depressive symptoms was 61.4% and the detection rate of anxiety symptoms was 65.5% in patients, the scores and incidence of depression and anxiety were different between the two groups (all P < 0.01). Conclusions The disease burden of middle-old aged female HIV/AIDS patients was heavy, and their physical and psychological conditions was significantly worse than those of HIV negative women of the same age in the same area. Their demand for health service in treatment, care and psychological counseling was relatively large, and more attention should be paid to them.

Prevalence and influencing factors of HIV, HCV and syphilis among drug addicts in compulsory detoxification center of Anhui Province

YAO Hui, ZHANG Si-chen, FENG Jin-bao, CHEN Chao-jie, WANG Hai, LEI Yan-hua, FAN Yin-guang

2021, 25(12): 1403-1408. doi: 10.16462/j.cnki.zhjbkz.2021.12.008

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Objective To understand the behavioral characteristics and the prevalence rates of HIV, HCV and syphilis, and to explore the influencing factors among drug addicts in compulsory detoxification center of Anhui Province. Methods Drug addicts who newly entered the Binhu compulsory detoxification center in Anhui Province from July 1, 2018 to June 30, 2020 were taken as the survey subjects. Demographic and behavioral information of the survey subjects were collected, and blood was collected for relevant antibody testing. Univariate Chi-Square test and multivariate Logistic regression analysis were performed to explore the influencing factors of infection. Results A total of 950 drug addicts were investigated, mainly male, with an average age of (34.98±8.54) years old. Among them, 84.5% (803/950) were new drug users. The positive rate of HIV, HCV and syphilis antibodies was 1.2%, 10.0% and 9.2%, respectively. Multivariate Logistic regression analyses showed that female (OR=3.84, 95% CI=2.35-6.27) and HIV antibody positive (OR=6.19, 95% CI=1.42-26.96) were influencing factors for syphilis infection, and peer education (OR=0.44, 95% CI=0.23-0.87) is a protective factor for syphilis infection. Female (OR=2.05, 95% CI=1.08-3.89), older age (OR=6.77, 95% CI=1.35-33.95) and injecting drug use (OR=51.84, 95% CI=27.65-97.19) were influencing factors for HCV infection. Conclusion The drug addicts in compulsory detoxification center of Anhui province are mainly new drug users. It is necessary to strengthen the control of new drugs.At the same time, effective intervention measures should be developed for women, the elderly group, and injecting drug addicts.

Situation on rectal douching and associated factors among men who have sex with men

MENG Xiao-jun, YIN Han-lu, LI Jun, XU Zhu-ping, ZOU Hua-chun, GU Jing

2021, 25(12): 1409-1413. doi: 10.16462/j.cnki.zhjbkz.2021.12.009

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Objective This study aimed to explore the prevalence of associated with rectal douching among men who have sex with men (MSM) and related factors, in order to provide targeted interventions. Methods In this observational study, snowball sampling was used to recruit 400 MSM in KTV, bathroom, bar and so on in Wuxi, Jiangsu Province from May 1, 2020 to July 10, 2020. A questionnaire was used to collect socio-demographic characteristics, behaviors, substances abuse, history of diagnosed sexually transmitted diseases (STDs) and rectal douching. Blood sample was collected and tested for HIV. Chi-square test and Logistic regression analysis model were performed to determine factors associated with rectal douching among MSM. Results A total of 400 MSM were recruited, among whom 51.3% practiced rectal douching in the past 6 months, 57.6% before anal sex only, 14.6% after anal sex only and 27.8% (57/205) before and after anal sex. Monthly income > 5 000 RMB (OR=2.18, 95% CI: 1.36-3.51, P=0.001), homosexual (OR=19.35, 95% CI: 4.01-93.38, P < 0.001), bisexual (OR=10.31, 95% CI: 2.12-50.14, P=0.004), engaging in receptive anal sex exclusively in the past 6 months (OR=8.96, 95% CI: 4.14-19.40, P < 0.001), engaging in both insertive and receptive anal sex in the past 6 months (OR=10.71, 95% CI: 4.80-23.89, P < 0.001), substances use (OR=3.20, 95% CI: 1.60-6.42, P=0.001), history of diagnosed STDs (OR=2.17, 95% CI: 1.30-3.63, P=0.003) and positive HIV status (OR=3.60, 95% CI: 1.14-11.36, P=0.029) were associated with rectal douching in MSM. Conclusions Rectal douching is common in MSM, which is a significant factor associated with HIV transmission. Health education and behavioral interventions related to rectal douching should be enhanced among MSM in order to reduce the risk of HIV transmission.

