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Dai Y, Li Y, Zhou D, Zhang J. Analysis of risky sexual behaviors among male college students who were sexually active in Sichuan, China: a cross-sectional survey. AIDS Res Ther 2024; 21:46. [PMID: 39061023 PMCID: PMC11282637 DOI: 10.1186/s12981-024-00636-1] [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: 02/24/2023] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Males have accounted for a significant share of new HIV infections among young people in the recent years. This study aimed to identify the factors associated with risky sexual behaviors, including early sexual debut, multiple sexual partnership and condomless sex, among sexually active male college students and provide implications for tailored health interventions. METHODS The cross-sectional study was conducted from December 2020 to December 2021 in 16 colleges that were located in Sichuan Province, one of the high-risk areas in China. Overall 1640 male college students who reported sexually experienced were analyzed in this study. Multivariable logistic regression analysis was applied to determine factors associated with early sexual debut, multiple sexual partnership and condomless sex. RESULTS The average age of included male students was 19.95 ± 1.56. Of them, 27.74% initiated sexual behavior early, 48.60% reported multiple sexual partnership, and 16.52% did not use condoms at the latest sexual intercourse. Students who were younger (age ≤ 19, AOR = 7.60, 95%CI: 4.84-11.93; age20-21, AOR = 3.26, 95%CI: 2.04-5.21) and self-identified as sexual minorities (AOR = 2.38, 95%CI: 1.69-3.36) were more likely to have early sexual debut. The odds of having multiple sexual partners were higher among those who were ethnic minorities (AOR = 1.79, 95%CI: 1.33-2.41) and accepted extramarital sex (AOR = 1.33, 95%CI: 1.03-1.71). The likelihood of engaging in condomless sex at the latest sexual intercourse was lower among those who had sufficient knowledgeable about HIV (AOR = 0.63, 95%CI: 0.44-0.89), were very confident in condom use efficacy (AOR = 0.26, 95%CI: 0.16-0.43) and confident (AOR = 0.48, 95%CI: 0.34-0.69). Early sexual debut was positively associated with multiple sexual partnership (AOR = 3.64, 95%CI: 2.82-4.71) and condomless sex at the latest intercourse (AOR = 1.53, 95%CI: 1.07-2.20), respectively. CONCLUSION Early sexual debut, multiple sexual partnership and condomless sex were of considerable concern among male college students. Comprehensive sex education curricula were advised by developing customized information on HIV prevention, sexuality and empowering students with assertiveness and negotiation skills with regard to condom use during and before college.
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Affiliation(s)
- Yingxue Dai
- Chengdu Center for Disease Control and Prevention, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yajie Li
- Center for Disease Control and Prevention of Tibet autonomous region, Lhasa, China
| | - Dinglun Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jianxin Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Zhong X, Yuan D, Fan SF, Liu Y, Su L, He SJ, Liang S, Yang Y. Molecular network analysis of 308 newly diagnosed HIV infection and 210 ART failure patients from rural counties in Sichuan. PLoS One 2024; 19:e0298324. [PMID: 38363761 PMCID: PMC10871515 DOI: 10.1371/journal.pone.0298324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 01/18/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Few studies on molecular epidemiology have studied people with newly diagnosed HIV infection and ART Failure Patients at the same time in rural China. With more serious HIV epidemic than in other provinces in China, Sichuan is an area suitable for this study. OBJECTIVE To analyze the characteristics of HIV-1 molecular networks and factors related to network entry among newly diagnosed HIV infection and ART Failure Patients in three county-level cities (A, B, C) in Sichuan Province, to provide scientific basis for accurate prevention and control. METHODS Nested PCR amplification method was used to amplify HIV-1 pol gene region of 530 blood samples, Sequencer 4.9 was used to edit, clean and splice the gene sequence, Bioedit correction, Fastree 2.1.8 and Figtree 1.4.2 to construct evolutionary tree and determine genotype. HyPhy2.2.4 and Cytoscape 3.6.1 software were used to construct molecular network. Logistic regression analysis was applied. RESULTS 523(98.68%) pol sequences were obtained, and a total of 518 valid sequences with basic information came into the final analyses. A total of 6 genotypes were detected, namely CRF01_AE (320,61.78%), CRF07_BC (149,28.76%), B (30,5.79%), CRF08_BC (11, 2.12%), CRF55_01B (6, 1.16%) and C (2, 0.39%). 186 of 518(35.91%) sequences entered the network at a genetic distance of 0.8%, forming 42 propagation clusters. "High-risk transmitters"(connected with two and more) accounted for 21.62%. Logistic regression showed that≥50 years old (OR = 2.474) were more risky than 18-49 years old, CRF07_BC sub-type (OR = 0.174) were less risky than CRF01_AE sub-type, B sub-type (OR = 6.698) is higher risky than CRF01_AE sub-type, and District B (OR = 0.077) less risky than that of A city. CONCLUSION The sources of HIV infection in rural Sichuan are diversified and complicated. The prevention and control of HIV infection in Sichuan Province should focus on strengthening the long-term dynamic detection of elderly population, B strain sub-type, and in City A.
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Affiliation(s)
- Xia Zhong
- School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dan Yuan
- Institute of HIV/AIDS prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Shuang feng Fan
- Department of HIV/AIDS prevention, Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Yang Liu
- Department of HIV/AIDS prevention, Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Ling Su
- Institute of HIV/AIDS prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Shi Jiao He
- Department of HIV/AIDS prevention, Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Shu Liang
- Institute of HIV/AIDS prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yi Yang
- School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Zhang L, Mou Y, Wang J. East-west disparities in safer sex inside China: a sociocultural perspective. Sex Health 2023; 20:323-329. [PMID: 37088545 DOI: 10.1071/sh22025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/27/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND This study responds to the increasing rate of HIV/AIDS and unplanned pregnancies among Chinese college students from a sociocultural perspective, and investigates the influences of sociocultural factors in shaping sex-related beliefs and acts among Chinese college students. METHODS An online survey was conducted on a purposive sample of 1286 female college students in four cities in east and west China. RESULTS Significant east-west disparities have emerged in the rate of sexual intercourse experience, rate of safer sex, conservative sexual values, authority sex education, unofficial sex knowledge access and HIV knowledge. A higher rate of sexual activity, but lower rate of safer sex, were found among the students in the west relative to those in the east. CONCLUSIONS This study demonstrates that in a large country, such as China, regional disparities in economy, social development and sexual norms are salient to affect individuals' sexual behaviours.
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Affiliation(s)
- Lin Zhang
- School of Media & Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Mou
- School of Media & Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Jilong Wang
- School of Media & Communication, Shanghai Jiao Tong University, Shanghai, China
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Yang Y, Deng H, He H, Fan SF, Li Y, Wu X, Li N, Xi J, Xu J, Xiao J, Liao RP, Xiao W. Lifetime commercial heterosexual behavior among HIV negative elderly men from rural Chengdu, China: a modified knowledge-attitude-practice perspective. BMC Public Health 2021; 21:2095. [PMID: 34781900 PMCID: PMC8594087 DOI: 10.1186/s12889-021-12139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background China is facing big challenges to achieve the “90–90-90 targets”. The HIV prevalence of elderly (≥50 years) men have been steadily increasing in China, mainly through the sexual transmission route, but sexual behaviors of them are far from well-studied. In 2019, elderly men accounted for 59.2% of HIV/AIDS cases in Sichuan, China. Methods The research design is a cross-sectional study. Face-to-face interviews were conducted among 795 HIV negative elderly men from rural Chengdu, capital City of Sichuan. Bivariate and multivariate logistic regression models were applied to examine factors associated with commercial heterosexual behavior from a modified Knowledge-Attitude-Practice (KAP) perspective. Results 129 (16.23%) respondents admitted high-risk sexual behaviors, including 11.07% commercial heterosexual behavior, 6.16% extramarital, 2.89% casual and 0.25% homosexual behavior, and no one used condom consistently. 427(68.43%) had ever gotten HIV-related Health Education (HRHE), mainly through mass media (70.49%). The HIV-related knowledge awareness rate was only 31.41%. Migration history (AOR =2.46,95% CI = 1.02–5.91), age(≥60 vs. 50–59, OR = 0.41, 95% CI = 0.19–0.91), receiving HRHE from mass media (OR = 0.37, 95%CI = 0.16–0.85), marital status (married vs. never married, OR = 0.04, 95%CI = 0–0.52), and undecided (AOR =0.02, 95%CI = 0.01–0.09) and objection (AOR =0.04, 95%CI = 0.01–0.1) attitude toward commercial sex were related to lifetime commercial heterosexual behavior. Conclusions High-risk sexual behaviors are common among elderly men from rural areas in Chengdu. Receiving HRHE from mass media and undecided and objection attitude toward commercial sex prevent elderly from being involving in commercial heterosexual behavior. According to the results, health facilities should continue to conduct systematic interventions, paying more attention to 50–59 years old group. Sex and condom use need to be talked in public. Working with mass media, health facilities give elderly men education not only focusing on HIV/AIDS, but also on knowledge and skills of condom use.
