中华疾病控制杂志

Prevalence study of neurocognitive functions and modifiable risk factors in HIV-infected individuals

YUAN Shi-ying, CHEN Xiao-xiao, LIN Hai-jiang, SHI Rui-zi, LI Jing, XU Lu-lu, QIAO Shi-jie, DING Ying-ying, HE Na

2020, 24(12): 1365-1370. doi: 10.16462/j.cnki.zhjbkz.2020.12.001

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Objective To investigate the effects of regulatory risk factors on neurocognitive function of human immunodeficiency virus infected persons. Methods Using the baseline survey data of the prospective cohort study of HIV and aging related diseases from 2018 to 2019, elderly HIV infected persons aged 40 and above were selected. A general linear model (GLM) was used to analyze the effects of regulatory risk factors including cardiovascular disease risk factors and bad life behavior on neurocognitive performance of infected persons. Results A total of 625 HIV infected persons were included in the study. Cardiovascular disease risk factors and bad life behavior were reported in the elderly HIV infected patients. At different age stages, the neurocognitive function of infected persons decreased to different degrees, and the cognitive function decreased significantly after 60 years of age. Multivariate regression analysis model showed that hypertension was a risk factor for orientation, memory, delayed recall, language function and exercise ability of infected persons, and other regulatory risk factors such as smoking, alcohol consumption, diabetes and abdominal obesity had not been statistically correlated. Moreover, after clinical grading analysis of blood pressure, it found that prehypertension was associated with decreased language function (β=-0.327, P=0.020), orientation force (β=-0.216, P=0. 028). Even if it did not develop to hypertension state, high-value blood pressure have a negative effect on neurocognitive function. Conclusions Hypertension is associated with the decline of neurocognitive function in middle-aged and elderly HIV patients, and orientation and language ability may be adversely affected in the early stage of hypertension. During HIV follow-up management in the future, we should strengthen the prevention and control of hypertension, early detection of hypertension and standardized clinical management.

Comparative analysis of HIV prevalence and sexual behaviors between Chinese and Vietnamese female sex workers

ZHU jing, HU Dan, YIN Yue-qi, WANG Ning, WANG Bei

2020, 24(12): 1371-1375. doi: 10.16462/j.cnki.zhjbkz.2020.12.002

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Objective To assess the prevalence of human immunodeficiency virus (HIV) infection of Chinese and Vietnamese female sex workers (FSWs), and to examine the risk factors and patterns of sexual behaviors that associated with HIV between the two groups. Methods A cross-sectional survey was conducted between 2015 and 2016 in Hekou County, Yunnan Province, China. Convenience sampling method was used to recruit participates, and a questionnaire survey was conducted to collect information on demographics, sexual behavior, HIV related knowledge and attitude. Blood samples were collected for testing of HIV, herpes simplex virus type 2 (HSV-2) and syphilis. Multivariate Logistic regression model was used to examine factors correlated with HIV infection. Results Of 1 263 respondents who participated in the study, 227 were Chinese and 1 036 were Vietnamese. HIV prevalence in Chinese FSWs and Vietnamese FSWs were 0.44% and 2.12%, respectively. Vietnamese FSWs were more likely to have higher commercial sexual service charge and more commercial sexual partners compared with Chinese FSWs. HSV-2 positive (OR=3.83, 95% CI: 1.37-10.76, P=0.032), insufficient HIV related knowledge (OR=10.40, 95% CI: 3.77-28.66, P=0.001), and accepted HIV related interventions (OR=0.27, 95% CI: 0.08-0.84, P=0.022) were associated with HIV infection in the multivariate Logistic regression model. Conclusions There may be different risk patterns of HIV acquisition between Chinese and Vietnamese FSWs. Improving coverage and accessibility in future interventions of HIV prevention is in great need for Vietnamese FSWs. In addition, condom use with regular, no commercial sexual partners need to be strengthened targeting Chinese FSWs.

High-risk behavior survey of 2017-2018 Dehong Dai Jingpo autonomous prefecture newly reported Burmese HIV infected people

YANG Yue-cheng, ZHAO Hao, LI Lin, CAO Yan-fen, YE Run-hua, YAO Shi-tang, WANG Ji-bao, HAN Meng-jie, HE Na, DUAN Song

