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Chen P, Yu H, Lin CF, Guo J, Elliott J, Bleakney A, Jan YK. Effect of adaptive sports on quality of life in individuals with disabilities who use wheelchairs: a mixed-methods systematic review. Disabil Rehabil Assist Technol 2024:1-17. [PMID: 38330244 DOI: 10.1080/17483107.2024.2313110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Adaptive sports participation has been shown to improve quality of life (QoL) in individual with disabilities. However, inconsistent results in various domains of QoL exist in the literature. The objective of this mixed-methods systematic review is to identify and synthesize evidence from quantitative and qualitative studies on the effect of adaptive sports on QoL in individuals with disabilities who use wheelchairs for mobility. METHODS A systematic literature review of quantitative, qualitative, and mixed-methods research on the effect of adaptive sports on QoL was conducted on five databases (Scopus, Web of Science, PsycINFO, Medline, and PubMed). Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool. RESULTS This review identified 4 key findings from 41 studies, including 31 quantitative and 10 qualitative studies. First, individuals with disabilities using wheelchairs for mobility who actively engaged in adaptive sports tend to report higher QoL scores compared with those who were inactive or did not participate. Second, the relationship between the duration of regular participation in adaptive sports and QoL scores exhibited inconsistent results. Third, a multi-component adaptive sports program demonstrates the potential to further improve QoL scores. Last, qualitative investigations reveal that participation in adaptive sports positively influences various domains of well-being in wheelchair users, including encompassing physical and emotional well-being, interpersonal relationships, material well-being, personal development, self-determination, and social inclusion. CONCLUSION This review provides a comprehensive relationship between adaptive sports participation and QoL of wheelchair users. This study identifies the value of multi-component interventions and demonstrates the diverse positive influences of adaptive sports on well-being.
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Affiliation(s)
- Panpan Chen
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Cheng-Feng Lin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Jiaqi Guo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jeannette Elliott
- Disability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Adam Bleakney
- Disability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Yih-Kuen Jan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Chen M, Li Q, Wang L. Understanding factors influencing people with disabilities' participation in sports and cultural activities. BMC Public Health 2024; 24:389. [PMID: 38321421 PMCID: PMC10845523 DOI: 10.1186/s12889-024-17791-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Improving people with disabilities' participation in sports and cultural activities benefits their physical and mental health. However, only a few studies have examined the factors that influence participation systematically. METHODS Using the survey data gathered from 4,319 disabled people living in a district in Wuhan, China, this study explored the impacts of sports and cultural activity participation in terms of individual physiological characteristics, socioeconomic factors, and built environmental features. The sports and cultural facility supply and the walkability index of their community environment were calculated to assess built environment features. Binary logistic regression models were also used to investigate the influence of the aforementioned variables. RESULTS There is a significant positive correlation between sports and cultural activity participation and education (OR = 3.44, p < 0.01), employment status (OR = 2.04, p < 0.01), as well as the number of cultural facilities (OR = 1.33, p < 0.01) in the neighborhood area. No significant association was found between the inclination to participate frequently and individual psychological factors. CONCLUSION Regarding people with disabilities' participation in sports and cultural activities, socioeconomic and built environment factors are more influential than individual psychological ones. The findings can give ideas for identifying targeted and comprehensive interventions to promote a healthy lifestyle for people with disabilities.
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Affiliation(s)
- Ming Chen
- School of Civil Engineering and Architecture, Wuhan University of Technology, No. 122, Luoshi Road, 430070, Wuhan, China
| | - Qianxue Li
- School of Civil Engineering and Architecture, Wuhan University of Technology, No. 122, Luoshi Road, 430070, Wuhan, China
| | - Luqi Wang
- School of Civil Engineering and Architecture, Wuhan University of Technology, No. 122, Luoshi Road, 430070, Wuhan, China.
