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CN 34-1304/R ISSN 1674-3679

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2024, Volume 28,  Issue 12

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Public Health Theory and Education
Focusing on the construction of interdisciplinary curriculum systems and to enhance the quality of high-level public health talent cultivation
FANG Xinyu, FAN Yinguang, YE Dongqing
2024, 28(12): 1365-1372. doi: 10.16462/j.cnki.zhjbkz.2024.12.001
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The Guidelines for the Development of High-Level Schools of Public Health (2021) emphasize cultivating interdisciplinary public health professionals with Chinese characteristics and world-class capabilities. The focus lies on promoting cross-disciplinary integration, merging medical and preventive sciences, innovating education models, and building multi-disciplinary research platforms. A well-structured curriculum and teaching system are identified as key to improving talent development. However, research on constructing interdisciplinary curricula remains insufficient. This study focuses on optimizing interdisciplinary curriculum systems by drawing on international best practices and aligning them with domestic conditions. It proposes strategies in areas such as curriculum design, teaching practice, faculty development, evaluation mechanisms, and policy support. Recommendations include innovative teaching methods, enhanced faculty training, refined evaluation systems, and robust policy frameworks to advance deep academic integration. By establishing a flexible and systematic education model, this study aims to enhance the quality of interdisciplinary public health talent cultivation and contribute to the development of high-level schools of public health in China.
International public health talent cultivation models and their implications for the construction of high-level schools of public health in China
WANG Liyi, WANG Jianming
2024, 28(12): 1373-1380. doi: 10.16462/j.cnki.zhjbkz.2024.12.002
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  Objective  The aim of this study is to select the world′s first-class level universities as the standard and explore the path of cultivating talents in domestic high-level schools of public health.  Methods  The talent-cultivating models of five representative schools of public health were analyzed based on the rankings of public health schools by the US news & world report (US news) and the 2023 Shanghai Ranking comprehensive ranking.  Results  All of the world′s first-class schools of public health have established their vision and tasks for talent cultivation centered around human health. They maintain strong communication ties with government institutions, provide all-round academic support for students, constantly innovate research and concepts, stress diversity and inclusiveness, and attach importance to cultivating professional competence.  Conclusions  On the basis of gaining experience from the world′s famous universities, China′s high-level schools of public health should pay attention to developing their characteristics, leveraging their advantages, and demonstrating first-class level.
Qualitative study on problems in the pilot program of standardized training for public health physicians
HUI Zhaozhao, WU Qian, MA Jing, LI Zhaoqing, WANG Lirong, LI Yanqin, LIU Mengran, ZHANG Yue, DAI Zheng, ZHUANG Guihua
2024, 28(12): 1381-1386. doi: 10.16462/j.cnki.zhjbkz.2024.12.003
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  Objective  This study aims to identify the problems in the pilot program of standardized training for public health physicians in China and provide insights for comprehensive promotion.  Methods  A total of 35 worker were recruited from of the centers for disease control and prevention(CDC) with purpose method in the descriptive qualititive study between July and August 2022. Semi-structured interviews were conducted via the Tencent Meeting platform. The interview data were transcribed verbatim and analyzed using MAXQDA 2020 software with the content analysis method.  Results  The problems in the pilot program were categorized into three themes: deficient policy system (imperfect management, inaccurate clinical training positioning, inconsistent training content/materials), lack of support resources (insufficient financial support, inadequate training professionals, poor hardware conditions) and recruitment difficulties (work-training conflicts, lack of training motivation).  Conclusions  The standardized training for public health physicians in China is still in its exploratory phase. To advance this program, efforts should focus on strengthening system construction, increasing financial support, improving coordination between educational institutions and regional entities, and establishing effective incentive mechanisms. This will help lay a solid foundation for the success of the program.
Remark on the development and characteristics of grass-roots public health in China
NI Jindong
2024, 28(12): 1387-1390. doi: 10.16462/j.cnki.zhjbkz.2024.12.004
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In the new era, the situation and tasks of disease prevention and control in China are severe, with the increasing burden of newly emerging infectious diseases and chronic diseases intertwined with an aging population. Under the guiding principles of "Focusing on prevention" for hygiene and health service, the tasks and missions of grassroots health work are significant, serving as the first line of defense for people′s health and maintaining social stability. Among them, grass-roots public health is the "doorkeeper" for building the health of the entire life cycle of the people, and is increasingly receiving high attention from governments and society at all levels. However, there are much unclear on the development and characteristics of grass-roots public health in China and on the responsibilities of grass-roots public health institutions and personnel. This is an important and urgent issue that spans the current development of China′s healthcare industry. On the basis of tracing the historical development of grassroots health in China, this article combines national policies, practical problems, and literature evidence to propose the research progress, characteristics, and functional responsibilities of grassroots public health, in order to promote the development of grass-roots public health of China and promote people′s health.
