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Yu B, Jia P, Huang YL, Zhou JM, Xie T, Yu J, Liu C, Xiong J, Han JY, Yang SF, Dong PJ, Yang C, Wang ZX, Yang SJ. Self-efficacy as a crucial psychological predictor of treatment adherence among elderly people living with HIV: analyses based on the health belief model. AIDS Care 2021; 34:1041-1047. [PMID: 34156890 DOI: 10.1080/09540121.2021.1938964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Medication adherence to antiretroviral therapy (ART) among elderly people living with HIV (PLWH) is of serious concern. Our study aimed to understand the medication adherence of elderly PLWH under ART based on the health belief model (HBM). A baseline survey with a total of 529 elderly PLWH was conducted in Sichuan. Logistic and linear regression analysis, mediation analysis, and path analysis based on prior evidence were used. Only self-efficacy showed direct associations with medication adherence in the last four days (ORm = 1.37, 95%CI: 1.11, 1.70) and the last month (ORm = 1.39, 95%CI: 1.18, 1.63) in the multivariate analysis. Self-efficacy mediated the relations between perceived benefits, perceived barriers, cues to action and medication adherence. Inner relations existed within the HBM. In addition to the direct effects, perceived benefits (β = 0.149, p = 0.031; β = 0.093, p = 0.005), perceived barriers (β = -0.070, p = 0.008; β = -0.062, p = 0.012), and cues to action (β = 0.184, p = 0.013; β = 0.135, p = 0.014) showed indirect effects on medication adherence in the last four days and the last month, respectively. HBM may be effective in predicting medication adherence of elderly PLWH, and self-efficacy may be a crucial predictor and mediator. Efforts should be focused on how to enhance elderly PLWH's self-efficacy without neglect of other medication beliefs.
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Affiliation(s)
- Bin Yu
- West China Second University Hospital of Sichuan University and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, People's Republic of China.,Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Peng Jia
- School of Resources and Environmental Science, Wuhan University, Wuhan, People's Republic of China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China
| | - Yu-Ling Huang
- Sichuan Center for Disease Control and Prevention, Chengdu, People's Republic of China
| | - Jun-Min Zhou
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Tian Xie
- Pidu District Center for Disease Control and Prevention, Chengdu, People's Republic of China
| | - Jun Yu
- Lu County Center for Disease Control and Prevention, Luzhou, People's Republic of China
| | - Chang Liu
- Lu County Center for Disease Control and Prevention, Luzhou, People's Republic of China
| | - Jun Xiong
- Lu County Center for Disease Control and Prevention, Luzhou, People's Republic of China
| | - Jia-Yu Han
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Shi-Fan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Pei-Jie Dong
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Chao Yang
- Department of epidemiology and statistics, School of Public Health, Southwest Medical University, Luzhou, People's Republic of China
| | - Zi-Xin Wang
- Centre for Health Behaviors Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Shu-Juan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China
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Zhao J, Ma Z, Chen F, Li L, Ren M, Li A, Jing B, Li H. Human immune deficiency virus-related structural alterations in the brain are dependent on age. Hum Brain Mapp 2021; 42:3131-3140. [PMID: 33755269 PMCID: PMC8193536 DOI: 10.1002/hbm.25423] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/27/2022] Open
Abstract
Currently, it is still unknown whether human immune deficiency virus (HIV)‐related structural alterations in the brain are dependent on age. With people living with HIV at different ages, we aim to investigate age‐specific structural alterations in HIV patients. Eighty‐three male HIV patients and eighty‐three age‐matched male controls were enrolled, and high‐resolution T1 weighted images were collected and analyzed with four morphological metrics. Then, statistical analyses were respectively conducted to ascertain HIV effects, age effects, and medication effects in brain structure of HIV patients, and the relationship with neuropsychological evaluations were further explored. Finally, discriminative performances of these structural abnormalities were quantitatively testified with three machine learning models. Compared with healthy controls, HIV patients displayed lower gray matter volumes (GMV), lower gyrification index, deeper sulcus depth, and larger cortical thickness (CTH). Age‐specific differences were found in GMV and CTH: young‐aged HIV patients displayed more obvious morphological alterations than middle‐aged HIV patients when comparing corresponding age‐matched healthy controls. Furthermore, age‐specific long‐term medication effect of combination antiretroviral therapy were also presented. Additionally, several subcortical structural changes were negatively associated with language, attention and motor functions. Finally, three machine learning models demonstrated young‐aged HIV patients were easier to be recognized than middle‐aged HIV patients. Our study indicated young‐aged HIV patients were more vulnerable to HIV infection in brain structure than middle‐aged patients, and future studies should not ignore the age effect in studying the HIV‐related abnormalities.
