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CN 34-1304/R ISSN 1674-3679

2019 Vol. 23, No. 12

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Original Articles
Analysis of gene mutation sites in patients with failed anti-HIV-1 treatment in Lincang City from 2011 to 2018
DENG Xue-mei, LIU Jia-fa, ZHANG Mi, LI Jian-jian, YANG Bi-hui, SUN Ai-si, SHU Yuan-lu, DONG Xing-qi
2019, 23(12): 1429-1435, 1465. doi: 10.16462/j.cnki.zhjbkz.2019.12.001
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  Objective  To understand the major genotype-resistant mutation sites and change trends of HIV/AIDS patients with failure of antiviral therapy (ART) in Lincang City, Yunnan Province.  Methods  The In-House method was used to amplify the Pol gene region in the plasma samples of HIV/AIDS patients with failure of ART in Lincang City from 2011 to 2018. The target sequence was spliced and submitted to the HIV resistance database to identify and analyze the HIV-1 subtypes and resistant mutation sites.  Results  The 950 strains of HIV/AIDS patients with antiviral failure were mainly CRF08_BC, accounting for 75.5% (717/950), and the total gene mutation rate was 67.1% (637/950), which was dominated by non-nucleoside reverse transcriptase inhibitors (NNRTIs), accounting for 62.4% (593/950); followed by nucleoside reverse transcriptase inhibitors (NRTIs), accounting for 34.7% (330/950); protease inhibitors (PIs) was 7.5% (71/950). A total of 15 NRTIs of resistance-related mutation sites were detected, mainly M184V (29.3%) which was detected mostly in AZT/D4T+3TC+NVP programs; including 17 kinds of NNRTIs, mainly was K103N/S (25.1%), the most detected in AZT/TDF+3TC+EFV programs. There were 22 kinds of PIs, mainly secondary sites were L10F/V/I (2.2%) and L33F (2.1%). The top three NRTIs mutation sites in the area were changed from T69D/N/G, M184I/V and D67N/G/S to M184I/V, K70R/Q/E/T and T215Y/F/V/I/N/A/D. NNRTIs mutation sites were changed from V179D/T/E/F, E138A/K/G/R and Y181C/F/G/V to K103N/S, E138A/K/G/R and V179D/T/E/F. The mutation sites of the first three PIs did not change much.  Conclusions  The second-line regimen based on PIs is a better choice in free antiviral treatments. Mastering the drug resistance of different gene mutations is beneficial to the compatibility of first-line drugs, thus delaying the use of second-line drugs.
Analysis of late diagnosis and its influencing factors of newly reported HIV/AIDS in Guizhou Province from 2014 to 2018
CAO Wen-jie, YUAN Zhi, YAO Yong-ming, XIONG Bing, WEI Wei, LIN Feng, LU Jun-duan
2019, 23(12): 1436-1441. doi: 10.16462/j.cnki.zhjbkz.2019.12.002
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  Objective  To find late diagnosis and its influencing factors of newly reported HIV/AIDS in Guizhou Province from 2014 to 2018.  Methods  Through the Chinese National Comprehensive HIV/AIDS Prevention and Care Information System, all newly reported HIV/AIDS cases from 2014 to 2018 in Guizhou Province were analyzed and related factors of late diagnosis were analyzed using binary Logistic regression model.  Results  From 2014 to 2018, there were 33 611 newly reported HIV/AIDS cases in Guizhou Province, and the late diagnosis rates of newly reported cases were 35.46%, 34.49%, 38.35%, 39.74% and 38.80% respectively. The analysis showed that the proportion of late diagnosis cases from medical institutions increased year by year (χ2=64.603, P < 0.001). By analyzing the late diagnosis rate of cases from different sample sources, medical institutions was significantly higher than that reported by voluntary counseling and testing, positive spouses or sexual partners(χ2=276.033, P < 0.001). Multivariate analysis showed that gender, marital status, route of transmission, occupation, ethnicity and source of samples were associated with the late diagnosis of newly reported cases (all P < 0.05).  Conclusions  It shows a slow upward trend of late diagnosis rate among HIV/AIDS reported in Guizhou Province from 2014 to 2018.On the one hand, it is of great significance to continue to strengthen the publicity and education of the whole population in Guizhou, in order to improve the awareness of HIV active detection. On the other hand, we should continue to expand HIV testing in Guizhou Province to improve the early detection level of HIV/AIDS.