Original Articles
The spatial-temporal distribution of newly reported HIV-infected patients and factors associated with recent HIV infection in Taizhou of Zhejiang Province from 2019 to 2022
WU Xuanhe, WANG Shanling, WANG Yating, XIE Yali, WANG Tingting, SHEN Weiwei, CHEN Xiaoxiao, LIN Haijiang, HE Na
2024, 28(12): 1391-1398. doi: 10.16462/j.cnki.zhjbkz.2024.12.005
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  Objective  This study aims to analyze the epidemiological characteristics of newly reported human immunodeficiency virus(HIV) cases and the influencing factors of recent infection in Taizhou City, Zhejiang Province.  Methods  HIV-1 limiting-antigen avidity enzyme immunoassay (LAg-Avidity EIA) was performed to detect recent infection within new HIV diagnoses reported between 2019 and 2022 in Taizhou City. Multivariate logistic regression models were employed for multifactorial analysis of factors influencing the proportion of recent infection. The spatial analysis was conducted with arc geographic information system(ArcGIS) 10.7 software.  Results  In total, 1 785 eligible subjects were enrolled for further study, with 313 cases (17.5%) classified as HIV recent infections. The proportion of recent infections in 2019-2022 was 10.6%, 15.9%, 23.9% and 20.2%, respectively. The high-risk population for recent infection includes individuals aged 18- < 30 years old, illiterate, homosexual transmission and voluntary testing and counseling. HIV recent infections were primarily distributed in Linhai, Jiaojiang, Luqiao and Wenling.  Conclusions  The proportion of HIV recent infection in Taizhou City was relatively high and showed an increasing trend from 2019 to 2022. The recent infection cases are predominantly male, with uneven distribution across regions. It is important to enhance targeted education in high-risk population, focusing on areas with dense cases, and strengthen the detection and discovery of individuals aged 40 and above.
Survival analysis of HIV/AIDS in Anhui among different AIDS diagnosis and treatment guidelines, 2006-2022
GUO Qisheng, YE Yongsheng, WANG Yangguang, SONG Jinling, GAO Meng, DAI Seying, ZHANG Jin, FAN Yinguang
2024, 28(12): 1399-1405. doi: 10.16462/j.cnki.zhjbkz.2024.12.006
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  Objective  This study aims to compare the survival rates of HIV infected and AIDS patients (HIV/AIDS) in Anhui Province under different versions of Guidelines for Diagnosis and Treatment of AIDS, and explore the factors influencing survival time.  Methods  Based on a retrospective cohort study of HIV/AIDS in Anhui Province from 2006 to 2022, the study period was divided into five phases according to the publication dates of the Guidelines. The Life-table method and Cox proportional hazards model were used to analyze survival rates and factors influencing survival time.  Results  A total of 25 334 participants were included, of whom 83.51% were male, 68.76% were aged of diagnosis > 30- < 60 years, and 49.70% resided in northern Anhui Province. The one-year survival rates across the five periods (95%, 95%, 97%, 97%, and 96%) showed significant differences (χ2 =46.180, P < 0.001). Similarly, the two-year survival rates for the first four periods (93%, 94%, 95%, and 95%) also exhibited significant differences (χ2 =17.103, P < 0.001). Cox proportional hazards regression analysis revealed the following factors influencing HIV/AIDS mortality risk, females had 0.654 times lower risk than males (95% CI : 0.588-0.727, P < 0.001). Individuals aged over 60 years had 4.665 times higher risk compared to younger individuals (95% CI: 3.930-5.539, P < 0.001). Unmarried individuals had 1.555 times higher risk than married individuals (95% CI : 1.382-1.750, P < 0.001). Those with education above primary school had 0.756 times lower risk compared to those with primary education (95% CI: 0.688-0.831, P0.001). Homosexual transmission was associated with 0.586 times lower risk than heterosexual transmission (95% CI: 0.524-0.656, P < 0.001). Additionally, higher CD4+ T lymphocyte (CD4) counts were associated with 0.385 times lower risk compared to lower counts (95% CI: 0.329-0.451, P < 0.001).  Conclusions  With the updates to China′s Guidelines, the survival rate of HIV/AIDS has shown an upward trend.