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Affiliation(s)
- Jing Zhao
- School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Zhe Ma
- Department of RadiologyHenan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhouHenanChina
- School of Biomedical EngineeringCapital Medical UniversityBeijingChina
| | - Feng Chen
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Li Li
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Meiji Ren
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Aixin Li
- Center for Infectious DiseasesBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Bin Jing
- School of Biomedical EngineeringCapital Medical UniversityBeijingChina
| | - Hongjun Li
- School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
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Sun Y, Luo J, Qian C, Luo L, Xu M, Min H, Cen Y. The Value of Nutritional Status in the Prognostic Analysis of Patients with AIDS-Related Lymphoma. Infect Drug Resist 2021; 14:1105-1113. [PMID: 33776456 PMCID: PMC7987257 DOI: 10.2147/idr.s295077] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/24/2021] [Indexed: 12/30/2022] Open
Abstract
Objective Many studies have suggested that indexes of nutritional status, such as body mass index (BMI), serum albumin (ALB), serum pre-albumin (PA), and hemoglobin, may be used as risk factors for the prognosis of HIV or lymphoma. Therefore, this study aimed to retrospectively analyze and explore the value of nutritional status in the prognostic assessment of patients with AIDS-related lymphoma (ARL). Methods In this retrospective study, the clinical data of 69 patients with ARL were collected. All patients had a definite diagnosis of non-Hodgkin lymphoma by pathological examination and met the requirements of the Hematopoietic and Lymphocytic Tissue Tumor Classification (2016) established by the World Health Organization. Patients who did not receive standard chemotherapy, those with incomplete medical records, and those with an unclear pathological diagnosis were excluded. The patients were divided into two groups (survival and death) according to the prognostic outcome, and their clinical characteristics and prognoses were discussed by relevant statistical methods. Results During the three-year follow-up period, 20 (28.99%) patients died, and 49 (71.01%) survived. The one-year cumulative survival rate was 78.26%. A univariate analysis found that the prognosis was associated with the International Prognostic Index (IPI) score, BMI, ALB, PA, and CD4 T lymphocyte count. The Cox risk proportional regression analysis showed that the IPI score, BMI, and PA were the independent risk factors for survival; their combination had a greater ability to forecast the clinical outcome (area under the curve = 0.874, P < 0.001). Conclusion In this study, at the time of the visit, the patients with ARL tended to be in the advanced stages of disease and, therefore, at high risk of mortality. Therefore, their nutritional status might be of great value to the prognostic assessment. The combination of BMI, PA, and IPI scores could be used for risk stratification and better screening of high-risk patients.