Analysis of survival and its related factors of HIV/AIDS patient in Luzhou, 2010-2019

WU Yang hao-tian, FENG Cai-bi, CHEN Hang, GUO Man, YANG Na, LIU Qian-qian, YAN Huan, DING Ming-feng, LI Gai-yun, LI Yi-lun, HAN Xue-mei, CAO Yong-wen

2021, 25(12): 1414-1419,1425. doi: 10.16462/j.cnki.zhjbkz.2021.12.010

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Objective To analyze the survival of HIV/AIDS patient and its related factors in Luzhou City. Methods The HIV/AIDS patient aged 15 years and above in Luzhou City from 2010 to 2019 were selected. Life table method was used to calculate the survival rate. Kaplan-Meier method was used to calculate the average survival time and draw the survival curve. Cox proportion hazard regression model was performed to identify the factors related to survival time. Results A total number of 12 274 cases were selected, the median survival time was 87.35 (86.22-88.49) months. The survival rate of 1, 3, 5, 7 and 9 years were 78%, 73%, 69%, 66%, and 63% respectively. Cox multivariate analysis showed that the risk of death in men was 1.491 times that than in women. The Han had 2.118 the risk times than other ethnic groups. The divorced or widowed had 1.545 times the risk than the married. The aged 60 years and above at the time of infection had 3.392 times risk than the aged less than or equal to 15- < 21 years old. The college and above had 0.473 the risk times than the illiteracy. Injecting drugs, collecting (supplying) blood and blood/blood products transfusions were 1.513 times than heterosexual transmission. The samples obtained from medical institutions were 1.131 times than detection of consulting. The first CD4⁺T cell test value of 501- cells/μl was 0.205 times than ≤200 cells/μl. First diagnosed AIDS was 1.166 times than HIV infection. Not receiving antiviral treatment was 3.524 times than receiving antiviral treatment. Conclusions The factors such as gender, marital status, age, education level, transmission route, sample source, first CD4⁺T cell count, disease state and antiviral treatment affect the survival of HIV/AIDSpatient. Early detection, early diagnosis, and early treatment can reduce the risk of death from HIV/AIDS cases.

The relationship between HIV serostatus disclosure, self-stigma, social support and suicidal ideation in AIDS patients

YU Yong, SU Li-li, SUN Yin-meng, XIE Jing, ZHANG Li, XIAO Shui-yuan

2021, 25(12): 1420-1425. doi: 10.16462/j.cnki.zhjbkz.2021.12.011

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Objective To investigate self-stigma and suicidal ideation in acquired immunodeficiency syndrome (AIDS) patients, and to explore the relationship between self-stigma, suicidal ideation, human immunodeficiency virus (HIV) serostatus disclosure and social support in AIDS patients. Methods A total of 1 276 AIDS patients in a provincial capital city were investigated anonymously using the general situation questionnaire, perceived social support scale (PSSS), self-stigma scale (SSS), and Beck scale for suicide ideation-Chinese version (BSI-CV). Results 54.2% (692/1 276) of the sample reported that they have suicidal ideation in the past week or the most severe depression. Multivariate analysis showed that after controlling for other factors, self-stigma was negatively correlated with social support (OR=0.57, 95% CI: 0.45-0.72, P < 0.001), and HIV serostatus disclosure was positively correlated with social support (OR=1.47, 95% CI: 1.12-1.92, P=0.005); self-stigma was positively correlated with suicidal ideation (OR=5.53, 95% CI: 4.21-7.27, P < 0.001), and social support was negatively correlated with suicidal ideation (OR=0.58, 95% CI: 0.45-0.76, P < 0.001). HIV serostatus disclosure played a partial mediating effect between self-stigma and social support (the mediating effect accounted for 29.0% of the total effect); social support played a partial mediating effect between self-stigma and suicidal ideation (the mediating effect accounted for 17.5% of the total effect). Conclusions The proportion of suicidal ideation is higher among AIDS patients. Patients with low self-stigma and who inform family, friends, and regular partners of the infection results perceive higher social support. Patients with high self-stigma and low social support have stronger suicidal ideation. The HIV serostatus disclosure plays a partial mediating role between self-stigma and social support in AIDS patients, while social support plays a partial mediating role between self-stigma and suicidal ideation.