Association of autonomic nervous system function with depressive symptoms in HIV-positive individuals
ZHANG Yunqiu, HAN Lei, SHI Luqian, QIAO Xiaotong, GAO Meiyang, DING Yingying
2024, 28(12): 1406-1413. doi: 10.16462/j.cnki.zhjbkz.2024.12.007
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  Objective  To analyze the association of depressive symptoms with autonomic nervous system (ANS) function among human immunodeficiency virus (HIV) positive individuals.  Methods  This was a cross-sectional study between January and December 2023. HIV-positive individuals were recruited using convenient sampling. The composite autonomic symptom scale 31 composite autonomic symptom score (COMPASS-31) questionnaire was used to evaluate the autonomic nervous function symptom. A linear regression model was used to analyze the associated factors of COMPASS-31 scores among HIV-positive individuals, with adjustment for potential confounding factors, and stratification by different age groups.  Results  In total, 311 HIV-positive individuals were included. The average age was (42.0±14.0) years. The average COMPASS-31 total score was 8.1 (3.9, 14.8) points. The total score, vasomotor scores and gastrointestinal scores were higher, while Bladder scores were comparatively lower among HIV-positive individuals under 45 years. Multivariable linear regression results showed that age, waist-to-hip ratio (WHR) and maximum hand grip were negatively correlated with COMPASS-31 score, while insomnia symptoms and sleep duration of less than 6 hours were positively correlated with COMPASS-31 score. After further adjustment of depressive symptom score (β=-0.07, 95% CI: -0.14-0.00, P=0.045; β=-2.84, 95% CI: -4.73--0.95, P=0.004; β=-0.14, 95% CI: -0.25--0.02, P=0.020), age, high WHR and maximum hand grip were negatively correlated with COMPASS-31score (β=0.070, 95% CI: 0.42-0.97, P < 0.001), while depressive symptom score were positively correlated with COMPASS-31 score (β=-3.56, 95% CI: -6.07--1.05, P=0.006; β=-0.20, 95% CI: -0.36--0.04, P=0.014). Further stratified analysis by age groups revealed that among HIV-positive individuals under 45 years old, higher WHR and maximum hand grip were negatively correlated with COMPASS-31 scores. Additionally, positive correlations between COMPASS-31 scores and CD4 cell count >500 cells/μL, as well as depressive symptom scores, were observed exclusively in this young age group (β=3.51, 95% CI: 0.89-6.14, P=0.010; β=0.79, 95% CI: 0.44-1.14, P < 0.001).  Conclusions  Depression can aggravate the severity of autonomic nervous dysfunction symptoms in HIV-positive individuals, appropriate health guidance should be provided in response.
Late detection of new HIV/AIDS cases in Qinghai Province from 2017-2022 and its influencing factors
KUANG Jiaying, DONG Shicun, MA Binzhong, LIANG Da, LI Jiping
2024, 28(12): 1414-1419. doi: 10.16462/j.cnki.zhjbkz.2024.12.008
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  Objective  To analyze the late detection status of newly reported cases of human immunodeficiency virus / acquired immune deficiency syndrome (HIV/AIDS) in Qinghai Province from 2017 to 2022 and the related influencing factors, so as to provide the basis for formulating the early detection strategy of HIV/AIDS cases in Qinghai Province.  Methods  The ewly reported HIV/AIDS data was download from the AIDS integrated prevention and control information management system in Qinghai Province from 2017 to 2022. We described the basic demographic characteristics of its late detection cases and analyzed the influencing factors of late detection using single factor analysis and multivariable logistic regression models.  Results  There were a total of 2 299 newly reported HIV/AIDS cases in Qinghai Province from 2017 to 2022, of which 1 015 were late detected cases, corresponding to a late detection rate of 44.15%. There was no statistically significant difference in the proportion of HIV/AIDS cases detected late across different years(χ2 =6.817, P=0.230). Multivariable logistic regression analysis showed that age, nationality, registered residence and sample source were the main factors influencing the late detection of HIV/AIDS cases at diagnosis. The older the age, the higher the rate of late detection of cases (χ2 =85.613, P < 0.001). The risk of late detection in the age group ≥ 60 years old was 6.459 times higher than that in the age group 0- < 20 years old (OR=6.459, 95% CI: 2.577-16.190). The risk of late detection of HIV/AIDS cases among Hui ethnicity was 1.289 times higher than that of the Han ethnicity (OR=1.289, 95% CI: 1.024-1.623), while the risk of late detection for cases from other ethnicities was lower than that of the Han ethnicity (OR=0.638, 95% CI: 0.441-0.924). The risk of late detection for cases with household registration from other provinces was lower than that of cases with local household registration (OR=0.548, 95% CI: 0.332-0.934). Cases detected through testing consultation (OR=0.506, 95% CI: 0.409-0.627) and other methods (OR=0.660, 95% CI: 0.508-0.857) had a lower risk of late detection compared to those detected in medical institutions.  Conclusions  The proportion of late detection of newly reported HIV/AIDS cases in Qinghai Province from 2017 to 2022 was higher than the national level. The next step is to increase the coverage of HIV testing, actively carry out HIV mobilization testing for middle-aged and elderly people and local residents, focus on strengthening HIV testing promotion for ethnic minoritiy populations, expand the coverage of voluntary counseling and testing (VCT) outpatient testing, and increase the enthusiasm of key departments in medical institutions to actively provide HIV testing and consulting services.
