1
|
Yang H, Li Y, Xu M, Hu Y, Yuan F, Liu L, Li L, Yuan D, Ye L, Zhou C, Zhang Y, Su L, Liang S. The Update of HIV-1 Prevalence and Incidence and Spatio-Temporal Analyses of HIV Recent Infection Among Four Sub-Groups in Sichuan, China During Surveillance Period Between 2016 and 2022. Infect Drug Resist 2023; 16:6535-6548. [PMID: 37814665 PMCID: PMC10560476 DOI: 10.2147/idr.s428744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023] Open
Abstract
Background Sichuan Province has gradually become a hot-spot for HIV/AIDS. Little is known about the HIV-1 incidence and prevalence among four sub-groups since 2015. Meanwhile, the distributions of hot-spot areas related to recent infection cases that indicate current transmission among the four subgroups are also rare. Objective The main purpose of this study was to assess the HIV-1 prevalence and incidence and to visualize the distributions of hot-spot areas of current transmission among four subgroups (people who inject drugs, male STD clinic attendees, female sex workers and men who had sex with men) during the surveillance period in Sichuan province between 2016 and 2022. Results Of the 267,617 individuals, 2158 HIV-positive samples were tested with Lag-Avidity EIA, among which 493 samples were identified as recent infections. Among people who inject drugs (PWID), both HIV-1 prevalence (from 1.41% to 0.34%) and incidence (from 0.03% to 0.140%) showed a significant decreasing trend. Among men who had sex with men (MSM), female sex workers (FSWs), and male STD clinic attendees, HIV-1 prevalence indicated significant decreasing trends, whereas HIV-1 incidence showed no significant changes. Spatial analysis demonstrated the formation of hot-spots and clusters of current transmissions sharing regional differences, mainly concentrated in the southeast, and most of these were consecutive hot-spots. Conclusion The prevention and control were efficacious and persistent. However, among the other three subgroups, there is a need for a regional cooperative in prevention and control approaches and collaborative research in many aspects.
Collapse
Affiliation(s)
- Hong Yang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Yiping Li
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Mengjiao Xu
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Ying Hu
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Fengshun Yuan
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Lunhao Liu
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Ling Li
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Dan Yuan
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Li Ye
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Chang Zhou
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Yan Zhang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Ling Su
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Shu Liang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| |
Collapse
|
2
|
Zhang F, Chung L. HIV/AIDS Awareness Among Young Adults in Hong Kong: The Roles of Knowledge, Acceptance and Stigma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7473. [PMID: 34299919 PMCID: PMC8304163 DOI: 10.3390/ijerph18147473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/23/2022]
Abstract
In the past decade, HIV (Human Immunodeficiency Virus) infection risk and the prevalence of infected cases in the younger generation have increased in Hong Kong. To promote HIV prevention and control, it is critical to understand the situation of HIV-related knowledge, stigma, and awareness among the younger adults, especially college students. 810 college students (mean age = 20.63 ± 2.05) have participated in the current survey. In mediation pathway analysis, the results show that participants' greater knowledge about HIV is associated with higher awareness, and this relationship is partially mediated by the knowledge-related increase in accepting attitudes toward the people with HIV, but not via reducing stigma. Our findings provide an updated profile of HIV-related knowledge, attitude and awareness among college students in Hong Kong. In addition, we have clarified the mediating role of acceptance in the relationship between knowledge and awareness and pinpointed the importance of knowledge education and workshops to promote acceptance of people with HIV. Insights were provided for tailoring health-promotion programs to reduce risky sex and prevent HIV infection on college campuses.