Analysis of HIV/AIDS epidemic characteristics and spatiotemporal aggregation in Lanzhou City from 2011 to 2018
CHEN Ji-jun, WANG Yu-hong, SONG ping, FENG Ai-juan, QI Yue-jun
2019, 23(12): 1442-1447. doi: 10.16462/j.cnki.zhjbkz.2019.12.003
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  Objective  To detect the characteristics of acquired immune deficiency syndrom (AIDS) epidemic in Lanzhou City from 2011 to 2018 and the spatiotemporal aggregation of human immunodeficiency virus (HIV) infection and AIDS patients at county level, and to provide scientific reference for prevention and control of HIV/AIDS in Lanzhou City.  Methods  The space-time scanning and measurement method was used to detect, test, and analyze the spatiotemporal aggregation of HIV/AIDS reports. The aggregation characteristics of the AIDS epidemic in time and space were obtained, and the detection results were visualized by ArcGIS 10.3.  Results  From 2011 to 2018, there were four statistically significant high spatial and temporal aggregation areas in HIV/AIDS in Lanzhou City. One type of gathering area was Chengguan District, Anning District and Gaolan County. The gathering time was from 2015 to 2018 (LLR=108.63, RR=2.02, P < 0.001); The second type of aggregation area was the Qilihe area, which gathered from 2015 to 2018 (LLR=60.93, RR=2.11, P < 0.001). It was detected that the Qilihe District had a type Ⅰ aggregation of heterosexual transmission from 2014 to 2017, and Gaolan County, Anning District and Chengguan District had a type Ⅱ aggregation of heterosexual transmission from 2015 to 2018; It was detected that Gaolan County, Anning District and Chengguan District had a type of gathering of same-sex transmission from 2015 to 2018; In the Qilihe District, there was a second category of same-sex communication between 2017 and 2018.  Conclusion  The HIV/AIDS epidemic in Lanzhou City has spatiotemporal aggregation regardless of the number of reports or different transmission routes. The prevention and control situation is still severe and should be highly valued by the relevant local departments.
Comparison of prevalence and correlates of smoking between males with and without HIV-infection in Taizhou City
NING Chen-xi, CHEN Xiao-xiao, LIN Hai-jiang, QIAO Xiao-tong, HE Na, DING Ying-ying
2019, 23(12): 1448-1454. doi: 10.16462/j.cnki.zhjbkz.2019.12.004
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  Objective  To analyze and compare the prevalence and correlates of smoking among HIV-infected and HIV-uninfected men in Taizhou City, and to provide this for the development and implementation of tobacco control measures for HIV-infected population.  Methods  We used baseline data from the ongoing prospective cohort study of Comparative HIV and Aging Research in Taizhou(CHART), China. 3 785 men were included in analysis. We collected basic characteristics, smoking behaviors, and so on. All analysis were performed using SAS 9.3.  Results  Compared to HIV-uninfected men, the prevalence of current smoking was lower(33.9%, 95% CI: 31.4%-36.5% versus 44.6%, 95%CI: 44.3%-48.3%) but prevalence of previous smoking was higher(14.1%, 95% CI: 12.3%-16.1% versus 12.5%, 95% CI: 11.2%-13.9%; χ2=56.81, P < 0.001). Among male HIV-positive people, the rate of smoking cessation after infection was 23.7%. Multivariate multinomial Logistic regression analysis showed that compared to HIV-uninfected men, in addition to occupation, body mass index and regular exercise that were associated with current smoking, older age(40-50years, OR=1.87, 95%CI: 1.28-2.74, P=0.001; ≥ 50 years, OR=2.30, 95% CI: 1.56-3.39, P < 0.001) and homosexual transmission(OR=0.45, 95% CI: 0.35-0.59, P < 0.001) were also associated with current smoking among HIV-infected men.  Conclusions  Cigarette smoking remains highly prevalent among HIV-infected men in Taizhou City, but with low self-reported smoking cessation rate even after knowing their HIV-positive status. Targeted measures can be taken to control tobacco by strengthening the awareness of HIV-positive persons to quit smoking and combining the factors affecting current smoking among HIV-infected population.
Analysis of the suicidal behavior and psychosocial factors among HIV positive patients in Guangzhou
LIU Yang, LI Jing-jia, CHEN Wei-yi, DU Xuan, GU Jing
2019, 23(12): 1455-1459. doi: 10.16462/j.cnki.zhjbkz.2019.12.005
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  Objective  To investigate the status of suicidal behaviors and suicidal ideation among HIV positive patients in Guangzhou, and to explore its relevant psycho-social factors.  Methods  We conducted a cross-sectional survey of HIV positive adult patients in six districts of Guangzhou to collect social-demographic characteristics, HIV infection time, suicidal ideation, suicidal behaviors and psycho-social factors. Use suicidal ideation and suicidal behaviors as the dependent variables to conduct the univariate analysis and multivariate Logistic regression analysis.  Results  Of the 464 subjects, 5.2% and 17.4% of them had suicidal behaviors and suicidal ideation. Analysis showed that the infection route, depression, anxiety, social discrimination, self-discrimination were correlated with the suicidal behaviors(all P < 0.05), while age, health status, spouse infection, depression, anxiety and social support, social discrimination, self-discrimination were correlated with the suicidal ideation(all P < 0.05). Multivariate Logistic regression model showed that depression and self-discrimination were associated with suicidal behaviors(all P < 0.05), depression and social discrimination were associated with suicidal ideation (all P < 0.05).  Conclusions  HIV-positive adult patients in Guangzhou have a high incidence of suicidal ideation and behaviors. Psychological counseling, risk assessment and timely treatment related to depression, social discrimination self-discrimination and early antiviral treatment should be targeted in HIV-positive adult patients.
