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Yi M, Li X, Chiaramonte D, Sun S, Pan S, Soulliard Z, Eisenstadt BE, Ljótsson B, Hagaman A, Pachankis J. Guided internet-based LGBTQ-affirmative cognitive-behavioral therapy: A randomized controlled trial among sexual minority men in China. Behav Res Ther 2024; 181:104605. [PMID: 39029333 DOI: 10.1016/j.brat.2024.104605] [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: 01/11/2024] [Revised: 05/09/2024] [Accepted: 07/12/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE LGBTQ-affirmative cognitive-behavioral therapy (CBT) addresses minority stress to improve sexual minority individuals' mental and behavioral health. This treatment has never been tested in high-stigma contexts like China using online delivery. METHOD Chinese young sexual minority men (n = 120; ages 16-30; HIV-negative; reporting depression and/or anxiety symptoms and past-90-day HIV-transmission-risk behavior), were randomized to receive 10 sessions of culturally adapted asynchronous LGBTQ-affirmative internet-based CBT (ICBT) or weekly assessments only. The primary outcome included HIV-transmission-risk behavior (i.e., past-30-day condomless anal sex). Secondary outcomes included HIV social-cognitive mechanisms (e.g., condom use self-efficacy), mental health (e.g., depression), and behavioral health (e.g., alcohol use), as well as minority stress (e.g., acceptance concerns), and universal (e.g., emotion regulation) mechanisms at baseline and 4- and 8-month follow-up. Moderation analyses examined treatment efficacy as a function of baseline stigma experiences and session completion. RESULTS Compared to assessment only, LGBTQ-affirmative ICBT did not yield greater reductions in HIV-transmission-risk behavior or social-cognitive mechanisms. However, LGBTQ-affirmative ICBT yielded greater improvements in depression (d = -0.50, d = -0.63) and anxiety (d = -0.51, d = -0.49) at 4- and 8-month follow-up, respectively; alcohol use (d = -0.40) at 8-month follow-up; and certain minority stress (e.g., internalized stigma) and universal (i.e., emotion dysregulation) mechanisms compared to assessment only. LGBTQ-affirmative ICBT was more efficacious for reducing HIV-transmission-risk behavior for participants with lower internalized stigma (d = 0.42). Greater session completion predicted greater reductions in suicidality and rumination. CONCLUSIONS LGBTQ-affirmative ICBT demonstrates preliminary efficacy for Chinese young sexual minority men. Findings can inform future interventions for young sexual minority men in contexts with limited affirmative supports.
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Affiliation(s)
- Mengyao Yi
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China.
| | | | - Shufang Sun
- Brown University School of Public Health, Providence, RI, USA
| | - Si Pan
- The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | | | | | | | - Ashley Hagaman
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - John Pachankis
- Yale School of Public Health, Yale University, New Haven, CT, USA.
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Liu L, Ruan Y, Chen S, Tang H, Liu J, Jiang Y, Pei H, Huang T, Lan G, Xie Y. Willingness to Use Long-Acting Injectable Cabotegravir and Associated Factors Among Men Who Have Sex with Men in Guangxi, China. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2795-2806. [PMID: 38849704 DOI: 10.1007/s10508-024-02886-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/10/2024] [Accepted: 04/30/2024] [Indexed: 06/09/2024]
Abstract
Cabotegravir (CAB-LA), the first long-acting injectable pre-exposure prophylaxis (PrEP), has been approved for use in the USA and is not currently on the market in China. However, willingness to use CAB-LA and associated factors among men who have sex with men (MSM) have not yet been evaluated in China. A cross-sectional study was conducted in Guangxi, China, in 2022 recruiting 1,006 MSM. Their mean age was 30.2 years, 74.2% had college or above education, and 48.6% had a monthly income between 3,000 and 5,999 Chinese yuan (CNY). Most (73.4%) had previously heard of PrEP while few (8.3%) had ever used this type of preventative medication. Willingness to use CAB-LA was 79.8% and was positively associated with eight variables: younger age, being married to a woman, having a low monthly income, having six or more male partners in the past six months, having only regular male partners in the past month, having a high perceived risk of HIV infection, and history of using PrEP. Ten other variables were not significantly associated with willingness to use CAB-LA. Among 894 participants who were willing to use or did not definitely reject using CAB-LA, the main concerns about CAB-LA were its side effects (90.2%), efficacy (63.6%), and high cost (58.2%). Only 14.7% were willing to pay more than 1,200 CNY (~US$180) every two months to use CAB-LA. The preferred injection places were centers for disease control facilities, hospitals, and social organizations. Many (89.0%) said that they would recommend CAB-LA to their male sexual partners. We conclude that willingness to use CAB-LA was high among MSM in Guangxi. However, implementation of CAB-LA faces tough challenges due to its high cost and the low use of PrEP. Peer education may play a large role in the implementation of CAB-LA in China.
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Affiliation(s)
- Lu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, 22, Shuangyong Road, Nanning, 530021, 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
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Shiwen Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, 22, Shuangyong Road, Nanning, 530021, China
| | - Hongyang Tang
- Division of AIDS Control and Prevention, Nanning Center for Disease Control and Prevention, Nanning, China
| | - Junhui Liu
- Division of AIDS Control and Prevention, Nanning Center for Disease Control and Prevention, Nanning, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, 22, Shuangyong Road, Nanning, 530021, China
| | - Hengyan Pei
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, 22, Shuangyong Road, Nanning, 530021, China
| | - Tengda Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, 22, Shuangyong Road, Nanning, 530021, 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
- Division of AIDS Control and Prevention, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Yihong Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, 22, Shuangyong Road, Nanning, 530021, China.
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Peng W, Zhou Q, Goldsamt LA, Shen Y, Wang R, Li X. Culture-based stigmatizing attitudes toward condom use among Chinese older adults: An interpretative phenomenological analysis. Public Health Nurs 2024. [PMID: 38940530 DOI: 10.1111/phn.13358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/12/2024] [Accepted: 06/07/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To explore their perceptions and attitudes toward condom use and the underlying reasons for the low usage frequency among Chinese older adults. METHODS A qualitative study design utilizing interpretive phenomenological analysis was employed. Data were collected through field observation and face-to-face in-depth interviews among older adults aged 50 years or above and having engaged in sexual activities within the previous year. RESULTS Three main themes emerged: perceiving unnecessary due to misconceptions and low awareness, interactive stereotypes rooted in sociocultural beliefs, and stigmatized social norms including gender inequity and economic unbalance. CONCLUSIONS Tailored interventions focusing on addressing misconceptions, increasing awareness, and reducing culturally ingrained stereotypes and stigma surrounding condom use are essential to promote condom use among older adults in order to prevent HIV transmission in China.
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Affiliation(s)
- Wenwen Peng
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Qidi Zhou
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Lloyd A Goldsamt
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Yan Shen
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Run Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
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Li L, Yang D, Chen X, Kuai W, Ma X. The prevalence of hepatitis B virus infection among HIV-infected patients in the Ningxia Hui Autonomous Region, China, November 2002 to July 2023. Diagn Microbiol Infect Dis 2024; 110:116417. [PMID: 38954861 DOI: 10.1016/j.diagmicrobio.2024.116417] [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: 04/22/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024]
Abstract
We tested HIV-infected people with HBV serological markers of Ningxia. Of 1008 HIV-positive individuals, 70 (6.9 %) tested positive for HBsAg, 570 (56.5 %) tested positive for anti-HBs, and 483 (47.9 %) tested positive for anti-HBc. Of 70 HBV-positive individuals, 13 (18.5 %) tested positive for HBeAg, 31 (44.3 %) tested positive for anti-HBe, 3 (4.2 %) exhibited acute infection.
