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Wang N, Lan G, Zhu Q, Chen H, Huang J, Meng Q, Shen Z, Liang S, Wu X, Luo L, Ye R, Chen J, Tan S, Xing H, Shao Y, Ruan Y, Lin M. HIV Epidemiology, Care, and Treatment Outcomes Among Student and Nonstudent Youths Living With HIV in Southwest China Between 1996 and 2019: Historical Cohort Study. JMIR Public Health Surveill 2023; 9:e38881. [PMID: 36826980 PMCID: PMC10007008 DOI: 10.2196/38881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/13/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Nearly one-third of new HIV infections occurred among youth in 2019 worldwide. Previous studies suggested that student youths living with HIV and nonstudent youths living with HIV might differ in some risk factors, transmission routes, HIV care, and disease outcomes. OBJECTIVE This study aimed to compare the HIV epidemic, disease outcomes, and access to care among student and nonstudent youths living with HIV aged 16 to 25 years in Guangxi, China. METHODS We performed a historical cohort study by extracting data on all HIV or AIDS cases aged 16 to 25 years in Guangxi, China, during 1996-2019 from the Chinese Comprehensive Response Information Management System of HIV or AIDS. We conducted analyses to assess possible differences in demographic and behavioral characteristics, HIV care, and disease outcomes between student and nonstudent youths living with HIV. Multivariate Cox regression was used to assess differences in mortality and virologic failure between student and nonstudent cases. RESULTS A total of 13,839 youths aged 16 to 25 years were infected with HIV during 1996-2019. Among them, 10,202 cases were infected through sexual contact, most of whom were men (n=5507, 54%); 868 (8.5%) were students, and 9334 (91.5%) were not students. The number of student youths living with HIV was lower before 2006 but gradually increased from 2007 to 2019. In contrast, the nonstudent cases increased rapidly in 2005, then gradually declined after 2012. Student cases were mainly infected through homosexual contact (n=614, 70.7% vs n=1447, 15.5%; P<.001), while nonstudent cases were more likely to be infected through heterosexual contact (n=7887, 84.5% vs n=254, 29.3%; P<.001). Moreover, nonstudent cases had a significantly lower CD4 count than student cases at the time of HIV diagnosis (332 vs 362 cells/μL; P<.001). Nonstudents also had a delayed antiretroviral therapy (ART) initiation compared to students (93 days vs 22 days; P<.001). Furthermore, the mortality rate of 0.4 and 1.0 deaths per 100 person-years were recorded for student and nonstudent youths with HIV, respectively. Overall, the mortality risk in nonstudent cases was 2.3 times that of student cases (adjusted hazard ratio [AHR] 2.3, 95% CI 1.2-4.2; P=.008). The virologic failure rate was 2.3 and 2.6 per 100 person-years among student and nonstudent youths living with HIV, respectively. Nonstudent cases had double the risk of virologic failure compared to student cases (AHR 1.9, 95% CI 1.3-2.6; P<.001). CONCLUSIONS Nonstudent youths living with HIV might face a low CD4 count at the time of HIV diagnosis, delayed ART initiation, and increased risk of death and virologic failure. Thus, HIV prevention and interventions should target youths who dropped out of school early to encourage safe sex and HIV screening, remove barriers to HIV care, and promote early ART initiation to curb the HIV epidemic among youths.