Collapse
Affiliation(s)
- Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China;
| | - Louisa Chung
- The Department of Health and Physical Education, The Education University of Hong Kong, Taipo, Hong Kong
| |
Collapse
|
3
|
Zhao P, Tang W, Cheng H, Huang S, Zheng H, Yang B, Wang C. Uptake of provider-initiated HIV and syphilis testing among heterosexual STD clinic patients in Guangdong, China: results from a cross-sectional study. BMJ Open 2020; 10:e041503. [PMID: 33376172 PMCID: PMC7778783 DOI: 10.1136/bmjopen-2020-041503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Underscreening of HIV and syphilis in clinical settings is pervasive in resource-constrained settings. Heavy patient loads and competing health priorities in these settings inhibit provider's ability to meet screening coverage targets. The objective of this study was to examine determinants of provider-initiated HIV and syphilis testing uptake at sexually transmitted disease (STD) clinics in China. DESIGN A cross-sectional study was performed between July 2016 and December 2016. SETTING Seven STD clinics in Guangdong Province, China. PARTICIPANTS Heterosexual STD clinic patients met the inclusion criteria, regardless of their interest in receiving HIV or syphilis testing. OUTCOME MEASURES The syphilis and HIV testing uptake determined by patient receipt of results. RESULTS A total of 1943 individuals were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively, of whom, 2.2% (26/1177) and 21.5% (310/1443) were found to be HIV-positive and syphilis-positive, respectively. The most common reason for rejecting HIV and syphilis testing was a low self-perceived risk of HIV and syphilis infection. After adjusting for covariates, condom use in the last sexual act, consistent condom use in the last 6 months, having paid sex in the last 6 months and having received any kind of HIV/STD-related knowledge during the last 12 years were positively associated with both HIV and syphilis testing uptake. CONCLUSIONS The low-level of HIV and syphilis testing uptake, alongside with the high-level of engagement in risky sexual behaviours among heterosexual STD clinic patients, warranted a more targeted and intensive behavioural interventions to promote HIV and syphilis testing in this population.
Collapse
Affiliation(s)
- Peizhen Zhao
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Weiming Tang
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
- Project-China, University of North Carolina at Chapel Hill, Guangzhou, China
| | - Huanhuan Cheng
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Shujie Huang
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Heping Zheng
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Bin Yang
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Cheng Wang
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| |
Collapse
|
4
|
Xu F, Bu K, Chen F, Jin S, Zhang H, Zhang D, Sun C, Wang N, Han M, Wang L. Structural equation modeling test of the pre-intentional phase of the health action process approach (HAPA) model on condom use intention among senior high school students in Tianjin, China. Medicine (Baltimore) 2020; 99:e22776. [PMID: 33126316 PMCID: PMC7598788 DOI: 10.1097/md.0000000000022776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Based on the Theory of Health Action Process Approach (HAPA) Model, this study aimed to investigate factors associated with condom use intention in Chinese adolescents.In 2017, we conducted a cross-sectional study using stratified cluster, convenience sampling method to assess condom use intention among senior high school students in Tianjin, China. One thousand eighty two senior high school students were anonymously surveyed through self-administered questionnaires. Structural equation modelling was used to assess the pre-intentional phase of HAPA model.Among the participants, 41.5% (449/1082) were male, 54.1% (585/1082) were female, 4.4% (48/1082) were gender-deficient. The average age was 16.7 years. The final pre-intentional phase of HAPA model was acceptable (CFI = 0.95; GFI = 0.94; RMSEA = 0.06). Action self-efficacy (r = 0.60) had a strong direct effect on condom use intention.The pre-intentional phase of HAPA model is valid to assess condom use intention among Chinese senior high school students. The pre-intention phase of the HAPA model could be applied to guide AIDS health educations of students, and further research is needed to evaluate the effect.