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Affiliation(s)
- Longshan Li
- Ningxia Center for Diseases Control and Prevention, Yinchuan 750001, China
| | - Dongzhi Yang
- Ningxia Center for Diseases Control and Prevention, Yinchuan 750001, China
| | - Xiaoying Chen
- Ningxia Center for Diseases Control and Prevention, Yinchuan 750001, China
| | - Wenhe Kuai
- Ningxia Center for Diseases Control and Prevention, Yinchuan 750001, China
| | - Xueping Ma
- Ningxia Center for Diseases Control and Prevention, Yinchuan 750001, China.
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Li L, Feng X, Zhao F, Yuan D, An X, Tian X, Wu H, Su B, Zhang T, Liu L. Real-world performance of HIV low viral load values in diagnosing acute HIV infection in a tertiary care hospital in Beijing, China. BMC Infect Dis 2024; 24:587. [PMID: 38879487 PMCID: PMC11179375 DOI: 10.1186/s12879-024-09486-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/09/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Early diagnosis of HIV infection decreases the time from HIV diagnosis to viral suppression and reduces further HIV transmission. The Chinese Guidelines for the Diagnosis and Treatment of HIV/AIDS (2021 edition) state that an HIV RNA level > 5,000 copies/mL is the threshold for diagnosing HIV infection. The impact of low viral load values on HIV diagnosis needs to be investigated. METHODS There were 3455 human immunodeficiency virus (HIV1 + 2) antibody results (immunoblotting method) and 65,129 HIV viral load values at Beijing Youan Hospital from 2019 to 2022. A total of 2434 patients had both antibody confirmatory results and viral load results. The confirmatory antibody results and HIV viral load results of 2434 patients were analyzed to investigate the impact of low viral load values on HIV diagnosis. RESULTS Of the 2434 patients who had both confirmatory antibody results and viral load results, the viral load values of 140 patients (5.8%) had viral loads ranging from 40 copies/mL to 5,000 copies/mL before positive confirmatory antibody result, and of these 140 patients, the sample receipt time for the viral load tests of 96 (66.7%) individuals was 1 to 6 days earlier than the corresponding sample receipt time for the confirmatory antibody test. In addition, 34 patients (1.4%) had low viral loads ranging from 40 copies/mL to 1,000 copies/mL before positive confirmatory antibody result. CONCLUSION This study revealed that there is a risk of missed diagnosis if a threshold of 5000 copies/mL is used for the diagnosis of HIV infection. These data provide valuable information for the early diagnosis of HIV infection, and our findings have potential benefits for decreasing HIV transmission.
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Affiliation(s)
- Li Li
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Xia Feng
- Department of Clinical Laboratory, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Fei Zhao
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Defu Yuan
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Xizhao An
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Xiaoxue Tian
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Hao Wu
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Bin Su
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
- Beijing Youan Hospital, Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Capital Medical University, Beijing, 100069, China.
| | - Tong Zhang
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
- Beijing Youan Hospital, Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Capital Medical University, Beijing, 100069, China.
| | - Lifeng Liu
- Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
- Beijing Youan Hospital, Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Capital Medical University, Beijing, 100069, China.
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Xie Z, Chen B, Duan Z. Spatiotemporal Analysis of HIV/AIDS Incidence in China From 2009 to 2019 and Its Association With Socioeconomic Factors: Geospatial Study. JMIR Public Health Surveill 2024; 10:e56229. [PMID: 38848123 PMCID: PMC11193075 DOI: 10.2196/56229] [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: 01/10/2024] [Revised: 03/20/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The Joint United Nations Program on HIV/AIDS (UNAIDS) has set the "95-95-95" targets to ensure that 95% of all people living with HIV will know their HIV status, 95% of all people living with HIV will receive sustained antiretroviral therapy (ART), and 95% of all people receiving ART will achieve viral suppression (<1000 copies/mL). However, few countries have currently achieved these targets, posing challenges to the realization of the UNAIDS goal to eliminate the global HIV/AIDS epidemic by 2030. The Chinese government has implemented corresponding policies for HIV/AIDS prevention and control; however, it still faces the challenge of a large number of HIV/AIDS cases. Existing research predominantly focuses on the study of a particular region or population in China, and there is relatively limited research on the macro-level analysis of the spatiotemporal distribution of HIV/AIDS across China and its association with socioeconomic factors. OBJECTIVE This study seeks to identify the impact of these factors on the spatiotemporal distribution of HIV/AIDS incidence in China, aiming to provide scientific recommendations for future policy development. METHODS This study employed ArcGIS 10.2 (Esri) for spatial analysis, encompassing measures such as the imbalance index, geographical concentration index, spatial autocorrelation analysis (Moran I), and hot spot analysis (Getis-Ord Gi*). These methods were used to unveil the spatiotemporal distribution characteristics of HIV/AIDS incidence in 31 provinces of China from 2009 to 2019. Geographical Detector was used for ecological detection, risk area detection, factor detection, and interaction detection. The analysis focused on 9 selected socioeconomic indicators to further investigate the influence of socioeconomic factors on HIV/AIDS incidence in China. RESULTS The spatiotemporal distribution analysis of HIV/AIDS incidence in China from 2009 to 2019 revealed distinct patterns. The spatial distribution type of HIV/AIDS incidence in China was random in 2009-2010. However, from 2011 to 2019, the distribution pattern evolved toward a clustered arrangement, with the degree of clustering increasing each year. Notably, from 2012 onwards, there was a significant and rapid growth in the aggregation of cold and hot spot clusters of HIV/AIDS incidence in China, stabilizing only by the year 2016. An analysis of the impact of socioeconomic factors on HIV/AIDS incidence in China highlighted the "urbanization rate" and "urban basic medical insurance fund expenditure" as the primary factors influencing the spatial distribution of HIV/AIDS incidence. Additionally, among social factors, indicators related to medical resources exerted a crucial influence on HIV/AIDS incidence. CONCLUSIONS From 2009 to 2019, HIV/AIDS incidence in China was influenced by various socioeconomic factors. In the future, it is imperative to optimize the combination of different socioeconomic indicators based on regional incidence patterns. This optimization will facilitate the formulation of corresponding policies to address the challenges posed by the HIV/AIDS epidemic.
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Affiliation(s)
- Ziyi Xie
- Faculty of Humanities and Social Science, Macao Polytechnic University, Macao, China
| | - Bowen Chen
- Faculty of Humanities and Social Science, Macao Polytechnic University, Macao, China
| | - Zhizhuang Duan
- Xingzhi College, Zhejiang Normal University, Jinhua, China
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Zhang C, Yan Y, Zhu X, Li L, Li Y, Wang G, He F, Song Y, Liu Y, Zhang N. Evaluating the spatial accessibility and spatial layout optimization of HIV/AIDS healthcare services in Shandong Province, China. Sci Rep 2024; 14:11258. [PMID: 38755199 PMCID: PMC11099158 DOI: 10.1038/s41598-024-61484-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
Improving access to HIV/AIDS healthcare services is of great concern to government and policymakers striving to strengthen overall public health. How to reasonably allocate HIV/AIDS healthcare resources and maximize the equality of access to healthcare services across subdistrict areas has become an urgent problem to be solved. However, there is limited research on this topic in China. It is necessary to evaluate spatial accessibility to improve the accessibility and equity of HIV/AIDS healthcare services. In this study, the improved multi-modal two-step floating catchment area (2SFCA) and inverted 2SFCA (i2SFCA) methods are used to measure the spatial accessibility of HIV/AIDS healthcare services and the crowdedness of the healthcare sites in Shandong Province, China. Then, the theoretical supply and the optimal spatial distribution of resources are calculated and visualized by minimizing the accessibility gaps between demand locations. This study showed that the spatial accessibility of HIV/AIDS service resources in Shandong Province was concentrated and unevenly distributed, and the accessibility scores in the marginal areas of prefecture-level cities were significantly lower than those in other areas. Regions with a large number of doctors had significantly higher levels of spatial accessibility. The ART accessibility scores in the southwest of Shandong Province were higher than those in other regions. As the travel friction coefficient increased, the accessibility scores formed an approximately circular cluster distribution centered on the healthcare sites in geographical distribution. More ART drugs needed to be supplied in marginal areas and more doctors were needed to work on HIV/AIDS in urban areas to address the spatial distribution imbalance of HIV/AIDS healthcare services. This study profoundly analyzed the spatial accessibility of HIV/AIDS healthcare services and provided essential references for decision-makers. In addition, it gives a significant exploration for achieving the goal of equal access to HIV/AIDS healthcare services in the future.