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Affiliation(s)
- Na Wang
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China.,Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin, China
| | - Guanghua Lan
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Qiuying Zhu
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Huanhuan Chen
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Jinghua Huang
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Qin Meng
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Zhiyong Shen
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Shujia Liang
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Xiuling Wu
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Liuhong Luo
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Rongyi Ye
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin, China
| | - Jinli Chen
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin, China
| | - Shengkui Tan
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, School of Public Health, Guilin Medical University, Guilin, China
| | - Hui Xing
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Mei Lin
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
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Niu D, Tang H, Chen F, Zhao D, Zhao H, Hou Y, Wang S, Lyu F. Treatment failure and associated factors among people living with HIV on highly active antiretroviral therapy in mainland China: A systematic review and meta-analysis. PLoS One 2023; 18:e0284405. [PMID: 37130123 PMCID: PMC10153698 DOI: 10.1371/journal.pone.0284405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/30/2023] [Indexed: 05/03/2023] Open
Abstract
OBJECTIVE Reducing the prevalence of treatment failure among people living with HIV (PLHIV) on highly active antiretroviral therapy (HAART) is crucial for improving individual health and reducing disease burden. This study aimed to assess existing evidence on treatment failure and its associated factors among PLHIV in mainland China. METHODS We conducted a comprehensive search of PubMed, Web of Science, Cochrane Library, WanFang, China National Knowledge Infrastructure, and SinoMed databases. Relevant studies on treatment failure among PLHIV in mainland China until September 2022 were searched, including cross-sectional, case-control, and cohort studies. The primary outcome was treatment failure, and secondary outcomes were the potential influencing factors of treatment failure. We performed a meta-analysis to pool each outcome of interest, including meta-regression, subgroup, publication bias, and sensitivity analyses. RESULTS A total of 81 studies were deemed eligible and included in the final meta-analysis. The pooled treatment failure prevalence among PLHIV in mainland China was 14.40% (95% confidence interval [CI]:12.30-16.63), of which the virological and immunological failure prevalence was 10.53% (95%CI:8.51-12.74) and 18.75% (95%CI:15.44-22.06), respectively. The treatment failure prevalence before and after 2016 was 18.96% (95%CI:13.84-24.67) and 13.19% (95%CI:10.91-15.64). Factors associated with treatment failure included good treatment adherence (odds ratio [OR] = 0.36, 95%CI:0.26-0.51), baseline CD4 counts>200 cells/μL (OR = 0.39, 95%CI:0.21-0.75), HAART regimens containing Tenofovir Disoproxil Fumarate (TDF) (OR = 0.70, 95%CI:0.54-0.92), WHO clinical stage III/IV (OR = 2.02, 95%CI:1.14-3.59) and age≥40 years (OR = 1.56, 95%CI:1.23-1.97). CONCLUSION The prevalence of treatment failure among PLHIV receiving HAART in mainland China was low and tended to decline. Poor adherence, low baseline CD4 count, HAART regimens without TDF, advanced clinical stage, and old age were contributing factors for treatment failure. Relevant intervention programs are needed with increasing treatment adherence through behavioral intervention or precise intervention targeting older adults.
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Affiliation(s)
- Dandan Niu
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Houlin Tang
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fangfang Chen
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Decai Zhao
- Division of Treatment and Care, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hehe Zhao
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yushan Hou
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shi Wang
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fan Lyu
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Liu M, He XQ, Deng RN, Tang SQ, Harypursat V, Lu YQ, He K, Huo Q, Yang HH, Liu Q, Chen YK. Pretreatment drug resistance in people living with HIV: A large retrospective cohort study in Chongqing, China. HIV Med 2022; 23 Suppl 1:95-105. [PMID: 35293098 PMCID: PMC9311700 DOI: 10.1111/hiv.13253] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 12/24/2022]
Abstract
Objectives The emergence of pretreatment drug resistance (PDR) caused by increased usage of antiretroviral therapy (ART) represents a significant challenge to HIV management. In this study, we evaluated the prevalence of PDR in people living with HIV (PLWH) in Chongqing, China. Methods We retrospectively collected the data of 1110 ART‐naïve PLWH in Chongqing from January 1, 2018 to June 30, 2021. HIV‐1 genotypes and drug resistance were analyzed using the HIV‐1 pol sequence. Risk factors associated with PDR were evaluated via the logistic regression model. Results Nine genotypes were detected among 1110 participants, with CRF07_BC (55.68%) being the dominant genotype, followed by CRF01_AE (21.44%), CRF08_BC (14.14%), and other genotypes (8.74%). Of all the participants, 24.14% exhibited drug resistance mutations (DRMs). The predominant DRMs for non‐nucleoside reverse transcriptase inhibitors (NNRTIs) and nucleoside reverse transcriptase inhibitors (NRTIs) were V179D/E/A/DIN (13.60%) and M184V/I (1.44%), respectively, whereas only two major DRMs (M46L and I54L) were identified for protease inhibitors (PIs). The total prevalence of PDR was 10.54%, with 2.43%, 7.66%, and 1.71% participants exhibiting PDR to NRTIs, NNRTIs, and PIs, respectively. Furthermore, female PLWH, delays in ART initiation, and the CRF08_BC genotype were associated with a higher risk of PDR. Conclusions Our study provides the first large cohort data on the prevalence of PDR in Chongqing, China. HIV‐1 genotypes are diverse and complex, with a moderate level of PDR, which does not reach the threshold for the initiation of a public health response. Nevertheless, continuous surveillance of PDR is both useful and advisable.
