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Núñez I, Amuchastegui A, Vásquez-Salinas A, Díaz S, Caro-Vega Y. Challenges to the HIV Care Continuum During the COVID-19 Pandemic in Mexico: A Mixed Methods Study. AIDS Behav 2024; 28:886-897. [PMID: 37789236 DOI: 10.1007/s10461-023-04195-w] [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] [Accepted: 09/21/2023] [Indexed: 10/05/2023]
Abstract
The COVID-19 pandemic has been reported to disrupt the access to care of people who live with HIV (PWH). The impact of the pandemic on the longitudinal HIV care continuum, however, has not been properly evaluated. We performed a mixed-methods study using data from the Mexican System of Distribution, Logistics, and ART Surveillance on PWH that are cared for in the state of Oaxaca. We evaluated the number of HIV diagnoses performed in the state before and during the pandemic with an interrupted time series. We used the longitudinal HIV care continuum framework to describe the stages of HIV care before and during the pandemic. Finally, we performed a qualitative analysis to determine which were the challenges faced by staff and users regarding HIV care during the pandemic. New HIV diagnoses were lower during the first year of the pandemic compared with the year immediately before. Among 2682 PWH with enough information to determine their status of care, 728 started receiving care during the COVID-19 pandemic and 1954 before the pandemic. PWH engaged before the pandemic spent 42825 months (58.2% of follow-up) in optimal HIV control compared with 3061 months (56.1% of follow-up) for those engaged in care during the pandemic. Staff and users reported decreases in the frequency of appointments, prioritisation of unhealthy users, larger disbursements of ART medication, and novel communication strategies with PWH. Despite challenges due to government cutbacks, changes implemented by staff helped maintain HIV care due to higher flexibility in ART delivery and individualised attention.
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Affiliation(s)
- Isaac Núñez
- Departamento de Educación Médica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- División de Estudios de Postgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ana Amuchastegui
- Departamento de Educación y Comunicación, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Alejandra Vásquez-Salinas
- Centro Ambulatorio Para la Prevención y Atención del Sida E Infecciones de Transmisión Sexual (CAPASITS Oaxaca), Oaxaca, Mexico
| | | | - Yanink Caro-Vega
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga # 15, Belisario Domínguez Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
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Liu Y, Su R, Li D, Wang S, Han M. Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics - China, 2015-2022. China CDC Wkly 2024; 6:6-11. [PMID: 38223658 PMCID: PMC10787340 DOI: 10.46234/ccdcw2024.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/08/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction Human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) clinics play a critical role in identifying and diagnosing HIV cases. This study aimed to describe the trend of HIV positivity rate (HPR) among Chinese VCT clinics between 2015 and 2022. Methods This study utilized data from the China Information System for Disease Control and Prevention to analyze the trend in the HPR for VCT clinics from 2015 to 2022. The HPR was calculated by dividing the number of newly-reported HIV cases by the number of HIV tests, multiplied by 100%. To identify temporal and spatial trends in the HPR, we employed joinpoint regression analysis and the Getis-Ord hotspot analysis. Results From 2015 to 2022, VCT clinics in China performed a total of 22,075,386 HIV tests, leading to the identification of 260,353 HIV cases, resulting in a HPR of 1.18%. The HPR consistently declined over the study period, with an average annual percent change (AAPC) of -7.5% (95% confidence interval: -12.6%, -2.2%, P<0.05). The number of HPR hotspots also decreased from 41 in 2015 to 23 in 2022. These HPR hotspots were primarily located in Yunnan, Sichuan, Guangdong, and Guangxi provincial-level administrative divisions (PLADs). Among the 31 PLADs, 16 showed a significant decrease in HPR during the study period (AAPC<0, PAAPC<0.05). Conclusions VCT clinics in China have played a significant role in identifying HIV cases. The declining HPR observed in these clinics may indicates the progress has been made in some degree in mitigating HIV among high-risk populations. Therefore, it is crucial to further improving the utilization of VCT clinics for HIV testing.