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Affiliation(s)
- Yi Yang
- Department of Social Medicine and Health Administration, School of Administration, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, 611137, China.
| | - Hua Deng
- Department of Urology, Chengdu Second Peoples' Hospital, 10 Qingyunnan Road, Chengdu, 610017, China
| | - Huan He
- School of Public Administration, Southwestern University of Finance and Economics, 555 Liutai Avenue, Wenjiang District, Chengdu, China
| | - Shuang Feng Fan
- Department of HIV/AIDS prevention, Chengdu Center for Disease Control and Prevention, No.4, Longxiang Road, Wuhou District, Chengdu, 610000, China
| | - Yuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, 611137, China
| | - Xia Wu
- Department of HIV/AIDS prevention, Pengzhou Center for Disease Control and Prevention, 331 Longta Road, Pengzhou District, Chengdu, 610000, China
| | - Na Li
- Department of HIV/AIDS prevention, Pengzhou Center for Disease Control and Prevention, 331 Longta Road, Pengzhou District, Chengdu, 610000, China
| | - Jing Xi
- Department of HIV/AIDS prevention, Chengdu Center for Disease Control and Prevention, No.4, Longxiang Road, Wuhou District, Chengdu, 610000, China
| | - Jing Xu
- Department of Social Medicine and Health Administration, School of Administration, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, 611137, China
| | - Jie Xiao
- Department of Social Medicine and Health Administration, School of Administration, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, 611137, China
| | - Rui Ping Liao
- Department of HIV/AIDS prevention, Pengzhou Center for Disease Control and Prevention, 331 Longta Road, Pengzhou District, Chengdu, 610000, China
| | - Wei Xiao
- Department of HIV/AIDS prevention, Pengzhou Center for Disease Control and Prevention, 331 Longta Road, Pengzhou District, Chengdu, 610000, China
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Yuan D, Yu B, Li Y, Wang Z, Liu M, Ye L, Huang Y, Su L, Zhang Y, Api L, Chen M, Zhou C, Liu L, Zhang L, Liang S, Jia P, Yang S. Prevalence and Molecular Epidemiology of Transmitted Drug Resistance and Genetic Transmission Networks Among Newly Diagnosed People Living With HIV/AIDS in a Minority Area, China. Front Public Health 2021; 9:731280. [PMID: 34708015 PMCID: PMC8542729 DOI: 10.3389/fpubh.2021.731280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/02/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Transmitted drug resistance (TDR) can compromise antiretroviral therapy (ART) efficacy. We aimed to understand the molecular epidemiology of TDR and its genetic transmission networks among newly diagnosed people living with HIV/AIDS (PLWH). Methods: A total of 1,318 newly diagnosed PLWH, identified in all population-based HIV screening in an HIV-affected county of a minority area of China (i.e., Butuo county), were enrolled between January 1, 2018, and November 31, 2018. HIV-1 pol gene sequences were used for phylogenetic and genotypic drug resistance analyses. The genetic transmission networks were identified. Results: The prevalence of TDR among newly diagnosed PLWH was 8.12% (107/1,318). Patients in the stage of AIDS (adjusted odds ratio, OR: 2.32) and who had a history of sharing a needle ≥5 times (adjusted OR: 3.89) were more likely to have an increased risk of TDR. The prevalence of TDR for non-nucleoside reverse transcriptase inhibitors (NNRTIs) is higher than that of other inhibitors, with a relatively high prevalence of three mutations [V179D/E/DE (4.93%), K103N/KN (3.11%), and E138A/G (1.52%)]. A total of 577 (43.78%) pol sequences were involved in the genetic transmission network, with 171 clusters ranging in size from 2 to 91 pol sequences; 37.38% (40/107) of individuals carrying TDR were involved in the network, and individuals with the same TDR-associated mutations were usually cross-linked. Conclusions: Our data suggest a relatively high level of TDR and many transmission clusters among the newly diagnosed PLWH. Targeted intervention, early identification, and monitoring of resistance are warranted to reduce the TDR and prevent HIV-1 transmission in areas with a high rate of HIV-1.
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Affiliation(s)
- Dan Yuan
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Bin Yu
- West China Second University Hospital of Sichuan University and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yiping Li
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Zixin Wang
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Meijing Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Ye
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yuling Huang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Ling Su
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yan Zhang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Laze Api
- Butuo Center for Disease Control and Prevention, Liangshan, China
| | - Maogang Chen
- Liangshan Center for Disease Control and Prevention, Xichang, China
| | - Chang Zhou
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Li Liu
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Linglin Zhang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Shu Liang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Peng Jia
- School of Resources and Environmental Science, Wuhan University, Wuhan, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan University, Wuhan, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan University, Wuhan, China
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Yang S, Jike C, Pei R, Liu D, Yu G, Wang J, Zhong S, Jike E, Jia P, Wang Z. Perceptions of social norms played an important role in the occurrence of casual sex among Yi minority residents in China: a population-based study. AIDS Care 2021; 34:908-915. [PMID: 34011235 DOI: 10.1080/09540121.2021.1929814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Liangshan is one of the areas severely affected by both HIV and poverty in China. We investigated associations between perceptions of social norms related to casual sex and the occurrence of casual sex in lifetime among Yi minority people. Participants were Yi minority people aged 15-49 years old living in Liangshan. Of the participants, 11.8% were confirmed to be HIV-positive. About half of the participants (46.6%) had engaged in casual sex in their lifetime. All six perceptions of social norms were significantly associated with the presence of casual sex in lifetime. They were acceptable of belife: (1) casual sex in general (OR: 15.03), (2) not to use condom during casual sex (OR: 1.58), (3) a Yi woman to have more than one sex partner(OR: 4.54), (4) a Yi man to have more than one sex partner(OR: 4.51), (5) premarital sex with casual sex partner (OR: 4.29), and (6) extra-marital sex with casual sex partner (OR: 3.23). Casual sex may play an important role in facilitating HIV transmission among Yi minority people. Future interventions should consider making use of the Yi clan system to change perceptions of social norms related to casual sex.
