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Zhang W, Wong CKH, Xin Y, Fong DYT, Wong JYH. A Web-Based Sexual Health Intervention to Prevent Sexually Transmitted Infections in Hong Kong: Model-Based Cost-Effectiveness Analysis. J Med Internet Res 2023; 25:e45054. [PMID: 37561571 PMCID: PMC10450529 DOI: 10.2196/45054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/30/2023] [Accepted: 06/28/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) remain a significant public health concern, particularly among young adults, and Chlamydia trachomatis (CT) infections are the most common STIs in young women. One of the most effective ways to prevent STIs is the consistent use of condoms during sexual intercourse. There has been no economic evaluation of the interactive web-based sexual health program, Smart Girlfriend, within the Chinese population. OBJECTIVE This study aimed to evaluate the long-term cost-effectiveness of Smart Girlfriend in preventing STIs in the Chinese population. The evaluation compared the program with a control intervention that used a 1-page information sheet on condom use. METHODS A decision-analytic model that included a decision tree followed by a Markov structure of CT infections was developed since CT is the most prevalent STI among young women. The model represents the long-term experience of individuals who received either the intervention or the control. One-way and probabilistic sensitivity analyses were conducted. The main outcomes were the number of CT infections and the incremental cost as per quality-adjusted life year (QALY). RESULTS A cohort of 10,000 sexually active nonpregnant young women initially entered the model in a noninfectious state (ie, "well"). In the base-case analysis, the implementation of the Smart Girlfriend program resulted in the prevention of 0.45% of CT infections, 0.3% of pelvic inflammatory disease, and 0.04% of chronic pelvic pain, leading to a gain of 70 discounted QALYs and cost savings over a 4-year time horizon, compared to the control group. With more than 4548 users, the intervention would be cost-effective, and with more than 8315 users, the intervention would be cost saving. A 99% probability of being cost-effective was detected with a willingness to pay US $17,409 per QALY. CONCLUSIONS Smart Girlfriend is a cost-effective and possibly cost-saving program over a 4-year time horizon. This result was particularly sensitive to the number of website users; launching the website would be cost-effective if more than 4548 people used it. Further work is warranted to explore if the findings could be expanded to apply to women who have sex with women and in the context of other STIs. TRIAL REGISTRATION ClinicalTrial.gov NCT03695679; https://clinicaltrials.gov/study/NCT03695679.
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Affiliation(s)
- Wen Zhang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China (Hong Kong)
| | - Carlos K H Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Yiqiao Xin
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, United Kingdom
| | - Daniel Y T Fong
- School of Nursing, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Janet Y H Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China (Hong Kong)
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Tang Y, Yang X, Duan L, Zhan W, Chen K, Chai H, Liu P, Chen M, Zhao H, Liang L, Wei M, Luo M. Genetic and clinical characteristics of genital Chlamydia trachomatis infection in Guangzhou, China. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 101:105285. [PMID: 35447370 DOI: 10.1016/j.meegid.2022.105285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/14/2022] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Genital Chlamydia trachomatis (CT) is one of the most common agents of sexually transmitted infections and can cause severe disorders. This study aimed to analyse the genetic and clinical characteristics of genital CT infection among women in Guangzhou, China. METHODS From September 2020 to August 2021, a total of 8955 female patients were enrolled in this study. The presence of genital CT was detected by real-time PCR, and 273 positive samples were randomly selected for further genetic and clinical characteristics analysis. RESULTS The positive rate of genital CT infection was 7.5% (670/8955), with the highest rate in women aged 21-30 years. A total of 8 genotypes were identified: DH, J, K, and recombinant genotype Ba/D. The predominant genotype was J (n = 78, 28.6%), followed by E (n = 63, 23.1%), F (n = 48, 17.6%), and D (n = 38, 13.9%). Abnormal vaginal discharge (n = 165, 61.8%), cervical columnar epithelial ectopy (n = 124, 46.4%), vaginal itching (n = 77, 28.8%), and lower abdominal pain (n = 61, 22.8%) were the predominant symptoms. Additionally, genotype G infection exhibited a significantly higher rate of abnormal vaginal discharge (P = 0.03) and genotype D infection exhibited a higher white blood cell count (P = 0.01) than the other genotypes. Phylogenetic analysis revealed a total of 20 variants with 25 mutation positions and the H2 variant in four patients was first discovered in our study. CONCLUSIONS Genotypes J, E, F, and D were the major genotypes of genital CT in Guangzhou, and they manifested as abnormal vaginal discharge, cervical columnar epithelial ectopy, vaginal itching, and lower abdominal pain. The present study provides guidance for future integrated interventions to reduce the burden of genital CT infection and accelerate the development of vaccines.