2020, 24(12): 1376-1381. doi: 10.16462/j.cnki.zhjbkz.2020.12.003

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Objective To study the general demographic characteristics and high-risk behaviors of HIV infected Burmese newly reported from 2017 to 2018 in Dehong Dai Jingpo autonomous prefecture (Dehong Prefecture) of Yunnan Province. Methods A cross-sectional survey was conducted among the newly reported Burmese infected persons from 2017 to 2018 to collect general demographic information, entry related information and information on the occurrence of high-risk behaviors. Results A total of 1 208 HIV infected Burmese were investigated, including 820 males (67.88%)and 388 females (32.12%); 58.1% (702 cases) ≥30 years old, 70.1% (847 cases) with primary school and below, 73.5% (888 cases) with border card/passport, 79.06% (955 cases) from Kachin, Shan and Mandalay provinces; 15.89% (192/1 208) of men and 0.58% (7/1 208) of women had drug abuse behavior in Dehong.16.22% (133/820) men and 36.1% (140/388) women had unprotected sexual behavior in Dehong. The results of multivariate Logistic regression analysis showed that primary school and below, entry by road/ other means, coming from Kachin state and Shan state were risk factors for male drug abuse behavior. Female, ≥30 years old, entry with certificate/ passport, and the number of round trips ≥6 times in a year were risk factors for unprotected sex in Dehong. Conclusions Burmese HIV-infected people are mostly young and middle-aged, with a low education level, and a high proportion of high-risk behaviors in Dehong. Prefecture should consolidate the effectiveness of the existing AIDS prevention work and manage well the Burmese HIV-infected people.

Analysis on the change trend of HIV/AIDS risk behaviors and infection status among permanent foreigners in Ruili City of Yunnan Province

LI Xue-hua, ZHANG Zu-yang, LI Zhou-lin, JIA Man-hong, FU Li-ru, SONG Li-jun, NIU Jin, LUO Hong-bing

2020, 24(12): 1382-1386. doi: 10.16462/j.cnki.zhjbkz.2020.12.004

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Objective To understand the trend/change of the awareness rate, related risk behaviors and infection status on human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) among permanent foreigners in Ruili City of Yunnan Province. Methods Continuous sampling method in fixed places was used. Questionnaire survey and HIV antibody test were carried out among permanent foreigners in Ruili City for 4 straight years. About 400 people were surveyed per year. Results A total of 1 677 permanent foreigners were investigated during 4 years, and the awareness rate of HIV/AIDS knowledge had increased from 66.7% to 79.4% (χ² _trend==35.673, P < 0.001). There was no significant trend change in the rate of condom use among spouses (χ² _trend=0.166, P=0.684). The rate of recent consistent condom use with casual sexual partners had decreased from 66.7% to 42.3% (χ² _trend=4.954, P=0.026), and there was no significant trend change in the rate of consistent condom use with casual sexual partners in the last year (χ² _trend=3.960, P=0.271). There was no significant trend change in the rate of recent condom use with commercial sex workers (χ² _trend=3.468, P=0.062), and the rate of consistent condom use had increased from 56.8% to 87.1% (χ² _trend=3.215, P=0.036). The HIV antibody positive rate had increased from 1.3% to 4.9% (χ² _trend=8.606, P=0.003). Conclusions Among permanent foreigners, the awareness rate of permanent foreigners needs to be improved. The high-risk behavior prevails without decreasing tendency, and the HIV infection rate is increasing. It is one of the key priorities for HIV/AIDS prevention and control to actively explore effective ways on health promotion and education, mobilizing testing, the follow-up of HIV infected people and effective antiviral treatment referral in Ruili in the future.

Study on the infection characteristics and influencing factors of HIV-seroconcordant couples in Fujian Province

LIAN Qiao-ling, CHEN Liang, ZHANG Ming-ya, WU Shao-bin, PAN Yun-jiao

2020, 24(12): 1387-1392,1440. doi: 10.16462/j.cnki.zhjbkz.2020.12.005

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Objective To investigate the infection characteristics and influencing factors of HIV-seroconcordant couples in Fujian Province. Methods A unified face-to-face questionnaire was used to investigate the couples diagnosed with HIV/AIDS reported before December 31, 2019 in Fujian Province, and demographic information and disease-related information were collected.Univariate and multivariate Logistic regression models were used to analyze the influencing factors of infection status. Results A total of 1 042 couples (2 084 persons) infected with HIV/AIDS were under survey, among whom 82 (7.9%) cases' partners were HIV-serodiscordant during the first testing, and 5.7% couples whose reported interval were over 365 d. Multivariate Logistic regression analysis showed that those who aged < 30 years old (OR=3.642, 95% CI:1.491-8.894) were more likely to report an interval over 365 d. 97.5% (1 016/1 042) of subsequent reported cases among the HIV-seroconcordant couples completed the CD4⁺ T cell counts testing. There were 266 cases(26.2%)whose CD4⁺ T cell counts were under 200 cells/μl in the first testing. Multivariate Logistic regression analysis showed that the spouses of those who were female as first reported cases (OR=2.285, 95% CI:1.676-3.115), or AIDS (OR=1.845, 95% CI:1.356-2.510) were more likely under 200 cells/μl in first testing. The spouses of those who aged < 30 years old (OR=0.463, 95% CI:0.259-0.825) were just the opposite. Conclusion The characteristics of infection in different HIV-seroconcordant couples are different. The awareness of HIV infection and detection among married people should be enhanced, and their spouses should be actively mobilized for notification and detection. In order to reduce the transmission between spouses, targeted measures should be taken to promote early HIV testing and detection for those who were female, AIDS or the old.