A 4-year follow-up study on sexual orientation, sexual behavior and AIDS related knowledge of undergraduate students in a medical university
ZHANG Qi, SONG Lv, FU Yuan-sheng, WU Qian, WANG Xiu, WANG Jing-jing, HE Ting-ting, FAN Yin-guang
2019, 23(12): 1460-1465. doi: 10.16462/j.cnki.zhjbkz.2019.12.006
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  Objective  To explore the characteristics of medical sexual orientation, sexual behavior and acquired immunodeficiency syndrome(AIDS) related knowledge changing with grade.  Methods  A group of 876 undergraduate students of 2015 in a medical university were selected to conduct an anonymous survey once a year and a total of four times using self-compiled questionnaires on AIDS-related knowledge, sexual orientation and behavior of college students. Descriptive epidemiological methods were adopted for statistical description.  Results  The distribution of sexual orientation among medical students with different survey batches was statistically significant (χ2=26.223, P=0.036). The proportion of openly gay people in the total number of homosexuals showed an increasing trend (χtrend2=4.150, P=0.042). Follow-up study of Chinese medicine students on AIDS related knowledge of the overall rate of increased (χtrend2=23.462, P < 0.001). The incidence of general sexual behavior and male homosexual sex among medical students in the past six months showed an increasing trend with grade growth (χtrend2=4.450, P=0.035; χtrend2=6.738, P=0.009). At the second and third follow-ups, the proportion of men who used condoms occasionally and never used condoms increased, and the difference was statistically significant (χ2=7.935, P=0.047).  Conclusions  Due to the weak awareness of medical sexual safety protection, the school should continue to strengthen the AIDS publicity and prevention education of medical students in all grades, and improve the school sexual health education mechanism.
Effect evaluation of compreherive intervention model for HIV/AIDS among college students in Yantai
LIN Rong, CHENG Xiao-song, JIANG Ju-jun, XUE Jian, YU Xiang-dong, SUN Hao-yu, WANG Mao-bo
2019, 23(12): 1466-1470. doi: 10.16462/j.cnki.zhjbkz.2019.12.007
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  Objective  To study the effect of AIDS intervention programs among college students, and to provide fundamental support for the formulating of AIDS prevention strategies.  Methods  A cluster sampling methods was used to conduct a longitudinal follow-up survey among 2 000 freshmen from four colleges in Yantai in 2016, The knowledge, attitudes and behaviors related to AIDS were analyzed by generalized estimating equation analysis method. We also conducted in-depth personal interviews among university leaders.  Results  The awareness rate of AIDS among young students in Yantai was 70.4%, 85.9%, and 95.8%, respectively. The generalized estimating equation showed that the total awareness rate of AIDS knowledge increased year by year (Z=-23.42, P < 0.001). The occurrence of different types of sexual behaviors maintained at a low level, and no obvious trend changes were observed. Multivariate Logistic regression showed that a high occurrence of sexual behaviors among young college students was found related to male, poor knowledge of AIDS prevention, having not received public services related to AIDS prevention, and having not participated in public services related to AIDS prevention (all P < 0.05). Interview results showed that, three of the four colleges have included AIDS health education into their teaching plans, and the AIDS epidemic notification system has been fully implemented.  Conclusions  The awareness rate of AIDS knowledge among college freshmen in Yantai is relatively low. Implementing comprehensive intervention measures and establishing a multi-sectoral cooperation mechanism are the most effective measures to improve the knowledge of AIDS prevention, and promote safe sexual behaviors among young college students.