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Affiliation(s)
- Min Liu
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Xiao-Qing He
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Ren-Ni Deng
- Department of Clinical Laboratory, Chongqing Public Health Medical Center, Chongqing, China
| | - Sheng-Quan Tang
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Vijay Harypursat
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Yan-Qiu Lu
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Kun He
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Qin Huo
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Hong-Hong Yang
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Qian Liu
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Yao-Kai Chen
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China.,Department of Clinical Laboratory, Chongqing Public Health Medical Center, Chongqing, China
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Hsieh E, Polo R, Qian HZ, Fuster-RuizdeApodaca MJ, Del Amo J. Intersectionality of stigmas and health-related quality of life in people ageing with HIV in China, Europe, and Latin America. THE LANCET. HEALTHY LONGEVITY 2022; 3:e206-e215. [PMID: 36098292 DOI: 10.1016/s2666-7568(22)00003-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/19/2021] [Accepted: 01/04/2022] [Indexed: 12/24/2022] Open
Abstract
People ageing with HIV face crucial challenges that can compromise their long-term health, one of which is stigma. HIV-related stigma can interact with other coexistent inequities to create a unique oppression system that results in traumatic experiences. This intersectionality of stigmas represents a new inequality that is greater than the sum of the original component inequalities. In this Series paper we review the literature regarding the intersectionality of HIV-related and ageing-related stigma and health-related quality of life among people ageing with HIV in China, Europe, and Latin America-three regions that represent distinct epidemiological and cultural trends in terms of HIV and ageing. Substantial gaps in the literature were identified, in particular a scarcity of data from Latin America. We also found inconsistencies between countries in terms of definitions and reporting practices related to people ageing with HIV. Research that fully considers the intersectional stigmas faced by this vulnerable population will contribute to advancing the United Nations 2030 Agenda for Sustainable Development.
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Affiliation(s)
- Evelyn Hsieh
- Section of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven VA Medical Center, West Haven, CT, USA
| | - Rosa Polo
- HIV, STIs, Viral Hepatitis and Tuberculosis Control Division, Ministry of Health, Madrid, Spain
| | - Han-Zhu Qian
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Maria J Fuster-RuizdeApodaca
- Departamento de Psicología Social y de las Organizaciones, Universidad Nacional de Educación a Distancia, Madrid, Spain; Spanish AIDS Interdisciplinary Society, Madrid, Spain.
| | - Julia Del Amo
- HIV, STIs, Viral Hepatitis and Tuberculosis Control Division, Ministry of Health, Madrid, Spain; Ciber de Enfermedades Infecciosas, Madrid, Spain
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Zhou C, Zhang W, Lu R, Ouyang L, Xing H, Shao Y, Wu G, Ruan Y. Higher Risk of Mortality and Virologic Failure in HIV-Infected Patients With High Viral Load at Antiretroviral Therapy Initiation: An Observational Cohort Study in Chongqing, China. Front Public Health 2022; 10:800839. [PMID: 35186841 PMCID: PMC8851314 DOI: 10.3389/fpubh.2022.800839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/05/2022] [Indexed: 12/15/2022] Open
Abstract
Background Viral load (VL) is a strong predictor of human immunodeficiency virus (HIV) disease progression. The aim of this study was to evaluate the effect of high baseline VL on antiretroviral therapy (ART) outcomes among HIV-infected patients. Methods This retrospective study observed HIV-infected patients who had baseline VL test at ART initiation between 2015 and 2019 in Chongqing, China. Cox proportional hazards regression and logistic regression models were used to evaluate the effects of baseline VL on Acquired immunodeficiency syndrome (AIDS)-related mortality and virologic failure, respectively. Results The cohort included 7,176 HIV-infected patients, of whom 38.7% had a baseline VL ≥ 100,000 copies/mL. Of the patients who died during follow-up, 58.9% had a baseline VL ≥ 100,000 copies/mL. Compared with a baseline VL < 10,000 copies/mL, ART initiation at VL ≥ 100,000 copies/mL was significantly associated with the AIDS-related death (adjusted hazard ratio, AHR = 1.4) and virologic failure (adjusted odds ratio, AOR = 2.4). Compared with patients with a baseline VL < 10,000 copies/mL, patients on the recommended first-line regimen with a VL ≥ 100,000 copies/mL at ART initiaition had higher mortality rate (5.1 vs. 1.7 per 100 person-years), but there was no significant difference in the mortality accoding to the initial VL level among patients on second-line ART (2.8 vs. 2.7 per 100 person-years). ART initiation ≤ 30 days after HIV diagnosis was associated with a lower risk of AIDS-related death (AHR = 0.6). Conclusions ART initiation with VL ≥ 100,000 copies/mL was associated with a significantly greater risk of mortality and virologic failure. Optimizing the ART regimen and initiating ART early may help to reduce mortality effectively among patients with a high baseline VL. VL testing for all HIV patients is recommended at HIV diagnosis or on ART initiation.