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Affiliation(s)
- Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China
| | - Chunnong Jike
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, People's Republic of China
| | - Rong Pei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Gang Yu
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, People's Republic of China
| | - Ju Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, People's Republic of China
| | - Shiyong Zhong
- Butuo County Center for Disease Prevention and Control, Butuo, People's Republic of China
| | - Ersha Jike
- Butuo County Center for Disease Prevention and Control, Butuo, People's Republic of China
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China.,Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Zixin Wang
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
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Dong Z, Ma L, Cai C, Gao GF, Lyu F. Demographic features of identified PLWHA infected through commercial and nonmarital noncommercial heterosexual contact in China from 2015 to 2018: a retrospective cross-sectional study. BMC Infect Dis 2021; 21:71. [PMID: 33441089 PMCID: PMC7807498 DOI: 10.1186/s12879-020-05757-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/29/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Understanding the demographic characteristics of people living with HIV/AIDS (PLWHA) infected through commercial heterosexual contact (CHC) or nonmarital noncommercial heterosexual contact (NMNCHC) is important for HIV/AIDS prevention and control. METHODS Cases reported through the Chinese HIV/AIDS Case Reporting System (CRS) from 2015 to 2018 were analyzed. A descriptive and preliminary inferential analysis were performed for those demographic characteristics deemed of interest. RESULTS Overall, 523,121 identified PLWHA between 2015 and 2018 in the CRS were analyzed. The constituent ratio of heterosexual transmission increased from 66.25% in 2015 to 71.48% in 2018. The proportion of CHC heterosexual transmission decreased from 40.18% in 2015 to 37.99% in 2018, while that of NMNCHC increased from 46.33% in 2015 to 49.02% in 2018. PLWHA infected through NMNCHC were significantly younger than those who were infected through CHC (Student's t test, P < 0.0001), with an average age gap ranging from 5.63 (2015) to 7.46 (2018) years, and the average age of both groups increased annually. The frequency of newly identified PLWHA who were infected through CHC had a remarkable increase among the ages of 65 and above. Gender distribution was significantly different between CHC and NMNCHC (χ2 = 8909.00(2015), 9941.90(2016), 11,004.00 (2017), 12,836.00(2018), all P < 0.0001), and the ratio of men to women in the NMCHC group was 1.50:1 (2015), 1.51:1 (2016), 1.54:1 (2017), and 1.52:1 (2018), while in the commercial heterosexual contact (CHC) group, these ratios were 11.45:1 (2015), 12.08:1 (2016), 12.53:1 (2017), and 13.28:1 (2018). Marital status was significantly different between CHC and NMNCHC (χ2 = 94.67 (2015), 109.88(2016), 58.18(2017), 152.38(2018), all P < 0.0001). As the educational level improved, the proportion of NMNCHC also increased (Cochran - Armitage test, P < 0.0001). CONCLUSIONS We found that heterosexual transmission was the primary mode of HIV transmission in China from 2015 to 2018. PLWHA infected through CHC and NMNCHC had different characteristics in age, gender, marital status, and educational level. The frequency of PLWHA infected through CHC increased substantially in the age group of 65 and above. This study provides useful baseline data for future studies on the heterosexual transmission of HIV in China.
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Affiliation(s)
- Zhilong Dong
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Liying Ma
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Chang Cai
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - George Fu Gao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
| | - Fan Lyu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
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Liu L, Dong A, Liao L, Feng Y, Shao Y, Liang S, Ruan Y, Xing H. Survey of Pretreatment HIV Drug Resistance and Genetic Transmission Network Analysis Among HIV Patients in a High Drug-Use Area of Southwest China. Curr HIV Res 2021; 17:441-451. [PMID: 31778107 PMCID: PMC7497539 DOI: 10.2174/1570162x17666191128101426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 11/22/2022]
Abstract
Background: Pretreatment drug resistance (PDR) poses an increasing threat to the success of antiretroviral treatment (ART) programs in China. We aimed to conduct a survey of PDR among HIV patients in an area in Southwest China with extensive drug trafficking. Methods: Consecutive cross-sectional surveys were conducted in Liangshan Prefecture of Sichuan Province from 2009 to 2018 based on the WHO-recommended method. PDR was identified by testing pol region sequences with the Stanford HIVdb algorithm (version 7.0). PDR prevalence and related factors were assessed by multivariable logistic regression. The transmission of HIV drug resistance was analyzed using a genetic transmission network. Results: HIV-1 pol genes from 1889 patients were successfully amplified. The distribution of HIV-1 genotypes was as follows: CRF07_BC (94.0%), CRF08_BC (2.3%), CRF01_AE (2.0%) and others (1.4%). Of the participants, 6.9% (95% CI: 4.1-8.1%) had pretreatment resistance to 12 antiretroviral drugs recommended by the WHO, and nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitors (PI) resistance were identified among 1.4% (95% CI: 0.7-3.4%), 5.8% (95% CI: 1.2-8.7%) and 0.4% (95% CI: 0.1-3.0%) of the patients, respectively. In the multivariate logistic model, the prevalence of PDR was 1.52-fold higher among intravenous drug users (IDUs) than among patients infected by heterosexual transmission (95% CI: 1.07-2.38; P=0.049), and the prevalence of PDR among patients diagnosed from 2017-2018 was 2.03-fold higher than that among patients diagnosed from 2009-2016 (95% CI: 1.18-5.76; P=0.018). A total of 26 clusters containing PDR and a rapidly growing drug resistance-related cluster containing the E138Q and V179D mutations were identified by genetic transmission network analysis. Conclusion: The results show a moderate overall level of PDR prevalence and rapidly growing drug resistance over time. Preventive intervention should be focused on controlling the HIV epidemic among drug users, and surveillance is urgently needed to monitor the trend of PDR.
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Affiliation(s)
- Lei Liu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Aobo Dong
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Lingjie Liao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Yi Feng
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Yiming Shao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Shu Liang
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yuhua Ruan
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Hui Xing
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
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Yuan D, Liu M, Li Y, Jia P, Su L, Ye L, Zhang Y, Ling P, Zhou C, Liang S, Yang H, Liu H, Yang S. Genetic transmission networks of HIV-1 CRF07_BC strain among HIV-1 infections with virologic failure of ART in a minority area of China: a population-based study. BMC Infect Dis 2020; 20:631. [PMID: 32842977 PMCID: PMC7448482 DOI: 10.1186/s12879-020-05347-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/13/2020] [Indexed: 12/16/2022] Open
Abstract
Background The drug resistance and the virologic failure of antiretroviral therapy (ART) are quite severe in Liangshan. A better understanding of the virologic failure of ART and the HIV-1 transmission network dynamics is essential for the surveillance and prevention of HIV. Here, we analyzed the HIV-1 CRF07_BC strain genetic transmission networks and their associated factors among people living with HIV-1 (PLWH) who had virologic failure of ART by using close genetic links. Methods The drug-resistant mutations were determined using the Stanford University HIV Drug Resistance Database. HIV-1 pol genes sequences were used for phylogenetic and genotypic drug resistance analysis. The genetic transmission networks were performed by comparing sequences, constructing the phylogenetic tree, calculating the pairwise distance, and visualizing the network. Results A total of 1050 PLWH with CRF07_BC pol sequences were finally identified and included in the genetic transmission network analysis from 2016 to 2017. Of the 1050 CRF07_BC pol sequences, 346 (32.95%) fell into clusters at a genetic distance of 0.006, resulting in 137 clusters ranging in size from 2 to 40 individuals. Subjects who were widowed or divorced were less likely to form a genetic transmission network (adjusted OR: 0.50), while subjects who had shared a needle ≥ five times were more likely to form a network (adjusted OR: 1.88). Conclusions The genetic transmission networks revealed the complex transmission pattern, highlighting the urgent need for transmission monitoring of virologic failure of ART and selection of more effective therapeutic regimens to promote viral suppression.
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Affiliation(s)
- Dan Yuan
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Meijing Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Number16, Section 3, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Yiping Li
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ling Su
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Li Ye
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yan Zhang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Pan Ling
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Chang Zhou
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Shu Liang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Hong Yang
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Honglu Liu
- Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China.
| | - Shujuan Yang
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China. .,West China School of Public Health and West China Fourth Hospital, Sichuan University, Number16, Section 3, South Renmin Road, Chengdu, 610041, Sichuan, China.
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10
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Pei R, Ji-Ke C, Yu G, Yang Y, Nan L, Liao Q, Wang J, Liu D, Yang S. Sexual behaviors related to HIV infection in Yi women of childbearing age in rural areas of southwest China. AIDS Care 2020; 32:1388-1392. [PMID: 32583673 DOI: 10.1080/09540121.2020.1784445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Liangshan Prefecture, the highest HIV-affected epidemic region in China, has more than 2.5 million Yi people. We firstly investigated the sexual behaviors and the related social determinants of health for HIV infection in Yi women of childbearing age in this area. A total of 800 Yi women of childbearing age were enrolled. Path analysis of the risk factors revealed that casual sex (0.152) and number of sex partners (0.152) were directly associated with HIV infection. Furthermore, education level (0.057), out-migrating for work (0.032), sense of self-worth (0.024) and number of sex partners (0.079) were indirectly related to HIV infection and mediated by casual sex and multiple sexual partners. The epidemic of HIV infection among Yi women of childbearing age in Liangshan Prefecture is serious, future promotion should increase their knowledge about condom and modify their perceptions of sexual behaviors.