Characteristics and influencing factors of heterosexual behavior among young men who have sex with men in Taizhou City from 2015 to 2018
LI Jing, XU Yuan-yuan, LI Gui-xia, WANG Shan-ling, SHEN Wei-wei, LIN Hai-jiang, DING Ying-ying, CHEN Xiao-xiao
2019, 23(12): 1471-1475, 1481. doi: 10.16462/j.cnki.zhjbkz.2019.12.008
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  Objective  To investigate characteristics and influencing factors of heterosexual behavior among young men who have sex with men (YMSM) in Taizhou, and to provide evidence for conducting intervention on acquired immune deficiency syndrome (AIDS).  Methods  The demographic characteristics, behavioral characteristics and AIDS related knowledge of YMSM in Taizhou were investigated by the method of questionnaire survey from January to July in 2015, February to September in 2016, January to August in 2017, and January to August in 2018. Human immunodeficiency virus (HIV), syphilis and hepatitis C virus (HCV) were tested in everyone.  Results  A total of 432 YMSM were recruited, including 56 YMSM who had heterosexual behavior. 14.3% of YMSM who had heterosexual behavior never used condoms when having heterosexual behavior. 26.8% did not use condoms when having the last heterosexual behavior. The detection rates of HIV and syphilis were both 5.4%. No HCV positive person was found. The awareness rate of AIDS related knowledge was 91.1%. In multivariate logistic regression, marital status and local residence time were influencing factors of heterosexual behavior among YMSM.  Conclusions  YMSM in Taizhou are at risk of spreading HIV and syphilis. Although the awareness rate of AIDS related knowledge is better, there are still high-risk behavior such as commercial sex behavior and knowledge-practice separation such as not using condoms. It is necessary to promote intervention activities for safe sexual behavior, especially among YMSM who are married and live in the local areas for less than 2 years.
Status and associated factors of recreational drug use among man who have sex with man in Nanjing
XU Yuan-yuan, ZHU Zheng-ping, WU Su-shu, LIU Li, GUO Lu, LI Xin
2019, 23(12): 1476-1481. doi: 10.16462/j.cnki.zhjbkz.2019.12.009
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  Objective  To understand the prevalence of synthetic drug use among man who have sex with man (MSM) in Nanjing and the associated factors.  Methods  MSM were recruited by snow-ball sampling, peer recommendation and network recruitment. Multivariate logistic regression analysis was performed to evaluate the correlated factors of recreational drug use.  Results  29.6% of the 876 MSM ever used recreational drugs. The prevalence of HIV and syphilis infections were 9.5% and 9.0% respectively. After controlling the influence of correlated factors, recreational drug use was correlated with unprotected anal intercourse in the past 6 months(OR=1.83, 95% CI: 1.35-2.47, P < 0.001), multiple male sex partnership in the past 6 months(OR=2.25, 95% CI: 1.65-3.05, P < 0.001), higher HIV prevalence (OR=1.95, 95% CI: 1.21-3.17, P=0.007) and higher syphilis prevalence(OR=1.71, 95% CI: 1.02-2.84, P=0.040). Multivariate Logistic analysis showed that demographic and behavioral factors associated with recreational drug use including: less than 30 years old (OR=1.50, 95% CI: 1.07-2.11, P=0.020), self-identified as homosexual orientation (OR=1.65, 95% CI: 1.16-2.34, P=0.005), seeking male partners mainly via the internet(OR=1.58, 95% CI: 1.07-2.35, P=0.022), higher monthly income(OR=1.57, 95% CI: 1.13-2.17, P=0.007), receptive sexual role(OR=1.55, 95% CI: 1.04-2.32, P=0.033).  Conclusions  MSM has a high prevalence of recreational drug use in Nanjing, which was positively correlated with HIV/syphilis infection and high risk behaviors. Intervention efforts should be devoted to reduce and combat drug use among MSM.
Analysis of HIV infection status and factors among men who have sex with men in Guangzhou
LIANG Rong-jiao, WANG Cheng, ZHAO Pei-zhen, LUO Quan, TANG Shao-kai, HE Wan-ping, YANG Yun-qing, YE Xing-dong, ZHU Hui-lan, WANG Jian-qin
2019, 23(12): 1482-1486, 1497. doi: 10.16462/j.cnki.zhjbkz.2019.12.010
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  Objective  To understand infection status of human immunodeficiency virus (HIV) and analyze the influencing factors among men who have sex with men (MSM) in Guangzhou.  Methods  Men who have sex with men (MSM) were recruited from 2014 to 2017. Face-to-face questionnaire survey was conducted to collect information of characterisitc and behaviors. Blood samples were used to detect HIV antibodie. Data were analyzed using SPSS 19.0.  Results  Among 2 419 MSM, 200(8.27%) participants were confirmed positive for HIV. Multivariate Logistic regression analysis showed that with Guangzhou and monthly economic income >0.5 million as reference, non-Guangzhou (OR=1.712, 95% CI: 1.176-2.492, P=0.005) and monthly economic income ≤ 0.5 million (OR=1.998, 95% CI: 1.409-2.833, P < 0.001) were associated with HIV infection among MSM. Diagnosed syphilis (OR=2.461, 95% CI: 1.375-4.405, P=0.002), undetected syphilis (OR=2.333, 95% CI: 1.635-3.331, P < 0.001), anal sex role passive (OR=2.015, 95% CI: 1.244-3.267, P=0.004), both active and passive (OR=2.115, 95% CI: 1.374-3.251, P=0.001), non-using condoms every time during anal sex (OR=1.955, 95% CI: 1.374-2.781, P < 0.001), non-fixed anal sex objects (OR=2.150, 95% CI: 1.463-3.160, P < 0.001) were major risk factors for HIV infection among MSM.  Conclusions  The prevalance of HIV infection and high-risk sexual behavior were high among MSM in Guangzhou. It is urgent to expand the scope of HIV testing and advocate safe sexual behaviors among MSM.