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Affiliation(s)
- Chao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000, Shandong, China
| | - Yujie Yan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000, Shandong, China
| | - Xiaoyan Zhu
- Shandong Center for Disease Control and Prevention, Jinan, 250014, Shandong, China
| | - Ling Li
- Shandong Center for Disease Control and Prevention, Jinan, 250014, Shandong, China
| | - Yajun Li
- Shandong Center for Disease Control and Prevention, Jinan, 250014, Shandong, China
| | - Guoyong Wang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, Shandong, China
| | - Fenfen He
- Department of Occupational and Environmental Health and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - Yining Song
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000, Shandong, China
| | - Yunxia Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000, Shandong, China.
- Climate Change and Health Center, Shandong University, Jinan, Shandong Province, China.
| | - Na Zhang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, Shandong, China.
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Wang X, Xu H, Zhang Y, Zeng J, Liu C, Luo R, Zhong H, Cai W, Li L, Gu J. Exploring the relationship between illness perception, self-management and quality of life among HIV-positive men who have sex with men. J Adv Nurs 2024. [PMID: 38712981 DOI: 10.1111/jan.16194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/15/2024] [Accepted: 04/06/2024] [Indexed: 05/08/2024]
Abstract
AIMS This study aimed to explore the mediating effect of self-management (SM) on the relationship between illness perception and quality of life (QOL) among Human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). DESIGN A cross-sectional study. METHODS We explored the effect of illness perception and self-management on QOL using the multiple regression model. Moreover, we conducted a simple mediation analysis to examine the role of SM in the relationship between illness perception and QOL. In addition, a parallel mediation analysis was performed to investigate the differences in domains of SM on the relationship between illness perception and QOL. RESULTS Among 300 Chinese HIV-positive MSM, the mean score of SM was 39.9 ± 6.97, with a range of 14.0-54.0. The higher score in SM indicated a higher level of HIV SM. SM was negatively related to illness perception (r = -0.47) while positively related to QOL (r = 0.56). SM partially mediated the relationship between illness perception and QOL, accounting for 25.3% of the total effect. Specifically, both daily self-management health practices and the chronic nature of the self-management domain played a parallel role in mediating the relationship between illness perception and QOL. CONCLUSION Our study demonstrated that SM was a significant factor influencing QOL among HIV-positive MSM. Focusing on daily self-management health practices and the chronic nature of self-management could be the potential key targets for enhancing HIV self-management strategies. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE This study emphasized the role of SM in the well-being of HIV-positive MSM and underscored the importance of developing interventions that integrate SM strategies to improve QOL in this population. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Xu Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - He Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yao Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Zeng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Cong Liu
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Rui Luo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Haidan Zhong
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen University Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
- Center for Health Information Research, Sun Yat-sen University, Guangzhou, China
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Tang J, Ren J, Wang H, Shi M, Jia X, Zhang L. Real experience of caregivers of patients with HIV/AIDS from the perspective of iceberg theory: a qualitative research. BMJ Open 2024; 14:e079474. [PMID: 38719298 PMCID: PMC11086469 DOI: 10.1136/bmjopen-2023-079474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the caregiving behaviours and supportive needs of caregivers of patients with HIV/AIDS and provide a basis for healthcare institutions to carry out caregiver interventions. DESIGN A purposive sampling method was used to select 11 caregivers of patients with HIV/AIDS in the Infectious Disease Department of a tertiary hospital in Nanjing, China, to conduct semistructured interviews. Colaizzi analysis was used to collate and analyse the interview data. SETTING All interviews were conducted at a tertiary hospital specialising in infectious diseases in Nanjing, Jiangsu Province. PARTICIPANTS We purposively sampled 11 caregivers of people with HIV/AIDS, including nine women and two men. RESULTS Analysing the results from the perspective of iceberg theory, three thematic layers were identified: behavioural, value and belief. The behavioural layer includes a lack of awareness of the disease, physical and mental coping disorders, and an increased sense of stigma; the values layer includes a heightened sense of responsibility, the constraints of traditional gender norms, the influence of strong family values and the oppression of public opinion and morality and the belief layer includes the faith of standing together through storms and stress. CONCLUSION Healthcare professionals should value the experiences of caregivers of patients with HIV/AIDS and provide professional support to improve their quality of life.
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Affiliation(s)
- Jie Tang
- School of Nursing, Nanjing University of Chinese Medicine, Lianyungang, Jiangsu, China
| | - Jingxia Ren
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Anyang, Henan, China
| | - Huiqun Wang
- Department of Infectious Disease, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Min Shi
- School of Nursing, Nanjing University of Chinese Medicine, Lianyungang, Jiangsu, China
| | - Xiaofeng Jia
- School of Nursing, Nanjing University of Chinese Medicine, Yantai, Shandong, China
| | - Liman Zhang
- Department of Infectious Disease, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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Li N, Zheng HY, He WQ, He XY, Li R, Cui WB, Yang WL, Dong XQ, Shen ZQ, Zheng YT. Treatment outcomes amongst older people with HIV infection receiving antiretroviral therapy. AIDS 2024; 38:803-812. [PMID: 38578958 PMCID: PMC10994140 DOI: 10.1097/qad.0000000000003831] [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: 09/06/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVES There is conflicting data regarding the response of older people with HIV (PWH) to antiretroviral therapy (ART). The objective of this study was to evaluate the long-term immunological and virological responses, changes in regimen, and adverse drug reactions (ADRs) in older participants (50+ years) compared with younger (18-34 years) and middle-aged (35-49 years) PWH. METHODS A retrospective review of medical records was conducted on 1622 participants who received ART in Yunnan Province, China, from 2010 to 2019. The study compared CD4+ T-cell counts, CD4+/CD8+ ratio, and relative numbers between different groups using the Kruskal-Wallis test. Cox proportional hazards regression models were used to identify variables associated with the occurrence of immune reconstitution insufficiency. The rates of immune reconstitution, incidence of ADRs, and rates of treatment change were analyzed using the chi-squared test or Fisher's exact test. RESULTS Over 95% achieved viral load 200 copies/ml or less, with no age-related difference. However, older participants exhibited significantly lower CD4+ T-cell counts and CD4+/CD8+ recovery post-ART (P < 0.001), with only 32.21% achieving immune reconstitution (compared with young: 52.16%, middle-aged: 39.29%, P < 0.001) at the end of follow-up. Middle-aged and elderly participants changed ART regimens more because of ADRs, especially bone marrow suppression and renal dysfunction. CONCLUSION Although the virological response was consistent across age groups, older individuals showed poorer immune responses and higher susceptibility to side effects. This underscores the need for tailored interventions and comprehensive management for older patients with HIV.