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Affiliation(s)
- Rong Pei
- Sichuan University of Arts and Science, Dazhou, People's Republic of China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Chunnong Ji-Ke
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Gang Yu
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Yihui Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, People's Republic of China
| | - Lei Nan
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Qiang Liao
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Ju Wang
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.,International Initiative on Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China
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11
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Shi Y, Yang Y, Wang Y, Yang D, Yang Y, Dong S, Li C, Chen Y, Jiang Q, Zhou Y. Prevalence and associated factors of Treponema pallidum infection in a rural area of southwestern China. BMC Public Health 2020; 20:824. [PMID: 32487047 PMCID: PMC7268706 DOI: 10.1186/s12889-020-08952-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 05/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background Epidemiological data on Treponema pallidum infection are scarce from the southwestern region of China. The purpose of this study was to determine the distribution and determinants of T. pallidum infection in the region. Methods A community-based cross-sectional study of 2608 participants aged ≥14 years was conducted in a rural area of southwestern China in 2014–15. A pretested questionnaire was used to collect sociodemographic characteristics and other factors associated with T. pallidum infection. The diagnoses of T. pallidum, human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were determined by commercial test kits. Logistic regression analysis was used to determine the correlates for T. pallidum infection, and adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. Results The prevalence of T. pallidum infection was 1.2% (95% CI 0.8 to 1.7%). Risk factors varied by gender. In the male group, T. pallidum infection was significantly associated with ever injection drug use (aOR = 9.42, 95% CI 2.47 to 35.87) and HCV infection (aOR = 13.28, 95% CI 3.20 to 51.70). In the female group, correlates for T. pallidum infection included spouse having syphilis (aOR = 126.66, 95% CI 7.58 to 2122.94), ever having blood transfusion (aOR = 10.51, 95% CI 1.58 to 41.21) and HBV infection (aOR = 4.19, 95% CI 1.35 to 10.93). Conclusions The prevalence of T. pallidum infection was high in the rural area of southwestern China. Correlates for T. pallidum infection varied with sex specific. Intervention should be developed for the prevention and control of T. pallidum infection.
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Affiliation(s)
- Ying Shi
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Ya Yang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yingjian Wang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Dongjian Yang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yu Yang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Shurong Dong
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Chunlin Li
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada
| | - Qingwu Jiang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yibiao Zhou
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. .,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.
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12
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Impact of maternal HIV infection on pregnancy outcomes in southwestern China - a hospital registry based study. Epidemiol Infect 2020; 147:e124. [PMID: 30868995 PMCID: PMC6518757 DOI: 10.1017/s0950268818003345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Globally, human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) continues to be a major public health issue. With improved survival, the number of people living with HIV/AIDS is increasing, with over 2 million among pregnant women. Investigating adverse pregnant outcomes of HIV-infected population and associated factors are of great importance to maternal and infant health. A cross-sectional data collected from hospital delivery records of 4397 mother-infant pairs in southwestern China were analysed. Adverse pregnant outcomes (including low birthweight/preterm delivery/low Apgar score) and maternal HIV status and other characteristics were measured. Two hundred thirteen (4.9%) mothers were HIV positive; maternal HIV infection, rural residence and pregnancy history were associated with all three indicators of adverse pregnancy outcomes. This research suggested that maternal population have high prevalence in HIV infection in this region. HIV-infected women had higher risks of experiencing adverse pregnancy outcomes. Rural residence predisposes adverse pregnancy outcomes. Findings of this study suggest social and medical support for maternal-infant care needed in this region, selectively towards rural areas and HIV-positive mothers.
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13
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Xiao C, Jike C, Liu D, Jia P, Xu X, Xiao L, Yu G, Nan L, Sun X, Ge J, Wang J, Wang K, Liao Q, Wang Q, Wenwen Z, Yang S. The changing modes of human immunodeficiency virus transmission and spatial variations among women in a minority prefecture in southwest China: An exploratory study. Medicine (Baltimore) 2020; 99:e18776. [PMID: 32028390 PMCID: PMC7015565 DOI: 10.1097/md.0000000000018776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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
Liangshan Yi Autonomous Prefecture in Southwest China has a high human immunodeficiency virus (HIV) prevalence rate. This study examined the changing modes of HIV transmission among women with new HIV infections and explored the spatial heterogeneities in the factors associated with heterosexual transmission in this minority region.The data consisting of women with new HIV infections from 2011 to 2014 were collected from multiple sources. New infections were identified by BED capture enzyme immunoassay. The Bayesian hierarchical model was used to estimate the proportion of women with new HIV infections via heterosexual transmission across all townships in the Prefecture. A geographically weighted regression (GWR) model was utilized to investigate spatial variations in the sociodemographic characteristics associated with the changing modes of HIV transmission.An analytical sample of 927 women with new HIV infections was constructed and utilized to investigate the changing mode of HIV transmission. The rate of heterosexual transmission among women with new HIV infections in 2011 was below 20%. However, by 2014 this rate dramatically increased to nearly 80%. Among sociodemographic characteristics, GWR results revealed significant ethnic differences in heterosexual HIV transmission between Yi women and women in other ethnic groups, with Yi women demonstrating a lower risk of infection through heterosexual transmission. However, such ethnic differences were observed only in 30% of the townships in the Prefecture. Moreover, having a primary education decreased the odds of heterosexual transmission, which was observed in about 56% of the townships. Also, being involved in occupations other than agriculture or animal husbandry and being single or married decreased the odds of HIV infection through heterosexual contact among women, which did not significantly vary across the Prefecture.Heterosexual transmission was the predominant mode of HIV transmission among women in the Prefecture, and this transformation was clearly marked by a fast-growing trend and a spatial diffusion pattern. Spatial variations also existed in sociodemographic factors that were associated with the changing modes of HIV transmission.
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Affiliation(s)
- Chenghan Xiao
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Chunnong Jike
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Danping Liu
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands
| | - Xiaohe Xu
- School of Public Administration, Sichuan University, Chengdu
- Department of Sociology, The University of Texas at San Antonio, TX
| | - Lin Xiao
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Gang Yu
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Lei Nan
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Xiaxia Sun
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Jingjing Ge
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Ju Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Ke Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Qiang Liao
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Qixing Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Zhai Wenwen
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Shujuan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
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14
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Zhang T, Miao Y, Li L, Bian Y. Awareness of HIV/AIDS and its routes of transmission as well as access to health knowledge among rural residents in Western China: a cross-sectional study. BMC Public Health 2019; 19:1630. [PMID: 31801504 PMCID: PMC6894352 DOI: 10.1186/s12889-019-7992-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 11/22/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the coverage of HIV health education among rural residents in western China by ascertaining their awareness of HIV/AIDS and its transmission routes, and to investigate how these residents receive health information. METHODS A survey was conducted through stratified clustered sampling at 99 county hospitals in 11 provinces in western China. Information was collected on awareness of HIV/AIDS and its transmission routes, as well as residents' access to health knowledge. Chi-square analysis was used to analyse the differences in HIV/AIDS awareness (knowing of the existence of HIV/AIDS, hereinafter referred to as "HIV awareness rate") between different subgroups categorized by demographic status, regional factors, and different methods of access to health knowledge. To further analyse the effects of access to health knowledge on HIV awareness, a logistic regression model was established. The relationship between access to health knowledge and transmission routes was also examined using chi-square analysis. RESULTS The HIV awareness rate of the total 9274 participants was 80.9%. There were statistically significant differences between subgroups classified by age (χ2 = 482.118, p<0.001), education (χ2 = 853.465, p<0.001), occupation (χ2 = 340.553, p<0.001), income (χ2 = 186.448, p<0.001), cumulative HIV cases according to province (χ2 = 59.513, p<0.001), per capita annual net income of rural households according to province (χ2 = 64.676, p<0.001), proportion of minority population according to province (χ2 = 94.898, p<0.001), direct access to health knowledge (medical staff: χ2 = 419.775, p<0.001; mass media: χ2 = 740.238, p<0.001; family members: χ2 = 12.189, p<0.001; socializing: χ2 = 48.780, p<0.001; health education activities: χ2 = 154.400, p<0.001), and indirect access to health knowledge (having a non-communicable disease with medical instructions χ2 = 78.709, p<0.001; physical examinations: χ2 = 135.679, p<0.001). The logistic regression model showed that education and mass media had the strongest impacts on HIV awareness among all methods of access. Participants had the least awareness of HIV's mother-to-child transmission route. CONCLUSION The HIV awareness rate indicated that previous HIV health education covered 80% of the rural population in western China. Mass media should take greater responsibility in HIV health education for the general population, and special attention should be paid to the elderly, the most impoverished population, minority community as well as the mother-to-child transmission route.