Impact of childhood sexual abuse on risky sexual behaviors among men who have sex with men in Guangzhou
TAN Zhi-min, LI Jing, CHEN Xiao-bin, CHENG Wei-bin, XU Hui-fang, JIANG Hong-bo, YANG Yi
2019, 23(12): 1487-1491. doi: 10.16462/j.cnki.zhjbkz.2019.12.011
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  Objective  To explore the experience of childhood sexual abuse (CSA) among men who have sex with men (MSM) in Guangzhou, and to evaluate its impact on risky sexual behaviors in adulthood.  Methods  A non-probability sampling method was used to recruit MSM aged 18 years and over in Guangzhou. Sociodemographic characteristics, experience of CSA and risky sexual behaviors during the past 6 months were collected using an electronic questionnaire. χ2 tests were used to compare the prevalence of CSA and risky sexual behaviors during the past 6 months among different sociodemographic characteristics. Logistic regressions were performed to assess the impact of CSA on risky sexual behaviors.  Results  Overall, 976 MSM were included with an average age of (28.35±6.83) years old. Nearly one-third (26.95%, 263/976) of MSM experienced CSA. Participants having multiple sexual partners (MSP) and unprotected anal intercourse (UAI) during the past 6 months accounted for 61.68% (602/976) and 47.95% (468/976), respectively. After adjusting age, ethnicity, household registration, local residence time, marital status, education, employment status, monthly income and sexual orientation, the results of multivariate Logistic regression showed that MSM who experienced CSA were likely to have MSP during the past 6 months (aOR=1.62; 95%CI: 1.19-2.22) than those did not experience CSA. But the association between UAI and CSA was not statistically significant.  Conclusions  The prevalence of CSA among MSM in Guangzhou is high. CSA can substantially increase the risk of risky sexual behaviors in adulthood. Intervention to reduce the risk of sexual risk behaviors may need to be tailored for MSM who experienced CSA.
Predictors related to condom use behaviors based on the theory of planned behavior among female sex workers
HUANG Jing-yue, ZHANG Wei-hua, MENG Yu, WANG Ke, ZHAO Rong-xian, YANG Su-lian, HUANG Jiao, WANG Xia, TONG Ye-qing, GUO Heng, WEI Sheng
2019, 23(12): 1492-1497. doi: 10.16462/j.cnki.zhjbkz.2019.12.012
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  Objective  To identify predictors related to condom use in different tiered female sex workers (FSWs) in Hubei Province.  Methods  A cross-sectional study was conducted in Hubei Province in 2015 to investigate 816 eligible FSWs by using a multistage sampling method. All data were collected by using a structured questionnaire with scales on condom use, which was designed based on the theory of planned behavior (TPB). A structural equation model (SEM) was used to identify predictors of condom use in the different tiered FSWs.  Results  It showed that low-tier FSWs used less condom than higher-tier FSWs in commercial sexual behaviors of the last time and during the last month(P < 0.001). The TPB scores were significantly different in different tiered FSWs. The scores of PBC in low-tier FSWs were lower than those in higher-tier FSWs (11.43±2.86 vs 12.06±2.87, respectively, P=0.002); But the scores of behavioral intentions were higher than those in higher-tier FSWs (5.47±1.11 vs 5.20±1.15, respectively, P=0.001). The PBC was the major factor related to condom use in low-tier FSWs (effect coefficient=0.55, P < 0.001), while the behavioral intention was the major factor related to condom use in higher-tier FSWs (effect coefficient=0.33, P < 0.001). Behavioral attitude was the major factor of intention to use condoms for both low-tier (effect coefficient=0.49, P < 0.001) and higher-tier FSWs (effect coefficient=0.42, P < 0.001).  Conclusions  Changing the attitude to condom use in FSWs is an important measure to promote the behavior intention. Condom promotion interventions should focus on the perceived behavioral control in low-tier FSWs, and promote the behavior intention in higher-tier FSWs.