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Affiliation(s)
- Yuan Tang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China
| | - Xiaohan Yang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Lei Duan
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China
| | - Wenli Zhan
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Keyi Chen
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Huiying Chai
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Pan Liu
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Minchai Chen
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Hongyu Zhao
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Lihua Liang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Mengru Wei
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China
| | - Mingyong Luo
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China.
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Weng R, Zhang C, Wen L, Luo Y, Ye J, Wang H, Li J, Ning N, Huang J, Chen X, Cai Y. Chlamydia-related knowledge, opinion to opportunistic testing, and practices of providers among different sexually transmitted infections related departments in hospitals in Shenzhen city, China. BMC Health Serv Res 2022; 22:601. [PMID: 35509056 PMCID: PMC9067339 DOI: 10.1186/s12913-022-08012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/27/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Chlamydia trachomatis (CT) infection could lead to seriously adverse outcomes if left untreated. This study aimed to determine CT-related knowledge, opinion to testing, and practices of providers among different sexually transmitted infections (STI) related departments in hospitals in Shenzhen city, China, and also to explore the differences in these responses. MATERIALS AND METHODS From 1st April 2018 to 15th April 2018, a cross-sectional study was conducted in Shenzhen and 64 of 66 hospitals agreed to participate in this study. In the hospital sites, all the providers from the department of obstetrics and gynecology, department of dermatology and venereology, department of urology, and anorectal surgical department were recruited. A structured paper-based questionnaire was used to obtain data on CT-related information. RESULTS A total of 355 providers from 64 hospitals participated in the current study. Compared to providers from the department of dermatology and venereology, those from the department of obstetrics and gynecology (OR = 0.31, 95% CI 0.16-0.62), department of urology (OR = 0.32, 95% CI 0.16-0.65), and anorectal surgical department (OR = 0.25, 95% CI 0.09-0.71) were less likely to identify that "Be in a long-term mutually monogamous relationship with a partner who has been tested and has negative STI test results." is an appropriate way for a sexually active person to reduce risk of getting CT. Also, those from the department of obstetrics and gynecology (OR = 0.45, 95% CI 0.23-0.87) were less likely to identify that "Use latex condoms the right way every time you have sex" is another appropriate way. A high proportion of providers agreed that all sexually active patients attending to their department should be screened regularly (77.1%), and they are willing to offer opportunistic CT screening (96.0%). Only 11.4% of respondents correctly identified that the appropriate time frame of the CT retesting is three months. CONCLUSIONS Providers among STI-related departments in hospitals showed a very high willingness to offer opportunistic CT screening. However, this study showed important gaps in providers' knowledge and practices in China, targeted training in CT-related knowledge and practice is urgently needed.
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Affiliation(s)
- Rongxing Weng
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
| | - Chunlai Zhang
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
| | - Lizhang Wen
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
| | - Yiting Luo
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
| | - Jianbin Ye
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
| | - Honglin Wang
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
| | - Jing Li
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
| | - Ning Ning
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
- Shantou University Medical College, Shantou, 515000, China
| | - Junxin Huang
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China
| | - Xiangsheng Chen
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Dermatology, Nanjing, China
- National Center for STD Control, China Center for Disease Control and Prevention, Nanjing, China
| | - Yumao Cai
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, China.