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Affiliation(s)
- Tianqi Zhang
- Institute of Chinese Medical Sciences & State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Yang Miao
- Institute of Chinese Medical Sciences & State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Lingui Li
- College of Management, Ningxia Medical University, 1160 Shengli Street, Yinchuan, Ningxia Province, China
| | - Ying Bian
- Institute of Chinese Medical Sciences & State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Avenida da Universidade, Taipa, Macau, China.
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15
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Choi EPH, Wong JYH, Fong DYT. Disparities Between HIV Testing Levels and the Self-Reported HIV-Negative Status of Sexually Active College Students. JOURNAL OF SEX RESEARCH 2019; 56:1023-1030. [PMID: 30526085 DOI: 10.1080/00224499.2018.1541961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The methodological issues of using self-reported human immunodeficiency virus (HIV) testing history to determine HIV infection status are understudied. This study aimed to assess the disparities between HIV testing history and self-reported HIV status, with a specific objective of estimating the prevalence of self-reported HIV-negative status in sexually active students who had never had an HIV test (inaccurate self-disclosure). Participants were recruited from four Hong Kong universities; 255 students were included in the analysis, with 16.1% of participants being men who have sex with men (MSM). Overall, 81.6% of participants reported they never had been tested for HIV, with inaccurate self-disclosure by 65.9% of participants. Among participants who used condoms inconsistently, only 20.2% had had HIV tests, with inaccurate self-disclosure by 66.7% of subjects. Among MSM students, only 36.6% had had HIV tests, with inaccurate self-disclosure by 61.0% of participants. Among MSM students who used condoms inconsistently, only 35.1% had had HIV tests, with inaccurate self-disclosure by 62.2% of participants. The findings raise concerns about the use of self-reported HIV status in clinical practice and research. The low prevalence of HIV testing found suggests that interventions to promote HIV testing should be continued.
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16
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Wang H, Chen ACC, Wan S, Chen H. Status and associated factors of self-management in people living with HIV/AIDS in Liangshan area, China: a cross-sectional study. Patient Prefer Adherence 2019; 13:863-870. [PMID: 31213780 PMCID: PMC6538009 DOI: 10.2147/ppa.s203799] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/06/2019] [Indexed: 02/05/2023] Open
Abstract
Background: HIV self-management is a lifetime and central task for people living with HIV/AIDS (PLWH). To date, there is little evidence to identify the related factors of self-management in PLWH from China. Purpose: This study aimed to investigate the status and related factors of self-management in PLWH from the Liangshan area of Sichuan Province, China. Patients and methods: A total of 322 PLWH were recruited from August to December 2017 in the study. Demographics characteristics and disease-related data were documented for each participant, social support was measured by the Medical Outcomes Study Social Support Survey (MOS-SSS-C), and self-management was evaluated by the HIV Self-Management Scale. Descriptive statistics analysis, independent Student's t-test, one-way ANOVA, Spearman rank correlation, and multiple regression analysis were used to analyze the data. Results: The total score of HIV self-management was 38.26±7.17. Significant differences in self-management scores were found among the subgroups of different education level, marital status, nation, religion, resident place, occupation, infection route, symptom, research site, and household per capita monthly income. Self-management was positively significantly correlated with social support. Multiple regression analysis identified that nation, resident place, gender, marital status, and social support were the contributors of HIV self-management. Conclusion: The study demostrated that self-management in Yi Autonomous Prefecture was relatively low. The results indicate that the associated factors of self-management should be considered to develop effective intervention to improve the self-management of PLWH.
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Affiliation(s)
- Huan Wang
- West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Angela Chia-Chen Chen
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Shaoping Wan
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
| | - Hong Chen
- West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Correspondence: Hong ChenWest China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Wuhou District, Chengdu, Sichuan Province, People’s Republic of ChinaTel +861 898 060 1733Email
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Pei R, Ji-ke C, Yang S, Nan L, Wang Q, Zhang S, Liao Q, Yu G, Xiao L, Gong Y, Zhang J, Wang K, Wang J, Wang Z. Risk factors for HIV infection among 15 to 25-year-old rural unmarried Yi adolescents in an ethnic minority region of China. Medicine (Baltimore) 2018; 97:e12279. [PMID: 30200171 PMCID: PMC6133621 DOI: 10.1097/md.0000000000012279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We aimed to analyze factors related to human immunodeficiency virus (HIV) infection among 15 to 25-year-old rural unmarried Yi adolescents in Liangshan Yi Autonomous Prefecture from 2011 to 2016, and to investigate the relationship among the HIV-related risk factors.Three sites (Butuo, Zhaojue, and Ganluo counties) with a Yi population were selected from 2011 to 2016 in Liangshan prefecture. We used questionnaires to investigate demographic and behavioral characteristics and performed HIV testing. Logistic regression analysis and multiple correspondence analysis (MCA) were used to analyze the data.A total of 6311 qualified rural unmarried Yi adolescents were involved in this study, with an HIV infection rate of 4.18% (264/6311). Logistic regression analysis indicated that males (OR = 1.56, 95% CI = 1.17-2.08), illiteracy (OR = 2.70, 95% CI = 1.79-4.08), primary school education or below (OR = 1.62, 95% CI = 1.12-2.36), history of out-migrating for work (OR = 1.58, 95% CI = 1.18-2.13), and injecting drug user (IDU) (OR = 6.42, 95% CI = 3.06-13.46) contributed to the risk of HIV infection. MCA revealed a strong interrelationship between the following risk factors and HIV infection: aged 23 to 25 years, IDU, history of out-migrating for work, and ever having sexual behaviors.HIV infection among 15 to 25-year-old rural unmarried Yi adolescents in Liangshan is a serious issue. MCA and logistic regression analysis can be used to assess the relationship between risk factors for HIV infection.
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Affiliation(s)
- Rong Pei
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Chunnong Ji-ke
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Shujuan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Lei Nan
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Qixing Wang
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Suhua Zhang
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Qiang Liao
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Gang Yu
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Lin Xiao
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Yuhan Gong
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Jianxin Zhang
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Ke Wang
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Ju Wang
- Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China
| | - Zhuo Wang
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
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18
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Yang S, Zhai W, Pei R, Jike C, Nan L, Yu G, Liao Q, Wang Q, Liu D, Gao B, Xiao L, Gong Y, Wang K, Wang J. Factors associated with HIV infection among Yi minority residents in Liangshan Prefecture, Sichuan Province: A path analysis. Medicine (Baltimore) 2018; 97:e0250. [PMID: 29620638 PMCID: PMC5902278 DOI: 10.1097/md.0000000000010250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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
We aimed to evaluate HIV prevalence among residents of Liangshan Prefecture through HIV sentinel surveillance (HSS) data over the period from 2010 to 2016, and investigate risk factors for HIV infection in this population and interactions among them.Two sites (Dechang and Ningnan counties) with majority-Han populations, and 1 site (Butuo) with a majority-Yi population were selected. We used questionnaires to investigate residents' demographic and behavioral characteristics from 2010 to 2016, and performed HIV testing. Multivariate logistic regression and path analysis were undertaken to investigate the interactions and mediating effects among significant risk factors for HIV infection.A total of 5403 community residents in the Yi area and 10,897 community residents in the Han areas were enrolled. HIV prevalence in the Yi area was consistently high, ranging from 9.46% (63/666, 2011) to 2.88% (23/798, 2012) over the period from 2010 to 2016. HIV prevalence in the Han areas ranged from 0.15% (2/1333, 2010) to 0.44% (7/1604, 2011) over the same period. Multivariate logistic regression showed that unprotected casual sexual behavior, male gender, illiteracy, drug use, and injection drug use were positively associated with HIV infection risk in the Yi area. Path analysis of the risk factors revealed that casual sexual behavior (0.051) and injection drug use (0.161) were directly associated with HIV infection. However, marital status (0.004), ethnicity (0.017), education level (-0.004), HIV/AIDS-related prevention knowledge (-0.012), and drug use (0.11) had an indirect influence on HIV infection through casual sexual behavior and injection drug use.The prevalence of HIV is high among residents of majority-Yi areas, and injection drug use and casual sexual behavior are risk factors for infection.