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Olasagasti-Ibargoien J, Castañeda-Babarro A, León-Guereño P, Uria-Olaizola N. Barriers to Physical Activity for Women with Physical Disabilities: A Systematic Review. J Funct Morphol Kinesiol 2023; 8:82. [PMID: 37367246 PMCID: PMC10299685 DOI: 10.3390/jfmk8020082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
Physical activity is essential for women with physical disabilities. This review aims to identify the barriers they face in practicing sport. A systematic review was conducted using the PubMed/Medline, Scopus, and Web of Science databases in January 2023, with an update in March 2023. The eligibility criteria used for inclusion were as follows. (i) Women with physical disabilities; (ii) women who engage in or want to engage in physical activities and/or sport, both adapted and non-adapted; (iii) identification of women's barriers to such practice; (iv) research articles; and (v) papers written in English and published in peer-reviewed journals. The exclusion were as follows. (i) Women with illness, injury or transient physical activity difficulties; (ii) mention of rehabilitative physical activity; and (iii) results showing no differentiation in barrier types by gender. This review identified different barriers, grouped into eight types according to the differentiating factor, thus showing that disable people's participation in physical activity is directly related to some specific barriers which seem to differ according to their gender. Therefore, the success of participation in physical activities depends not only on the user's concern, but also on an inclusive social environment.
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Affiliation(s)
- Jurgi Olasagasti-Ibargoien
- Health, Physical Activity and Sports Science Laboratory, Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (J.O.-I.); (A.C.-B.)
| | - Arkaitz Castañeda-Babarro
- Health, Physical Activity and Sports Science Laboratory, Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (J.O.-I.); (A.C.-B.)
| | - Patxi León-Guereño
- Health, Physical Activity and Sports Science Laboratory, Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (J.O.-I.); (A.C.-B.)
| | - Naroa Uria-Olaizola
- Deusto Sports and Society, Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain;
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Jalali MT, Sarikhani Y, Askarian F, Marzaleh MA, Najibi SM, Delavari S. Factors facilitating and inhibiting the social participation of the elderly in health-oriented activities in Shiraz, Southern Iran. BMC Geriatr 2023; 23:175. [PMID: 36973677 PMCID: PMC10042408 DOI: 10.1186/s12877-023-03892-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The social participation (SP) of the elderly is one of the factors that contribute to the improvement of their well-being. SP, one of the most important factors of active ageing, is mainly influenced by a number of facilitating or inhibiting factors. AIMS This study aimed to identify the factors that prevent and facilitate the SP of the elderly population in Iran. METHODS A cross-sectional study carried out in Shiraz, southern Iran in 2021. Participants were selected using a convenience sampling method. Shiraz is divided into 11 districts and the largest park in each district is selected for data gathering. The questionnaires were completed by 612 people aged over 60. Data were collected using the Canadian Elderly Survey Project scale and a health-related lifestyle questionnaire and were analyzed using t-test, ANOVA, Pearson's correlation, and ANCOVA. RESULTS The mean SP score of the elderly in Shiraz was 24.2 out of 60, which is below the midpoint. The results of the covariance analysis revealed that the SP had a significant relationship with the experience of physician consultation, cost barriers, age, marital status, income level, and education level (P < 0.001). Moreover, the results of Pearson correlation revealed a significant correlation between SP and different dimensions of health-oriented activities (< 0.001). CONCLUSIONS This study revealed that the main barriers to older people's participation in health-related activities are cost and access barriers, such as transportation issues. Moreover, higher income level and higher educational attainment have been recognized as the main facilitators of SP in the elderly. In this regard, it can be suggested to apply a combination of health promotion strategies, financial support programs, and development of optimal transportation infrastructure to increase the SP of the elderly.