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Affiliation(s)
- Yanbo Sun
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, People's Republic of China
| | - Jing Luo
- Department of Gastrointestinal Surgery, The First People's Hospital of Qujing, Qujing, 655000, People's Republic of China
| | - Chuan Qian
- The Second Department of Infection, Yunnan Provincial Infectious Disease Hospital, Kunming, 650301, People's Republic of China
| | - Lan Luo
- The Second Department of Infection, Yunnan Provincial Infectious Disease Hospital, Kunming, 650301, People's Republic of China
| | - Manqi Xu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, People's Republic of China
| | - Haiyan Min
- The Second Department of Infection, Yunnan Provincial Infectious Disease Hospital, Kunming, 650301, People's Republic of China
| | - Yunyun Cen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, People's Republic of China
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Yan L, Yan Z, Wilson E, Arayasirikul S, Lin J, Yan H, McFarland W. Awareness and Willingness to use HIV Pre-exposure Prophylaxis (PrEP) Among Trans Women in China: A Community-Based Survey. AIDS Behav 2021; 25:866-874. [PMID: 32989576 DOI: 10.1007/s10461-020-03050-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 01/01/2023]
Abstract
China's national guidelines call for increasing HIV pre-exposure prophylaxis (PrEP) use to reverse the epidemic in populations at highest risk. However, few data exist on PrEP awareness and willingness among trans women in China. Our research aim was to fill this data gap through a cross-sectional survey among trans women in Nanjing and Suzhou cities of Jiangsu province. Respondent-driven sampling (RDS) was used to recruit participants to gauge their awareness of and willingness to use PrEP. Logistic regression analysis was used to characterize associations with awareness of PrEP and willingness to use PrEP. Of 222 HIV-negative/unknown serostatus trans women, 33.3% were aware of PrEP and 49.1% were willing to use PrEP. PrEP awareness was associated with a university degree or above (adjusted odds ratio [AOR] 2.77, 95% CI 1.31-5.89) and not using alcohol with sex (AOR 2.02, 95% CI 1.00-4.09). Willingness to use PrEP was higher among trans women with one (AOR 3.56, 95% CI 1.68-7.54) or multiple sexual partners (AOR 2.53, 95% CI 1.24-5.15) compared to those with no partners. This study witnessed low awareness of PrEP, yet substantial willingness to use PrEP. Implementation research to identify ways to promote, scale up access, and assess effectiveness of PrEP for trans women is urgently needed in China.
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Affiliation(s)
- Li Yan
- Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Zihan Yan
- University of California Berkeley, Berkeley, USA
| | - Erin Wilson
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 710, San Francisco, CA, 94102-6033, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA
| | - Sean Arayasirikul
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 710, San Francisco, CA, 94102-6033, USA
| | - Jessica Lin
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 710, San Francisco, CA, 94102-6033, USA
| | - Hongjing Yan
- Section of AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Willi McFarland
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 710, San Francisco, CA, 94102-6033, USA.
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA.
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Yuan FS, Liu L, Liu LH, Zeng YL, Zhang LL, He F, Liu XJ, Li JM, Liu Q, Xu MJ, Zhuoma L, Hu Y, Pei XD, Luan RS. Epidemiological and spatiotemporal analyses of HIV/AIDS prevalence among older adults in Sichuan, China between 2008 and 2019: A population-based study. Int J Infect Dis 2021; 105:769-775. [PMID: 33618006 DOI: 10.1016/j.ijid.2021.02.077] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/12/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES To describe epidemiological trends and spatial distributions of HIV/AIDS among older adults (aged ≥50) in Sichuan Province, China during 2008-19, and provide scientific reference for HIV/AIDS prevention, intervention and treatment. METHODS Data on HIV/AIDS cases reported in 2008-19 was extracted from the Case Report System. The Cochran-Armitage trend test was used to determine epidemic trends. Spatial autocorrelation and space-time analysis were conducted with ArcGIS10.6 and ArcGIS Pro2.4, respectively. RESULTS A total of 77854 HIV/AIDS cases among older adults were included in the study. Newly reported cases increased from 320 in 2008 to 22189 in 2019, and the reported incidence rate (number of new reported cases/older adult population) rose from 0.001% to 0.077%. Infections through heterosexual transmission increased from 65.3% to 98.2% of total cases in older adults in this period. Spatial analysis at the county-level showed significant clustering throughout Sichuan, with the main hot spots concentrated in the southeast. Spatiotemporal analysis indicated that most of the southeastern counties/districts were Consecutive Hot Spots. CONCLUSIONS Older adults have become a key population in the HIV/AIDS epidemic in Sichuan; comprehensive prevention and intervention measures targeted to older adults are urgently needed to control the spread of HIV/AIDS.