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Affiliation(s)
- Na Li
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming
- State Key Laboratory of Genetic Evolution & Animal Models, Key Laboratory of Bioactive Peptides of Yunnan Province, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan
- Yunnan Provincial Hospital of Infectious Disease, Kunming, China
| | - Hong-Yi Zheng
- State Key Laboratory of Genetic Evolution & Animal Models, Key Laboratory of Bioactive Peptides of Yunnan Province, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan
| | - Wen-Qiang He
- State Key Laboratory of Genetic Evolution & Animal Models, Key Laboratory of Bioactive Peptides of Yunnan Province, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan
| | - Xiao-Yan He
- State Key Laboratory of Genetic Evolution & Animal Models, Key Laboratory of Bioactive Peptides of Yunnan Province, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan
| | - Rui Li
- State Key Laboratory of Genetic Evolution & Animal Models, Key Laboratory of Bioactive Peptides of Yunnan Province, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan
| | - Wen-Bo Cui
- Yunnan Provincial Hospital of Infectious Disease, Kunming, China
| | - Wei-Lin Yang
- Yunnan Provincial Hospital of Infectious Disease, Kunming, China
| | - Xing-Qi Dong
- Yunnan Provincial Hospital of Infectious Disease, Kunming, China
| | - Zhi-Qiang Shen
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming
| | - Yong-Tang Zheng
- State Key Laboratory of Genetic Evolution & Animal Models, Key Laboratory of Bioactive Peptides of Yunnan Province, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan
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Yu C, Wu Y, Zhang Y, Li M, Xie X, Xie L. Hope level and associated factors among older people living with HIV/AIDS: a cross-sectional study. Front Public Health 2024; 12:1371675. [PMID: 38694993 PMCID: PMC11061488 DOI: 10.3389/fpubh.2024.1371675] [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: 01/16/2024] [Accepted: 03/29/2024] [Indexed: 05/04/2024] Open
Abstract
Background In China, little is known about the hope level of older people living with HIV/AIDS (PLWHA). This study was to examine the hope level of older PLWHA in China and identify related factors. Methods This cross-sectional study was conducted in Sichuan province in China among older PLWHA. A standardized self-report questionnaire, the Herth Hope Index, was adopted. Multiple linear regression was used to identify factors influencing hope level. p-values <0.05 were considered statistically significant. Results There were 314 participants with an average age of 64.5 (SD ± 8.7). Most of the participants were males (72.6%), primary school and below (65.9%), rural household registration (58.6%) and married (64.3%). More than half of the older adults had pension insurance, had a monthly income of more than RMB 1,000 and considered themselves to be in good health. About 80% confirmed being diagnosed for more than a year and disclosed their HIV status to family and friends. The majority of the population had low medium social support (79%). More than 80% had moderate and severe HIV stigma. Many older PLWHA had medium and high levels of hope, with an average score of 34.31 (SD ± 4.85). Multiple linear regression showed that having pension insurance (β = 1.337, p = 0.015), longer diagnosis (β = 0.497, p = 0.031), better self-reported health (β = 1.416, p<0.001) and higher levels of social support (β = 2.222, p < 0.001) were positively associated with higher levels of hope. HIV stigma (β = -1.265, p < 0.001) was negatively correlated with hope level. Conclusion The hope level of older PLWHA is good, but there is still room for improvement, and its hope is related to multiple factors. Therefore, the AIDS-related healthcare sector should pay special attention to the hope of older PLWHA, help them to improve their health, provide financial assistance and social aid to those with financial difficulties, and take measures to reduce HIV stigma, improve family support for the older adults, and guide the older adults to adopt a positive approach to life.
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Affiliation(s)
- Chunlan Yu
- Outpatient Department, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yan Wu
- Outpatient Department, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yuli Zhang
- Department of Hepatobiliary Surgery, The First Branch of The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mei Li
- Department of Gynecology, The First Branch of The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Xie
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Longsheng Xie
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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12
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Xia H, Li L, Wu Y, Gao L, Zhang D, Ma P. Rapid Initiation of Antiretroviral Therapy Under the Treat-All Policy Reduces Loss to Follow-Up and Virological Failure in Routine Human Immunodeficiency Virus Care Settings in China: A Retrospective Cohort Study (2016-2022). AIDS Patient Care STDS 2024; 38:168-176. [PMID: 38656215 DOI: 10.1089/apc.2024.0045] [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] [Indexed: 04/26/2024] Open
Abstract
Following the World Health Organization's guidelines for rapid antiretroviral therapy (ART) initiation [≤7 days after human immunodeficiency virus (HIV) diagnosis], China implemented Treat-All in 2016 and has made significant efforts to provide timely ART since 2017. This study included newly diagnosed HIV adults from Tianjin, China, between 2016 and 2022. Our primary outcome was loss to follow-up (LTFU) at 12 months after enrollment. The secondary outcome was 12-month virological failure. The association between rapid ART and LTFU, as well as virological failure, was assessed via Cox regression and logistic regression. A total of 896 (19.1%) of 4688 participants received ART ≤7 days postdiagnosis. The rate of rapid ART has increased from 7.5% in 2016 to 33.3% by 2022. The rapid ART group had an LTFU rate of 3.3%, as opposed to 5.0% in the delayed group. The rapid ART group had a much reduced virological failure rate (0.6% vs. 1.8%). Rapid ART individuals had a reduced likelihood of LTFU [adjusted hazard ratio: 0.65, 95% confidence intervals (CI): 0.44-0.96] and virological failure (adjusted odds ratio: 0.35, 95% CI: 0.12-0.80). The real-world data indicated that rapid ART is practicable and beneficial for Chinese people with HIV, providing evidence for its widespread implementation and scaling up.
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Affiliation(s)
- Huan Xia
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Lei Li
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Yue Wu
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Liying Gao
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Defa Zhang
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Ping Ma
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
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He S, Dong W, Fairley CK, Li Z, Wei Y, Lai H, Li R, Lu P, Shen M, Wu Z, Zhang L. Optimizing health resource allocation for improving timely HIV diagnosis in China. J Int AIDS Soc 2024; 27:e26221. [PMID: 38444111 PMCID: PMC10935715 DOI: 10.1002/jia2.26221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/30/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION The Joint United Nations Programme on HIV/AIDS (UNAIDS) updated the 95-95-95 targets for the HIV endgame in 2030. To achieve the first target in a timely manner, we investigate the optimized strategy of resource allocation to maximize timely HIV diagnosis in 14 populations in China. METHODS We developed a mathematical model by integrating epidemiological, demographical and behavioural data from 12 high-risk and two general populations to evaluate the impact of various resource allocation strategies of HIV testing on HIV incidence in China. We identified the optimized allocation strategy that maximizes the number of HIV diagnoses at an estimated total spending on HIV tests in China and calculated the per-capita cost of new HIV case detection. RESULTS We estimated that 144,795 new HIV cases may occur annually in 14 populations in China, with a total annual spending of US$2.8 billion on HIV testing. The largest proportion of spending was allocated to general males (44.0%), followed by general females (42.6%) and pregnant women (5.1%). Despite this allocation strategy, only 45.5% (65,867/144,795, timely diagnosis rate) of annual new infections were diagnosed within a year of acquisition, with a cost of $42,852 required for each new HIV case detection. By optimizing the allocation of HIV testing resources within the same spending amount, we found that general females received the highest proportion of spending allocation (45.1%), followed by low-risk men who have sex with men (13.9%) and pregnant women (8.4%). In contrast, the proportion of spending allocation for the general males decreased to 0.2%. With this optimized strategy, we estimated that 120,755 (83.4%) of annual new infections would be diagnosed within a year of acquisition, with the cost required for one HIV case detection reduced to $23,364/case. Further spending increases could allow for significant increases in HIV testing among lower-risk populations. CONCLUSIONS Optimizing resource allocation for HIV testing in high-risk populations would improve HIV timely diagnosis rate of new infections and reduce cost per HIV case detection.