Awareness and testing willingness of hepatitis C among people aged 50 and above in Anhui Province
WANG Ziwei, LI Ying, HUANG Zhuojun, GAO Meng, GONG Liping, LI Zeyang, XU Xuewei, DAI Seying, FAN Yinguang
2024, 28(12): 1420-1425. doi: 10.16462/j.cnki.zhjbkz.2024.12.009
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  Objective  To understand the awareness of hepatitis C prevention and treatment and willingness to be tested among people aged 50 and above, and analyzing factors influencing their willingness to undergo hepatitis C testing, in order to provide a reference for hepatitis C prevention and treatment work.  Methods  A multistage sampling method was used to select people aged 50 years and above between January and July 2023 in Hefei City, Chuzhou City and Bozhou City, Anhui Province. Information on demographic characteristics, awareness of hepatitis C prevention and treatment, and willingness to be tested for hepatitis C was collected from the survey respondents. Chi-quare test was used to compare the differences in the willingness to test for hepatitis C among people aged 50 and above with different characteristics, and binary logistic regression analysis was used to analyze the relevant factors affecting the willingness to test for hepatitis C among people aged 50 and above in Anhui Province.  Results  Among the 6 857 participants, males accounted for 51.7%, with an average age of (69.97±9.02) years. The overall awareness rate regarding hepatitis C prevention and treatment was 21.6%. The self-reported past hepatitis C testing rate among the participants was 10.2%, and 79.4% expressed willingness to undergo hepatitis C testing in the next three months. Additionally, 79.4% of the participants expressed willingness to undergo hepatitis C testing in the next three months. The results of the multivariate analysis showed that females (OR=0.811, 95% CI: 0.709-0.928, P=0.002), married/cohabiting (OR=0.362, 95% CI: 0.247-0.531, P < 0.001) and separated/divorced/widowed (OR=0.614, 95% CI: 0.416-0.904, P=0.014), middle school (OR=0.671, 95% CI: 0.570-0.790, P < 0.001), individual monthly income of 3 000-5 000 (OR=0.522, 95% CI: 0.440-0.618, P < 0.001) and ≥5 000 (OR=0.502, 95% CI: 0.365-0.690, P < 0.001) had lower willingness to be tested for hepatitis C; while cohabitation with parents / children / spouses / sexual partners (OR=4.686, 95% CI: 3.739-5.874, P < 0.001) and pension institutions (OR=3.203, 95% CI: 2.276-4.507, P < 0.001), having had a HIV test (OR=2.872, 95% CI: 2.434-3.389, P < 0.001), and high-risk groups (OR=2.220, 95% CI: 1.930-2.554, P < 0.001) had a higher willingness to be tested for hepatitis C.  Conclusions  Currently, the cyclic patterns of AIDS incidence and mortality in China have reached their historical peak, with cycles becoming notably longer. Predictions indicate a future downward trend in both incidence and mortality, so we should pay close attention to the epidemic situation of AIDS, and actively take preventive and control measures.