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Affiliation(s)
- Feng-Shun Yuan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Li Liu
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China.
| | - Lun-Hao Liu
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Ya-Li Zeng
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Ling-Lin Zhang
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Fang He
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Xiao-Jin Liu
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Ju-Mei Li
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Qian Liu
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Meng-Jiao Xu
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Lacuo Zhuoma
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Ying Hu
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Xiao-di Pei
- Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China
| | - Rong-Sheng Luan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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Zhu Q, Fang P, Zhao Y, Dai D, Luo X. How about the quality and recommendation on prevention, diagnosis, and treatment of HIV/AIDS guidelines developed by WHO: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e23638. [PMID: 33350740 PMCID: PMC7769307 DOI: 10.1097/md.0000000000023638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) has become a pandemic that has infected millions of people around the world and brings a tremendous economic burden. There are numerous guidelines for prevention, diagnosis, and treatment of HIV/AIDS published in recent years, but the quality of these guidelines is still unknown. Therefore, we conducted this study to evaluate the quality of prevention, diagnosis, and treatment of HIV/AIDS published by World Health Organization (WHO) as well as perform a comparison of recommendations between those guidelines. And we also hope our finding could provide suggestions to enhance the quality of future guidelines in this area. METHODS We obtained guidelines from WHO Guidelines approved by the Guidelines Review Committee (GRC). Two reviewers will independently select eligible guidelines. The quality of included guidelines will be appraised by at least four reviewers through AGREE II and RIGHT tools. The results will be checked for discrepancies. Differences between them than two reviewers will be considered as discrepant and the final discrepancies will be resolved by consensus. The results will be presented in tables and the descriptive statistics will be calculated for all domains of the AGREE II instrument as standard score and median (range) as the reporting quality result of eligible guidelines will also be evaluated through RIGHT criteria. In this study, we will also compare the differences and similarities of recommendations among different guidelines. RESULTS The results of this study will increase the knowledge about the development of recommendations guidelines for HIV/AIDS of high methodological rigor and reporting quality. This study may also identify potential limitations for future research in this area. CONCLUSION This study may guide health professionals, policy makers, and health policy managers in choosing the guidelines for recommendation to better to achieve the 90-90-90 targets. INPLASY REGISTRATION NUMBER INPLASY2020110010.
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Affiliation(s)
| | | | - Yadong Zhao
- School of Public Health
- Sexually Transmitted Disease and Acquired Immune Deficiency Syndrome Prevention Branch, Gansu Provincial Center for Disease Control and Prevention, Lanzhou City, Lanzhou, Gansu Province, China
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Epidemiological and time series analysis on the incidence and death of AIDS and HIV in China. BMC Public Health 2020; 20:1906. [PMID: 33317484 PMCID: PMC7734828 DOI: 10.1186/s12889-020-09977-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/26/2020] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the regional and age-specific distribution of AIDS/HIV in China from 2004 to 2017 and to conduct time series analysis of the epidemiological trends. Method Using official surveillance data from publicly accessible database of the national infectious disease reporting system, we described long-term patterns of incidence and death in AIDS/HIV, analyzed age group and regional epidemic characteristics, and established Autoregressive Integrated Moving Average (ARIMA) models for time series analysis. Result The incidence and death of AIDS/HIV have increased rapidly from 2004 to 2017, with significant difference regarding age groups and provincial regions (a few provinces appear as hot spots). With goodness-of-fit criteria and using data from 2004 to 2015, ARIMA (0,1,3) × (2,0,0), ARIMA (3,1,0) × (1,0,1), and ARIMA (0,1,2) × (2,0,0) were chosen as the optimal model for the incidence of AIDS, HIV, and combined; ARIMA (0,1,3) × (1,0,0) was chosen as the optimal model for the death of AIDS, HIV, and combined. ARIMA models robustly predicted the incidence and death of AIDS/HIV in 2016 and 2017. Conclusion A focused intervention strategy targeting specific regions and age groups is essential for the prevention and control of AIDS/HIV. ARIMA models function as data-driven and evidence-based methods to forecast the trends of infectious diseases and formulate public health policies. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09977-8.