The effect of migrant workers' electronic-health literacy on their condom negotiation efficacy

DAI Su-hui, ZHANG Ke-chun, CAI Yong, WANG Zi-xin, WANG Dong-ya, LUO Dan, CHEN Ya-qi, ZOU Hua-chun, CAO Bo-lin

2021, 25(12): 1426-1430. doi: 10.16462/j.cnki.zhjbkz.2021.12.012

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Objective To understand the level of electronic-health(e-health)literacy and safe sexual behaviors among migrant workers, and to analyze the impact of e-health literacy on condom negotiation efficacy, so as to provide a basis for further interventions to promote the sexual health of migrant workers. Methods A cross-sectional survey was conducted. The migrant workers' demographic characteristics, e-health literacy and condom negotiation efficacy were measured. In addition, Linear regression models were used to analyze the related factors that affect condom negotiation efficacy. Results The e-health literacy among migrant industrial workers was at the middle level(score=3.01±0.92), but there were significant differences by their gender, age, education, and income(all P < 0.05). Higher-educated (β=0.210, P < 0.001), higher-income (β=0.155, P < 0.001) and male (β=-0.136, P < 0.05) migrant workers had higher e-health literacy. In addition, migrant workers differed in their efficacy of using comdoms (β=0.035, P < 0.001), communicating (β=0.402, P < 0.001), and refusing sex (β=0.278, P < 0.001), which correlated positively with their e-health literacy. The higher the e-health literacy, the stronger the condom negotiation efficacy. Conclusion The improved e-health literacy of migrant workers has a positive effect on migrant workers' ability to negotiate condoms effectively. Improving e-health literacy of migrant workers should be considered for future sexual behavior promotion projects, in order to achieve a broader meaning of AIDS prevention and treatment.

Influenza vaccination and seroepidemiological status in elderly HIV-infected patients in Taizhou, Zhejiang Province

LI Shi-zhen, WENG Jian, JIN Yan, LIANG Hong-biao, WANG Shan-ling, SHEN Wei-wei, HU Ya-fei, LIN Hai-jiang, HE Na, CHEN Xiao-xiao

2021, 25(12): 1431-1435. doi: 10.16462/j.cnki.zhjbkz.2021.12.013

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Objective To elucidate the characteristics and influencing factors of influenza vaccination among elderly people infected with HIV and the positive rate of influenza antibodies from 2018 to 2019. Methods Epidemiological methods of description were used to analyze the current status of influenza vaccination and post-vaccination antibody levels in elderly HIV-infected patients, and Logistic regression models were applied to analyze the influencing factors. Results A total of 749 HIV-infected people over 60 years old in Taizhou were included in this study. The influenza vaccination rate from 2018 to 2019 was 33.9%, of which the vaccination rate in 2018 and 2019 was 22.3% and 23.6%, respectively, and the continuous vaccination rate was 12.0%. There were differences in age, occupation and education level among the elderly HIV-infected people with different vaccination choices. Age 70-80 years old (OR=1.84; 95% CI: 1.32-2.58), farmer (OR=3.89; 95% CI: 1.69-8.98) were factors influencing vaccination rates. In addition, the serological positive rates of influenza antibody immunoglobulin G (IgG) in elderly HIV-infected patients were 21.2% (Influenza A H1N1), 18.1% (Influenza A H3N2) and 8.8% (Influenza B). Conclusions Influenza vaccination rates among elderly HIV-infected patients in Taizhou, Zhejiang Province, were significantly associated with their age and occupation. More evidence is needed to evaluate the efficacy of vaccination.

Knowledge awareness and service acceptance of non-occupational post-exposure prophylaxis among college students who have sex in three cities of China

SHAO Ying, LI Jian-wei, WANG Zhang-li, WANG Ya-li, GAO Yue, TANG Hou-lin, ZHANG Guang, SUN Li-jun