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Affiliation(s)
- Yi Liu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Rong Su
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shaorong Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengjie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Wu X, Zhang L, Lu Z, Li Y, He Y, Zhao F, Peng Q, Zhou X, Wang H, Zou H. Longitudinal trajectories of weight changes among people living with HIV on antiretroviral therapy: A group-based study. iScience 2023; 26:108259. [PMID: 38026178 PMCID: PMC10665799 DOI: 10.1016/j.isci.2023.108259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/07/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Weight changes vary among people living with HIV (PLHIV) on different antiretroviral therapy (ART) regimens. Here, we performed multi-trajectory modeling fitting growth mixture models (GMM) to identify longitudinal weight change trajectories of PLHIV. Multiple logistic regression was used to assess correlates of rapid weight gains; 12,683 PLHIV (median age: 34 years [interquartile range 29-42], 91.1% male) who initiated ART at the Third People's Hospital of Shenzhen, China, between January 2003 and September 2022 were included. We identified two trajectories: slow (70.5%) and rapid weight gains (29.5%). PLHIV who initiated ART with dolutegravir- (adjusted odds ratio [aOR] 2.46, 1.92-3.15), raltegravir- (2.74, 1.96-3.82), and lopinavir (1.62, 1.36-1.94)-based regimens were more likely to have rapid weight gains compared with efavirenz-based regimen. The monitoring of nutritional status should be strengthened for PLHIV who initiated these regimens during regular ART follow-ups.
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Affiliation(s)
- Xinsheng Wu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Lukun Zhang
- National Clinical Research Centre for Infectious Diseases, The Third People’s Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuwei Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yun He
- National Clinical Research Centre for Infectious Diseases, The Third People’s Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Fang Zhao
- National Clinical Research Centre for Infectious Diseases, The Third People’s Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Qiaoli Peng
- National Clinical Research Centre for Infectious Diseases, The Third People’s Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hui Wang
- National Clinical Research Centre for Infectious Diseases, The Third People’s Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Southwest Medical University, Luzhou, China
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Wu X, Wu G, Ma P, Wang R, Li L, Chen Y, Xu J, Li Y, Li Q, Yang Y, Wang L, Xin X, Qiao Y, Fu G, Huang X, Su B, Zhang T, Wang H, Zou H. Associations of modern initial antiretroviral therapy regimens with all-cause mortality in people living with HIV in resource-limited settings: a retrospective multicenter cohort study in China. Nat Commun 2023; 14:5334. [PMID: 37660054 PMCID: PMC10475132 DOI: 10.1038/s41467-023-41051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/04/2023] Open
Abstract
Despite the proven virological advantages, there remains some controversy regarding whether first-line integrase strand transfer inhibitors (INSTIs)-based antiretroviral therapy (ART) contributes to reducing mortality of people living with HIV (PLHIV) in clinical practice. Here we report a retrospective study comparing all-cause mortality among PLHIV in China who were on different initial ART regimens (nevirapine, efavirenz, dolutegravir, lopinavir, and others [including darunavir, raltegravie, elvitegravir and rilpivirine]) between 2017 and 2019. A total of 41,018 individuals were included across China, representing 21.3% of newly reported HIV/AIDS cases collectively in the country during this period. Only the differences in all-cause mortality of PLHIV between the efavirenz group and the nevirapine group, the dolutegravir group and the nevirapine group, and the lopinavir group and the nevirapine group, were observed in China. After stratifying the cause of mortality, we found that the differences in mortality between initial ART regimens were mainly observed in AIDS-related mortality.