Status and influencing factors of standardized follow-up among the people with HIV/AIDS in Liaoning Province

ZHOU Dan, GAI Xiao-qun, KANG Xu, SUN Li-xiang, YAO Wen-qing, WANG Li

2020, 24(12): 1393-1397. doi: 10.16462/j.cnki.zhjbkz.2020.12.006

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Objective To understand the status and influencing factors of standardized follow-up of the people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Liaoning Province. Methods Data were collected from both Case Reporting Cards and Follow-up Cards in National HIV/AIDS Information System for the end of 2016 to 2019, respectively. Logistic regression model was used to analyze influencing factors of standardized follow-up of the HIV/AIDS. Results There were 13 008, 15 215, 17 583 and 19 365 patients in Liaoning Province in four years, respectively. The proportion of patients having received standardized follow-up were 84.41%, 86.87%, 86.45% and 89.87% from 2016 to 2019, with significant upward trend (χ² _trend=184.953, P < 0.001). Results of multivariate regression analysis showed that HIV/AIDS patients who were aged 20 to 39 years, aged 40 to 59 years, married with spouse, divorced or widowed, cultural level of college and above or in AIDS phase were more likely to have received standardized follow-up than patients who were younger than 20 years old, unmarried, junior secondary and below or in HIV phase (all P < 0.05). Compared to the patients infected by homosexuality transmission and from testing consultation/thematic survey, the patients infected by heterosexual transmission and injecting drugs, from patient testing and medical examination of detainees were less likely to have received standardized follow-up (all P < 0.05). Conclusions Standardized follow-up management need to be strengthened for HIV/AIDS patients in Liaoning Province. The different measures according to the people with different characteristics should be taken to improve the quality of follow-up and control the spread of AIDS effectively.

Analysis of survival of HIV/AIDS aged 50 years and above in Chengdu after antiretroviral therapy

SHI Ya-ying, ZHOU Min, WU Xue-qing, HE Shi-jiao, LIU Fang, ZHU Yan-feng

2020, 24(12): 1398-1402,1469. doi: 10.16462/j.cnki.zhjbkz.2020.12.007

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Objective To understand the survival of HIV/AIDS aged 50 years and above in Chengdu after receiving antiretroviral therapy(ART), and to explore the factors affecting the survival of HIV/AIDS aged 50 years and above after ART, so as to provide the basis for the health authorities at all levels to formulate the treatment policy for HIV/AIDS aged 50 years and above. Methods The HIV/AIDS aged 50 years and above who were receiving ART in Chengdu from 2010 to 2018 were selected. Life-table method was used to describe the survival situation. Survival analysis method was used to stratify the study subjects according to the factors by the Cox risk regression model. Results The cumulative survival rate decreased from 0.97 to 0.91 within 20 months after treatment, and the cumulative survival rate was 0.82 at 9 years up to the end point of observation. Cox multivariate analysis showed that the risk of death in women was 0.689 times than in men. The aged 70 years and above was 4.037 times than the aged from 50 to 54 years old. Spinsterhood and divorced were 1.909 and 1.269 times than married. The college and above was 0.403 times than illiteracy. The first CD4⁺T cell test value of >500 /mm³ was 0.318 times higher than < 100 /mm³. Conclusions The survival rate of AIDS patients aged 50 years and above after ART is high. The factors such as age, education level and marital status affect the survival of AIDS patients aged 50 years and above. Corresponding treatment measures and publicity means should be developed according to the actual situation in Chengdu.