2021, 25(12): 1436-1440,1469. doi: 10.16462/j.cnki.zhjbkz.2021.12.014

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Objective To understand the knowledge awareness and service acceptance of non-occupational post-exposure prophylaxisn (PEP) and their influencing factors among college students who have sex in three cities of China. Methods An online survey was conducted among college students who had sex in Beijing, Shenzhen, Kunming by using the questionnaires to collect their demographic information, sexual behavior characteristics, knowledge awareness of HIV/AIDS prevention and nPEP, and service acceptance of nPEP. Logistic regression model was used to analyze the influencing factors of knowledge awareness and service acceptance of nPEP. Results Of 1 022 subjects surveyed, male accounted for 70.1%. 28.7% of the subjects had sex with men only in the last 6 months. 67.5% had sex using condom every time in the last 3 months. The rate of awareness of HIV/AIDS prevention, and nPEP knowledge were 86.5% and 26.6%, respectively. 11.3% of them counseled nPEP, and 5.6% received nPEP services. The results of multivariate analysis showed that the age group of 20 (OR=3.155, 95%CI: 1.081-9.205), 21 (OR=4.666, 95%CI: 1.598-13.625), 22-24 years old (OR=4.481, 95%CI: 1.548-12.971), and the awareness of knowledge of HIV/AIDS prevention (OR=6.919, 95%CI : 2.720-17.598) were the influencing factors of awareness of nPEP knowledge. Male (OR=3.928, 95%CI: 1.348-11.448), awareness of AIDS prevention knowledge (OR=6.205, 95%CI: 3.119-12.346), and awareness of nPEP knowledge (OR=2.263, 95%CI : 1.002-5.11) were the influencing factors for acceptance of nPEP service. Conclusion Among college students who have sexual intercourse, awareness of nPEP knowledge is, at a lower level. nPEP knowledge and service information should be promoted combining with HIV/AIDS control and prevention knowledge and sexual health education in colleges.

Analysis on the epidemiological characteristics and transmitted drug resistance of MSM HIV infected individuals in Longgang District, Shenzhen City

WANG Xiao-li, ZHOU Jian-ming, JIN Yu-juan, LONG Qing-ping, LI Jing-mei

2021, 25(12): 1441-1446. doi: 10.16462/j.cnki.zhjbkz.2021.12.015

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Objective To understand the epidemiological characteristics of HIV infected individuals and the prevalence of drug-resistant strains among men who have sex with men (MSM) in Longgang District of Shenzhen City, so as to provide guidance for the development of MSM HIV infected individuals prevention and control policy. Methods Perioheral venous blood plasma of newly reported MSM HIV infected individuals were collected in Longgang District of Shenzhen City from 2016 to 2018. After extracting viral RNA, the HIV-1 pol region gene fragments were amplified and sequenced. The phylogenetic tree was constructed by the MEGA 6.0 software for HIV genotype determination. Drug resistance was analyzed by using the Stanford University's HIV drug resistance database. Results A total of 119 among 148 samples were successfully amplified, including subtypes of CRF07_BC (45.38%, 54/119), CRF01_AE (28.57%, 34/119), CRF55_01B (25.21%, 30/119) and B subtype (0.84%, 1/119). The prevalence rate of HIV-1 drug-resistant strains in MSM HIV infected individuals in Longgang District before antiviral treatment was 4.20% (5/119), and the drug-resistant rate to nucleoside reverse transcriptase inhibitors (NRTIs) was the highest 2.52% (3/119) during 2016 to 2018. The overall drug resistance mutation rate was 31.1% (37/119). All patients infected with CRF55_01B subtype had V179E mutation resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs). Conclusion The newly confirmed MSM HIV infected individuals in Longgang District from 2016 to 2018 is at a low drug resistance level. Further attention should be paid to the effect of V179D/E mutation on the efficacy of clinical first-line drugs in the treatment of patients with CRF55_01B subtype infection.

Application of moving epidemic method (MEM) in the formulation of influenza epidemic threshold in Qinghai Province

XU Zhang-yi, ZHAO Jin-hua, DING Xiao-jin, XU Li-li

2021, 25(12): 1447-1452. doi: 10.16462/j.cnki.zhjbkz.2021.12.016

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Objective Using moving epidemic method (MEM) to establish an influenza early warning system, so as to provide scientific basis for influenza prevention and control in Qinghai Province. Methods The influenza surveillance data of Qinghai Province from 2013-2020 were obtained in "China Influenza Surveillance Information System", and the positive rate data of influenza virus was collected and sorted weekly. Then the threshold of influenza epidemic and classification intensity were estimated by MEM, and the early warning effect of MEM was verified by cross-validation method. Results The corresponding influenza epidemic threshold and grading intensity threshold were obtained through MEM. The epidemic start threshold, epidemic end threshold, medium intensity threshold, high-intensity threshold, and extremely high-intensity threshold were 16%, 7%, 29%, 48%and 60%, respectively. The sensitivity and the specificity of this study were 93% and 96%, and the model fitting effect was good. Conclusion The MEM model established in this study has high sensitivity and specificity in Qinghai Province, which can be used to establish an influenza early warning system in Qinghai Province to guide influenza prevention.