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Grants
- HZ is supported by the Shenzhen Science and Technology Innovation Commission Basic Research Program [JCYJ20190807155409373], the Natural Science Foundation of China Excellent Young Scientists Fund [82022064], Natural Science Foundation of China International/Regional Research Collaboration Project [72061137001], the Sanming Project of Medicine in Shenzhen [SZSM201811071], the High Level Project of Medicine in Longhua, Shenzhen [HLPM201907020105], Special Support Plan for High-Level Talents of Guangdong Province [2019TQ05Y230], the Fundamental Research Funds for the Central Universities [58000-31620005], Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences [2020-JKCS-030]. GW is supported by the Chongqing Talents Program for Innovative and Entrepreneurial Pioneers [cstc2021ycjh-bgzxm0097], the Chongqing Natural Science Foundation Project [cstc2021jcyj-msxmX1171], the Chinese State Key Laboratory of Infectious Disease Prevention and Control [2021SKLID303]. PM is supported by the Health Science and Technology Project of Tianjin Health Commission [ZC20037], the Tianjin Key Medical Discipline (Specialty) Construction Project [Infectious Diseases ZD02]. LL is supported by the National Key Research and Development Program of China [2022YFC2304800], the Science and Technology Project of Guangzhou [20220020285]. XH is supported by the Public Health Talent Grant by Beijing Municipal Health Commission [Global Health Governance-02-12; 2022-1-007], the Capital Health Development Research [2022-2-2185; 2022-1G-3011]. BS is supported by the High-Level Public Health Specialized Talents Project of Beijing Municipal Health Commission [2022-2-018], the National Key R&D Program of China [2021YFC2301900; 2021YFC2301905], the Beijing Key Laboratory for HIV/AIDS Research [BZ0089]. All funding parties did not have any role in the design of the study or in the explanation of the data.
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Affiliation(s)
- Xinsheng Wu
- Shenzhen Campus of Sun Yat-sen University, Shenzhen, PR China
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Guohui Wu
- Institute for AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, PR China
| | - Ping Ma
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, PR China
- Tianjin Association of STD/AIDS Prevention and Control, Tianjin, PR China
| | - Rugang Wang
- Dalian Public Health Clinical Center, Dalian, PR China
| | - Linghua Li
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, PR China
| | - Yuanyi Chen
- Shenzhen Campus of Sun Yat-sen University, Shenzhen, PR China
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, PR China
| | - Yuwei Li
- Shenzhen Campus of Sun Yat-sen University, Shenzhen, PR China
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Quanmin Li
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, PR China
| | - Yuecheng Yang
- Dehong Prefecture Center for Disease Control and Prevention, Dehong, PR China
| | - Lijing Wang
- Shijiazhuang Fifth Hospital, Shijiazhuang, PR China
| | - Xiaoli Xin
- No.6 People's Hospital of Shenyang, Shenyang, PR China
| | - Ying Qiao
- No.2 Hospital of Hohhot, Hohhot, PR China
| | - Gengfeng Fu
- Department of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China.
| | - Xiaojie Huang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, PR China.
| | - Bin Su
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, PR China.
| | - Tong Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, PR China.
| | - Hui Wang
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, PR China.
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, PR China.
- School of Public Health, Southwest Medical University, Luzhou, PR China.