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Affiliation(s)
- Chao Zhou
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Wei Zhang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Rongrong Lu
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Lin Ouyang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Hui Xing
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Guohui Wu
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- *Correspondence: Guohui Wu
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
- Yuhua Ruan
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Lu R, Zhang X, Zhou C, Zhang W, Ouyang L, Xing H, Shao Y, Ruan Y, Wu G. Trends of Human Immunodeficiency Virus, Syphilis, and Hepatitis C Infections Among Men Who Have Sex With Men in Chongqing, China: A Serial Cross-sectional Survey From 2011 to 2018. Sex Transm Dis 2021; 47:491-498. [PMID: 32541307 PMCID: PMC7294744 DOI: 10.1097/olq.0000000000001173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) prevalence and incidence rates have expeditiously increased among Chongqing men who have sex with men (MSM) over the past decade. This study investigated the trends of HIV, syphilis, and hepatitis C virus (HCV) infections and behavioral attributes of Chongqing MSM. METHODS Chongqing MSM who were 18 years or older were recruited annually from 2011 to 2018. Interviewer-administered paper-pencil interviews were used to collect demographics, behavioral information, and sexually transmitted diseases history. Blood samples were collected for the tests of HIV, syphilis, and HCV. A stepwise regression model was conducted to assess the associations of demographics, behaviors, and syphilis and HCV infections with HIV infection. RESULTS A total of 4900 MSM participated in the study. The average HIV, syphilis, and HCV prevalence over 8 years were 15.4%, 4.0%, and 0.3%, respectively. The HIV prevalence ranged from 13.5% to 16.4%. Syphilis and HCV were generally low and stable across years. An increased proportion of participants received HIV counseling, testing, and condoms. Multivariable regression indicated that HIV-positive MSM were more likely to be older, married, and less educated, and they were more likely to perform unprotected anal intercourse with male partners in the past 6 months, have syphilis, and less likely to receive HIV counseling, testing, condoms, and peer education in the past year. CONCLUSIONS The HIV counseling, testing, and peer education programs showed a negative association with HIV-positive status among Chongqing MSM. The HIV prevalence is still high. More programs must be implemented to effectively curb the HIV epidemic.