Analysis of epidemic and etiological characteristics of influenza-like cases in Hefei City from 2015 to 2020

LI Ying-qing, LIU Xu-xiang, ZHAO Ke-fu, HU Cheng-yang, ZHANG Kang-di, CHENG Xin, WANG Jie, YU Wen-jie, WANG Xin-qiang, HOU Sai, ZHANG Xiu-jun

2021, 25(12): 1453-1458. doi: 10.16462/j.cnki.zhjbkz.2021.12.017

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Objective To explore the activity level and epidemic dynamics of influenza in Hefei City from 2015 to 2019, and to provide scientific basis for the prevention and control of influenza in the future. Methods Data of daily influenza-like illness (ILI) cases and corresponding etiological surveillance information were collected from "China Influenza Surveillance Information System" to analyze the influenza epidemic from 2015 to 2019 in Hefei City. Results A total of 183 789 ILI cases were reported in 3 sentinel hospitals in Hefei City from 2015 to 2019, accounting for 5.06% of the total number of outpatients visits and emergency departments visits. The peak of ILI cases was mainly from November of the current year to April of the following year, and the difference of positive rate in different months was statistically difference (χ²=484.793, P < 0.001). The laboratory received a total of 17 442 samples, of which 4 925 were positive, which accounting for 28.24% of the total number of samples submitted for inspection. The high positive rate was from December to April of the following year, and there was statistically different in different months (χ²=2 567.306, P < 0.001). Besides, the main subtype of influenza viruses was Victoria and H3 types. There was a positive correlation between the prevalence of ILI and the positive rate of etiology(r=0.491, P=0.021). Conclusions The influenza epidemic peaked in winter and summer from 2015 to 2019, and there was a mixed epidemic of influenza virus subtypes.

Investigation on influenza vaccination rate and its influencing factors among community health workers in Jing'an District of Shanghai

LYU Li-xue, LI En-guo, FU Chao-wei

2021, 25(12): 1459-1462. doi: 10.16462/j.cnki.zhjbkz.2021.12.018

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Abstract:
Objective To investigate the influenza vaccination rate and its influencing factors among community health workers in Jing'an District. Methods A questionnaire survey was conducted among all health workers in all 15 community health service centers in Jing'an District, Shanghai. Chi-square test and Logistic regression analysis model were used to analyze the influencing factors of influenza vaccination rate. Results The coverage rate of the influenza vaccination was 14.57%. The results of multivariate Logistic regression analysis showed that different departments, different majors, scores of influenza vaccine knowledge, belief and attitude, the free vaccination and living with the elderly were the possible influencing factors of influenza vaccination rate of community health workers. Conclusions The coverage rate of influenza vaccine was low among community health workers in Jing'an District. Health education should be strengthened to improve their cognitive level, and the relevant departments should promote the policy of free influenza vaccination for health workers.

Prognostic factors and nomogram construction of non-small cell lung cancer patients based on inflammatory and nutritional indicators

PENG Si-min, YU Na, CHE Jun, REN Jin-jin, LI Da-peng, ZHANG Yu-song, XU Jia-ying, QIN Li-qiang

2021, 25(12): 1463-1469. doi: 10.16462/j.cnki.zhjbkz.2021.12.019

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Objective To explore the prognostic factors of non-small-cell lung cancer (NSCLC) patients based on inflammation and nutritional indicators, and to establish a nomogram for predicting overall survival (OS). Methods A total of 371 NSCLC patients in Suzhou lung cancer survival cohort from January 2016 to January 2020 were randomly divided into a training cohort (n=278) and a validation cohort (n=93). In the training cohort, independent risk factors were determined by Cox proportional hazard model and a nomogram was constructed. The bootstrap and ten-fold cross-validation were used to evaluate the performance of the model. Results The 1-year survival rate was 83.8% in the training cohort and 83.9% in the validation cohort, and the 2-year survival rate was 65.1% and 66.7%, respectively. Finally, the variables included in the model were smoking, stage, treatment, body mass index (BMI), red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and albumin-to-globulin ratio (AGR) as risk factors for OS of NSCLC patients (P < 0.05). The C-index of the training cohort and validation cohort for predicting OS were 0.824 and 0.762, respectively. After ten-fold cross-validation of the model, its average accuracy rate was 77.3%, and the area under the curve (AUC) was 0.885 (95% CI: 0.751-1.000). Conclusions The nomogram based on inflammation and nutrition indicators can effectively predict OS of NSCLC patients.