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Han S, Hu Y, Lu H, Zhang L, Zhu Z, Luo J, Relf MV, Mulawa MI, Pei Y, Wu B. Cognitive behavioral therapy for persons living with HIV in China: A randomized pilot trial. J Affect Disord 2020; 277:640-648. [PMID: 32911214 DOI: 10.1016/j.jad.2020.08.085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/09/2020] [Accepted: 08/25/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Chinese persons living with HIV (PLWH) suffer from prevalent mental health issues. We aimed to develop a tailored cognitive behavioral therapy (CBT), test its feasibility, acceptability, and preliminary effects (depression, anxiety, and medication adherence) for Chinese PLWH. METHODS Twenty PLWH were assigned randomly. Intervention participants learned skills in CBT and relaxation training in a tailored group-based weekly 10-session project. Each session lasted for two hours and was delivered by nurses and volunteers. Control participants only received laboratory tests and free antiretroviral therapy (ART) medication. Feasibility and acceptability were descriptively summarized. Depression, anxiety, and ART medication adherence data were collected at the baseline (T0), after the intervention (T1) and after 6 months of follow-up (T2). RESULTS The average CBT attendance rate for all sessions was 60%. No participants in the intervention group dropped out of the study. All participants in the intervention group agreed that they could benefit from the CBT. Participants in the intervention group showed a greater improvement in anxiety and self-reported ART medication adherence than those in the control group at T1. However, no preliminary intervention effect was found at T2. LIMITATIONS The small sample size leads to a lack of representativeness in the study sample. We excluded participants with severe comorbidities, which may lead to an underestimate of the intervention effect of CBT among Chinese PLWH. CONCLUSIONS CBT is feasible and acceptable, demonstrating promising preliminary effects on anxiety and ART medication adherence among Chinese PLWH. Additional research is needed to test the effectiveness of this approach.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Fudan University, Shanghai 200032, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai 200032, China.
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center Affiliated with Fudan University, Shanghai 201508, China.
| | - Lin Zhang
- Shanghai Public Health Clinical Center Affiliated with Fudan University, Shanghai 201508, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai 200032, China
| | - Jianfeng Luo
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Michael V Relf
- Duke Global Health Institute, Duke University, Durham, USA
| | - Marta I Mulawa
- Duke Global Health Institute, Duke University, Durham, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, USA
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Zhang K, Wei B, Tang Z, Wei Y, Zhao Z, Li D, Tao C. Acute HIV infection in a large teaching hospital in western China: Clinical, virological, and molecular epidemiological characteristics. J Med Virol 2020; 92:3288-3294. [PMID: 32644261 DOI: 10.1002/jmv.26282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 06/27/2020] [Accepted: 07/01/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To provide information on clinical, virological, and molecular epidemiological characteristics for early identification, diagnosis, and treatment of acute HIV infection (AHI). METHODS A retrospective study was conducted with patients with AHI from 2012 to 2017 in West China Hospital. RESULTS A total of 47 patients with AHI were found using a fourth-generation kit. Thirteen (27.66%) of these patients were negative if tested by third-generation tests. Median age of patients with AHI was 26 and 91.49% of them were males. Homosexual contact was responsible for 46.81% of AHI transmission. Among the individuals with AHI, 80.85% were outpatients. Common symptoms/signs were fever, headache, rash, cough and sputum, and sore throat. The syphilis coinfection rate was 17.24%. Most of the AHI was distributed in Fiebig stages IV (61.70%) and II (27.66%) with different clinical and virological characteristics. The increasing trend of cut-off index values was obvious in the course of AHI, helpful for auxiliary diagnosis. The main genetic forms of AHI were CRF07_BC and CRF01_AE, and a rare subtype CRF55_01B in Sichuan province was found. The drug resistance mutation rate was relatively high (17.65%) and five different mutations were identified. CONCLUSIONS Fourth-generation assays are strongly recommended for screening AHI compared to third-generation ones. Different clinical and virological characteristics in different Fiebig stages were found. Young individuals and outpatients were the majority of patients with AHI and this deserves special attention. Attention should also be paid to the rare CRF55_01B in Sichuan province and surveillance of HIV resistance ought to be strengthened.