Prevalence and associated factors of group sex behavior among HIV-infected men who have sex with men in Chongqing
CHEN Huailiang, JIANG Can, MA Ping, GAO Chunmei, CHEN Jin
2024, 28(12): 1426-1432. doi: 10.16462/j.cnki.zhjbkz.2024.12.010
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  Objective  To explore the prevalence and associated factors of group sex behavior among human immunodeficiency virus (HIV) infected men who have sex with men (MSM), so as to provide a basis for the formulation of targeted intervention strategies and measures.  Methods  From June 2022 to June 2023, HIV-infected MSM were recruited and surveyed by two community-based organizations in Chongqing. The survey contents included sociodemographic characteristics, sexual orientation, HIV infection and high-risk behaviors, HIV stigma perception score, anxiety symptom score and depressive symptom score. Binary logistic regression model was used to explore factors associated with group sex behavior.  Results  In total, 1 501 participants were surveyed in this study, 26.4% reported group sex participation in their lifetime and 9.3% reported group sex participation in the past 6 months, of which 56.8% reported inconsistent condom use in group sex behavior. Multivariate logistic regression analysis indicated homosexuality (OR=2.221, 95% CI: 1.116-4.422), time from HIV diagnosis ≥5 years (OR=5.405, 95% CI: 1.940-15.059), HIV-related stigma perception (OR=1.075, 95% CI: 1.034-1.117), poor adherence to antiretroviral therapy (OR=2.748, 95% CI: 1.493-5.059), gay applications use in the past 6 months (using 1 application: OR=3.117, 95% CI: 1.006-9.657; using 2 applications: OR=6.065, 95% CI: 1.848-19.901; using 3 applications and above: OR=11.665, 95% CI: 3.043-44.711), rush poppers use in the past 6 months (OR=9.178, 95% CI: 4.584-18.380), methamphetamine use in the past 6 months (OR=38.186, 95% CI: 11.427-127.602) unprotect and sex intercourse (OR=3.227, 95% CI: 1.824-5.711) were significantly associated with group sex behavior in the past 6 months among HIV-infected MSM (all P < 0.05).  Conclusions  Group sex behavior and inconsistent condom use are common among HIV-infected MSM in Chongqing. Special attention should be paid to HIV-related stigma, gay applications use, substances use and group sex behavior within this subpopulation, so as to mitigate further transmission of HIV or sexually transmitted diseases (STDs).
Association between sexual behavioral characteristics and HIV testing service utilization among adolescents
HE Dan, ZHANG Haiyan, GU Huayan, WANG Xinyue, WANG Wei
2024, 28(12): 1433-1438. doi: 10.16462/j.cnki.zhjbkz.2024.12.011
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  Objective  To analyze the association between human immunodeficiency virus (HIV) testing utilization and different characteristics of sexual behavior among sexually exposed adolescents in Chongqing.  Methods  From January to July 2021, adolescents aged 15-24 years from Chongqing were selected using multi-stage random and convenience sampling methods to complete self-administered anonymous questionnaires. Adolescents with sexual history were included. Multivariate logistic regression models were used to analyze the association between sexual behavior and HIV testing utilization.  Results  A total of 2 824 subjects were enrolled in this analysis, and the proportion of previous HIV testing was 12.11%. The results of multivariate logistic regression analysis showed that adolescents who had their first sexual intercourse at the age of 16- < 20 years old (OR=0.39, 95% CI: 0.25-0.61, P < 0.001) and ≥20 years old (OR=0.41, 95% CI: 0.24-0.70, P=0.001) had lower rates of previous HIV testing, compared with adolescents whose first sexual intercourse age were < 16 years old. Adolescents who sought sexual partners online (OR=3.43, 95% CI: 2.43-4.84, P < 0.001), had multiple sexual partners (2 people: OR=1.64, 95% CI: 1.19-2.26, P=0.002, ≥3 people: OR=1.97, 95% CI: 1.39-2.81, P < 0.001), and only had homosexual behavior (OR=3.39, 95% CI: 2.00-5.73, P < 0.001) were more likely to take HIV testing services than adolescents who did not seek partners online, had only one partner, and only had heterosexual sex. Subgroup analyses revealed that all of the above associations were present among college students, but that factors differed slightly among vocational school students and out-of-school adolescents.  Conclusions  Acceptance of HIV testing services among adolescents is associated with a number of factors, including age at first sexual intercourse, online sexual partner seeking, multiple sexual partners, and homosexual behavior. It is important to continue to strengthen health education, risk awareness and the promotion of proactive HIV testing among adolescents.