Collapse
Affiliation(s)
- Fang Xu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
- Department of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Kai Bu
- School of Health Humanities, Peking University
| | - Fangfang Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | | | - Hanxi Zhang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Dong Zhang
- Dongli Center for Disease Control and Prevention, Tianjin
| | - Caixia Sun
- Qinghai Of Health Sciences, Qinghai, Beijing, China
| | - Ning Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Mengjie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| |
Collapse
|
5
|
Kennedy CE, Fonner VA, Armstrong KA, Denison JA, Yeh PT, O’Reilly KR, Sweat MD. The Evidence Project risk of bias tool: assessing study rigor for both randomized and non-randomized intervention studies. Syst Rev 2019; 8:3. [PMID: 30606262 PMCID: PMC6317181 DOI: 10.1186/s13643-018-0925-0] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/18/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Different tools exist for assessing risk of bias of intervention studies for systematic reviews. We present a tool for assessing risk of bias across both randomized and non-randomized study designs. The tool was developed by the Evidence Project, which conducts systematic reviews and meta-analyses of behavioral interventions for HIV in low- and middle-income countries. METHODS We present the eight items of the tool and describe considerations for each and for the tool as a whole. We then evaluate reliability of the tool by presenting inter-rater reliability for 125 selected studies from seven published reviews, calculating a kappa for each individual item and a weighted kappa for the total count of items. RESULTS The tool includes eight items, each of which is rated as being present (yes) or not present (no) and, for some items, not applicable or not reported. The items include (1) cohort, (2) control or comparison group, (3) pre-post intervention data, (4) random assignment of participants to the intervention, (5) random selection of participants for assessment, (6) follow-up rate of 80% or more, (7) comparison groups equivalent on sociodemographics, and (8) comparison groups equivalent at baseline on outcome measures. Together, items (1)-(3) summarize the study design, while the remaining items consider other common elements of study rigor. Inter-rater reliability was moderate to substantial for all items, ranging from 0.41 to 0.80 (median κ = 0.66). Agreement between raters on the total count of items endorsed was also substantial (κw = 0.66). CONCLUSIONS Strengths of the tool include its applicability to a range of study designs, from randomized trials to various types of observational and quasi-experimental studies. It is relatively easy to use and interpret and can be applied to a range of review topics without adaptation, facilitating comparability across reviews. Limitations include the lack of potentially relevant items measured in other tools and potential threats to validity of some items. To date, the tool has been applied in over 30 reviews. We believe it is a practical option for assessing risk of bias in systematic reviews of interventions that include a range of study designs.
Collapse
Affiliation(s)
- Caitlin E. Kennedy
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E5547, Baltimore, MD 21205 USA
| | - Virginia A. Fonner
- Division of Global and Community Health, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 176 Croghan Spur Road, Suite 104, Charleston, SC 29407 USA
| | - Kevin A. Armstrong
- Division of Global and Community Health, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 176 Croghan Spur Road, Suite 104, Charleston, SC 29407 USA
| | - Julie A. Denison
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E5547, Baltimore, MD 21205 USA
| | - Ping Teresa Yeh
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E5547, Baltimore, MD 21205 USA
| | - Kevin R. O’Reilly
- Division of Global and Community Health, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 176 Croghan Spur Road, Suite 104, Charleston, SC 29407 USA
| | - Michael D. Sweat
- Division of Global and Community Health, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 176 Croghan Spur Road, Suite 104, Charleston, SC 29407 USA
| |
Collapse
|
6
|
Lai J, Qin C, Nehl EJ, Jiang J, Huang Y, Liang B, Xu Y, Huang J, Xu Z, Ning C, Liao Y, Zang N, Wei W, Qin F, Yu J, Ye L, Qin X, Liang H. HIV prevalence among female sex workers in Guigang City, Guangxi, China: an 8-year consecutive cross-sectional study. BMC Public Health 2018; 18:450. [PMID: 29618343 PMCID: PMC5885366 DOI: 10.1186/s12889-018-5380-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 03/26/2018] [Indexed: 11/22/2022] Open
Abstract