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Affiliation(s)
- Marzie Tajik Jalali
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yaser Sarikhani
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fatemeh Askarian
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Milad Ahmadi Marzaleh
- Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Health Management and Information sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyede Maryam Najibi
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sajad Delavari
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Kim HM. Effects of self-efficacy, self-esteem, and disability acceptance on the social participation of people with physical disabilities: Focusing on COVID-19 pandemic. Brain Behav 2023; 13:e2824. [PMID: 36448298 PMCID: PMC9847590 DOI: 10.1002/brb3.2824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/23/2022] [Accepted: 11/01/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE The objective of this study was to understand the effects of self-efficacy, self-esteem, and the degree of disability acceptance of people with physical disabilities living in COVID-19 pandemic on their social participation. METHODS Among the 4577 registered disabled people who participated in the 2nd wave of the Panel Survey of Employment for the Disabled (PSED), 1682 people with physical disabilities who faithfully answered all the survey items were selected as the final study subjects. This study used the variables of social participation, self-efficacy, self-esteem, and disability acceptance, which were validated by experts' review and consulting and research at the Korea Employment Agency for Persons with Disability. Pearson's correlation analysis and multiple linear regression analysis were performed to identify variables that could predict the social participation of the study subjects. RESULTS The self-efficacy, self-esteem, and the degree of disability acceptance of people with physical disabilities were positively correlated with social participation. The results of this study showed that self-efficacy, self-esteem, the degree of disability acceptance, economic activity, and education level explained 22.4% of social participation. CONCLUSIONS It was found that self-efficacy, self-esteem, and the degree of disability acceptance of people with physical disabilities were important variables affecting social participation. These psychoemotional variables shall be considered for intervention approaches to improve the social participation of people with physical disabilities in the future.
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Affiliation(s)
- Hyeong-Min Kim
- Department of Occupational Therapy, Gimcheon University, Gimcheon, South Korea
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Lakhani A, Dema S, Hose J, Erdem N, Wollersheim D, Grimbeek P, Charlifue S. What happens post-lockdown for people with disability? Autonomy, quality of life, service access and health changes for people with spinal cord injury in Victoria, Australia after COVID-19 social distancing restrictions. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5366-e5377. [PMID: 35924426 PMCID: PMC9538439 DOI: 10.1111/hsc.13958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/05/2022] [Accepted: 07/16/2022] [Indexed: 06/17/2023]
Abstract
Social distancing restrictions are undoubtedly important for controlling the spread of COVID-19 however, they are also adversely impacting population health and health service access. It is important that priority populations with a disability which may already have adverse health, access to health services, and autonomy and participation compared to those without disability, are able to receive preventative health and social care during periods of restriction. The impact of social distancing restrictions on people with disability is not uniform nor well-understood. Research has been cross-sectional and considered data gathered during social distancing restrictions, or longitudinal, considering data gathered during a pre-pandemic baseline. This longitudinal study investigated the impact of lifting social distancing restrictions on priority domains for people with disability including autonomy and participation, access to health services, health issues and quality of life. People with spinal cord injury in Victoria, Australia (n = 71) completed a survey towards the end of social-distancing restrictions (T1) and 6-months post social distancing restrictions (T2). Non-parametric tests for significant differences confirmed that 6-months post-lifting social distancing restrictions participants experienced a significant increase in health conditions, a significant decrease in the number of inaccessible health services, and a significantly lower level of limitations across participation and autonomy, outdoor autonomy and work and education domains. QOL improved 6-months post lifting restrictions, however not to a significant level. The adverse health experienced by people with spinal cord injury after lifting restrictions may in part result from limited health service access and reduced participation during the time of restrictions. Clear definitions of what constitutes as essential care may ensure that eligible and required care remains received during lockdown or instances when service provision is compromised. Health and social care providers should be equipped with the knowledge of priority populations so that their support can be targeted to those most in need.