Analysis on the survival status and influencing factors of HIV/AIDS: a retrospective cohort study from 2000 to 2021 in Nanjing, China
XU Yuanyuan, LI Xiaoshan, WANG Jingwen, QIU Beibei, WU Sushu, LI Xin, SHI Hongjie, ZHU Zhengping
2024, 28(12): 1439-1445. doi: 10.16462/j.cnki.zhjbkz.2024.12.012
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  Objective  To investigate the survival status and influencing factors of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (HIV/AIDS) patients in Nanjing.  Methods  The retrospective cohort study of newly diagnosed HIV was conducted in Nanjing and used citywide data from the HIV/AIDS Comprehensive Information Management System from 2000 to 2021. Kaplan-Meier and cox proportional hazard regression method were used to draw the survival curve and analyze the factors associated with AIDS-related deaths, respectively.  Results  Among 5 903 HIV/AIDS cases, the AIDS-related mortality was 0.93 per 100 person-years and the cumulative survival rates at 1, 5, 10, and 22 years were 97.2%, 95.3%, 92.9%, and 90.0%, respectively. Multivariate analysis revealed that compared to untreated HIV/AIDS, the earlier the initiation of antiretroviral therapy (ART) after diagnosis, the lower the AIDS-related death risk. The HIV/AIDS with a baseline viral load (VL) ≥80 000 copies/mL had 6.54 times higher AIDS-related death risk than those with VL < 20 000 copies/mL. Compared to the first CD4 count before ART < 200 cells/μL, the higher the CD4 level, the lower the AIDS related death risk. ART was more effective in prolonging survival time among those with first CD4 count before ART < 200 cells/μL.  Conclusions  The AIDS-related mortality of HIV/AIDS is low in Nanjing. Early diagnosis, low baseline VL and rapid initiation of ART are protective factors for AIDS-related death. Therefore, on the basis of promoting the early diagnosis of HIV, we should strengthen the baseline monitoring of VL, optimize the follow-up management process to promote rapid ART, so as to further reduce the risk of AIDS-related death.
Factors associated with unprotected anal sex behavior among adolescent boys who have sex with men in and out of school in Fuzhou City
ZHANG Hong, CHEN Jianhui, LIU Meiyan, LIN Chunzhong, XU Shaoyi, XUE Honghong
2024, 28(12): 1446-1453. doi: 10.16462/j.cnki.zhjbkz.2024.12.013
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  Objective  To analyze the characteristics of in-school and out-of-school adolescent men who have sex with men (MSM) populations and factors associated with the occurrence of unprotected anal intercourse (UAI) in Fuzhou City, and to provide a basis for the development of acquired immune deficiency syndrome(AIDS) prevention and control strategies for adolescent MSM.  Methods  From April to December 2022, MSM aged 15 to 24 years who had engaged in oral/anal sex with men in the last 6 months were recruited online and grouped according to in-school and out-of-school subgroups, and descriptive epidemiological methods were used to analyse differences in population characteristics, and logistic regression models were used to analyse differences in the factors associated with the occurrence of UAI.  Results  A total of 2 276 MSM aged 15-24 years were surveyed, including 1 306 in-school and 970 out-of-school. The HIV knowledge rates of in-school and out-of-school adolescent MSM were 88.51% (1 156/1 306) and 86.08% (835/970), respectively. The proportion of in-school adolescent MSM who consistently used condoms in anal sex and heterosexual sex in the last 6 months was higher than that of out-of-school; the proportion of out-of-school adolescent MSM with junior high school education or less, commercial same-sex sex in the last 6 months, heterosexual sex, use of psychoactive substances, and HIV antibody testing in the last year was higher than that of out-of-school, and the differences were statistically significant (all P < 0.05). The proportions of in-school and out-of-school adolescents MSM experiencing UAI were 49.81% (530/1 064) and 56.16% (488/869), respectively, and the difference was statistically significant (χ2 =7.724, P=0.005). Factors associated with the occurrence of UAI among in-school adolescent MSM: age at first sexual intercourse > 18-24 years was 0.742 of 15-18 years (95% CI: 0.580-0.950); 1-2 episodes of anal sex in the last week was 1.775 times higher than no episodes (95% CI: 1.353-2.330); and no use of psychoactive substances was 0.611 of users (95% CI: 0.440-0.849).Factors associated with the occurrence of UAI among out-of-school adolescent MSM: out-of-province household registration was 1.867 times more common than Fujian Province household registration (95% CI: 1.365-2.555); college and above education level was 0.545 of junior high school and below (95% CI: 0.350-0.848); internet searching for a sexual partner was 0.564 of place (95% CI: 0.329-0.967); having anal intercourse in the last week 1-2 times was 1.858 (95% CI: 1.353-2.553) times more likely to not have occurred; having anal sex >2 times in the last week was 1.711 (95% CI: 1.085-2.698) times more likely to not have occurred; and not having heterosexual sex in the last 6 months was 0.705 (95% CI: 0.517-0.962) of have occurred.  Conclusions  Out-of-school adolescent MSM have low educational attainment, low age at first sex, and low adherence to condom use, but have a high proportion of commercial sex and a high risk of UAI; In-school adolescent MSM have a low proportion of prior human immunodeficiency virus(HIV) testing, and both have different characteristics and factors associated with the occurrence of UAI. Therefore, differentiated interventions should be explored to reduce the risk of HIV transmission.