Factors associated with being recaptured among low-fee female sex workers in HIV surveillance and intervention
NONG Gui-de, DONG Yu-lian, MAO Yan-fang, DONG Xiu-ming, LI Jian
2019, 23(12): 1498-1502, 1509. doi: 10.16462/j.cnki.zhjbkz.2019.12.013
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  Objective  This objective of the study was to analyze the factors related to being recaptured and condom use among low-fee female sex workers (FSWs) to provide reference in developing human immunodeficiency virus (HIV) intervention strategy.  Methods  Physical examination certificates were designed by Zhongshan County Center for Disease Control and Prevention to record HIV and syphilis test results for low-fee FSWs from 2013 to 2015. Low-fee FSWs were asked to show physical examination certificates in the next intervention and test. Multivariate Logistic regression was used to analyze factors associated with being captured with physical examination certificates. Generalized linear mixed model was used to analyze factors associated with condom use with clients.  Results  A total of 220 low-fee FSWs were recruited by using physical examination certificates and received 389 interviews from 2013 to 2015. The proportions of HIV positive and syphilis positive were 4.2% (9/213) and 30.0% (64/213) respectively among those who had HIV and syphilis test. Results of multivariate Logistic regression analysis showed that low-fee FSWs who had been FSWs for more than 4 years (OR=2.95, 95% CI: 1.35-6.45), and worked in the local county in the past 30 days (OR=11.74, 95% CI: 5.26-26.20), were more likely to be captured with physical examination certificates. Results of generalized linear mixed model showed that those who were captured at least once (OR=3.33, 95% CI: 1.34-8.27), had junior middle school education and above (OR=22.79, 95% CI: 3.75-138.57), had high HIV knowledge (OR=3.57, 95% CI: 1.52-8.38), and charged more than 30 yuan for vaginal sex (OR=30.68, 95% CI: 12.57-74.90), were more likely to use condom consistently.  Conclusions  Physical examination certificates could be used for low-fee FSWs surveillance and intervention and tracking their HIV and syphilis status. The intervention strategy should take these into consideration.
The present situation of access to HIV/AIDS public health services among cross-border couples in Dehong Prefecture
YANG Yue-cheng, HE Chun-yan, LI Lin, YE Run-hua, WANG Ji-bao, YAO Shi-tang, HE Na, DING Ying-ying, DUAN Song
2019, 23(12): 1503-1509. doi: 10.16462/j.cnki.zhjbkz.2019.12.014
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  Objective  To investigate the accessibility of HIV-related public health services among cross-border couples living in Dehong Prefecture and age differences.  Methods  A cross-sectional survey was conducted among cross-border couples in Dehong Prefecture from January 2017 to July 2019.  Results  In total, 32 182 participants were included. The proportion of people who had received HIV testing services, HIV-related intervention services in past year, care and help in the past year, and participated in new rural cooperative medical services (NCMS) were 57.8%, 92.7%, 6.5% and 94.5%, respectively; and the latter three services were significantly different across age groups (P < 0.001). In multivariable Logistic regression model, variables significantly associated with having ever received HIV testing services older age (51-85 years: OR=0.71, 95% CI: 0.63-0.81), women (OR=1.14, 95% CI: 1.03-1.25), county/city (Longchuan: OR=6.30, 95% CI: 5.72-6.93; Lianghe: OR=1.27, 95% CI: 1.11-1.44; Yingjiang: OR=0.88, 95% CI: 0.82-0.94), Dai ethnic minority (OR=1.60, 95% CI: 1.50-1.72), marriage registration (marriage registration for border inhabitants: OR=0.60, 95% CI: 0.56-0.65; non-registration: OR=0.66, 95% CI: 0.62-0.70), years of marriage (4-5 years: OR=1.21, 95% CI: 1.12-1.31; 6-60 years: OR=1.30, 95%CI: 1.22-1.39), having not received care and help in the past year (OR=0.64, 95% CI: 0.58-0.71) and having not participated in NCMS (OR=0.58, 95% CI: 0.52-0.65).  Conclusions  The accessibility to HIV-related public health services are relatively high among cross-border couples in Dehong Prefecture. However, the relatively low proportion of receiving AIDS testing services, particularly among certain groups and counties/cities, need to be strengthened.