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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Luo Q, Wu Z, Mi G, Xu J, Scott SR. Using HIV Risk Self-Assessment Tools to Increase HIV Testing in Men Who Have Sex With Men in Beijing, China: App-Based Randomized Controlled Trial. J Med Internet Res 2023; 25:e45262. [PMID: 37656500 PMCID: PMC10504623 DOI: 10.2196/45262] [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: 12/22/2022] [Revised: 07/13/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) in China hold a low-risk perception of acquiring HIV. This has resulted in an inadequate HIV testing rate. OBJECTIVE This study aims to investigate whether administering HIV risk self-assessments with tailored feedback on a gay geosocial networking (GSN) app could improve HIV testing rates and reduce sexual risk behaviors in Chinese MSM. METHODS We recruited MSM from Beijing, China, who used the GSN platform Blued in October 2017 in this 12-month double-blinded randomized controlled trial. From October 2017 to September 2018, eligible participants were randomly assigned to use a self-reported HIV risk assessment tool that provided tailored feedback according to transmission risk (group 1), access to the same HIV risk assessment without feedback (group 2), or government-recommended HIV education materials (control). All interventions were remotely delivered through the mobile phone-based app Blued, and participants were followed up at 1, 3, 6, and 12 months from baseline. The number of HIV tests over the 12-month study was the primary outcome and was assessed using an intention-to-treat analysis with an incident rate ratio (IRR). Unprotected anal intercourse (UAI) over 6 months was assessed by a modified intention-to-treat analysis and was the secondary outcome. All statistical analyses were conducted in SAS 9.3 (SAS Institute, Inc.), and a P value <.05 was considered statistically significant. RESULTS In total, 9280 MSM were recruited from baseline and were randomly assigned to group 1 (n=3028), group 2 (n=3065), or controls (n=3187). After follow-up, 1034 (34.1%), 993 (32.4%), and 1103 (34.6%) remained in each group, respectively. Over 12 months, group 1 took 391 tests (mean of 2.51 tests per person), group 2 took 352 tests (mean of 2.01 tests per person), and controls took 295 tests (mean of 1.72 tests per person). Group 1 had significantly more HIV testing than the control group (IRR 1.32, 95% CI 1.09-4.58; P=.01), while group 2 did not differ significantly from the controls (IRR 1.06, 95% CI 0.86-1.30; P=.60). The proportion of UAI was not statistically different among different groups, but all 3 groups had UAI, which declined from baseline. CONCLUSIONS Repeated HIV risk assessments coupled with tailored feedback through GSN apps improved HIV testing. Such interventions should be considered a simple way of improving HIV testing among MSM in China and increasing awareness of HIV status. TRIAL REGISTRATION ClinicalTrials.gov NCT03320239; https://clinicaltrials.gov/study/NCT03320239.
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Affiliation(s)
- Qianqian Luo
- School of Nursing, Binzhou Medical University, Yantai, China
| | - Zunyou Wu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guodong Mi
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Blued City Holdings, Ltd, Beijing, China
| | - Jie Xu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sarah Robbins Scott
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Wu X, Wu G, Ma P, Wang R, Li L, Sun Y, Xu J, Li Y, Zhang T, Li Q, Yang Y, Wang L, Xin X, Qiao Y, Fang B, Lu Z, Zhou X, Chen Y, Liu Q, Fu G, Wei H, Huang X, Su B, Wang H, Zou H. Immediate and long-term outcomes after treat-all among people living with HIV in China: an interrupted time series analysis. Infect Dis Poverty 2023; 12:73. [PMID: 37580822 PMCID: PMC10424386 DOI: 10.1186/s40249-023-01119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/12/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND In 2003, China implemented free antiretroviral therapy (ART) for people living with HIV (PLHIV), establishing an eligibility threshold of CD4 < 200 cells/μl. Subsequently, the entry criteria were revised in 2012 (eligibility threshold: CD4 ≤ 350 cells/μl), 2014 (CD4 ≤ 500 cells/μl), and 2016 (treat-all). However, the impact of treat-all policy on HIV care and treatment indicators in China is unknown. We aimed to elucidate the immediate and long-term impact of the implementation of treat-all policy in China. METHODS Anonymized programmatic data on ART initiation and collection in PLHIV who newly started ART were retrieved between 1 January 2015 and 31 December 2019, from two provincial and municipal Centers for Disease Control and Prevention and ten major infectious disease hospitals specialized in HIV care in China. We used Poisson and quasi-Poisson segmented regression models to estimate the immediate and long-term impact of treat-all on