The highly active antiretroviral therapy effect among HIV/AIDS patients with and without HCV coinfection in Chengdu City

DUAN Zhen-hua, XI Jing, DAI Zhen, FAN Shuang-feng, WU Xue-qing, HE Qin-ying

2020, 24(12): 1403-1406,1446. doi: 10.16462/j.cnki.zhjbkz.2020.12.008

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Objective This study aimed to analyze the impact of hepatitis C virus (HCV) coinfection on antiretroviral therapy(ART) effect with human immunodeficiency virus (HIV), and examine the impact of HCV coinfection on CD4⁺T cells count (CD4) and virologic failure (VF) in patients with HIV. Methods All data were extracted from the National HIV/AIDS (human immunodeficiency virus /acquired immunodeficiency syndrome) Comprehensive Response Information Management System. Information were collected from HIV-HCV coinfection patients who diagnosed with HIV during 2010-2018, with follow-up conducted till December 31, 2019. Cox proportional hazard model was used to analyze the factors associated with VF after ART. Results 555 HIV-HCV coinfection patients and matched another 555 HIV monoinfection patients were included. An increased CD4 cell count was observed in all groups within 4 years of receiving ART treatment, the average annual increase in the HIV monoinfection group and HIV-HCV co-infection group were 45.9 cells/mm³ and 37.1 cells/mm³ for the median CD4 cell counts. 171 individuals experienced VF with an incidence rate of 7.15 per 100 person-years. The multivariate Cox proportional hazard analysis showed that the HIV-HCV coinfection group was associated with increased hazard of VF (aHR=1.512, 95% CI: 1.042-2.195, P=0.030) compared to HIV monoinfection group. Conclusion HIV-HCV coinfection was significantly associated with increased hazard of VF during highly active antiretroviral therapy for HIV/AIDS.

Progress towards the UNAIDS 90-90-90 targets and factors associated with achieving these targets

XU Yuan-yuan, WU Su-shu, GOU Li-li, LIU Li, GUO Lu, LI Xin, SHI Hong-jie, ZHU Zheng-ping

2020, 24(12): 1407-1411. doi: 10.16462/j.cnki.zhjbkz.2020.12.009

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Objective To analyze the current status towards the UNAIDS 90-90-90 targets and factors associated with achieving these targets in Nanjing. Methods Data from the Chinese HIV/AIDS Comprehensive Response Information Management System regarding testing, ART and VL in Nanjing were collected. Multivariate Logistic regression analysis was performed to analyze the associated factors with achieving the 90-90-90 targets. Results The progress towards the 90-90-90 UNAIDS targets was at 74.0%, 88.5%, and 96.7% in Nanjing by 2018. HIV/AIDS infected by homosexual contact were less likely to be diagnosed (χ² =86.15, P < 0.001) People living with HIV (PLWH) infected through injecting drug use (aOR=0.263, 95% CI:0.156-0.442, P < 0.001), aged < 25 years (aOR=0.697, 95% CI:0.540-0.899, P=0.005) and identified from custodial institutions (aOR=0.353, 95% CI:0.193-0.646, P=0.001) were less likely to engage on ART. PLWH infected through homosexual contact (aOR=1.840, 95% CI:1.390-2.434, P < 0.001), aged 35-44 years (aOR=1.826, 95% CI:1.260-2.645, P=0.001), ethnic group of Han (aOR=1.797, 95% CI:1.038-3.109, P=0.036), of college degree or above (aOR=1.652, 95% CI:1.005-2.717, P=0.048) and married (aOR=1.466, 95% CI:1.051-2.046, P=0.024) were more likely to engage on ART. Conclusions Nanjing is rapidly moving towards achieving the UN targets. However, some challenges still exist. We need to continue to expand HIV testing and strengthen the treatment and care services for drug users, young people and the elderly.

Early treatment initiation post- HIV diagnosis may reduce care dropout

AN Jing, LOU Jin-cheng, YANG Gen, LAO Yun-fei

2020, 24(12): 1412-1417. doi: 10.16462/j.cnki.zhjbkz.2020.12.010

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Objective To analyze the effect of time interval from diagnosis of human immunodeficiency virus (HIV) to initiation of antiretroviral therapy (ART) on the dropout during treatment, and to provide reference for counseling on mobilization of ART. Methods COX regression was used to assess the risk of first dropout in patients with different time intervals. The data of 15- years ART in Yunnan Province were analyzed retrospectively. Results 110 373 cases of ART among people living with HIV in Yunnan from 2004 to 2018 were included in the analysis. the median time from the diagnosis of HIV to the start of ART was 47 (11 550) days, and the median follow-up was 2.63 (0.88, 5.28) years. Out of the total cases, 47 974 (43.5%) patients started ART within 30 days post-HIV-diagnosis, 15 811 (14.3%) patients had an interval of 31-90 days, 14 253 (12.9%) patients had an interval of 91-365 days, and 32 335 (29.3%) patients had an interval above 365 days. The total dropout rate was 6.77/100 person-years (95% CI:6.69-6.85). With the < 30 day group as the reference, the dropout risk in the 30-90 day group, the 91-365 day group and the >365 day group increased by 10%, 22% and 14%, respectively. In the groups of < 30- day, the 30-90 day, the 91-365 day and the >365 day, the cumulative dropout rates were respectively 11.4%, 12.7%, 15.0% and 15.7%. Conclusions Real-world data confirmed that shortening the time interval from HIV diagnosis to ART initiation (preferably within 30 days) can reduce treatment dropout. The results support the implementation of "one-stop AIDS testing and treatment service" as a prevention and treatment measure. This study provides powerful suggestions for Yunnan Province to guide the mobilization of treatment counseling.