Service demand and capacity of HIV prevention of mother-to-child transmission in Guangdong
TANG Liu-ying, WANG Xiong-hu, MA Yuan-zhu, GAO Shuang, WANG Zhi-qiang, LI Bing, XIA Jian-hong
2019, 23(12): 1510-1516. doi: 10.16462/j.cnki.zhjbkz.2019.12.015
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  Objective  To analyze the service demand and capacity for preventing mother-to-child transmission(MTCT) of acquired immune deficiency syndrome in Guangdong, as well as to find the weakness in the work.  Methods  The relevant data of service demands and intervention capacity of human acquired immunodeficiency virus(HIV)-infected maternal and their babies from 2014 to 2017 was collected, and SPSS 21.0 software was employed to analyze the differences among the pearl river delta area, western area, mountainous area and eastern area, and to explore the correlation between regional midwifery institutions or personnel numbers and the rate of HIV MTCT.  Results  The education of HIV-infected maternal wasn't high, generally, mainly in middle school (54.49%). The service demand of HIV-infected maternal was different in each area. The ethnic minorities outside the pearl river delta region (12.96%) and non-local living maternal in mountainous area (43.75%) were high. The proportion of maternal in the eastern area who didn't know the route of HIV infection was also high (77.78%). The service capacity varies in each area, and the proportion (mountainous area: 41.67%, eastern area: 44.44%) of the confirmation time in intrapartum/postpartum was high among those from the mountains and eastern areas, which lead to poor intervention (the proportions of starting to antiretroviral treatment time later than 36 weeks or untreated in mountainous and eastern areas were 43.75% and 55.56%, respectively), as well as a high proportion of untreated maternal and exposed-infant (mountainous area: 2.08%, eastern area: 33.33%), and a higher percentage (11.11%) of breastfeeding in eastern area. There was no significant correlation between the number of midwifery institutions or healthcare personnel and the rate of HIV MTCT in different regions.  Conclusions  The mountainous and eastern areas are the weak of HIV MTCT in Guangdong Province, and later detection, less-standard intervention, and lower quality of information management are the weak steps in those areas. Targeted measures should be urgently developed to strengthen the training of the key areas to eliminate the regional differences of service capacity, which is essential to achieve the elimination of HIV MTCT in Guangdong.
Demand for non-occupational post-exposure prophylaxis services for HIV and associated factors among men who have sex with men in Liuzhou, Guangxi
LIU Xue-mei, GUO Heng-sheng, FAN Yin-guang, ZHANG Qi, LIANG Jia-jia, WEI Tao, YANG Miao-ying, WEI Li, LAN Jian-guo, ZHU Na, FENG Xian-xiang, YE Dong-qing
2019, 23(12): 1517-1522. doi: 10.16462/j.cnki.zhjbkz.2019.12.016
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Abstract:
  Objective  To analyze the demand for non-occupational post-exposure prophylaxis (nPEP) services and related influencing factors among men who have sex with men (MSM) in Liuzhou City, Guangxi Province.  Methods  MSM was recruited in Liuzhou City, Guangxi Province. Face-to-face survey was used to collect demographic information, knowledge about AIDS, history of high-risk behavior, knowledge and demand for nPEP services. χ2 test was used to analyze the differences of demand for nPEP services among MSM with different characteristics and different high-risk behaviors. Log-binomial regression model was used to analyze the influencing factors of demand for nPEP services. Prevalence ratio and 95% confidence interval were calculated.  Results  31.1% of MSM population had heard of nPEP service, and 61.6% of them needed the service after being informed of nPEP about its protective effect. 58.6% of MSM would spend money to buy nPEP service after high-risk behavior. Logistic regression analysis showed that the education level was university degree or above (PR=2.743, 95% CI: 1.996-3.450), the perception of the local MSM AIDS epidemic was not serious or unknown (PR=0.211, 95% CI: 0.112-0.294), and the number of temporary sexual partners in half a year was 2 or more (PR=3.642, 95% CI: 2.223-4.842), these subjects above were influencing factors of nPEP service demanded for respondents.  Conclusions  MSM population in Liuzhou area of Guangxi have a certain need for nPEP service. We should implement nPEP service as soon as possible in accordance with local conditions, and strengthen the corresponding propaganda to reduce the harm of AIDS to MSM population.
Short Reports
Distribution of HIV subtypes in HIV/AIDS patients in Guizhou from 2013 to 2017
LIU Xing-feng, LI Zhi-jian, FANG Xing, ZHANG Xin-hui, HUANG Lu, WANG Huan, XIAO Zhi
2019, 23(12): 1523-1526. doi: 10.16462/j.cnki.zhjbkz.2019.12.017
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Abstract:
  Objective  To investigate the molecular characteristics of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients receiving antiretroviral therapy (ART) in Guizhou Province.  Methods  Using a convenience sampling strategy, 8 583 samples were collected in Guizhou and an investigation was conducted including face-to-face questionnaire interview and HIV testing.  Results  1 511 cases failed in HIV suppression (viral load, VL>1 000 copies/ml). 1 410 cases (93.31%) were successfully genotyped with HIV pol gene, among which 51.42% were genotyped as CRF01_AE, 26.67% as CRF07_BC and 16.1% as CRF08_BC.  Conclusion  The subtype changes caused by HIV gene mutation should precede the changes of main transmission routes of HIV through the analysis in recent years. Timely monitoring the changes of HIV subtypes can be one of the main bases for the prevention and control of AIDS.