A cross-sectional study of the awareness and utilization of HIV pre-exposure prophylaxis and post-exposure prophylaxis among MSM
DAI Seying, ZHANG Dandan, ZHANG Jin, YAO Hui, GAO Pan, WU Jiabin
2024, 28(12): 1454-1462. doi: 10.16462/j.cnki.zhjbkz.2024.12.014
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  Objective  To study the awareness and utilization of HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) among the men who have sex with men (MSM) in Hefei City.  Methods  In April-May 2022, a snowball sampling method was used, relying on social organization to recruit eligible survey objects from self-media online platforms, such as QQ groups and WeChat groups, which are active in MSM. Their demographic information, behavioral characteristics, awareness of PrEP and PEP knowledge, and service use were collected through the questionnaire star system, and logistic regression models were used to analyze the relevant factors influencing the use of PrEP and PEP.  Results  A total of 800 MSM were surveyed, 83.1% had heard of PrEP, and the proportions of those who had heard of PrEP who knew about PrEP, consulted PrEP and used PrEP were 64.5%, 42.6% and 20.0% respectively. 87.1% had heard of PEP, and the proportions of those who had heard of PEP who knew about PEP, consulted PEP and used PEP were 49.6%, 46.1% and 21.5%. Multifactorial logistic regression analyses showed that factors associated with PrEP utilization in the MSM included having used a new drug during sexual activity in the last 6 months (OR=1.98, 95% CI: 1.15-3.42) and having consulted PrEP (OR=7.96, 95% CI: 4.51-14.05). Factors associated with PEP utilization in the MSM included awareness of PEP knowledge (OR=1.97, 95% CI: 1.20-3.22) and having consulted PEP (OR=13.44, 95% CI: 7.10-25.42).  Conclusions  The MSM in Hefei City had heard of PrEP and PEP at a relatively high rate, but the rate of awareness and utilization of PrEP and PEP were both low. It should combine PrEP and PEP publicity and education with the existing HIV counselling and testing services to enhance the awareness rate of PrEP and PEP among the MSM in an all-rounded and multi-channel manner, and to promote the use of PrEP or PEP for MSM having high-risk behaviors as soon as possible.
Prediction study on the exposure of coal mine fuel vehicle exhaust and lung function damage
WANG Zhirong, QIAO Jinlin, AN Shigang, WANG Jia, LIU Sisi, LI Wenwen, ZOU Yuanjie, MU Min
2024, 28(12): 1463-1468. doi: 10.16462/j.cnki.zhjbkz.2024.12.015
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Abstract:
  Objective  The aim of this study was to observe the relationship between exposure to coal mine fuel vehicle exhaust and the respiratory system of the organism, with a particular focus on lung function damage, and to explore the risk factors for the occurrence of lung function decline in coal miners.  Methods  The current situation study was used to select the study subjects from the coal miners who underwent physical examination in northern Shaanxi in 2021 by cluster sampling. The subjects were divided into two groups based on their lung function: a normal group and an abnormal group. The relationship between lung function abnormalities and exposure to coal mine fuel vehicle exhaust was then examined using multifactorial logistic regression.  Results  A total of 564 study subjects were included, and the differences in age, gender, and length of service between the normal and abnormal lung function groups of coal miners in northern Shaanxi were statistically significant (all P < 0.05). The differences in carbon dioxide (CO2), nitric oxide (NO), nitrogen dioxide (NO2) and polycyclic aromatic hydrocarbon (PAH) exposure between the two groups were statistically significant (all P < 0.05). After adjusting for potential confounding factors such as age and seniority, miners exposed to high levels of NO (OR=2.01, 95% CI: 1.43-3.04, P < 0.001) and PAH (OR=1.81, 95% CI: 1.01-4.18, P < 0.05) exhibited a heightened risk of developing lung injury. Injury risk was observed among coal miners with high CO2 exposure (OR =1.24, 95% CI: 0.71-2.36)and NO2 exposure (OR=1.43, 95% CI: 0.54-4.17), but no significant difference was noted between these groups (all P>0.05).  Conclusions  Among coal miners, males, older, and seniority, exposure to NO and PAH from fuel vehicle exhaust are risk factors for lung function impairment. It is suggested that targeted protective measures should be taken to reduce lung function injury in coal miners.