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Hu H, Zhou Y, Shi L, Lu J, Zhang Z, Xu X, Huan X, Fu G. High prevalence of Chlamydia trachomatis infection among women attending STD and gynecology clinics in Jiangsu province, China: A cross-sectional survey. Medicine (Baltimore) 2021; 100:e27599. [PMID: 34797283 PMCID: PMC8601320 DOI: 10.1097/md.0000000000027599] [Citation(s) in RCA: 3] [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] [Received: 06/08/2021] [Accepted: 10/04/2021] [Indexed: 01/05/2023] Open
Abstract
Epidemics of Chlamydia trachomatis (CT) infection among women are major global public health concerns. This study examined the prevalence of CT infection and associated factors among women attending sexually transmitted disease (STD) and gynecology clinics in Jiangsu province, China.A cross-sectional survey was conducted among women attending STD and gynecology clinics in the province during 2018 to 2019. Socio-demographic and behavioral information were collected through face-to-face questionnaire survey. Cervical swab specimens were collected to test for CT. Chi square tests were used to compare differences in CT prevalence between subgroups of characteristics. Multivariate logistic regression analysis was used to identify factors associated with CT infection.A total of 2664 participants were enrolled. The prevalence of CT infection was 16.6% (95% confidence interval: 15.0%-18.1%). Of those, CT prevalence among participants from STD clinics (19.4%) and South Jiangsu (18.5%) were higher. Female outpatients who were service personnel (adjusted odds ratio [aOR] = 1.667, P = .004) or farmers (aOR = 1.593, P = .039), lived in South Jiangsu (aOR = 1.796, P = .004), and were from STD clinics (aOR = 1.608, P = .022) were more likely to infect CT.Our study showed a high prevalence of CT infection among women attending STD and gynecology clinics in Jiangsu province, China. CT screening, surveillance and treatment promotion should therefore be of top priority on the CT prevention agenda.
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Weng R, Hong F, Zhang C, Wen L, Chen X, Cai Y. Associated factors of willingness to undergo routine chlamydia trachomatis screening among hospital-based patients in Shenzhen, China: a cross-sectional study. BMC Public Health 2020; 20:1720. [PMID: 33198730 PMCID: PMC7670722 DOI: 10.1186/s12889-020-09828-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 11/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis (CT) is a common sexually transmitted infection (STI) with significant morbidity. The study aimed to explore the willingness to undergo routine CT screening and its associated factors among hospital-based patients in Shenzhen. METHODS We used data from the Shenzhen Gonorrhea and Chlamydia Intervention Programme. Participants were recruited with a stratified purposeful sampling design from 1 April 2018 to 16 May 2018. A structured questionnaire was used to obtain data on baseline characteristics and CT-related participant information. RESULTS Of the 16,546 participants, 64.79% were women, with a mean age of 31.85 ± 7.31 of all participants. Of the participants, 88.78% were willing to undergo routine CT screening. According to multivariate logistic regression analyses, willingness to undergo routine CT screening was associated with the following (P < 0.05): being a woman (AOR = 1.53, 95% CI = 1.34-1.75), one year or more residency in Shenzhen (AOR = 1.64, 95% CI = 1.37-1.95), any secondary education (AOR = 2.46, 95% CI = 1.92-3.15), monthly income ≥ RMB 10,000 (AOR = 1.24, 95% CI = 1.01-1.51), having forgotten CT diagnosis history (AOR = 1.42, 95% CI = 1.12-1.79), without current STI-related symptoms (AOR = 1.24, 95% CI = 1.10-1.41), and having correct understanding of the sequelae of CT infection (AOR = 1.68, 95% CI = 1.39-2.03). CONCLUSION This study reported high willingness to undergo routine CT screening among hospital-based patients in Shenzhen, and provided evidence for the promotion and the implementation of strategies and recommendations on routine CT screening in China.
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Affiliation(s)
- Rongxing Weng
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, 518020, Guangdong Province, China
| | - Fuchang Hong
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, 518020, Guangdong Province, China
| | - Chunlai Zhang
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, 518020, Guangdong Province, China
| | - Lizhang Wen
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, 518020, Guangdong Province, China
| | - Xiangsheng Chen
- Peking Union Medical College Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, China
- National Center for Sexually Transmitted Disease Control, Nanjing, China
| | - Yumao Cai
- Department of STD Control and Prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, 518020, Guangdong Province, China.