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Affiliation(s)
- Ali Lakhani
- The School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
- The Hopkins Centre, Menzies Health Institute QueenslandGriffith UniversityMeadowbrookQueenslandAustralia
- Palliative Care DepartmentEastern HealthWantirnaVictoriaAustralia
| | - Salvatore Dema
- Austin Health ‐ Royal Talbot Rehabilitation CentreKewVictoriaAustralia
| | - Josh Hose
- AQA VictoriaHeidelbergVictoriaAustralia
| | | | - Dennis Wollersheim
- The School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
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Duan W, Wu T, Bu H, He L. Development of a Three-Stage Strength-Based Meaning Intervention to Promote Mental Health Among Individuals with Physical Disabilities in Disadvantaged Communities: A Randomized Controlled Trial. JOURNAL OF HAPPINESS STUDIES 2022; 23:3865-3887. [PMID: 36213307 PMCID: PMC9531229 DOI: 10.1007/s10902-022-00578-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 05/08/2023]
Abstract
A three-stage strength-based meaning intervention (SMI) was developed in the present study, and its utility in facilitating the mental health of individuals with physical disabilities in low-income communities was tested. A randomized controlled and single-blind trial was adopted. A total of 50 qualified participants (mean age = 42.12, standard deviation = 8.68; 48% males; 26 for the intervention group, 24 for the control group) completed the pre-intervention test, post-intervention test, and three-month follow-up test. No significant difference was observed between the two groups at pre-intervention assessment . After intervention, the results in terms of strength knowledge, strength use, sense of meaning in life and mental health showed a significant improvement in the intervention group, with the changes maintained over three months except mental health. The differences in mental health between the post-intervention test and the three-month follow-up test were not significant in the intervention group. The results imply that the SMI model is a promising approach in promoting the mental health of individuals with physical disabilities in low-income communities as it promotes improved knowledge and use of strength and sense of meaning in life.
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Affiliation(s)
- Wenjie Duan
- School of Social and Public Administration, East China University of Science and Technology, 130 Meilong Road, Xuhui District, Shanghai, People’s Republic of China
| | - Tong Wu
- School of Social and Public Administration, East China University of Science and Technology, 130 Meilong Road, Xuhui District, Shanghai, People’s Republic of China
| | - He Bu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR People’s Republic of China
| | - Longtao He
- Research Institute of Social Development, Southwestern University of Finance and Economics, 555, Liutai Avenue, Wenjiang District, Chengdu, Sichuan People’s Republic of China
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Musculoskeletal Changes in Hemophilia Patients Subsequent to COVID-19 Lockdown. Healthcare (Basel) 2021; 9:healthcare9060702. [PMID: 34207821 PMCID: PMC8226565 DOI: 10.3390/healthcare9060702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 11/22/2022] Open
Abstract
(1) Background. The lockdown period due to the COVID−19 pandemic has drastically decreased levels of physical activity in the population. Hemophilia is characterized by hemarthrosis that leads to chronic, progressive and degenerative joint deterioration. (2) Methods. This observational study recruited 27 patients with hemophilia and arthropathy. Knee, ankle and elbow joints were assessed. The frequency of clinical hemarthrosis, pain intensity, pressure pain threshold, and joint ROM were evaluated. (3) Results. Following lockdown, a significant deterioration of joint condition, perceived joint pain and range of motion was noted in all joints. There were no changes in the frequency of knee hemarthrosis, while the frequency of ankle hemarthrosis significantly reduced. However, the frequency of elbow hemarthrosis increased. Depending on the degree of hemophilia severity, there were changes in pressure pain threshold in the elbow and in pain intensity and range of motion of the ankle joint. According to the type of treatment, i.e., prophylaxis vs. on-demand treatment, there were differences in the joint condition in elbows and the plantar flexion movement of the ankle. There were no differences in the knee joint based on the severity of the disease, the type of treatment or the development of inhibitors (4). Conclusions. Because of the COVID−19 lockdown, the musculoskeletal status of patients with hemophilia deteriorated. Joint condition, perceived pain, and range of motion were significantly affected. The frequency of clinical hemarthrosis did not increase during this period. A more active therapeutic model could prevent rapid deterioration in patients with hemophilic arthropathy during prolonged sedentary periods.