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Affiliation(s)
- Shujuan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Wenwen Zhai
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Rong Pei
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Chunnong Jike
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
| | - Lei Nan
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
| | - Gang Yu
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
| | - Qiang Liao
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
| | - Qixing Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
| | - Danping Liu
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Bo Gao
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu
| | - Lin Xiao
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
| | - Yuhan Gong
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
| | - Ke Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
| | - Ju Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, China
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19
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Zhang S, Jike C, Yang S, Liao Q, Yu G, Wang K, Wang J, Xiao L, Wang Q, Gong Y, Zhang J, Bian S, Liu Q. Factors related to HIV infection among unmarried youth in rural areas of Southwest China. AIDS Care 2018; 30:1058-1061. [PMID: 29499120 DOI: 10.1080/09540121.2018.1446070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We evaluated HIV prevalence among unmarried youth in rural areas of Liangshan Prefecture in southwest China over the period of 2011-2015, and the interactions between behaviors associated with HIV risk. We used HIV sentinel surveillance (HSS) data for our analysis. We used questionnaires to investigate information among unmarried youth aged 15 to 25 years and performed HIV testing. Multivariate logistic regression and path analysis were applied to explore associations between behavioral factors related with HIV infection. A total of 9536 unmarried youth were enrolled in this study, of whom 2.75% (262/9536) tested positive for HIV infection. Multivariate logistic regression showed that male gender, Yi ethnicity, illiteracy, out-migrating for work, needle sharing, and engaging in high-risk sexual behaviors were risk factors. Path analysis revealed that needle sharing had the greatest effect on HIV infection (0.267), followed by drug use (0.171), out-migrating for work (0.079), and high-risk sexual behavior (0.064). The epidemic of HIV infection among unmarried youth in rural areas of Liangshan Prefecture is severe, and prevention efforts should focus on high-risk groups such as youth who are male, Yi, illiterate, and out-migrating for work, and those who engage in high-risk sexual behaviors and needle sharing.
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Affiliation(s)
- Suhua Zhang
- a Department of Health Related Social and Behavioral Science , West China School of public health, Sichuan University , Chengdu , People's Republic of China.,c Jinjiang Maternity and Child Health Hopsital , Chengdu , People's Republic of China
| | - Chunnong Jike
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Shujuan Yang
- a Department of Health Related Social and Behavioral Science , West China School of public health, Sichuan University , Chengdu , People's Republic of China
| | - Qiang Liao
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Gang Yu
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Ke Wang
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Ju Wang
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Lin Xiao
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Qixing Wang
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Yuhan Gong
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Jianxin Zhang
- a Department of Health Related Social and Behavioral Science , West China School of public health, Sichuan University , Chengdu , People's Republic of China
| | - Shichao Bian
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
| | - Qian Liu
- b Liangshan Center for Disease Control and Prevention , Xichang , People's Republic of China
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20
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Lu X, Li Y, Wang Y, An N, Zhao C, Chen S. Regional Transmission Pattern of HIV-1 Non-CRF01_AE Strains Circulating in Hebei Province, China. AIDS Res Hum Retroviruses 2018; 34:222-227. [PMID: 28946751 DOI: 10.1089/aid.2017.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV-1 genetic diversity has recently been more and more complicated in Hebei province. To know about the transmission pattern of HIV-1 in Hebei, the phylogenetic analysis of non-CRF01_AE strains was performed using the maximum-likelihood (ML) method. Four clusters and two clusters were observed in the CRF07_BC and subtype B ML tree, respectively. Of these clusters, men who have sex with men (MSM) sequences were the most frequent, and no pure heterosexual cluster was found in this study. Our findings highlighted the close transmission relationship between the main HIV-1 non-CRF01_AE strains and the sexual exposure especially among MSM between neighboring provinces, such as Beijing and Liaoning, and Hebei. This provides new evidence that the main strains of HIV-1 were introduced into Hebei through sexual exposure especially among MSM from neighboring provinces, suggesting that it is urgent for us to take measures together with neighboring provinces to cut off HIV-1 dissemination chain through MSM.
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Affiliation(s)
- Xinli Lu
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Yan Li
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Yingying Wang
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Ning An
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Cuiying Zhao
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Suliang Chen
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
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21
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Pan SW, Carpiano RM, Li D, Zhang Z, Schechter MT, Spittal PM, Ruan Y. Ethnicity and HIV vulnerabilities among men who have sex with men in China. AIDS Care 2018; 30:1025-1030. [PMID: 29382213 DOI: 10.1080/09540121.2018.1428727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Ethnic affiliation can define sociocultural boundaries and contribute to the HIV vulnerabilities faced by men who have sex with men (MSM). This study investigated the influence of ethnic affiliation on HIV vulnerabilities among MSM in North China. Our study analyzed a cross-sectional survey of MSM (n = 398) in two major North China cities. We examined associations between ethnic affiliation and (a) HIV status, (b) sexual behaviors and experiences, and (c) substance use. Compared to ethnic majority Han MSM: MSM belonging to ethnic minority groups of South China had significantly greater odds of HIV infection (AOR: 7.40; 95% CI: 2.33-23.47) and experience of forced sex (AOR: 3.27; 95% CI: 1.12-9.52). Compared to ethnic majority Han MSM, Ethnic Hui MSM had significantly lower odds of condomless anal sex (AOR: 0.41; 95% CI: 0.21-0.82) and significantly greater odds of circumcision (AOR: 2.62; 95% CI: 1.24-5.51). HIV prevalence and riskier sexual behaviors among MSM in China appear to vary significantly by ethnic affiliation. Current epidemiological practices of aggregating all ethnic minority groups in China into a single category may be masking important interethnic differences in HIV risk, and precluding opportunities for more culturally appropriate interventions.