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Paula Almeida Cunha A, Kassandra Pereira Belfort I, Pedro Belfort Mendes F, Rodrigues Bastos dos Santos G, Henrique de Lima Costa L, de Matos Monteiro P, Lemos Gaspar R, Borges Ferreira M, de Sá Ferreira A, Cristina Moutinho Monteiro S, Castello Branco Vidal F. Human papillomavirus and Its Association with Other Sexually Transmitted Coinfection among Sexually Active Women from the Northeast of Brazil. Interdiscip Perspect Infect Dis 2020; 2020:8838317. [PMID: 33178264 PMCID: PMC7647780 DOI: 10.1155/2020/8838317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To verify the association between HPV infection and the presence of coinfections (Chlamydia trachomatis, Trichomonas vaginalis, and Neisseria gonorrhoeae) in women in the state of Maranhão. METHODS HPV-DNA detection was performed by the nested PCR, using the primers PGMY09/11 and GP + 5/GP + 6. For the identification of sexually transmitted agents, conventional PCR was performed using the following primers: KL1/KL2 (Chlamydia trachomatis), TVA5/TVA6 (Trichomonas vaginalis), and HO1/HO3 (Neisseria gonorrhoeae). DNA-HPV positive samples were subjected to automated sequencing for genotyping. RESULTS Among the 353 women evaluated, 204 (57.8%) had HPV-DNA, of which 140 (68.6%) exhibited HPV/STIs, while 64 (31.4%) had the only HPV. T. vaginalis infection showed a positive association with HPV (p=0.003). Women without cervical lesions were predominant (327/92.6%); however, the largest number of lesions was reported in women who had HPV/coinfections (18/8.8%). Multiple regression analysis showed that both HPV only and the concomitant presence of HPV/STI were able to indicate the occurrence of epithelial lesions (R = 0.164; R2 = 0.027). CONCLUSION The findings suggest that the presence of T. vaginalis can contribute to HPV infection, and HPV/IST association may influence the development of cervical intraepithelial lesions that are precursors of cervical cancer.
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Weng R, Yu W, Hong F, Zhang C, Wen L, Wang F, Luo Y, Ye J, Tang F, Wang H, Chen X, Cai Y. High Willingness to Participate in Partner Notification among Women Attending Reproductive Health and STI Clinics in Shenzhen, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E386. [PMID: 31936047 PMCID: PMC7013575 DOI: 10.3390/ijerph17020386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/04/2020] [Accepted: 01/05/2020] [Indexed: 11/29/2022]
Abstract
Genital Chlamydia trachomatis (CT) is one of the most common sexually transmitted infections (STI) worldwide. We explored the factors associated with willingness to participate in partner notification (PN) among women attending reproductive health and STI clinics in Shenzhen, China. An anonymous questionnaire was used to collect the sociodemographic characteristics, STI histories, and willingness to participate in routine CT screening and partner notification. In total, 87.31% (n = 10,780) of participants were willing to notify their sex partner(s) if they were diagnosed with a CT infection. Willingness to complete PN was significantly associated with: being married, residing in Shenzhen ≥1 year, having completed junior college or higher, not currently reporting STI-related symptoms, willing to have routine CT screening, and having a correct understanding of the health sequelae of CT infection. Nearly all women surveyed at reproductive health and STI clinics in Shenzhen reported willingness to complete PN. Promoting PN in these settings could help detect a large number of additional CT cases. Our findings provide evidence and implications for public health interventions on PN and suggest that targeted interventions are urgently needed for particular subpopulations including those not currently married, with shorter residency, lower education, and less awareness about the dangers of CT infection.
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Affiliation(s)
- Rongxing Weng
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Weiye Yu
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Fuchang Hong
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Chunlai Zhang
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Lizhang Wen
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Feng Wang
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Yiting Luo
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Jianbin Ye
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Fen Tang
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Honglin Wang
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
| | - Xiangsheng Chen
- Peking Union Medical College Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing 210042, China;
- National Center for Sexually Transmitted Disease Control, Nanjing 210042, China
| | - Yumao Cai
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (R.W.); (W.Y.); (F.H.); (C.Z.); (L.W.); (F.W.); (Y.L.); (J.Y.); (F.T.); (H.W.)
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