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Zuo Y, Ma Y, Zhang M, Wu X, Ren Z. The impact of sharing physical activity experience on social network sites on residents' social connectedness:a cross-sectional survey during COVID-19 social quarantine. Global Health 2021; 17:10. [PMID: 33430894 PMCID: PMC7797884 DOI: 10.1186/s12992-021-00661-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During isolation, sharing physical activity experiences on social network sites (SNS) can enhance individual social connectedness. The objective of the present study was to examine the associations between sharing physical activity experiences on SNS, positive self-presentation, positive feedback, and social connectedness during isolation. METHODS Based on the Physical Activity Experience Sharing Scale, Social Connectedness Scale, Positive Self-Presentation Scale, and Online Positive Feedback Scale, we collected 460 questionnaires online from across 31 provinces, municipalities and autonomous regions in China. We used multiple linear regression models to investigate the relationship between variables, and used bootstrapping to test for mediation.. RESULTS During isolation, sharing physical activity experiences was positively associated with social connectedness (b = 0.308, p < 0.001), as well as with positive self-presentation(b = 0.956, p < 0.001)and positive feedback(b = 0.421, p < 0.001). In addition,we found that positive self-presentation showed a significant positive impact on positive feedback (b = 0.563, p < 0.001), and that positive self-presentation(b = 0.331, p < 0.001) and positive feedback(b = 0.311, p < 0.001) were positively associated with social connectedness. Finally, we found an effect on sharing physical activity experiences indirectly through positive self-presentation (b = 0.316, 95% CI: [0.180, 0.463]),and positive feedback (b = 0.131, 95% CI: [0.063, 0.207]) and that the mediation chain between the two also had a significant impact on social connectedness (b = 0.167, 95% CI: [0.088, 0.251]). CONCLUSIONS During the COVID-19 pandemic, sharing physical activity experiences on SNS can create a positive, healthy, and energetic personal image, gain recognition from others, and establish new interpersonal relationships.
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Affiliation(s)
- Yifan Zuo
- School of Management, Jinan University, Guangzhou, 510632 China
- Shenzhen Tourism College, Jinan University, Shenzhen, 518053 China
| | - Yudan Ma
- Shanwei Polytechnic, Shanwei, 516600 China
| | - Mu Zhang
- Shenzhen Tourism College, Jinan University, Shenzhen, 518053 China
| | - Xiaoyuan Wu
- Department of Physical education, Shenzhen University, Shenzhen, 518061 China
| | - Zhanbing Ren
- Department of Physical education, Shenzhen University, Shenzhen, 518061 China
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Luo L, Hu R, Cao L, Zhang M, Wang X, Xu J. Association between childhood parental rearing, sexual partnerships, social support and posttraumatic stress disorders (PTSD) among young HIV-positive MSM. AIDS Care 2020; 33:920-928. [PMID: 33190511 DOI: 10.1080/09540121.2020.1842848] [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: 10/23/2022]
Abstract
We aimed to assess the effect of childhood parental rearing on post-traumatic stress disorder (PTSD) among young HIV-positive men who have sex with men (MSM), as well as the mediation effect of social support on this association. A convenient sampling method and questionnaire-based survey were used to recruit eligible participants from the Wuhan Medical Treatment Center from 20 December 2018 to 28 February 2019. Bivariate analyses were used to investigate the correlations between PTSD and childhood parental rearing, the number of sexual partners and social support. Mediation analyses were used to investigate the mediation of social support. Totally, 142 eligible MSM participated in our study, with prevalence of PTSD being 33.10%. It was found that maternal warmth (M1) and maternal favoring (M5) were positively correlated with social support. Paternal rejection (F5) was positively correlated with PTSD. The effects of M1 and M5 on PTSD were completely mediated by social support. The effects of paternal favoring (F4) and M5 on PTSD were completely mediated by subjective social support, and the effects of F5 and M1 were completely mediated by social support utility. Social support was an important mediator between parental rearing and PTSD.
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Affiliation(s)
- Li Luo
- Department of AIDS Prevention, Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Rong Hu
- Department of AIDS Prevention, Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Lin Cao
- Department of AIDS Prevention, Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Min Zhang
- Department of AIDS Prevention, Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Xia Wang
- Department of AIDS Prevention, Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Jun Xu
- Department of AIDS Prevention, Wuhan Centers for Disease Prevention and Control, Wuhan, China
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