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Affiliation(s)
- Stephen W Pan
- a Department of Public Health , Xi'an Jiaotong-Liverpool University , Suzhou , People's Republic of China
| | - Richard M Carpiano
- b School of Public Policy , University of California , Riverside , CA , USA.,c Department of Sociology , University of California , Riverside , CA , USA.,d Center for Healthy Communities , University of California , Riverside , CA , USA
| | - Dongliang Li
- e Chaoyang Center for Disease Control and Prevention , Beijing , People's Republic of China
| | - Zheng Zhang
- e Chaoyang Center for Disease Control and Prevention , Beijing , People's Republic of China
| | - Martin T Schechter
- f School of Population and Public Health , University of British Columbia , Vancouver , BC , Canada
| | - Patricia M Spittal
- f School of Population and Public Health , University of British Columbia , Vancouver , BC , Canada
| | - Yuhua Ruan
- g Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Infectious Disease Prevention and Control, Chinese Centers for Disease Control and Prevention , Beijing , People's Republic of China
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22
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Yang Y, Zhou YB, Xiao PL, Shi Y, Chen Y, Liang S, Yihuo WL, Song XX, Jiang QW. Prevalence of and risk factors associated with Cryptosporidium infection in an underdeveloped rural community of southwest China. Infect Dis Poverty 2017; 6:2. [PMID: 28126012 PMCID: PMC5267368 DOI: 10.1186/s40249-016-0223-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 12/15/2016] [Indexed: 12/25/2022] Open
Abstract
Background Cryptosporidium spp. is an important intestinal protozoan causing diarrhea in humans, livestock, and wild animals. Cryptosporidium infection remains a major public health issue, but its epidemiology in humans is still unclear, particularly in rural China. This study was designed to determine the prevalence of and risk factors associated with Cryptosporidium infection in a rural southwestern Chinese community. Methods A community-based cross-sectional survey was conducted among 687 residents of a small town in a Yi autonomous prefecture of southwest China in 2014. Blood samples were examined using a broad set of quality-controlled diagnostic methods for hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Stool specimens were processed using the modified acid-fast staining method, and microscopically examined for Cryptosporidium infection. Univariable and multivariable analyses were performed to determine the risk factors associated with Cryptosporidium infection. Results The majority of the participants were Yi people with poor living conditions and unsatisfactory hygiene habits, and the study area was of very low socioeconomic status. Of the 615 individuals included in the analysis, 14 (2.3%) were HIV positive, 51 (8.3%) were infected with HBV, and 74 (12.0%) had Cryptosporidium infection. The prevalences of HIV/HBV, HIV/Cryptosporidium, and HBV/Cryptosporidium co-infections were 0.3%, 0.3%, and 1.8%, respectively. The prevalence of HBV infection was higher in individuals with Cryptosporidium infection (χ2
= 5.00, P = 0.03). Owning livestock or poultry was an important risk factor for Cryptosporidium infection (aOR = 2.27, 95% CI: 1.01–5.08, P < 0.05). Cryptosporidium infection was significantly associated with HBV infection (aOR = 3.42, 95% CI: 1.47–7.92, P < 0.01), but not with HIV infection (aOR = 0.57, 95% CI: 0.07–4.39, P = 0.59). Conclusions The prevalence of Cryptosporidium infection was high in the rural area of southwestern China that was investigated, and there was a significant association between HBV infection and Cryptosporidium infection. Further investigations are needed to determine the significance of Cryptosporidium infection in patients infected with HBV. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0223-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ya Yang
- School of Public Health, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Center for Tropical Disease Research, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yi-Biao Zhou
- School of Public Health, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. .,Center for Tropical Disease Research, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.
| | - Peng-Lei Xiao
- School of Public Health, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Center for Tropical Disease Research, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yan Shi
- School of Public Health, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Center for Tropical Disease Research, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yue Chen
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, 2055 Mowry Road, Gainesville, FL, 32611, USA.,Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32611, USA
| | - Wu-Li Yihuo
- Puge Center for Disease Prevention and Control, 6 Qingnian Road, Puge County, Sichuan, 615300, China
| | - Xiu-Xia Song
- School of Public Health, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Center for Tropical Disease Research, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Qing-Wu Jiang
- School of Public Health, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Center for Tropical Disease Research, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
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23
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Lu X, Liu Y, Zhao H, Zhang Y, Zhao C, Chen S, Li J, Cui Z. Recombinant Patterns of Nine Novel HIV-1 Recombinant Strains Identified in Hebei Province, China. AIDS Res Hum Retroviruses 2016; 32:475-9. [PMID: 26892835 DOI: 10.1089/aid.2016.0005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We found cluster 1 and cluster 2 that were identified as two potential circulating recombinant forms (CRFs) by analyzing the recombinant breakpoints and phylogenetic tree. Three sequences composed of CRF01_AE, subtype C, and potential subtype B (N/A) in cluster 1 had nearly identical recombinant breakpoints, and four sequences composed of CRF01_AE and subtype B in cluster 2 possessed identical breakpoints. Demographic characteristics indicated that there were no epidemiological linkages among three subjects in cluster 1 and four subjects in cluster 2, respectively. Likewise, two unique recombinant forms (URFs) were found in this study: one URF was composed of subtype C and subtype B, and subtype B was inserted into a backbone of subtype C; another URF was composed of subtype C, subtype B, CRF01_AE, and subtype A2. It was inferred that the potential novel CRFs and URFs have spread into general populations, suggesting that the series research of novel recombinant strains will be a priority for our researches in the future.
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Affiliation(s)
- Xinli Lu
- Hebei Provincial Center for Disease Control and Prevention, Shjiazhuang, People's Republic of China
| | - Yongjian Liu
- Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Hongru Zhao
- Hebei Provincial Center for Disease Control and Prevention, Shjiazhuang, People's Republic of China
| | - Yuqi Zhang
- Hebei Provincial Center for Disease Control and Prevention, Shjiazhuang, People's Republic of China
| | - Cuiying Zhao
- Hebei Provincial Center for Disease Control and Prevention, Shjiazhuang, People's Republic of China
| | - Suliang Chen
- Hebei Provincial Center for Disease Control and Prevention, Shjiazhuang, People's Republic of China
| | - Jingyun Li
- Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Ze Cui
- Hebei Provincial Center for Disease Control and Prevention, Shjiazhuang, People's Republic of China
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24
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Lu X, Zhao C, Wang W, Nie C, Zhang Y, Zhao H, Chen S, Cui Z. HIV-1 genetic diversity and its distribution characteristics among newly diagnosed HIV-1 individuals in Hebei province, China. AIDS Res Ther 2016; 13:3. [PMID: 26793263 PMCID: PMC4719688 DOI: 10.1186/s12981-015-0087-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 12/29/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since the first HIV-1 case in 1989, Hebei province has presented a clearly rising trend of HIV-1 prevalence, and HIV-1 genetic diversity has become the vital barrier to HIV prevention and control in this area. To obtain detailed information of HIV-1 spread in different populations and in different areas of Hebei, a cross-sectional HIV-1 molecular epidemiological investigation was performed across the province. METHODS Blood samples of 154 newly diagnosed HIV-1 individuals were collected from ten prefectures in Hebei using stratified sampling. Partial gag and env genes were amplified and sequenced. HIV-1 genotypes were identified by phylogenetic tree analyses. RESULTS Among the 139 subjects genotyped, six HIV-1 subtypes were identified successfully, including subtype B (41.0 %), CRF01_AE (40.3 %), CRF07_BC (11.5 %), CRF08_BC (4.3 %), unique recombinant forms (URFs) (1.4 %) and subtype C (1.4 %). Subtype B was identified as the most frequent subtype. Two URF recombination patterns were the same as CRF01_AE/B. HIV-1 genotype distribution showed a significant statistical difference in different demographic characteristics, such as source (P < 0.05), occupation (P < 0.05) and ethnicity (P < 0.05). The distributions of subtype B (P < 0.05), CRF01_AE (P < 0.05), CRF07_BC (P < 0.05) and subtype C (P < 0.05) showed significant differences in all ten prefectures, and the distributions of all six subtypes were significantly different in Shijiazhuang (P < 0.05) and Xingtai (P < 0.05), but not in other prefectures (P > 0.05). The differences in HIV-1 genotype distribution were closely associated with transmission routes. Particularly, all six subtype strains were found in heterosexuals, showing that HIV-1 has spread from the high-risk populations to the general populations in Hebei, China. In addition, CRF01_AE instead of subtype B has become the major strain of HIV-1 infection among homosexuals. CONCLUSIONS Our study revealed HIV-1 evolution and genotype distribution by investigating newly diagnosed HIV-1 individuals in Hebei, China. This study provides important information to enhance the strategic plan for HIV prevention and control in China.