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Affiliation(s)
- Shihao He
- China‐Australia Joint Research Center for Infectious DiseasesSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
| | - Wei Dong
- National Center for AIDS/STD Control and Prevention (NCAIDS)Chinese Center for Disease Control and Prevention (China CDC)BeijingChina
| | - Christopher K. Fairley
- Melbourne Sexual Health CentreAlfred HealthMelbourneVictoriaAustralia
- Central Clinical SchoolFaculty of MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Zengbin Li
- China‐Australia Joint Research Center for Infectious DiseasesSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
| | - Yudong Wei
- China‐Australia Joint Research Center for Infectious DiseasesSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
| | - Hao Lai
- China‐Australia Joint Research Center for Infectious DiseasesSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
| | - Rui Li
- China‐Australia Joint Research Center for Infectious DiseasesSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
| | - Pengyi Lu
- China‐Australia Joint Research Center for Infectious DiseasesSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
| | - Mingwang Shen
- China‐Australia Joint Research Center for Infectious DiseasesSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi ProvinceXi'anChina
- The Interdisciplinary Center for Mathematics and Life SciencesSchool of Mathematics and StatisticsXi'an Jiaotong UniversityXi'anChina
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University)Ministry of EducationXi'anChina
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention (NCAIDS)Chinese Center for Disease Control and Prevention (China CDC)BeijingChina
| | - Lei Zhang
- China‐Australia Joint Research Center for Infectious DiseasesSchool of Public HealthXi'an Jiaotong University Health Science CenterXi'anChina
- Melbourne Sexual Health CentreAlfred HealthMelbourneVictoriaAustralia
- Central Clinical SchoolFaculty of MedicineMonash UniversityMelbourneVictoriaAustralia
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Su R, Liu Y, Li P, Ge L, Liao M, Fu Y, Song X, Shan D, Tang H, Li D. The impact of HIV self-testing on risk behaviors among men who have sex with men: a mixed-methods study. Front Public Health 2024; 12:1369931. [PMID: 38476479 PMCID: PMC10927815 DOI: 10.3389/fpubh.2024.1369931] [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: 01/13/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
Background Men who have sex with men (MSM) have a high prevalence of HIV and a low rate of HIV testing in China. HIV self-testing (HIVST) presents a viable strategy for expanding HIV testing among MSM. However, the impact of HIVST on risk behaviors among MSM remains controversial. Our study sought to ascertain this impact. Methods From April 2021 to January 2022, a mixed-methods study was conducted in Qingdao City, employing both quantitative and qualitative methodologies. The quantitative component entailed a cohort study among MSM who had used HIVST. Generalized estimating equations fitting Poisson regressions were used to analyze the changes in risk behaviors of MSM in short time after HIVST (ST-HIVST) and longer time after HIVST (LT-HIVST) compared to before HIVST. Subsequently, we conducted in-depth interviews with 18 MSM who completed the follow-up to delve deeper into the impact of HIVST on MSM. Results A total of 410 MSM were recruited in the cohort, of whom 83 were lost to follow-up. Compared to before HIVST, there were no significant changes in risk behaviors in ST-HIVST (p > 0.05), while the proportion of recreational drugs abuse (20.7% vs. 33.3%), commercial sex (14.6% vs. 22.9%), and unprotected anal sex (95.9% vs. 98.5%) increased significantly in LT-HIVST (p < 0.05). Specific changes varied across demographic characteristics. According to qualitative interviews, MSM might have decreased risk perception and increased risk behaviors after HIVST. Conclusion The use of HIVST may promote MSM to engage in risk behaviors. In the future, customized HIVST promotion programs need to be developed to expand HIV testing among MSM and simultaneously control their risk behaviors.
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Affiliation(s)
- Rong Su
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Liu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peilong Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin Ge
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meizhen Liao
- Shandong Provincial Center for Disease Control and Prevention, Ji’nan, China
| | - Yong Fu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Xin Song
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Duo Shan
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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15
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Zhang F, Zhu S, Zhao D, Tang H, Ruan L, Zhu W. Ambient temperature variations and AIDS-related mortality: A time-stratified case-crossover study in 103 counties, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169474. [PMID: 38135089 DOI: 10.1016/j.scitotenv.2023.169474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/16/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Climate change, characterized by the steady ascent of global temperatures and the escalating unpredictability of climate patterns, poses multifaceted challenges to public health worldwide. However, vulnerable groups, particularly the population affected by HIV/AIDS, have received little attention. OBJECTIVES We aimed to examine the impacts of temperature variations on AIDS-related mortality. METHODS Data on individuals with HIV/AIDS were collected from the HIV/AIDS Comprehensive Response Information Management System between 2013 and 2019. Temperature variation metrics were constructed by diurnal temperature range (DTR), temperature changes between neighboring days (TCN), and temperature variability (TV0-t). Time-stratified case-crossover design with conditional logistic regression models was used to investigate the associations between ambient temperature variations and AIDS-related mortality. RESULTS Each 1 °C elevated in DTR was linked with a 5.28 % [95 % confidence intervals (CIs): 1.61, 9.08] increment in AIDS-related mortality at a lag of 0-6 days. Stronger associations between DTR and AIDS-related mortality were observed in the married than in single, with corresponding excess ORs (%) of 5.33 (95 % CIs: 0.29, 10.62) versus 4.79 (95 % CIs: -0.50, 10.36) for 1 °C increased in DTR at lag 0-6 days. Additionally, we noticed the impact of DTR was more pronounced in the warm season, leading to a 7.32 % (95 % CIs: 0.57, 14.51) elevation in the risks of AIDS-related mortality for 1 °C increase in DTR at lag 0-6 days, while the effect value decreased to 5.16 % (95 % CIs: 0.71, 9.81) in the cold season. CONCLUSIONS Our findings indicated that DTR might be a significant risk factor for AIDS-related deaths among ambient temperature variation indicators, and underscored the importance of considering temperature variability in public health interventions aimed at mitigating this risk of AIDS-related mortality.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Dingyuan Zhao
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Heng Tang
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Lianguo Ruan
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430023, China; Hubei Clinical Research Center for Infectious Diseases, Wuhan 430023, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan 430023, China; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan 430023, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
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Zhao Y, Khoshnood K, Sheng Y. Social support as a mediator between mental health and stigma among newly HIV-positive men who have sex with men. Int J STD AIDS 2024:9564624241227653. [PMID: 38314565 DOI: 10.1177/09564624241227653] [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: 02/06/2024]
Abstract
OBJECTIVES The sociocultural context of China gives rise to unique experiences of HIV-related stigma and adverse impacts on mental health among men who have sex with men (MSM) living with HIV. However, few studies have explored the stigma among families in the cultural context of China and the role of social support as a mediator to explain how HIV-related stigma results in poor psychological well-being. This study aims to test the mediating effect of social support between HIV-related stigma and family stigma on the mental health of MSM. METHODS This cross-sectional study recruited newly MSM with HIV in two cities (Beijing and Wuhan) in China as participants from February 2021 to August 2022. A total of 257 MSM with HIV were recruited for the study. The mediating effects were examined using mediation models (SAS PROC CAUSALMED). RESULTS The overall total effect of HIV-related stigma on mental health was β = -1.483 (bootstrap 95% CI = -1.881, -1.104 p < 0.001), and the mediating effect of social support was β = -0.321 (bootstrap 95% CI = -0.571, -0.167 p = .001). A higher level of stigma from family predicts lower mental health with an overall total effect of β = -1.487 (bootstrap 95% CI = -1.823, -1.101 p < 0.001), while the indirect effect (mediation effect) of social support on mental health is β = -0.281 (bootstrap 95% CI = -0.477, -0.142 p = .003). CONCLUSIONS Given the mediating effect of social support on mental health, programs enhancing social support and decreasing stigmatization should be designed to improve the mental health of MSM with HIV, the interventions are needed at both the family and community levels. Public health campaigns in China that frame HIV and same-sex behavior as chronic issues and normal phenomena can correct misinformation related to HIV and MSM that leads to stigma and negative emotional reactions.
