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Xu Z, Shen Q, Wang D, Dong Z, Han W, Tian R, Zhou K, Ya X, Hu H. Real-world data in late presentation of HIV infection in Suzhou, China: Results from four consecutive cross-sectional surveys, 2017-2020. Front Public Health 2023; 11:1084840. [PMID: 36895684 PMCID: PMC9989277 DOI: 10.3389/fpubh.2023.1084840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/30/2023] [Indexed: 02/23/2023] Open
Abstract
Objectives This study aimed to examine the real prevalence of late presentation of HIV infection and to identify factors associated with late HIV presentation among patients with newly diagnosed HIV/AIDS in Suzhou, China. Methods Patients with newly diagnosed HIV/AIDS who registered in national AIDS surveillance system from 2017 to 2020 were included in this study. Late presentation (LP) of HIV infection was defined as HIV diagnosis with a CD4 count < 350 cells/μL or an AIDS-defining event. Multivariable logistic regression analyses were used to identify factors associated with LP. Results A total of 2,300 patients were enrolled. 1,325 were classified as late presenters, showing a high percentage of 57.6% (95% CI: 54.5-60.7%) and a rise (P = 0.004) over the four-year period. Patients with newly diagnosed HIV/AIDS who were older than 24 years of age (aOR = 1.549, P = 0.001 for 25-39 years; aOR = 2.389, P < 0.001 for 40 years and older), were Suzhou registered residents (aOR = 1.259, P = 0.026), and were from inpatient and outpatient (aOR = 1.935, P < 0.001) were more likely to be late presentation. Conclusions This study showed a high percentage and a rise of late presentation of HIV infection among patients with newly diagnosed HIV/AIDS in Suzhou, China, which is a challenge for future prevention and control of AIDS. Targeted measures should be urgently implemented to reduce late HIV diagnosis.
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Affiliation(s)
- Zhihui Xu
- Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Qiang Shen
- Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Di Wang
- Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Zefeng Dong
- Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Weining Han
- Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Runfang Tian
- Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Kai Zhou
- Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Xuerong Ya
- Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Haiyang Hu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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Sun C, Li J, Liu X, Zhang Z, Qiu T, Hu H, Wang Y, Fu G. HIV/AIDS late presentation and its associated factors in China from 2010 to 2020: a systematic review and meta-analysis. AIDS Res Ther 2021; 18:96. [PMID: 34895254 PMCID: PMC8665516 DOI: 10.1186/s12981-021-00415-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Late presentation to HIV/AIDS care presents serious health concerns, like increased transmission and high healthcare costs, increased mortality, early development of opportunistic infection, increased risk of antiretroviral therapy drug resistance. Despite the effort to contain the HIV/AIDS epidemic, LP has remained an impediment to individual immune reconstitution and public health. OBJECTIVE This review aimed to estimate the prevalence and determine the factors associated with late presentation to HIV/AIDS care. METHODS We searched PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Wanfang, and Weipu database for articles published from 2010 to 2020. We utilized I2 statistics and Q-test to estimate heterogeneity between studies. Random-effects meta-analysis models were used to calculate the aggregate odds ratio of late presentation to HIV/AIDS care. RESULTS Of 9563 titles and abstracts retrieved, 189 were identified as potentially eligible and 39 fulfilled the inclusion criteria. The pooled prevalence of late presentation to HIV/AIDS care was 43.26%. The major risk factors were patients ≥ 50 years old (OR = 2.19, 95% CI: 1.85-2.58; I2 = 97.44%), married (OR = 1.50, 95% CI: 1.35-1.68; I2 = 96.58%), with heterosexual contact as risk factor for infection (OR = 1.91, 95% CI: 1.73-2.11; I2 = 90.74%) and diagnosed in medical institutions (OR = 2.35,95% CI: 2.11-2.62; I2 = 96.05%). In middle or low HIV prevalence areas, patients ≥ 50 years old (P = 0.01), married (P < 0.01) and diagnosed in medical institutions (P = 0.01) were more likely to be presented late than in high prevalence areas. From 2016-2020, the OR of patients who were married and diagnosed in medical facilities were significantly lower than before (P < 0.01). CONCLUSION Patients ≥ 50 years old, married, with heterosexual contact as risk factor for infection, and diagnosed in medical institutions were risk factors of LP. Gender had no significant relationship with LP. In middle or low prevalence areas, patients who were ≥ 50 years old, married, and diagnosed in medical institutions were more likely to be presented late than in other areas. Married patients and those diagnosed in medical institutions after 2015 have a lower risk of LP than before.