Ecological analysis of mites on the body surface of Rattus brunneusculus in Yunnan Province from 2001 to 2015

CHEN Yan-ling, GUO Xian-guo, REN Tian-guang, ZHAO Cheng-fu, FAN Rong, MAO Ke-yu, HUANG Xiao-bin

2021, 25(12): 1470-1475. doi: 10.16462/j.cnki.zhjbkz.2021.12.020

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Objective The present study is to illustrate the infestation and ecological distribution of two groups of mites on the body surface of Southeast Asian house rat (Rattus brunneusculus, R. brunneusculus), together with the relationship between gamasid mites and chigger mites. Methods The original data came from the accumulated field investigations in 30 counties of Yunnan Province from 2001 to 2015. Some ecological methods were used in the statistical analyses. Results A total of 5 252 mites were collected from 308 R. brunneusculus individuals captured in 19 counties (cities), which were identified as comprising 151 species, 29 genera and 3 subfamilies under 6 families. The identified 117 species and 3 836 individuals of chigger mites were much more than 34 species and 1 416 individuals of gamasid mites. The infestation of R. brunneusculus with mites was common with 85.06% of overall prevalence (P_M), 17.05 mites/rat of overall mean abundance (M_A) and 20.05 mites/rat of overall mean intensity (M_I). Laelap nuttalli (C_r=11.21%), Leptotrombidium scutellare (C_r=11.88%) and Walchia ewingi (C_r=10.72%) were the dominant species of all the collected mites. Three dominant mite species were of aggregated distribution with C_A, I and K beyond the border values. The prevalence of female rats with mites (P_M=45.45%) was higher than that of male rats (P_M=39.61%, χ²=7.506, P=0.008). The adult rats showed a higher prevalence (P_M=72.40%) and mean abundance (M_A=19.08) than the juvenile rats (P_M=12.66%; M_A=8.33; P < 0.001). The rats in the mountainous landscape showed a higher prevalence (P_M=74.35%) and mean abundance (M_A = 15.38) than the rats in the flatland landscape (P_M=10.71%; M_A=1.68; P < 0.001). A negative association existed between gamasid mites and chigger mites with a negative association coefficient (V=0.44, P < 0.001). Based on Chao1's formula, the total number of mite species on R. brunneusculus was estimated to be 177 species which was 26 species more than the 151 species actually collected in the field investigation. Conclusions The infestation of R. brunneusculus rats with mites is common with abundant mite species. Three dominant mite species are of aggregated distribution on their rat hosts. A negative association exists between gamasid mites and chigger mites. The infestation of adult female rats with mites is relatively high in mountainous areas.

Analysis of the mediating effect of goal commitment and coping style between family function and perceived control in elderly patients with coronary heart disease after PCI

WANG Zuo-chuan, LI Zhong-qing, SONG Jiang-yan, CHEN Xiu-yun, QIN Yu, YANG Jie, CHEN Le, BI Qing-quan

2021, 25(12): 1476-1480. doi: 10.16462/j.cnki.zhjbkz.2021.12.021

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Objective To analyze the mediating effect of goal commitment and coping style between family function and perceived control in elderly patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods A questionnaire survey was conducted among 308 elderly patients with coronary heart disease after PCI using the General Information Questionnaire, the Control Attitudes Scale-Revised (CAS-R), the Family Adaption, Partnership, Growth, Affection, Resolve Index (APGAR), the Goal Commitment Self-report Scale (HWK), and the Simplified Coping Style Questionnaire-Postive Coping (SCSQ). Results The perceived control score was (27.35±3.44) points, family function score was (7.83±1.48) points, goal commitment score was (18.57±2.89) points, and positive response score was (21.96±2.46) points, respectively. Family function, positive coping were positively predictive of perceived control (all P < 0.01); Goal commitment and positive coping had a chain mediating effect between family function and perceived control (β=0.204, 95% CI: 0.127-0.269, P < 0.01), the mediating effect accounted for 46.90% of the total effect. Conclusions The family function can directly affect patient's perceived control. Also, it indirectly affects their perceived control through the mediating effect of positive coping and the chain mediating effect of goal commitment and positive coping.

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2021 Vol. 25, No. 12

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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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