three key indicators: monthly proportion of 30-day ART initiation, mean CD4 counts (cells/μl) at ART initiation, and mean estimated time from infection to diagnosis (year). We built separate models according to gender, age, route of transmission and region. RESULTS Monthly data on ART initiation and collection were available for 75,516 individuals [gender: 83.8% males; age: median 39 years, interquartile range (IQR): 28-53; region: 18.5% Northern China, 10.9% Northeastern China, 17.5% Southern China, 49.2% Southwestern China]. In the first month of treat-all, compared with the contemporaneous counterfactual, there was a significant increase in proportion of 30-day ART initiation [+ 12.6%, incidence rate ratio (IRR) = 1.126, 95% CI: 1.033-1.229; P = 0.007] and mean estimated time from infection to diagnosis (+ 7.0%, IRR = 1.070, 95% CI: 1.021-1.120; P = 0.004), while there was no significant change in mean CD4 at ART initiation (IRR = 0.990, 95% CI: 0.956-1.026; P = 0.585). By December 2019, the three outcomes were not significantly different from expected levels. In the stratified analysis, compared with the contemporaneous counterfactual, mean CD4 at ART initiation showed significant increases in Northern China (+ 3.3%, IRR = 1.033, 95% CI: 1.001-1.065; P = 0.041) and Northeastern China (+ 8.0%, IRR = 1.080, 95% CI: 1.003-1.164; P = 0.042) in the first month of treat-all; mean estimated time from infection to diagnosis showed significant increases in male (+ 5.6%, IRR = 1.056, 95% CI: 1.010-1.104; P = 0.016), female (+ 14.8%, IRR = 1.148, 95% CI: 1.062-1.240; P < 0.001), aged 26-35 (+ 5.3%, IRR = 1.053, 95% CI: 1.001-1.109; P = 0.048) and > 50 (+ 7.8%, IRR = 1.078, 95% CI: 1.000-1.161; P = 0.046), heterosexual transmission (+ 12.4%, IRR = 1.124, 95% CI: 1.042-1.213; P = 0.002) and Southwestern China (+ 12.9%, IRR = 1.129, 95% CI: 1.055-1.208; P < 0.001) in the first month of treat-all. CONCLUSIONS The implementation of treat-all policy in China was associated with a positive effect on HIV care and treatment outcomes. To advance the work of rapid ART, efforts should be made to streamline the testing and ART initiation process, provide comprehensive support services, and address the issue of uneven distribution of medical resources.
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Affiliation(s)
- Xinsheng Wu
- Shenzhen Campus of Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
- School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
| | - Guohui Wu
- Institute for AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, People's Republic of China
| | - Ping Ma
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, People's Republic of China
- Tianjin Association of STD/AIDS Prevention and Control, Tianjin, People's Republic of China
| | - Rugang Wang
- Dalian Public Health Clinical Center, Dalian, People's Republic of China
| | - Linghua Li
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yinghui Sun
- Shenzhen Campus of Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
- School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, People's Republic of China
| | - Yuwei Li
- Shenzhen Campus of Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
- School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
| | - Tong Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, No.8 Xitoutiao, Youanmenwai, Feng Tai District, Beijing, 100069, People's Republic of China
| | - Quanmin Li
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yuecheng Yang
- Dehong Prefecture Center for Disease Control and Prevention, Dehong, People's Republic of China
| | - Lijing Wang
- Shijiazhuang Fifth Hospital, Shijiazhuang, People's Republic of China
| | - Xiaoli Xin
- No.6 People's Hospital of Shenyang, Shenyang, People's Republic of China
| | - Ying Qiao
- No.2 Hospital of Hohhot, Hohhot, People's Republic of China
| | - Bingxue Fang
- Shenzhen Campus of Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
- School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
| | - Zhen Lu
- Shenzhen Campus of Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
- School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
| | - Xinyi Zhou
- Shenzhen Campus of Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
- School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
| | - Yuanyi Chen
- Shenzhen Campus of Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
- School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
| | - Qi Liu
- Shenzhen Campus of Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
- School of Public Health (Shenzhen), Sun Yat-sen University, No. 66, Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, People's Republic of China
| | - Gengfeng Fu
- Department of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Hongxia Wei
- Department of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, 1-1 Zhongfu Road, Nanjing, 210036, Jiangsu, People's Republic of China.