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Affiliation(s)
- Keyi Zhang
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Bin Wei
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Zhuoyun Tang
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yinhao Wei
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Zhongyi Zhao
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Dongdong Li
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Chuanmin Tao
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China
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Social Capital in Old People Living with HIV Is Associated with Quality of Life: A Cross-Sectional Study in China. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7294574. [PMID: 33313316 PMCID: PMC7721488 DOI: 10.1155/2020/7294574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/22/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Abstract
Objective Old people living with HIV (PLWH) are experiencing a lower quality of life (QoL) than their younger counterparts and have received insufficient attention in China. Given that social capital has been proven to be effective in improving QoL in other countries, we aimed to examine the association between social capital and QoL among old PLWH in China. Methods The data presented in this study was based on the baseline sample of an ongoing observational prospective cohort study, which was carried out from November 2018 to February 2019. Participants were old PLWH aged ≥50 in Sichuan, China, and were recruited by stratified multistage cluster sampling from 30 communities/towns. A total of 529 eligible participants finished the face-to-face investigation to measure their social capital (i.e., individual and family- (IF-) based social capital and community and society- (CS-) based social capital) and QoL. The QoL's dimensions of physical health summary (PCS) and mental health summary (MCS) were taken as dependent variables. Stepwise linear regression models were used to examine the association between social capital and QoL. Results After considering all significant covariates, the PCS was nonsignificantly correlated with IF-based social capital (β = −0.08, 95% CI [-0.28-0.11]) and CS-based social capital (β = 0.28, 95% CI [-0.03-0.59]), and MCS was significantly correlated with IF-based social capital (β = 0.77, 95% CI [0.54-0.99], p < 0.001) and CS-based social capital (β = 0.40, 95% CI [0.08-0.72], p < 0.05). Conclusion Targeted interventions related to building up social capital should be applied to improve the QoL of old PLWH. Providing extra relief funds and allowances might be helpful to improve PCS; improving community networking and engagement and improving family care might be helpful to improve MCS among this vulnerable population.
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Vrancken B, Zhao B, Li X, Han X, Liu H, Zhao J, Zhong P, Lin Y, Zai J, Liu M, Smith DM, Dellicour S, Chaillon A. Comparative Circulation Dynamics of the Five Main HIV Types in China. J Virol 2020; 94:e00683-20. [PMID: 32938762 PMCID: PMC7654276 DOI: 10.1128/jvi.00683-20] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/02/2020] [Indexed: 01/17/2023] Open
Abstract
The HIV epidemic in China accounts for 3% of the global HIV incidence. We compared the patterns and determinants of interprovincial spread of the five most prevalent circulating types. HIV pol sequences sampled across China were used to identify relevant transmission networks of the five most relevant HIV-1 types (B and circulating recombinant forms [CRFs] CRF01_AE, CRF07_BC, CRF08_BC, and CRF55_01B) in China. From these, the dispersal history across provinces was inferred. A generalized linear model (GLM) was used to test the association between migration rates among provinces and several measures of human mobility. A total of 10,707 sequences were collected between 2004 and 2017 across 26 provinces, among which 1,962 are newly reported here. A mean of 18 (minimum and maximum, 1 and 54) independent transmission networks involving up to 17 provinces were identified. Discrete phylogeographic analysis largely recapitulates the documented spread of the HIV types, which in turn, mirrors within-China population migration flows to a large extent. In line with the different spatiotemporal spread dynamics, the identified drivers thereof were also heterogeneous but are consistent with a central role of human mobility. The comparative analysis of the dispersal dynamics of the five main HIV types circulating in China suggests a key role of large population centers and developed transportation infrastructures as hubs of HIV dispersal. This advocates for coordinated public health efforts in addition to local targeted interventions.IMPORTANCE While traditional epidemiological studies are of great interest in describing the dynamics of epidemics, they struggle to fully capture the geospatial dynamics and factors driving the dispersal of pathogens like HIV as they have difficulties capturing linkages between infections. To overcome this, we used a discrete phylogeographic approach coupled to a generalized linear model extension to characterize the dynamics and drivers of the across-province spread of the five main HIV types circulating in China. Our results indicate that large urbanized areas with dense populations and developed transportation infrastructures are facilitators of HIV dispersal throughout China and highlight the need to consider harmonized country-wide public policies to control local HIV epidemics.