Comparison of antibiotic resistance spectrum between methicillin-resistant and methicillin-susceptible coagulase-negative staphylococci nasal isolates among 1 001 HIV infectors
HE Sui-ping, YE Jia-ping, BAI Chan, LI Ling-hua, LI Li-ya, CAI Wei-ping, WANG Ying-ying, LI Ying, ZHANG Wen-cui, LIU Ning, GONG Zi-jun, YAO Zhen-jiang
2019, 23(12): 1527-1530. doi: 10.16462/j.cnki.zhjbkz.2019.12.018
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Abstract:
  Objective  We aimed to elucidate the prevalence and the antibiotic resistance spectrum of nasal coagulase-negative staphylococci (CoNS) colonization among HIV infectors in Guangzhou.  Method  After isolation and identification, all CoNS isolates were tested for the antibiotic susceptibility, and the antibiotic resistance genes.  Result  Among the 1 001 HIV infectors, the prevalence of CoNS and MRCoNS were 57.44% and 48.15%, respectively. The three predominant resistant antibiotics of MRCoNS isolates were penicillin, erythromycin and trimethoprim-sulfame thoxazole, while predominant detection rates of genes were Aac(6')-aph(2')、ermC and linA genes. The multidrug resistance rate of MRCoNS isolates were significantly higher than methicillin-susceptible coagulase-negative staphylococci (MSCoNS) isolates (80.69% versus 39.66%, P < 0.001, OR=6.36).  Conclusions  The prevalence and multidrug resistant rates of nasal colonization CoNS and MRCoNS are high among HIV infectors in Guangzhou. MRCoNS isolates were 6.36 times more likely to be of multidrug resistance than MSCoNS isolates.
Association between general self-efficacy and HIV-related stigma among newly HIV-diagnosed man who have sex with man
WANG Na, QIU Xiao-qiang, RUAN Yu-hua
2019, 23(12): 1531-1534. doi: 10.16462/j.cnki.zhjbkz.2019.12.019
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Abstract:
  Objective  To investigate the association between general self-efficacy (GSES) and human immunodeficiency virus(HIV)-related stigma among newly HIV-diagnosed men who have sex with men (MSM) in Beijing.  Methods  HIV testing was conducted among MSM who met the inclusion criteria in Beijing from April 2013 to April 2014. Face-to-face interviews were conducted among newly HIV-diagnosed MSM. Multiple linear regression was used to analyze the association between general self-efficacy and HIV-related stigma among newly HIV-diagnosed MSM.  Results  Of the 367 newly HIV-diagnosed MSM, the general self-efficacy score of was (31.5±6.3) and the HIV-related stigma score was (26.9±20.9). Multiple linear regression showed that after adjusting for confounding factors, general self-efficacy was negativly associated with HIV-related stigma (GSES was continuous variable β=-0.010, P=0.022; GSES was dichotomous variable β=-0.117, P=0.028).  Conclusions  The newly HIV-diagnosed MSM face the problem of HIV-related stigma. For newly HIV-diagnosed MSM, higher self-efficacy helps reduce HIV-related stigma.
Analysis on HIV/AIDS surveillance among pregnant women in Taizhou City from 2014 to 2018
YU Ming-run, YANG Kai-xi, XU Ya-bin, PAN Long, DING Qing-yong, ZHANG Yi, ZHANG Xiang
2019, 23(12): 1535-1538. doi: 10.16462/j.cnki.zhjbkz.2019.12.020
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Abstract:
  Objective  To analyze the time trend of HIV epidemic and to provide basis for comprehensive HIV infection prevention among pregnant women.  Methods  From 2014 to 2018, continuous cross-sectional surveys were conducted among pregnant women in two maternity and child health care hospitals. 800 blood samples were collected each year to test HIV infection, syphilis and hepatitis C virus (HCV).  Results  A total of 4 000 eligible pregnant women completed the interview and blood testing. The awareness rate of knowledge about HIV/AIDS was 91.2%, and the rate was increasing year by year. Multivariate Logistic regression analysis showed that the awareness rate was associated with at age of more than 35, with lower education than college and the husband used to work in other places.  Conclusions  The rate of HIV infection among PRGs was at a low level in Taizhou.
History of Public Heal
The pioneer of mental health: Philippe Pinel
WANG Jun-ping, WANG Xiao-yu, WU Jun, YE Dong-qing
2019, 23(12): 1539-1542. doi: 10.16462/j.cnki.zhjbkz.2019.12.021
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Abstract:
Philippe Pinel (1745-1826) was a well-known French doctor and an outstanding mental health leader. Inspired by the ideas of the Enlightenment, he adopted "moral therapy" for the increasing mental patients in France. He took the lead in scientifically and effectively alleviating the current state of mental illness with the concept of humanitarian care, liberated mental patients, and opened the door for the mental health. Through field observation and meticulous statistical analysis, he classified mental illness into a more comprehensive scientific classification, guiding the direction for identifying, treating, and preventing mental illness, thus laying the theoretical and practical foundation. Many of his achievements about mental health have been used to this day, and he was known as the father of modern psychiatry.

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