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Affiliation(s)
- Chengqing Sun
- School of Public Health, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Jianjun Li
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, People’s Republic of China
| | - Xiaoyan Liu
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, People’s Republic of China
| | - Zhi Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, People’s Republic of China
| | - Tao Qiu
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, People’s Republic of China
| | - Haiyang Hu
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, People’s Republic of China
| | - You Wang
- Department of Radiology, Fourth Affiliated Hospitial Of Nanjing Medical University, Nanjing, Jiangsu People’s Republic of China
| | - Gengfeng Fu
- School of Public Health, Nanjing Medical University, Nanjing, People’s Republic of China
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, People’s Republic of China
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Li J, Marley G, Zhang Y, Chen Y, Tang W, Rongbin Y, Fu G. Determinants of Recent HIV Self-Testing Uptake Among Men Who Have Sex With Men in Jiangsu Province, China: An Online Cross-Sectional Survey. Front Public Health 2021; 9:736440. [PMID: 34790641 PMCID: PMC8591127 DOI: 10.3389/fpubh.2021.736440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To help inform regarding HIV self-testing (HIVST) upscale, we assessed the determinants of recent HIVST uptake among men who have sex with men (MSM) in Jiangsu province, China. Methods: We conducted a convenience online survey from March to April, 2020 among men aged ≥16 years, who had ever had sex with other men. Statistical analysis included Pearson's chi-square test, bivariate correlation, and multivariable logistic regression. p < 0.05 was considered statistically significant. Results: Of the total 692 participants, 69.5% (481) were aged between 18 and 40 years, and 65.9% (456) had reportedly ever self-tested. Using HIVST for first HIV test (aOR = 1.98, 95% CI: 1.21-3.26), perceiving HIVST as more private (aOR = 1.41, 95% CI: 0.85-2.35), and users not needing to go to a health facility (aOR = 1.68, 95% CI: 1.20-2.34) were associated with recent HIVST as facilitating factors. Conclusion: HIVST uptake rate has increased among Jiangsu MSM and can be further promoted by healthcare workers routinely recommending HIVST to their clients.
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Affiliation(s)
- Jianjun Li
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Gifty Marley
- School of Public Health, Nanjing Medical University, Nanjing, China
- University of North Carolina Project-China, Guangzhou, China
| | - Ye Zhang
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Yunting Chen
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yu Rongbin
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Gengfeng Fu
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
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Hua B, Yang VF, Goldsen KF. LGBT Older Adults at a Crossroads in Mainland China: The Intersections of Stigma, Cultural Values, and Structural Changes Within a Shifting Context. Int J Aging Hum Dev 2019; 88:440-456. [PMID: 30947509 DOI: 10.1177/0091415019837614] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this article, we explore the lives of lesbian, gay, bisexual, and transgender (LGBT) older adults in mainland China, with an emphasis on the shifting nature of the cultural context. Based on a culturally informed perspective, the intersection of LGBT stigma with cultural values (familial responsibility, filial piety, and loss of face) and larger structural changes (the aftermath of the one-child policy, economic reforms and globalization, LGBT human rights, and HIV policies) are creating dramatic shifts in Chinese society and impacting the lives of LGBT older adults. The increasing prevalence of HIV among gay and bisexual older men, although rarely acknowledged, is also contributing to challenges facing LGBT older adults and their families. These changes render LGBT older adults and those living with HIV and their caregivers at risk of economic insecurity. Resilience and resistance of LGBT older adults in China must be considered in both practice and policy to strengthen LGBT human rights globally.
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Affiliation(s)
- Boya Hua
- 1 Seattle Counseling Service, Seattle, WA, USA
| | - Vickie F Yang
- 2 School of Social Work, University of Washington, Seattle, WA, USA
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Hu X, Liang B, Zhou C, Jiang J, Huang J, Ning C, Liu J, Zhou B, Zang N, Lai J, Chen R, Liao Y, Pan P, Liu X, Lan G, Pang X, Ye L, Shen Z, Liang H. HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: a large-scale cross-sectional study. AIDS Res Ther 2019; 16:6. [PMID: 30876476 PMCID: PMC6420760 DOI: 10.1186/s12981-019-0221-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 03/02/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the prevalence of HIV late presentation and advanced HIV disease and to identify the factors associated with HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in the Guangxi Zhuang Autonomous Region, in Southwestern China. METHODS Patients with newly diagnosed HIV registered in the HIV surveillance system of Guangxi Centers for Disease Control between January 2012 and December 2016 were included in this study. RESULTS Of 45,118 newly diagnosed patients, 70.2% had late presentation, and 45.1% had advanced HIV disease. A higher prevalence of late presentation and advanced HIV disease was found in male heterosexuals and female people who use drugs (PWID). Heterosexuals (OR 2.11 [95% CI 1.90-2.34]) and PWID (OR 1.55 [95% CI 1.30-1.84]) had a higher risk of late presentation than men who have sex with men (MSM). Blood testing of the blood receivers (OR 1.75 [95% CI 1.36-2.26]) and diagnosed in hospital (OR 1.74 [95% CI 1.65-1.84]) had an increased risk of late presentation compared to those who diagnosis in voluntary counseling and testing (VCT). Heterosexuals (OR 2.86 [95% CI 2.51-3.27]), PWID (OR 2.23 [95% CI 1.83-2.71]), blood testing of the blood receivers (OR 1.58 [95% CI 1.29-1.94]) and diagnosed in hospital (OR 1.85 [95% CI 1.76-1.94]) were also independent risk factors associated with advanced HIV disease. Older age, lower level of education and being divorced or widowed were also associated with late presentation and advanced HIV disease. CONCLUSIONS Late presentation and advanced HIV disease were very common among patients with newly diagnosed HIV in Guangxi, China during 2012-2016. Targeted programs are urgently required to reduce HIV late diagnosis in Guangxi, especially for male heterosexuals, PWID, and patients with characteristics such as older age, lower level of education, divorced or widowed.