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Affiliation(s)
- Bram Vrancken
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Computational and Evolutionary Virology, KU Leuven, Leuven, Belgium
| | - Bin Zhao
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xingguang Li
- Department of Hospital Office, The First People's Hospital of Fangchenggang, Fangchenggang, China
| | - Xiaoxu Han
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haizhou Liu
- Centre for Emerging Infectious Diseases, The State Key Laboratory of Virology, Wuhan Institute of Virology, University of Chinese Academy of Sciences, Wuhan, China
| | - Jin Zhao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ping Zhong
- Department of AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention; Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China
| | - Yi Lin
- Department of AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention; Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China
| | - Junjie Zai
- Immunology innovation Team, School of Medicine, Ningbo University, Ningbo, Zhejiang China
| | - Mingchen Liu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Davey M Smith
- Division of Infectious Diseases and Global Public Health, University of California San Diego, California, USA
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Computational and Evolutionary Virology, KU Leuven, Leuven, Belgium
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Brussels, Belgium
| | - Antoine Chaillon
- Division of Infectious Diseases and Global Public Health, University of California San Diego, California, USA
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Zhang Q, Li X, Qiao S, Shen Z, Zhou Y. Comparing self-reported medication adherence measures with hair antiretroviral concentration among people living with HIV in Guangxi, China. AIDS Res Ther 2020; 17:8. [PMID: 32122394 PMCID: PMC7053048 DOI: 10.1186/s12981-020-00265-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/21/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Antiretroviral adherence is essential to HIV treatment efficacy. Various self-reported measures are commonly used for assessing antiretroviral adherence. Limited data are available regarding the validity of those self-reported measures in comparison with long-term objective biomarkers of adherence measures such as hair measures. METHODS Self-reported adherence (frequency, percentage, and visual analog scale [VAS]) and hair tenofovir concentration were evaluated at a single time point from 268 people living with HIV in China. The responses to each of three self-reported measures were converted into percentage and then dichotomized as "optimal" (100%) vs. "suboptimal" (less than 100%) adherence. Two composite adherence scores (CAS) were created from the three self-reported measures: (1) an overall adherence was the average percentage of the three self-reported measures; (2) responses were termed optimal adherence if participants reporting optimal adherence in all three self-reported measures, while were termed suboptimal adherence. Hair tenofovir concentration was also dichotomized as "optimal" (above the limit of quantitation, 36 pg/mg) vs. "suboptimal" adherence (blow 36 pg/mg). Spearman correlation, kappa statistics, and logistic regression analysis were used to calculate the correlations, agreements, and predictions of self-reported measures with hair measure, respectively. RESULTS Overall adherence, but any of the three self-reported adherence, was correlated with hair tenofovir concentration (r = 0.13, p < 0.05). Self-reported optimal adherence in VAS and CAS measures were agreed with and predicted optimal adherence assessed by hair measure (Kappa = 0.107, adjusted OR = 1.88, 95% CI 1.03-3.45; Kappa = 0.109, adjusted OR = 1.80, 95% CI 1.02-3.18; all p < 0.05, respectively). CONCLUSION VAS may be a good individual self-reported measure for antiretroviral adherence, and CAS may be a good composite self-reported measure for antiretroviral adherence.
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Affiliation(s)
- Quan Zhang
- South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29028, USA.
- Institute of Pedagogy and Applied Psychology, School of Public Administration, Hohai University, Nanjing, Jiangsu, China.
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29028, USA
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29028, USA
| | - Zhiyong Shen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Yuejiao Zhou
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
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