Short Reports
Epidemiological survey of newly reported young students with HIV/AIDS in Yunnan Province
LI Xuehua, XIAO Minyang, FU Liru, SONG Lijun, ZHANG Zuyang, NIU Jin, WANG Xiaowen, SHI Yuhua, LUO Hongbin
2024, 28(12): 1469-1473. doi: 10.16462/j.cnki.zhjbkz.2024.12.016
Abstract(27) HTML (7) PDF(2)
Abstract:
  Objective  To understand the characteristics and sexual behaviors among young students with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (HIV/AIDS) in Yunnan Province.  Methods  Through questionnaires and qualitative interviews, detailed sexual contact history and other information were obtained from young students with HIV/AIDS before diagnosis. The χ2 test was used to compare the differences between the study subjects in terms of gender, sexual behavior and friendship style. Qualitative interview data were analysed using phenomenological research methods.  Results  A total of 245 young students with HIV/AIDS were investigated. 81.7% had homosexual behavior among the boys. The comparison between online and offline dating boys showed that there were significant differences in the age of first homosexual behavior, the number of sex partners and the proportion of condom use (P < 0.05). Among the girls, 68.8% was 15- < 19 years old and 65.6% was ethnic minorities. Qualitative interviews showed that all boys were infected by homosexual transmission while all girls were infected by their fixed sexual partners, and their awareness of condom use was weak.  Conclusions  Among the newly reported HIV/AIDS cases in young students in Yunnan Province, same-sex transmission is the predominant. The proportion of female cases among minors is relatively high. It is recommended that the education sector include sex education in school entrance education or compulsory courses to improve the awareness and ability of young students to protect themselves.
Epidemiological characteristics and influencing factors of spatiotemporal clustering of other infectious diarrhea in Shenzhen, 2012-2022
XIONG Huawei, ZHU Yuanfa, CHENG Yanpeng, ZHANG Jia, LU Yan, YE Yanfen, LYU Qiuying, ZHANG Zhen, CHEN Zhigao
2024, 28(12): 1474-1480. doi: 10.16462/j.cnki.zhjbkz.2024.12.017
Abstract(33) HTML (8) PDF(8)
Abstract:
  Objective  Objective To analyze the epidemiological characteristics of other infectious diarrhea in Shenzhen city, as a reference for the epidemic prevention and control work.  Methods  Descriptive epidemiological methods to analyze the epidemiological characteristics of other infectious diarrhea in Shenzhen from 2012 to 2022, spatial autocorrelation analysis was used to analyze their spatiotemporal clustering features.  Results  From 2012 to 2022, Shenzhen documented a cumulative total of 396 302 cases of infectious diarrhea at an average annual incidence rate of approximately 273.84 per 100 000 individuals. The male-to-female case ratio stood at 1.40∶1.00 and predominantly affected children under three years old residing in dispersed households. Winter marked as its seasonal peak. Longgang District consistently exhibited the highest incidence rates among Shenzhen′s districts over six successive years, reaching an annual incidence rate of 359.24 per 100 000 individuals. Significant geographic disparities were observed.Spatial autocorrelation analyses revealed clustered patterns (Z=1.872-3.901, P < 0.05) during the period from 2017 to 2022, demonstrating "high-high" clusters annually. Consistent outcomes emerged from spatial scanandcorrelationanalyses, involving eight main district clusters all coinciding with winter peaks. Reported casenumbers correlated positively with urban migrant proportions while negatively with urban population densities.  Conclusions  From 2012 to 2022, the average annual incidence rate of other infectious diarrheal diseases in Shenzhen exceeds the national average for the corresponding period. The incidence peaks primarily during the winter season, with the majority of cases occurring among children under the age of three who are not enrolled in daycare. There is a positive correlation between the incidence rate and both the proportion of the migrant population and population density. Additionally, certain districts exhibit notable spatiotemporal clustering.

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