Study on latent transition of sexual behavior patterns based on human papilloma viruses infection of men who have sex with men

CHEN Zhen, LUO Tao, GULISIYA Hai-li-li, TIAN Tian, ZHANG Guo-zhen, DILIBAIER A-li-mu, LIU Li-rong, DAI Jiang-hong

2020, 24(12): 1418-1422. doi: 10.16462/j.cnki.zhjbkz.2020.12.011

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Objective To explore the trend of the development of sexual behavior patterns of men who have sex with men(MSM) based on human papilloma viruses(HPV) infection over time, so as to provide evidence for sexual behavior intervention. Methods In dynamic cohort of "effects of hepatitis B virus infection on persistent infection of human papillomavirus in men who have sex with men", the participants were followed up every 6 months, and the demographic characteristics and sexual behaviors of the participants were collected at baseline and the first visit. HPV test was also completed 2 times. The latent transition analysis(LTA) was used to classify the potential states of the sexual behavior patterns at baseline and observe the trend of each potential category over time. Results MSM sexual behavior patterns were divided into three potential categories: sexual behavior low risk group, medium risk group and high risk group by LTA method. Over time, the probability of a low-risk group with a low-risk status at first visit was 99.49%, and the probability of transitioning to a medium-risk state was 0.51%; the probability that the risk group in the sexual behavior remained in the medium-risk state was 74.88%, and the probability of transition to the low-risk state was 22.33%, the probability of transitioning to a high-risk state was 2.79%; and the probability that a high-risk group of sexual behavior remained at high-risk state was 100.00%. Conclusions Sexual behavior patterns of MSM tend to be stable in general, and intervention measures should be taken in high-risk groups in the future period to promote the transition of their sexual behavior risk to low-risk.

Results analysis of AIDS/Syphilis and high risk behaviors survey among men who have sex with men who use social APPs for dating in Yunnan Province

LI Zhi-qing, MA Yan-ling, LI You-fang, MA Jing, PAN Song-feng, CAI Yong-nian, WANG Yu-miao, WANG Jue

2020, 24(12): 1423-1427,1432. doi: 10.16462/j.cnki.zhjbkz.2020.12.012

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Objective To learn which dating App is most popular among men who have sex with men (MSM), analyze their demography, sexual behavior characteristics, AcquiredImmune Deficiency Syndrome (AIDS) and syphilis infection status, and provide evidence for formulating targeted intervention strategies. Methods The recruitment information was released by the MSM community-based organization to recruit participants among MSM. A same electronic questionnaire was used for a face-to-face survey and venous blood was collected for serological test of AIDS and syphilis. Results A total of 4 651 participants were involved. Based on the App they used most frequently, participants were divided into three groups. 2 160 (46.44%) were in Blued group, 2 113 (45.43%) in Wechat group and 378 (8.13%) in QQ group. In Blued group, the proportion of participants whose local residence duration was less than 3 months was 6.9% and highest in three groups. In Wechat group, the proportion of participants whose local residence duration was more than 12 months was 92.1%and highest in three groups. The difference was significant (χ² =60.326, P < 0.001). In Blued and Wechat group, the awareness rate of AIDS prevention knowledge and proportion of self identification as homosexual were higher than QQ group (P < 0.05). In Blued group, the proportions of participants who had group sex in the past six months were 8.1 % (highest), followed by QQ group (6.9%) and Wechat group (5.3%) (χ² =13.368, P=0.001). The positive rates of AIDS were 2.2% in blued group, 3.0% in wechat group and 3.4% in QQ group. There is no significant difference among the three groups (χ² =3.546, P=0.17). The positive rates of syphilis were 1.9% in Blued group, 3.7% in Wechat group and 2.9% in QQ group. There were significant differences among the three groups (χ² =14.017, P=0.001). Conclusions MSM who uses different dating APP have different infection risks of sexual transmitted infection. The targeted intervention strategies should be provided for MSM based on different characteristics respectively.