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Affiliation(s)
- Yafang Zhao
- Department of Ophthalmology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Kaveh Khoshnood
- Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Yu Sheng
- School of Nursing, Peking Union Medical College, Beijing, China
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Yu B, Wu D, Feng C, Xu P, Reinhardt JD, Yang S. Toward a Prognostic Model for Mortality Risk in Older People Living With HIV: A Prospective Cohort Study From Southwestern China. J Am Med Dir Assoc 2024; 25:243-251. [PMID: 37429452 DOI: 10.1016/j.jamda.2023.05.033] [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: 01/12/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE The existing prognostic models for mortality risk in people living with HIV (PLWH) may not be applicable for older PLWH because the risk factors were confined to biomarkers and clinical variables. We developed and validated a nomogram for the prognosis of all-cause mortality in older PLWH based on comprehensive predictors. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS We included 824 participants aged ≥50 years (mean age, 64.0 ± 7.6 years) from 30 study sites in Sichuan, China, and followed up from Nov 2018 to Mar 2021. METHODS Data on demographics, biomarkers, and clinical indicators were extracted from the registry; mental and social factors were assessed by a survey. Elastic net was used to select predictors. A nomogram was developed based on Cox proportional hazards regression model to visualize the relative effect size (points) of the selected predictors. The prognostic index (PI) was calculated by summing points of all predictors to quantify mortality risk. RESULTS Predictive performance of PI from the nomogram was good, with area under the curve of 0.76 for the training set, and 0.77 for the validation set. Change in CD4 count, virological failure in antiretroviral therapy, and living with comorbidities were robust predictors. Depressive symptoms were an important predictor in men, those aged ≥65 years, and those with time of diagnosis <1 year; low social capital was an additional predictor in people aged <65. Mortality risk increased approximately 10-fold among participants whose PI was in the fourth quartile compared with those in the first quartile (hazard ratio, 9.5; 95% CI, 2.9-31.5). CONCLUSION AND IMPLICATIONS Although biological and clinical factors are crucial predictors, mental and social predictors are essential for specific groups. The developed nomogram is useful for identifying risk factors and groups at risk of mortality in older PLWH.
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Affiliation(s)
- Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Sichuan Research Center of Sexual Sociology and Sex Education, Chengdu, China
| | - Dan Wu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China; Departmemt of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Chuanteng Feng
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Xu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; Jiangsu Province Hospital/Nanjing University First Affiliated Hospital, Nanjing, China; Swiss Paraplegic Research, Nottwil, Switzerland; University of Lucerne, Switzerland.
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China; International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan, China.
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18
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Wang D, Zhou Y, Wu D, Tucker JD, Ni Y, Lu Y, Lyu H, Ong J, He X, Huang S, Tang W. Factors Associated with the First-time HIV Testing Among Chinese men who have sex with men Who Received HIV Self-tests from Partners or Friends. AIDS Behav 2024; 28:705-712. [PMID: 38194057 DOI: 10.1007/s10461-023-04259-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/10/2024]
Abstract
Secondary distribution of HIV self-testing (HIVST) among individual social networks was an effective approach to expanding HIV testing among men who have sex with men (MSM). However, understanding the factors associated with first-time HIV testing behaviors in the secondary distribution of HIVST programs is limited. Hence, this study aims to identify factors related to first-time testers in the secondary distribution of HIVST. Participants were recruited from five provinces in southern China through Blued, a geo-social gay networking app in China from January 2021 to December 2021. Eligible consented participants (referred to as "seeds") finished a baseline survey and then applied for up to five HIVST kits. They were encouraged to distribute HIVST kits to other MSM (referred to as "alters") and alters were encouraged to scan a QR code to return their photographed testing results. All alters were invited to finish an online survey. In total, 229 seeds reached 292 alters, among whom 126 (43.2%) were first-time testers whereas 166 (56.8%) were non-first-time testers. Importantly, our results demonstrated that the first-time HIV testers were more likely to self-report as heterosexual (aOR = 4.88, 95% CI 1.01-23.61), disclose sexual orientation and/or SSB (aOR = 1.73, 95% CI 1.01-2.96), and receive HIVST knowledge from the seeds (aOR = 3.25, 95% CI 1.02-10.34). However, those who had sex with male partners in the last three months were less likely to be first-time testers (aOR = 0.43, 95% CI 0.23-0.82). Practical implications and limitations were also discussed to improve future HIV prevention programs.
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Affiliation(s)
- Dongya Wang
- School of Communication, University of Miami, Miami, FL, USA
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Yi Zhou
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Dan Wu
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Yuxin Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA
| | - Ying Lu
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Hang Lyu
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Jason Ong
- London School of Hygiene and Tropical Medicine, London, UK
| | - Xi He
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | - Shanzi Huang
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.
- University of North Carolina Project-China, Guangzhou, China.
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Liu Y, Su R, Li D, Wang S, Han M. Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics - China, 2015-2022. China CDC Wkly 2024; 6:6-11. [PMID: 38223658 PMCID: PMC10787340 DOI: 10.46234/ccdcw2024.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/08/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction Human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) clinics play a critical role in identifying and diagnosing HIV cases. This study aimed to describe the trend of HIV positivity rate (HPR) among Chinese VCT clinics between 2015 and 2022. Methods This study utilized data from the China Information System for Disease Control and Prevention to analyze the trend in the HPR for VCT clinics from 2015 to 2022. The HPR was calculated by dividing the number of newly-reported HIV cases by the number of HIV tests, multiplied by 100%. To identify temporal and spatial trends in the HPR, we employed joinpoint regression analysis and the Getis-Ord hotspot analysis. Results From 2015 to 2022, VCT clinics in China performed a total of 22,075,386 HIV tests, leading to the identification of 260,353 HIV cases, resulting in a HPR of 1.18%. The HPR consistently declined over the study period, with an average annual percent change (AAPC) of -7.5% (95% confidence interval: -12.6%, -2.2%, P<0.05). The number of HPR hotspots also decreased from 41 in 2015 to 23 in 2022. These HPR hotspots were primarily located in Yunnan, Sichuan, Guangdong, and Guangxi provincial-level administrative divisions (PLADs). Among the 31 PLADs, 16 showed a significant decrease in HPR during the study period (AAPC<0, PAAPC<0.05). Conclusions VCT clinics in China have played a significant role in identifying HIV cases. The declining HPR observed in these clinics may indicates the progress has been made in some degree in mitigating HIV among high-risk populations. Therefore, it is crucial to further improving the utilization of VCT clinics for HIV testing.
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Affiliation(s)
- Yi Liu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Rong Su
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shaorong Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengjie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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20
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Cai C, Tang H, Qin Q, Jin Y, Lyu F. Behavioral verification and risk factors of HIV cross-population transmission in China: analysis of national surveillance data 1989-2022. BMC Infect Dis 2024; 24:49. [PMID: 38178011 PMCID: PMC10765915 DOI: 10.1186/s12879-023-08956-9] [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: 10/26/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION The dynamic HIV/AIDS epidemic significantly impacts China, particularly affecting injection drug users (IDUs), former plasma donors (FPDs), men who have sex with men (MSM), and those engaging in high-risk heterosexual behavior (HRHB). This study specifically focuses on identifying the risk factors and influences that drive the spread of HIV among these population groups by performing a comprehensive analysis of contact histories of individuals diagnosed with HIV. METHODS Data for this research were gathered from China's HIV/AIDS Comprehensive Response Information Management System (CRIMS). Contact histories were described using bar and venn diagram. Trend in engaging in HBRB among MSM were identify potential change using the Cochran-Armitage test. Logistic regression was employed to analyze the factors influencing HBRB in MSM. RESULTS From 1989 through to 2022, a total of 1,457,218 individuals aged 15 years or older in China, who reported being infected with HIV, indicated they had one or more types of contact histories including injecting drug use, male homosexual behavior, commercial plasma donation, and high-risk heterosexual behavior. Among these, 97.0% reported a single type of contact history, while 3.0% reported having multiple contact histories. Of those with multiple contact histories, 98.0% (42,258 individuals) had engaged in HRHB. Among all HIV-infected IDUs, MSM, and FPDs, their respective proportions of engagement in HRHB were 11.8%, 5.7% and 6.2%. Prior to 2012, most were reported to be IDUs; however, subsequent to this, most reported being MSM. Factors that heightened the risk of engaging in HRHB among HIV-infected MSM included being of age between 25-34 years [adjusted odds ratio (AOR) = 1.29] or 35-44 years (AOR = 1.22), marital status such as being married (AOR = 1.23) or being divorced/widowed (AOR = 1.17), belonging to an ethnic minority (AOR = 1.29), receiving diagnosis in hospitals (AOR = 1.81), residing in rural areas (AOR = 1.12), among others. However, the risk of HRHB decreased when age ≥ 55 years (55-64 years: AOR = 0.82; ≥ 65 years: AOR = 0.64). CONCLUSION The potential for HIV transmission among diverse populations is substantial. As such, it is imperative that strategies are implemented to mitigate the propagation of HIV to the general populace via heterosexual intercourse.