Background Female sex workers (FSW) are a population that are at high risk for HIV infection, and their HIV/AIDS knowledge levels and sexual behaviors are of concern. This study describes changes in HIV prevalence and factors associated among female sex workers in Guigang City, Guangxi, one of the highest HIV prevalence areas in China. Methods Data were derived from an annual cross-sectional venue-based survey, 2008 to 2015, in the form of sentinel surveillance. The participants were recruited using cluster sampling. FSW aged 16 years and above who completed a questionnaire and HIV testing. Both descriptive and multi-level analyses were used to explore factors associated with changes in HIV prevalence. Results Seven thousand four hundred ninety-six FSW were recruited in this study. HIV prevalence among FSW in Guigang City fell into two periods, one with an increasing trend (2008–2011) and one with a decline (2012–2015). Differences between these time periods included age, relationship status, HIV knowledge, consistent condom use, lifetime illicit drug use, history of sexually transmitted infection in the past year, HIV testing, receipt of a condom distribution and education program or HIV counseling and testing, and peer education services. Conclusions Since 2012, a reduction in HIV prevalence among FSW in Guigang City has been observed. The decline of HIV prevalence was associated with coinciding changes in demographic characteristics of FSW, improvement of HIV knowledge and safer sexual behaviors, and a program that promotes condom use, HIV counseling & testing, and peer education.
Collapse
Affiliation(s)
- Jingzhen Lai
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Chunwei Qin
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China
| | - Eric J Nehl
- Rollins School of Public Health, Emory University, 1518 Clifton Road. NE, Atlanta, GA, 30322, USA
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Yunxuan Huang
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Yuexiang Xu
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China
| | - Jiegang Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Zhiliang Xu
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China
| | - Chuanyi Ning
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Yanyan Liao
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Ning Zang
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Wudi Wei
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Fengxiang Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Jun Yu
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China.
| | - Xionglin Qin
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China.
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China. .,Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22 Shuangyong Road, Nanning, 530021, Guangxi, China.
| |
Collapse
|
7
|
Operario D, Wang D, Zaller ND, Yang MF, Blaney K, Cheng J, Hong Q, Zhang H, Chai J, Szekeres G, Galea J, Coates TJ. Effect of a knowledge-based and skills-based programme for physicians on risk of sexually transmitted reinfections among high-risk patients in China: a cluster randomised trial. LANCET GLOBAL HEALTH 2016; 4:e29-36. [PMID: 26718807 DOI: 10.1016/s2214-109x(15)00249-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 09/22/2015] [Accepted: 10/19/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND China is experiencing growing epidemics of HIV and sexually transmitted infections (STIs). Programmes to train physicians in China on HIV and STI knowledge, diagnosis, treatment, and risk reduction counselling can potentially reduce HIV and STI risk among high-risk patients. We aimed to assess a knowledge-based and skills-based programme for physicians in China to reduce patients' STI risk. METHODS In this cluster randomised trial, we block randomised counties in two provinces in eastern China to intervention or control groups. In the intervention group, physicians from county general hospitals participated in a structured HIV and STI training programme and received opportunities to enhance their clinical and counselling skills, whereas in the control group, physicians from county hospitals received the training after the intervention group completed final assessments. We recruited STI patients from physicians in both groups, treated baseline gonorrhoea and chlamydia infections, and assessed 9-month gonorrhoea and chlamydia reinfection as the primary outcome. Statistical comparisons between intervention and delayed-control patients used multilevel analyses to account for cluster effects at county and physician levels. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, NCT00644150. FINDINGS Between April 1, 2007, and Sept 1, 2008, 51 counties were randomly assigned; 27 to receive immediate intervention and 24 to receive delayed intervention. 249 physicians from the 51 county-level hospitals were enrolled, 121 physicians in the intervention group and 128 in the control group. From these physicians, we enrolled 633 and 491 patients, respectively, of whom 508 (80%) and 402 (82%) were available for reassessment at 9 months. Intervention patients at follow-up had significantly lower odds of combined gonorrhoea or chlamydia reinfection than did control patients (58/508 [11%] vs 123/402 [31%]; adjusted odds ratio 0·62 [95% CI 0·46-0·84]). INTERPRETATION Integrating HIV and STI training into medical education in China could be an effective strategy to reduce the country's growing HIV risk and STI epidemics. FUNDING US National Institutes of Health.