| | - Xiaojie Huang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, No.8 Xitoutiao, Youanmenwai, Feng Tai District, Beijing, 100069, People's Republic of China.
| | - Bin Su
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, No.8 Xitoutiao, Youanmenwai, Feng Tai District, Beijing, 100069, People's Republic of China.
| | - Hui Wang
- National Clinical Research Centre for Infectious Diseases, The Third People's Hospital of Shenzhen and The Second Affiliated Hospital of Southern, University of Science and Technology, Bulan Road 29#, Longgang District, Shenzhen, 518112, Guangdong, People's Republic of China.
| | - Huachun Zou
- School of Public Health, Fudan University, 130 Dongan Road, Xuhui District, Shanghai, 200032, People's Republic of China.
- School of Public Health, Southwest Medical University, Luzhou, People's Republic of China.
- Kirby Institute, University of New South Wales, Sydney, Australia.
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7
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Zhou Y, Li Y, Xiao X, Qian HZ, Wang H. Perceptions toward antiretroviral therapy and delayed ART initiation among people living with HIV in Changsha, China: mediating effects of treatment willingness. Front Public Health 2023; 11:1105208. [PMID: 37383264 PMCID: PMC10294673 DOI: 10.3389/fpubh.2023.1105208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/11/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction Delayed antiretroviral therapy (ART) initiation is associated with poor HIV outcomes and a higher likelihood of HIV transmission. Methods This cross-sectional study assessed the proportion of delayed ART initiation which was defined as initiating ART after 30 days of HIV diagnosis, and evaluated the pathways influencing ART initiation among adult PLWH in Changsha, China who were diagnosed between 2014 and 2022. Results Of 518 participants, 37.8% delayed in initiating ART. Based on the theory of reasoned action (TRA), delayed initiation was indirectly associated with perceptions toward ART through the mediating pathway of patients' treatment willingness, with treatment willingness significantly being the full mediator. Discussion The findings may guide the development of interventions to improve timely uptake of ART in people who are newly diagnosed with HIV.
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Affiliation(s)
- Yaqin Zhou
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yixuan Li
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xueling Xiao
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Han-Zhu Qian
- School of Public Health, Yale University, New Haven, CT, United States
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, China
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Wang Y, Ma Y, Zhu Q, Xu W, Sun H, Li D, Jin C. Implementing Routine HIV Screening in Hospitals: An Effective Practice to Expand HIV Testing - Xishuangbanna Prefecture, Yunnan Province, China, 2019-2020. China CDC Wkly 2023; 5:283-286. [PMID: 37139144 PMCID: PMC10150746 DOI: 10.46234/ccdcw2023.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
What is already known about this topic? Research evidence is insufficient to suggest whether routine human immunodeficiency virus (HIV) screening in healthcare settings is effective in promoting greater awareness of HIV-positive status. What is added by this report? This study found that, following the implementation of routine HIV screening in hospitals in Xishuangbanna Prefecture, Yunnan Province, there was a significant increase in the number of HIV screenings, positive results, and the positive rate of HIV screening in primary-level hospitals. What are the implications for public health practice? Routine hospital-based HIV screening is effective in identifying HIV infections in areas with concentrated epidemics.
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Affiliation(s)
- Yidan Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanling Ma
- Yunnan Center for Disease Control and Prevention, Kunming City, Yunnan Province, China
| | - Qiyu Zhu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenyue Xu
- Xishuangbanna Center for Disease Control and Prevention, Xishuangbanna Prefecture, Yunnan Province, China
| | - Haolan Sun
- School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Australia
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cong Jin
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Cong Jin,
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