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Affiliation(s)
- Rongrong Lu
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xiangjun Zhang
- School of Community Health Sciences, University of Nevada, Reno, NV
| | - Chao Zhou
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Wei Zhang
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Lin Ouyang
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Hui Xing
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Guohui Wu
- From the Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
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Zhou Y, Yang Z, Liu M, Lu Y, Qin Y, He X, Zeng Y, Harypursat V, Chen Y. Independent Risk Factors for Deaths due to AIDS in Chongqing, China: Does Age Matter? Front Med (Lausanne) 2021; 7:586390. [PMID: 33681235 PMCID: PMC7925819 DOI: 10.3389/fmed.2020.586390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/07/2020] [Indexed: 11/18/2022] Open
Abstract
Background: People living with HIV (PLWH) are aging worldwide, and different management strategies may be required for older and younger PLWH. However, demographic characteristics, illness distribution, mortality, and independent risk factors in the PLWH population in China are not yet fully understood, especially in patients aged 50 years or older. Methods: We conducted a retrospective analysis of 4445 HIV-positive Chinese inpatients in Chongqing, China. Results: The mortality rate in patients 50 years or older (the older group) was significantly higher than that in those under 50 years (the younger group) (p < 0.001). In the younger group, independent risk factors for death included: nadir CD4+ T-cell counts <200 cells/μL, not owning medical healthcare insurance, not being on cART, injection drug use, and having one of the following comorbidities: Pneumocystis pneumonia, cryptococcal meningitis, AIDS malignancy, non-AIDS malignancy, and kidney disease. In the older group, independent predictors of death included: being urban residents, nadir CD4+ T-cell counts <200 cells/μL, not being on cART, and having comorbidities such as Pneumocystis pneumonia, hepatitis C, talaromycosis, non-AIDS malignancy, and kidney disease. Conclusions: Demographic characteristics, illness distribution, mortality, and independent risk factors for death in HIV-positive patients differ between the older group and the younger group, indicating that a changing suite of medical and allied support services may be required the for management of older PLWH.
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Affiliation(s)
- Yihong Zhou
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Zhongping Yang
- National Key Laboratory for Infectious Diseases Prevention and Treatment With Traditional Chinese Medicine, Chongqing Public Health Medical Center, Chongqing, China
| | - Min Liu
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Yanqiu Lu
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Yuanyuan Qin
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Xiaoqing He
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Yanming Zeng
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Vijay Harypursat
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
| | - Yaokai Chen
- Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
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8
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Han J, Jia P, Huang Y, Gao B, Yu B, Yang S, Yu J, Xiong J, Liu C, Xie T, Dong P, Yang C, Wang Z, Yang S. Association between social capital and mental health among older people living with HIV: the Sichuan Older HIV-Infected Cohort Study (SOHICS). BMC Public Health 2020; 20:581. [PMID: 32345273 PMCID: PMC7189431 DOI: 10.1186/s12889-020-08705-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mental health problems are common among older people living with HIV and associated with poorer health outcomes. Social capital is an important determinant of mental health problems but under-studied in this population. This study investigated the association between social capital and mental health problems among older people living with HIV in China. METHODS The study was based on the baseline data of a cohort study investigating mental health among older people living with HIV in Sichuan, China during November 2018 to February 2019. Participants were people living with HIV aged ≥50 years living in Sichuan province. Stratified multi-stage cluster sampling was used to recruit participants from 30 communities/towns; 529 out of 556 participants being approached completed the face-to-face interview. Social capital was measured by two validated health-related social capital scales: the Individual and Family scale and the Community and Society scale. Presence of probable depression (CES-D-10 score ≥ 10) and probable anxiety (GAD-7 score ≥ 5) were used as dependent variables. Two-level logistic regression models were applied to examine the association between social capital and probable depression/anxiety. RESULTS The prevalence of probable depression and probable anxiety was 25.9% (137/529) and 36.3% (192/529), respectively. After adjusting for significant covariates, the individual/family level of social capital was inversely associated with both probable depression (odds ratios (OR): 0.89, 95% CI: 0.84-0.93, p < 0.001) and probable anxiety (OR: 0.90, 95% CI: 0.86-0.95, p < 0.001). The community/society level social capital was associated with probable depression (OR: 0.91, 95% CI: 0.84-0.99, p < 0.001) but not probable anxiety (p > 0.05). CONCLUSIONS Interventions building up social capital should be considered to improve mental health of older people living with HIV. Some useful strategies include cognitive processing therapy, improving community networking and engagement, and promoting social bonding with neighborhood.
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Affiliation(s)
- Jiayu Han
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
- International Initiative on Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Yuling Huang
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Bo Gao
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bin Yu
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shifan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jun Yu
- Lu County Center for Disease Control and Prevention, Luzhou, China
| | - Jun Xiong
- Lu County Center for Disease Control and Prevention, Luzhou, China
| | - Chang Liu
- Lu County Center for Disease Control and Prevention, Luzhou, China
| | - Tian Xie
- Pidu District Center for Disease Control and Prevention, Chengdu, China
| | - Peijie Dong
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chao Yang
- Department of epidemiology and statistics, School of Public Health, Southwest Medical University, Luzhou, 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, China
| | - Shujuan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- International Initiative on Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
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