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Affiliation(s)
- Chang Cai
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Houlin Tang
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Qianqian Qin
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yichen Jin
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Fan Lyu
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
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21
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Hu J, Kang W, Guo J, Xu J, Lyu F, Zhang G. Analysis of HIV drug prophylaxis services cascade in healthcare workers: a cross-sectional study in China. BMC Infect Dis 2024; 24:4. [PMID: 38166686 PMCID: PMC10759606 DOI: 10.1186/s12879-023-08873-x] [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: 07/17/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) drug prophylaxis, including post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), has not yet been generally recognized and accepted by the whole society in China, and the utilization coverage among high-risk populations is low. Healthcare workers (HCWs) are important to the promotion and implementation of HIV drug prophylaxis strategy. This study analyzed the HIV drug prophylaxis services cascade (knowledge, attitude, and service) in HCWs, and explored the correlations between PEP and PrEP. METHODS A cross-sectional study was conducted among 1066 HCWs in 20 designated hospitals for HIV antiretroviral therapy in 20 cities in China. We collected information on participants' essential characteristics, HIV drug prophylaxis services cascade (knowledge, attitude, and service) and so on. The Chi-square test was used to analyse whether the differences and correlations between categorical variables were statistically significant, and Pearson contingency coefficient was used to analyse the strength of correlations. Multivariable logistic regression was used to analyse associated factors. RESULTS Among three stages of HIV drug prophylaxis services cascade, a high percentage of 1066 participants had knowledge of HIV drug prophylaxis (PEP: 78.2%, PrEP: 80.0%). Of them, almost all had supportive attitudes towards HIV drug prophylaxis (PEP: 99.6%, PrEP: 98.6%). Only about half of them would provide HIV drug prophylaxis services (PEP: 53.5%, PrEP: 48.5%). There were positive correlations between knowledge of PEP and PrEP (r = 0.292), between attitudes toward PEP and PrEP (r = 0.325), and between provision of PEP services and PrEP services (r = 0.555) in HCWs. CONCLUSIONS There was a positive correlation between PEP and PrEP in HCWs. At the stage of providing HIV drug prophylaxis services, training, advocacy and education for HCWs, should be targeted and also combine PEP and PrEP to maximize the effects, so as to improve the enthusiasm of HCWs to provide HIV drug prophylaxis services.
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Affiliation(s)
- Jingkun Hu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenting Kang
- Chinese Association of STD&AIDS Prevention and Control, Beijing, China
| | - Jiahuan Guo
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Xu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fan Lyu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Guang Zhang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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22
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Lv X, Zhao C, Song B, Huang H, Song S, Long H, Liu W, Du M, Liu M, Liu J. COVID-19 vaccination in people living with HIV and AIDS (PLWHA) in China: A cross-sectional study. Hum Vaccin Immunother 2023; 19:2151798. [PMID: 36861438 PMCID: PMC10026882 DOI: 10.1080/21645515.2022.2151798] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
COVID-19 appears to put people living with HIV and AIDS (PLWHA) at a higher risk of catastrophic consequences and mortality. However, investigations on the hesitancy and vaccination behavior of PLWHA in China were lacking compared to the general population. From January 2022 to March 2022, we conducted a multi-center cross-sectional survey of PLWHA in China. Logistic regression models were used to examine factors associated to vaccine hesitancy and COVID-19 vaccine uptake. Among 1424 participants, 108 participants (7.6%) were hesitant to be vaccinated while 1258 (88.3%) had already received at least one dose of the COVID-19 vaccine. Higher COVID-19 vaccine hesitancy was associated with older age, a lower academic level, chronic disease, lower CD4+ T cell counts, severe anxiety and despair, and high perception of illness. Lower education level, lower CD4+ T cell counts, and significant anxiety and depression were all associated with a lower vaccination rate. When compared to vaccinated participants, those who were not hesitant but nevertheless unvaccinated had a higher presence of chronic disease and lower CD4+ T cell count. Tailored interventions (e.g. targeted education programs) based on these linked characteristics were required to alleviate concerns for PLWHA in promoting COVID-19 vaccination rates, particularly for PLWHA with lower education levels, lower CD4+ T cell counts, and severe anxiety and depression.
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Affiliation(s)
- Xuan Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Chaobo Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Bing Song
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Huihuang Huang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Su Song
- Department of Infectious Diseases, Guiyang Public Health Clinical Center, Guiyang, China
| | - Hai Long
- Department of Infectious Diseases, Guiyang Public Health Clinical Center, Guiyang, China
| | - Weidong Liu
- Department of Dermatology, The Fourth People's Hospital of Datong, Datong, China
| | - Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
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23
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Zhang F, Wan Y, Tang H, Zhao D, Zhu S, Ruan L, Zhu W. Submicronic particulate matter (PM 1), a "neglected killer" for HIV/AIDS patients in Hubei, China: Results from a cohort study from 2001 to 2020. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:167093. [PMID: 37717746 DOI: 10.1016/j.scitotenv.2023.167093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/19/2023] [Accepted: 09/13/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Although with the progress of antiretroviral therapy, the life expectancy of HIV/AIDS patients was still not equal to that of normal people. Submicronic particulate matter (PM1) might play a role in mortality among people living with HIV/AIDS, However, cohort evidence is extensively scarce. METHODS This twenty-year open cohort study involved all individuals officially diagnosed with HIV/AIDS in Hubei Province from 2001 to 2020. Time-varying Cox proportional hazard models were applied to investigate the associations between long-term exposure to PM1 and mortality in HIV/AIDS patients. The concentration-response curves between PM1 and AIDS-related deaths/all-cause deaths were characterized by fitting restricted cubic spline models. These curves were then utilized to estimate the number of deaths attributed to PM1. RESULTS Long-term exposure to PM1 was significantly associated with AIDS-related deaths and all-cause death among HIV/AIDS patients, with excess risks of 2.33 % [95 % confidence interval (CIs): 1.62, 3.15] and 0.69 % (0.22, 1.17) for each 1 μg/m3 increase in annual PM1. HIV-positive people with lower initial CD4+ cell count levels or aged over 65 years old were more susceptible to PM1 exposure. We estimated about 844 AIDS-related deaths and 1175 all-cause deaths can be attributable to ambient PM1 exposure, accounting for 41.7 % and 23.8 % of the total deaths from corresponding causes, respectively. CONCLUSIONS Long-term exposure PM1 was a novel factor hindering the life spans of people living with HIV/AIDS. Early establishment of PM1 concentration standards and efforts to achieve them will bring substantial health benefits to people living with HIV/AIDS, especially in low- and middle-income countries facing the dual challenges of high air pollution and high AIDS prevalence.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Evironmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Yanluan Wan
- The Ganyu District People's Hospital of Lianyungang City, Lianyungang 222199, China
| | - Heng Tang
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Dingyuan Zhao
- Institute for the Prevention and Control of HIV/AIDS, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Shijie Zhu
- Department of Occupational and Evironmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Lianguo Ruan
- Department of Infectious Disease, Wuhan Jinyintan Hospital, Wuhan 430048, China
| | - Wei Zhu
- Department of Occupational and Evironmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
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24
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Liu Y, Zhang Y, Xu X, Deng Z, Wang X, Yuan D, Xue Z, Zhang X. Preventing HIV Epidemic in China: Policy Evolution and Coordination Mechanisms in the Past Four Decades. China CDC Wkly 2023; 5:1084-1091. [PMID: 38058986 PMCID: PMC10696225 DOI: 10.46234/ccdcw2023.203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023] Open
Affiliation(s)
- Yanli Liu
- School of Law, Politics and Public Administration, Hebei Normal University, Shijiazhuang, Hebei Province, China
| | - Yurong Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Xiaoxin Xu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Zhidi Deng