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Liu WJ, Hu HY, Su QD, Zhang Z, Liu Y, Sun YL, Yang XD, Sun DP, Cai SJ, Yang XX, Kamara I, Kamara A, Lebby M, Kargbo B, Ongpin P, Dong XP, Shu YL, Xu WB, Wu GZ, Gboun M, Gao GF. HIV prevalence in suspected Ebola cases during the 2014-2016 Ebola epidemic in Sierra Leone. Infect Dis Poverty 2019; 8:15. [PMID: 30827277 PMCID: PMC6398227 DOI: 10.1186/s40249-019-0525-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 02/06/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The 2014-2016 Ebola virus epidemic in West Africa was the largest outbreak of Ebola virus disease (EVD) in history. Clarifying the influence of other prevalent diseases such as human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) will help improve treatment and supportive care of patients with EVD. CASE PRESENTATION We examined HIV and hepatitis C virus (HCV) antibody prevalence among suspected EVD cases from the Sierra Leone-China Friendship Biological Safety Laboratory during the epidemic in Sierra Leone. HIV and HCV antibodies were tested in 678 EVD-negative samples by enzyme-linked immunosorbent assay. A high HIV prevalence (17.6%) and low HCV prevalence (0.22%) were observed among the suspected cases. Notably, we found decreased HIV positive rates among the suspected cases over the course of the epidemic. This suggests a potentially beneficial effect of an improved public health system after assistance from the World Health Organization and other international aid organizations. CONCLUSIONS This EVD epidemic had a considerable impact on the public health system and influenced the prevalence of HIV found among suspected cases in Sierra Leone, but also provided an opportunity to establish a better surveillance network for infectious diseases.
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Affiliation(s)
- William J. Liu
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention(China CDC), Beijing, 102206 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Hai-Yang Hu
- Jiangsu Provincial Center for Disease control and Prevention, Nanjing, 210009 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Qiu-Dong Su
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention(China CDC), Beijing, 102206 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Zhe Zhang
- Beijing Institute of Biotechnology, Beijing, 100071 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Yang Liu
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention(China CDC), Beijing, 102206 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Yu-Lan Sun
- Beijing Center for Disease Prevention and Control, Beijing, 100013 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Xian-Da Yang
- Jilin Provincial Center for Disease control and Prevention, Changchun, 130021 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Da-Peng Sun
- Shandong Provincial Center for Disease control and Prevention, Jinan, 250014 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Shao-Jian Cai
- Fujian Provincial Center for Disease control and Prevention, Fuzhou, 350001 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Xiu-Xu Yang
- Beijing Institute of Biotechnology, Beijing, 100071 China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Idrissa Kamara
- The Ministry of Health and Sanitation, Freetown, Sierra Leone
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Abdul Kamara
- The Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Matt Lebby
- The Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Brima Kargbo
- The Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Xiao-Ping Dong
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention(China CDC), Beijing, 102206 China
| | - Yue-Long Shu
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention(China CDC), Beijing, 102206 China
| | - Wen-Bo Xu
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention(China CDC), Beijing, 102206 China
| | - Gui-Zhen Wu
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention(China CDC), Beijing, 102206 China
| | | | - George F. Gao
- NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention(China CDC), Beijing, 102206 China
- Chinese Center for Disease Control and Prevention, Beijing, 102206 China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, 100101 China
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Zhang Y, Li X, Qiao S, Zhou Y, Shen Z. Information Communication Technology (ICT) use among PLHIV in China: A promising but underutilized venue for HIV prevention and care. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2018. [DOI: 10.1016/j.ijinfomgt.2017.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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