Collapse
Affiliation(s)
| | - Debin Wang
- School of Health Service Management, Anhui Medical University, China
| | - Nickolas D Zaller
- Fay Boozman College of Public Health, University of Arkansas, Fayetteville, AR, USA
| | | | | | - Jing Cheng
- School of Health Service Management, Anhui Medical University, China
| | - Qian Hong
- School of Health Service Management, Anhui Medical University, China
| | - Hongbo Zhang
- School of Public Health, Anhui Medical University, China
| | - Jing Chai
- School of Health Service Management, Anhui Medical University, China
| | - Gregory Szekeres
- Center for World Health, University of California Los Angeles, USA
| | - Jerome Galea
- Center for World Health, University of California Los Angeles, USA
| | - Thomas J Coates
- Center for World Health, University of California Los Angeles, USA.
| |
Collapse
|
8
|
Xiao Z, Li X, Lin D, Tam CC. Mass Media and HIV/AIDS Prevention Among Female Sex Workers in Beijing, China. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1095-1106. [PMID: 25950448 PMCID: PMC6277979 DOI: 10.1080/10810730.2015.1018575] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China.
Collapse
Affiliation(s)
- Zhiwen Xiao
- a Valenti School of Communication , University of Houston , Houston , Texas , USA
| | | | | | | |
Collapse
|
9
|
Hlavinkova L, Mentel A, Kollarova J, Kristufkova Z. Effectiveness of a prevention campaign on HIV/AIDS knowledge among adolescents in Eastern Slovakia. Int J Public Health 2014; 59:905-11. [PMID: 25312012 DOI: 10.1007/s00038-014-0607-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 09/09/2014] [Accepted: 09/12/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this manuscript was to evaluate results of the questionnaire given to young people before and after the prevention campaign to determine whether the prevention campaign improved HIV/AIDS-related knowledge of young people. METHODS A total of 533 students completed the pre-test and 496 students completed the post-test. Questionnaire was used as pre/post testing tool. Construct validity and measurement scale were assessed using the factor analysis. Rasch scaling was used to establish common scale for pre/post test and to transform raw score into the interval scale. A non-parametric Mann-Whitney U test was used to compare knowledge in pre-test and post-test. RESULTS Students increased their knowledge of HIV/AIDS (Pearson's measure of effect size r = 0.74) and the risk of acquiring HIV infection (r = 0.68) statistically significantly (p = 0.001). Girls (risk estimation: r = 0.78, knowledge: r = 0.81) improved much more than boys (risk estimation: r = 0.57, knowledge: r = 0.62). CONCLUSIONS This study suggests that, for the selected sample, the prevention campaign was an effective tool to increase young people's knowledge of HIV/AIDS. The authors recommend dividing and tailoring interventions by gender to achieve even more efficient preventive future interventions.
Collapse
Affiliation(s)
- Lucia Hlavinkova
- Department of Epidemiology, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia,
| | | | | | | |
Collapse
|
10
|
Fernández-Balbuena S, Belza MJ, Urdaneta E, Esteso R, Rosales-Statkus ME, de la Fuente L. Serving the underserved: an HIV testing program for populations reluctant to attend conventional settings. Int J Public Health 2014; 60:121-6. [PMID: 25224831 DOI: 10.1007/s00038-014-0606-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/18/2014] [Accepted: 09/08/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES We assess the contribution of a rapid-HIV testing program run by Médicos del Mundo and oriented to vulnerable populations reluctant to attend conventional settings. METHODS We compare the program outcomes with a network of 20 HIV/STI clinics (EPIVIH) and the Spanish National Surveillance System (SNHSS). RESULTS 33.3% of the new diagnoses were women (8.6% EPIVIH and 17.7% SNHSS). Transsexuals were 6.9% (1.9% EPIVIH), female sex workers 23.6% (2.0% EPIVIH) and 19.4% Sub-Saharan Africans (3.8% EPIVIH and 7.8% SNHSS). HIV prevalence in men was slightly higher than in the EPIVIH and almost twice among women. CONCLUSIONS This program is contributing substantially to the promotion of HIV diagnosis in female sex workers, sub-Saharan Africans and transsexuals, which are less present at clinical settings.