Analysis of the characteristics of the first homosexual behavior among young male students who have sex with men in Yantai City

LIN Rong, WANG Hong-tao, CHENG Xiao-song, XUE Jian, YU Xiang-dong, SUN Hao-yu, JIANG Ju-jun

2020, 24(12): 1428-1432. doi: 10.16462/j.cnki.zhjbkz.2020.12.013

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Objective To analyze the characteristics of first-time homosexual behavior among young male students who have sex with men (MSM) population, so as to provide reference for the formulation of acquired immune deficiency syndrome (AIDS) prevention and control measures in colleges and universities. Methods A combination of cross-sectional study and in-depth interview were used. A self-reported questionnaire was used to collect information of participant demographics and sexual debut. By in-depth interview, we further summarized reasons of sexual debut and condomless sexual intercourse. Results A total of 302 valid questionnaires were surveyed. The age at which the first homosexual behavior occurred was (17.59 ± 1.78) years old. Most of participants sought sexual partners from internet (34.1%). There was statistical difference between the protection of the first homosexual behavior and homosexual behavior in the past 6 months (χ² =52.247, P < 0.001). The results of in-depth interviews showed that 13 people acknowledged the first homosexual behavior that occurred through online connections such as dating software due to psychology such as curiosity and pursuit of stimulus. The main reason for not using condoms during the whole process was the lack of knowledge about AIDS prevention and control(77.8%). Conclusions For the first time, the homosexual behavior of young male students MSM populations were characterized by young age, poor protection awareness, low awareness rate, and finding sexual partners mainly through dating software. It was necessary to further strengthen the publicity and education for this group, including popularizing the age in advance, improving details, and strengthening behavioral intervention and communication skills. The active role of new media in AIDS prevention and education should be fully played.

Analysis of three factors affecting regular HIV testing among men who have sex with men

ZHAO Ya-fang, WANG Xia, SHENG Yu

2020, 24(12): 1433-1440. doi: 10.16462/j.cnki.zhjbkz.2020.12.014

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Objective Regular human immunodeficiency virus (HIV) testing is a key prevention strategy for identifying HIV infections among men who have sex with men (MSM). Informed by the theory of triadic influence, we aimed to analyze the influencing factors of regular HIV testing behavior from individual, social and environmental aspects. Methods From November 2018 to April 2019, we recruited MSM over 18 years old through both internet and face to face in Wuhan, Beijing, and other cities in China. Data on HIV test relevant behaviors, individual, social, environmental stream factors, etc were collected. Results We totally enrolled 543 MSM, 55.43% of them had HIV regular testing behavior in the past 12 months. Multivariate Logistic analysis showed that higher level perceived risk, greater self-efficacy for HIV testing, stronger HIV testing intention, younger age of first sexual intercourse, have not disclosure sexual orientation to family, and had ever tested for STD in the past 12 months were positively associated with HIV regular testing. Conclusions Proportion of HIV regular testing among MSM in China needs improvement. Findings implicated that intervention strategies should be carried out in combination with medical institutions at all levels and community-based organizations to create a positive and comfortable medical environment for HIV prevention. Comprehensive strategies should taken to combine MSM's intrapersonal changes and to encourage them to have HIV test at regular intervals.

Analysis of the differences of spousal notification among HIV discordant couples in two key areas of AIDS epidemic in Sichuan Province

ZHUOMA La-cuo, LAI Wen-hong, WANG Qiu-shi, LIU Fang, WANG Zhong-hong, HUANG Jun, LI Ju-mei, SU Ling, GONG Yi, ZENG Ya-li

2020, 24(12): 1441-1446. doi: 10.16462/j.cnki.zhjbkz.2020.12.015

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Objective To investigate the situation of partner notification and its influencing factors among human immunodeficiency virus (HIV) sero-discordant couples in Liangshan and Chengdu. Methods Using a self-designed questionnaire, HIV sero-discordant couples were surveyed to understand their individual situations, partner notification circumstances and possible influencing factors, etc. The chi-square test, t test, and binary Logistic regression were used for data analysis. Results The partner notification rate of the persons living with HIV/AIDS (PLWHA) was 86.5% (735/850), specifically 90.40% in Chengdu and 84.31% in Liangshan. The difference was statistically significant (χ² = 6.174, P=0.013). Analysis of the influencing factors showed that the proportion of partner notification was lower among the PLWHAs with little awareness of HIV knowledge (OR=4.962, 95% CI: 1.592-15.465, P=0.006) and PLWHAs who were diagnosed in 2016 or later (OR=9.057, 95% CI: 1.110-73.926, P=0.040; OR=27.746, 95% CI: 3.625-212.392, P=0.001) in Chengdu. However, in Liangshan, PLWHAs with these characteristics were less likely to notify partners of their infection status, including ethnic minority (OR=8.195, 95% CI:3.489-19.244, P < 0.001), junior high school education (OR=2.393, 95% CI:1.248-4.590, P=0.009), without co-infections (OR=16.146, 95% CI: 2.178-119.692, P=0.006), while PLWHAs with the following characteristics were more likely to notify partners, including having 3 or more children in the family (OR=0.325, 95% CI: 0.128-0.830, P=0.019), and having 2-4 sexual intercourse with partner in the recent month (OR=0.513, 95% CI: 0.288-0.912, P=0.023; OR=0.449). Conclusions The partner notification rate in Liangshan was lower than that in Chengdu, which may be related to factors such as demographic characteristics of different regions, awareness of AIDS-related knowledge, co-infection with other sexually transmitted diseases, and family relationships, etc. It suggested that different areas should take relevant measures according to local conditions to promote spousal notification, and to prevent intra-familiar transmission of HIV.