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25
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Zhou YB, Wang QX, Liang S, Gong YH, Yang MX, Chen Y, Nie SJ, Nan L, Yang AH, Liao Q, Yang Y, Song XX, Jiang QW. Geographical variations in risk factors associated with HIV infection among drug users in a prefecture in Southwest China. Infect Dis Poverty 2015; 4:38. [PMID: 26329887 PMCID: PMC4557839 DOI: 10.1186/s40249-015-0073-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 08/20/2015] [Indexed: 02/04/2023] Open
Abstract
Background Previous studies have shown inconsistent or even contradictory results for some risk factors associated with HIV infection among drug users, and these may be partially explained by geographical variations. Methods Data were collected from 11 methadone clinics in the Liangshan Yi Autonomous Prefecture from 2004 to 2012. A non-spatial logistical regression model and a geographically weighted logistic regression model were fitted to analyze the association between HIV infection and specific factors at the individual level. Results This study enrolled 6,458 patients. The prevalence of HIV infection was 25.1 %. The non-spatial model indicated that being divorced was positively associated with HIV infection. The spatial model also showed that being divorced was positively associated with HIV infection, but only for 49.4 % of individuals residing in some northern counties. The non-spatial model suggested that service sector work was negatively associated with HIV infection. However, the spatial model indicated that service work was associated with HIV infection, but only for 23.0 % of patients living in some western counties. The non-spatial model did not show that being married was associated with HIV infection in our study field, but the spatial model indicated that being married was negatively associated with HIV infection for 12.0 % of individuals living in some western counties. For other factors, the non-spatial and spatial models showed similar results. Conclusion The spatial model may be useful for improving understanding of geographical heterogeneity in the relationship between HIV infection and individual factors. Spatial heterogeneity may be useful for tailoring intervention strategies for local regions, which can consequently result in a more efficient allocation of limited resources toward the control of HIV transmission. Electronic supplementary material The online version of this article (doi:10.1186/s40249-015-0073-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yi-Biao Zhou
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China. .,Center for Tropical Disease Research, Fudan University, Shanghai, China.
| | - Qi-Xing Wang
- Center for Disease Prevention and Control of the Liangshan Yi Autonomous Prefecture, Sichuan, China.
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA. .,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
| | - Yu-Han Gong
- Center for Disease Prevention and Control of the Liangshan Yi Autonomous Prefecture, Sichuan, China.
| | - Mei-Xiao Yang
- Xuhui Center for Disease Prevention and Control, Shanghai, China.
| | - Yue Chen
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Shi-Jiao Nie
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai, 200032, China.
| | - Lei Nan
- Center for Disease Prevention and Control of the Liangshan Yi Autonomous Prefecture, Sichuan, China.
| | - Ai-Hui Yang
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai, 200032, China.
| | - Qiang Liao
- Center for Disease Prevention and Control of the Liangshan Yi Autonomous Prefecture, Sichuan, China.
| | - Yang Yang
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA. .,Department of Biostatistics, University of Florida, Gainesville, FL, USA.
| | - Xiu-Xia Song
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China. .,Center for Tropical Disease Research, Fudan University, Shanghai, China.
| | - Qing-Wu Jiang
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China. .,Center for Tropical Disease Research, Fudan University, Shanghai, China.
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26
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Zhou YB, Wang QX, Liang S, Gong YH, Yang MX, Nie SJ, Nan L, Yang AH, Liao Q, Yang Y, Song XX, Jiang QW. HIV-, HCV-, and co-infections and associated risk factors among drug users in southwestern China: a township-level ecological study incorporating spatial regression. PLoS One 2014; 9:e93157. [PMID: 24687006 PMCID: PMC3970964 DOI: 10.1371/journal.pone.0093157] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 03/01/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are major public health problems. Many studies have been performed to investigate the association between demographic and behavioral factors and HIV or HCV infection. However, some of the results of these studies have been in conflict. METHODOLOGY/PRINCIPAL FINDINGS The data of all entrants in the 11 national methadone clinics in the Yi Autonomous Prefecture from March 2004 to December 2012 were collected from the national database. Several spatial regression models were used to analyze specific community characteristics associated with the prevalence of HIV and HCV infection at the township level. The study enrolled 6,417 adult patients. The prevalence of HIV infection, HCV infection and co-infection was 25.4%, 30.9%, and 11.0%, respectively. Prevalence exhibited stark geographical variations in the area studied. The four regression models showed Yi ethnicity to be associated with both the prevalence of HIV and of HIV/HCV co-infection. The male drug users in some northwestern counties had greater odds of being infected with HIV than female drug users, but the opposite was observed in some eastern counties. The 'being in drug rehabilitation variable was found to be positively associated with prevalence of HCV infection in some southern townships, however, it was found to be negatively associated with it in some northern townships. CONCLUSIONS/SIGNIFICANCE The spatial modeling creates better representations of data such that public health interventions must focus on areas with high frequency of HIV/HCV to prevent further transmission of both HIV and HCV.
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Affiliation(s)
- Yi-Biao Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Tropical Disease Research Center, Fudan University, Shanghai, China
| | - Qi-Xing Wang
- Center for Disease Prevention and Control of Liangshan Prefecture, Sichuan, China
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Yu-Han Gong
- Center for Disease Prevention and Control of Liangshan Prefecture, Sichuan, China
| | - Mei-xia Yang
- Xuhui Center for Disease Prevention and Control, Shanghai, China
| | - Shi-Jiao Nie
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Tropical Disease Research Center, Fudan University, Shanghai, China
| | - Lei Nan
- Center for Disease Prevention and Control of Liangshan Prefecture, Sichuan, China
| | - Ai-Hui Yang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Tropical Disease Research Center, Fudan University, Shanghai, China
| | - Qiang Liao
- Center for Disease Prevention and Control of Liangshan Prefecture, Sichuan, China
| | - Yang Yang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
- Department of Biostatistics, University of Florida, Gainesville, Florida, United States of America
| | - Xiu-Xia Song
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Tropical Disease Research Center, Fudan University, Shanghai, China
| | - Qing-Wu Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Tropical Disease Research Center, Fudan University, Shanghai, China
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Zhou YB, Liang S, Wang QX, Gong YH, Nie SJ, Nan L, Yang AH, Liao Q, Song XX, Jiang QW. The geographic distribution patterns of HIV-, HCV- and co-infections among drug users in a national methadone maintenance treatment program in Southwest China. BMC Infect Dis 2014; 14:134. [PMID: 24612875 PMCID: PMC3975583 DOI: 10.1186/1471-2334-14-134] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 03/04/2014] [Indexed: 11/26/2022] Open
Abstract
Background HIV-, HCV- and HIV/HCV co-infections among drug users have become a rapidly emerging global public health problem. In order to constrain the dual epidemics of HIV/AIDS and drug use, China has adopted a methadone maintenance treatment program (MMTP) since 2004. Studies of the geographic heterogeneity of HIV and HCV infections at a local scale are sparse, which has critical implications for future MMTP implementation and health policies covering both HIV and HCV prevention among drug users in China. This study aimed to characterize geographic patterns of HIV and HCV prevalence at the township level among drug users in a Yi Autonomous Prefecture, Southwest of China. Methods Data on demographic and clinical characteristics of all clients in the 11 MMTP clinics of the Yi Autonomous Prefecture from March 2004 to December 2012 were collected. A GIS-based geographic analysis involving geographic autocorrelation analysis and geographic scan statistics were employed to identify the geographic distribution pattern of HIV-, HCV- and co-infections among drug users. Results A total of 6690 MMTP clients was analyzed. The prevalence of HIV-, HCV- and co-infections were 25.2%, 30.8%, and 10.9% respectively. There were significant global and local geographic autocorrelations for HIV-, HCV-, and co-infection. The Moran’s I was 0.3015, 0.3449, and 0.3155, respectively (P < 0.0001). Both the geographic autocorrelation analysis and the geographic scan statistical analysis showed that HIV-, HCV-, and co-infections in the prefecture exhibited significant geographic clustering at the township level. The geographic distribution pattern of each infection group was different. Conclusion HIV-, HCV-, and co-infections among drug users in the Yi Autonomous Prefecture all exhibited substantial geographic heterogeneity at the township level. The geographic distribution patterns of the three groups were different. These findings imply that it may be necessary to inform or invent site-specific intervention strategies to better devote currently limited resource to combat these two viruses.
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Affiliation(s)
- Yi-Biao Zhou
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China.
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