Collapse
Affiliation(s)
- Sonia Fernández-Balbuena
- National Epidemiology Centre, Carlos III Health Institute C/Sinesio Delgado 6, 28029, Madrid, Spain,
| | | | | | | | | | | | | |
Collapse
|
11
|
Muessig KE, Smith MK, Maman S, Huang Y, Chen XS. Advancing the prevention agenda for HIV and other sexually transmitted infections in south China: social science research to inform effective public health interventions. AIDS Behav 2014; 18 Suppl 2:S222-31. [PMID: 24443101 PMCID: PMC3982310 DOI: 10.1007/s10461-014-0695-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Despite widespread biomedical advances in treatment and prevention, HIV and other sexually transmitted infections (STI) continue to affect a large portion of the world's population. The profoundly social nature of behaviorally driven epidemics and disparities across socioeconomic divides in the distribution of HIV/STI and care outcomes emphasize the need for innovative, multilevel interventions. Interdisciplinary approaches to HIV/STI control are needed to combine insights from the social and biological sciences and public health fields. In this concluding essay to a Special Issue on HIV/STI in south China, we describe the evolution of the region's HIV/STI epidemics and the government response, then synthesize findings from the 11 studies presented in this issue to extend seven recommendations for future HIV/STI prevention and care research in China. We discuss lessons learned from forging international collaborations between the social and biological sciences and public health to inform a shared research agenda to better meet the needs of those most affected by HIV and other STI.
Collapse
Affiliation(s)
- Kathryn E. Muessig
- Department of Health Behavior, 306 Rosenau Hall, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7440 USA. Phone: 1-443-320-3152
| | - M. Kumi Smith
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Suzanne Maman
- Department of Health Behavior, 306 Rosenau Hall, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7440 USA. Phone: 1-443-320-3152
| | - Yingying Huang
- Department of Sociology, Renmin University, Beijing, China
| | - Xiang-sheng Chen
- National Center for STD Control and Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiangwangmiao Street, Nanjing, Jiangsu 210042, China (Tel: 86-25-845478901. Fax: 86-25-85424903)
| |
Collapse
|
12
|
Contextual effects of community mobilization and communication capacity as a positive factor for self-rated health status: a multi-level analysis. Int J Public Health 2013; 59:289-99. [PMID: 24362447 DOI: 10.1007/s00038-013-0532-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 10/26/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES We examined relationships between individual-level community participation, two types of contextual effects-community capacity for mobilization and capacity for health communication--and residents' self-reported health status in order to explore the role health communication may play in community building for health. METHODS To estimate multi-level effects of the community participation and the two contextual indicators with self-rated health status, we applied hierarchical generalized linear regression to crosssectional data from the Korean National Health and Nutrition Examination Survey. RESULTS After adjusting for individual- and community-level confounders, the likelihood of having high self-rated health status is significantly higher among those who live in a region with higher community capacity for mobilization, higher health communication capacity at the community level, and higher participation in community groups at the individual-level. CONCLUSIONS Our findings suggest that living in a community characterized by higher levels of communication and mobilization capacity is beneficial to residents' self-rated health status--increasing the odds of high health status by up to 9 %. Thus, building community capacity in mobilization and health communication may help develop better health promotion campaigns.
Collapse
|