A case-control study on the relationship between maternal copper and preeclampsia

GAO Lin-ying, WANG Ying, WU Wei-wei, FENG Yong-liang, YANG Hai-lan, WANG Su-ping

2020, 24(12): 1447-1451. doi: 10.16462/j.cnki.zhjbkz.2020.12.016

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Objective To investigate the level of copper (Cu) in pregnant women with preeclampsia and normotensive pregnant women, and their relationship with risk of preeclampsia. Methods A frequency matching case-control study was performed among the pregnant women who gave birth between March 2012 and September 2016 in the First Hospital of Shanxi Medical University. A total of 427 pregnant women with preeclampsia were as cases. 427 normotensive pregnant women matched for date of conception, residence, and age were randomly selected as controls. Demographic characteristics, childbearing history, pregnancy and health condition, behavior and lifestyle, family history of hypertension, and newborn birth condition were collected by face to face investigation and medical records review. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine levels of copper, manganese, zinc, and selenium in the maternal blood. Results The distribution of maternal blood copper was skewed, and the median and inter-quartile range of copper concentration in the preeclampsia and control group were 1.31(1.07, 1.60) mg/L and 1.31(1.06, 1.56) mg/L (Z=0.41, P=0.685). The median and quartile values of blood Cu in pregnant women with early and late preeclampsia were 1.25 (1.04, 1.56) mg/L and 1.34 (1.08, 1.61) mg/L (Z=1.78, P=0.075), respectively. There were no significant differences in blood Cu levels between the preeclampsia group, the control group and the pre-eclampsia group with different clinical subtypes (all P > 0.05). The results of Logistic regression analysis model showed that after the control of the level of education, income, pre-pegant body mass index, pregnancy weight gain, parity, gestational diabetes, family history of high blood pressure, and other elements, such as pregnant women were not found in the blood Cu with preeclampsia, early onset preeclampsia, and later in the pathogenesis of preeclampsia. Conclusions It can not be considered that maternal blood copper is related with preeclampsia and its subtypes.

Systematic review of association between metabolic syndrome and its components with neurocognitive impairment among HIV-infected population

SHI Rui-zi, HE Na

2020, 24(12): 1452-1458. doi: 10.16462/j.cnki.zhjbkz.2020.12.017

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Abstract:
To systematically review the literature about the association between metabolic syndrome (MS) and neurocognitive impairments (NCIs) among human immunodeficiency virus (HIV) infected patients. We systematically searched and reviewed related literature published on databases of Ovid Medline, Embase, CNKI, CQVIP and Wanfang Data from 1992 to 2019. Information excerpted from papers that met the inclusion and exclusion criteria were analyzed. A total of 22 articles were included, including 14 cross-sectional studies, seven cohort studies and one secondary analysis, which were mainly conducted in the United States. HIV-negative controls were included in ten studies. NCIs were assessed by using neuropsychological battery. Metabolic disturbance was prevalent and NCIs was also prevalent with obvious heterogeneity across different geographic areas. Summarized results suggested that MS was associated with increased risk of NCIs. In consideration of different scales applied in different studies for the neurocognitive assessment and related ability domains, the relationship between MS components and NCIs and/or ability domains was found to be complicated. Some of these studies revealed distinct differences in ability domains evaluation. Metabolic disturbance may increase risks of various aspects of NCIs in HIV patients. In view of the limited evidence, more research is needed in other regions and developing countries.

Research progress of co-infection of acquired immune deficiency syndrome and tuberculosis

LI Hong-miao, TANG Fei, CHEN Shuang-shuang, ZHANG Gen-you, LYU Li-ping, SHI Si-jiu, FAN Yin-guang

2020, 24(12): 1459-1464. doi: 10.16462/j.cnki.zhjbkz.2020.12.018

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The co-infection of acquired immune deficiency syndrome (AIDS) and tuberculosis (TB) can accelerate the disease progress, rapidly lead to the function failure of organs in patients, and finally lead to death. At present, the prevention and treatment of co-infection of AIDS and TB is not only a major clinical problem, but also has become a major public health problem in the world. In this paper, we reviewed the prevalence, pathogenesis, clinical features, diagnostic methods, treatment and preventive measures of HIV/TB double infection, in order to provide scientific basis for formulating measures to reduce the co-infection of AIDS and tuberculosis.

HIV-1 epidemic strains and genetic variation among therapy-naive men who have sex with men

LU Xin-li, ZHANG Yu-qi, QIU Yan-chao, LI Bao-jun, LI Yan, WANG Ying-ying, LIU Meng, AN Ning

2020, 24(12): 1465-1469. doi: 10.16462/j.cnki.zhjbkz.2020.12.019

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Objective To explore HIV-1 genotypes and genetic variation among therapy-naive men who have sex with men (MSM) in Shijiazhuang. Methods HIV-1 genotypic resistance assay was carried out using In-house method. HIV-1 genotypes and drug resistance were analyzed by phylogenetic analysis and submitting the sequences to the Stanford University Network HIV-1 database. Results Five HIV-1 subtypes were found among MSM in Shijiazhuang. Of them, CRF01_AE was the most frequent, accounting for 56.8% (25/44), followed by CRF07_BC 29.5% (13/44), URFs 9.1% (4/44), B 2.3% (1/44) and CRF55_01B 2.3% (1/44). URFs mainly included CRF01_AE/B and CRF01_AE/C. χ² -test verified that HIV-1 genotype distribution showed significant difference (P < 0.05) in marital status, age and first CD4 groups, respectively. The rate of HIV-1 primary drug resistance was 2.3% (1/44). P225H mutation was found in NNRT gene coding region, and one MSM with P225H occurred intermediate resistance to EFV and NVP. Conclusion It is critical for us to take measures to monitor HIV-1 epidemic and drug resistance.

Analysis on the characteristics of HIV-infected maternal and their babies in Guangdong Province

TANG Liu-ying, ZHOU Ying-na, WANG Xiong-hu, GAO Shuang, XIA Jian-hong

2020, 24(12): 1470-1474. doi: 10.16462/j.cnki.zhjbkz.2020.12.020

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Objective To investigate the characteristics of HIV-infected maternal and their babies in Guangdong Province, and to improve services on prevention of HIV mother-to-child transmission (MTCT). Methods Exporting monitoring data from national information management system for prevention MTCT, the general information and the relevant data about HIV prevention MTCT services from HIV-infected pregnant women and their babies in Guangdong Province from 2006 to 2017 were collected to compare the differences between different parities maternal. Results Among the 2 094 HIV-infected pregnant women, 61.70% were re-pregnant women, whose average age were (30.2±5.3) years old, the education level was mainly in junior high/senior high school (54.18%). Compared with the first-time pregnant maternal, re-pregnant maternal were tend to screening on later gestational age [28.0(14.0, 39.0) vs 21.0 (13.0, 38.0), weeks], with a high proportion of confirmed time during intrapartum/postpartum (41.18% vs 10.10%), HIV infection status of sexual partner was unknown (54.57% vs 41.52%), generally, the proportion of anti-viral treatment was not high (62.77% vs 87.41%), treatment begins late (intrapartum/postpartum started treatment accounted for 19.24% vs 6.28%). The preventive treatment rate of their infants were not high (82.35% vs 91.90%), while mixed feeding rate was higher (6.94% vs 3.42%). Conclusions The utilization of HIV MTCT in prevention of HIV-infected maternal in Guangdong was not high. Strengthening the health awareness of HIV-infected maternal, and enhancing the attention of medical staff to HIV-infected maternal and their babies, espesially among those re-pregnant women, are helpful to promote the work of prevention of HIV MTCT project in Guangdong Province.

Using spot maps to find out the truth about the cholera epidemic: John Snow

WANG Xiao-yu, XU Wen-jing, WU Jun, YE Dong-qing

2020, 24(12): 1475-1478. doi: 10.16462/j.cnki.zhjbkz.2020.12.021

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John Snow (1813-1858), a famous anesthesiologist and epidemiologist. Through investigation, he proved that cholera was transmitted by water contaminated by feces, and first put forward measures to prevent cholera, which prevented the spread of cholera in Britain in the 19th century. The investigation of cholera outbreak in Soho District of London in 1854 creatively used statistical methods for comparative analysis to determine the unique significance of field investigation in medical research. The drawing of "cholera epidemic map" also made mapping a basic research method in epidemiology. Snow was also known as "the father of epidemiology".

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2020 Vol. 24, 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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