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Xiaobo Wang
- School of Law, Politics and Public Administration, Hebei Normal University, Shijiazhuang, Hebei Province, China
| | - Duozhen Yuan
- School of Law, Politics and Public Administration, Hebei Normal University, Shijiazhuang, Hebei Province, China
| | - Zelin Xue
- School of Law, Politics and Public Administration, Hebei Normal University, Shijiazhuang, Hebei Province, China
| | - Xiulan Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
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25
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Hou Y, Jin Y, Cai C, Qin Q, Tang H, Lyu F. Comparative Analysis of Epidemiological Features of HIV/AIDS Cases Aged Over and Under 50 Years Old - China, 2010-2022. China CDC Wkly 2023; 5:1079-1083. [PMID: 38058988 PMCID: PMC10696226 DOI: 10.46234/ccdcw2023.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Recent data indicate a year-on-year increase in the proportion of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) cases reported among individuals aged ≥50 in China. This study compares the epidemiological characteristics of HIV/AIDS cases in populations above and below 50 years of age. By doing so, it seeks to scrutinize the current epidemiological landscape of HIV within these distinct age cohorts and suggest tailored interventions for each group. Methods We utilized data from the Chinese HIV/AIDS Comprehensive Response Information Management System for our comparative analysis. Joinpoint regression analysis was employed to assess the trends in standardized detection rates. Results In China, the number of newly reported HIV/AIDS cases in the 15-49 age group increased from 51,436 in 2010 to 55,397 in 2022, while it increased from 11,751 in 2010 to 51,856 in 2022 in the group aged ≥50 years. Recent years have seen a greater proportion and detection rate of HIV/AIDS cases among the ≥50 age demographic compared to the 15-49 age group. In 2022, significant statistical differences were observed between males and females in both age cohorts with respect to education, marital status, occupation, mode of transmission, location of diagnosis, and region. Conclusions The observed trend of a rising proportion of HIV/AIDS cases in individuals aged 50 years and older necessitates heightened attention. It is imperative that we develop and implement interventions specifically designed to prevent and control the transmission of HIV within this demographic.
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Affiliation(s)
- Yushan Hou
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yichen Jin
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chang Cai
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qianqian Qin
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fan Lyu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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26
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Zhou Y, Chen Y, Lu J, Zhang Z, Sun Q, Liu X, Xu X, Ya X, Hu H. Sustained high HIV incidence among men who have sex with men in Jiangsu province, China: based on the limiting-antigen avidity EIA method and six consecutive surveys, 2016-2021. Front Public Health 2023; 11:1277570. [PMID: 38054072 PMCID: PMC10694440 DOI: 10.3389/fpubh.2023.1277570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/25/2023] [Indexed: 12/07/2023] Open
Abstract
Background The epidemic of HIV infection among men who have sex with men (MSM) is a major public health concern in some parts of China, but data on trends in HIV incidence are limited. This study aimed to examine the trends in HIV incidence and factors associated with recent HIV infection among MSM in Jiangsu province, China, based on the limiting-antigen avidity enzyme immunoassay (LAg-Avidity-EIA) method. Methods Six consecutive surveys were implemented among MSM throughout Jiangsu province from 2016 to 2021. Participants were recruited in three ways. Socio-demographic and behavioral information were collected through face-to-face interviews. Venous blood samples were taken to test for HIV and syphilis. HIV incidence was estimated using the LAg-Avidity-EIA method. Chi-square trend tests were used to observe trends over the years. Multivariate regression analyses were used to identify factors associated with recent HIV infection. Results A total of 15,401 participants were enrolled in the study. The prevalence of HIV infection ranged from 8.0 to 9.8%, with no consistent rise or fall over the years (P = 0.189). HIV incidence ranged from 5.0 to 9.0%, and no uptrend or downtrend was shown (P = 0.418). MSM who lived locally for more than 2 years (aOR = 1.366, P = 0.019), had a lack of comprehensive HIV knowledge (aOR = 1.643, P = 0.031), had engaged in unprotected anal intercourse (UAI) in the past 6 months (aOR = 7.373, P < 0.001), had been tested for HIV within 12 months (aOR = 1.292, P = 0.035), and tested positive for syphilis (aOR = 2.840, P < 0.001) were likely to be recently infected with HIV. Conclusions HIV incidence among MSM has remained at a high level in Jiangsu province. In China, health education, condom use, and HIV/syphilis testing should continue to be top priorities for HIV prevention among MSM to reduce HIV transmission.
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Affiliation(s)
- Ying Zhou
- Institute of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuheng Chen
- Institute of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jing Lu
- Institute of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zhi Zhang
- Institute of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Qi Sun
- Institute of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiaoyan Liu
- Institute of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiaoqin Xu
- Institute of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xuerong Ya
- Section of STD/AIDS Control and Prevention, Suzhou Municipal Center for Disease Control and Prevention, Suzhou, China
| | - Haiyang Hu
- Institute of STD/AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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27
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Chen N, Chen S, Li X, Li Z. Modelling and analysis of the HIV/AIDS epidemic with fast and slow asymptomatic infections in China from 2008 to 2021. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:20770-20794. [PMID: 38124575 DOI: 10.3934/mbe.2023919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
The aim of this paper is to investigate the spread of the HIV/AIDS epidemic in China during 2008-2021. A new mathematical model is proposed to study the dynamics of HIV transmission with acute infection, fast asymptomatic infections, and slow asymptomatic infections. The basic reproduction number is obtained by the next-generation matrix method. A quantitative analysis of the model, including the local behavior, global behavior, and permanence, is performed. Numerical simulations are presented to enhance the results of these analyses. The behavior or the model's parameters are estimated from real data. A sensitivity analysis shows that the proportion of asymptomatic infections co-infected with other diseases significantly affects the basic reproduction number. We further analyze the impact of implementing single and multiple measure(s) in parallel with the epidemic. The study results conclude that multiple measures are more effective in controlling the spread of AIDS compared to just one. The HIV epidemic can be effectively curbed by reducing the contact rate between fast asymptomatic infected individuals and susceptible populations, increasing the early diagnosis and screening of HIV-infected individuals co-infected with other diseases, and treating co-infected patients promptly.
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Affiliation(s)
- Nawei Chen
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Shenglong Chen
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Xiaoyu Li
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Zhiming Li
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
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28
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Fu J, Chen X, Dai Z, Huang Y, Xiao W, Wang H, Si M, Wu Y, Zhang L, Jing S, Liu X, Yu F, Mi G, Su XY. HIV-related stigma, depression and suicidal ideation among HIV-positive MSM in China: a moderated mediation model. BMC Public Health 2023; 23:2117. [PMID: 37891525 PMCID: PMC10612198 DOI: 10.1186/s12889-023-17047-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND As the HIV epidemic among MSM in China continues, Chinese men who have sex with men (MSM) face various mental health difficulties, including suicide ideation, depression, and stigma. The current study aims to assess the mechanisms between HIV-related stigma, depression, and suicidal ideation among MSM in China. METHODS This national cross-sectional study was completed on the geosocial networking application (GSN) app, Blued, from December 2020 to March 2021. We used the HIV Stigma Scale and the Center for Epidemiologic Studies Depression Scale (CES-D10) to measure HIV stigma and depression, respectively. Suicidal ideation was measured by the suicidal ideation-related item. Descriptive analyses, logistic regression, and structural equation modeling (SEM) were used for data analysis. RESULTS A total of 244 HIV-positive MSM were included in the analysis. The mediation model revealed that the direct pathway of perceived HIV-related stigma on suicidal ideation was significant (standardized pathway coefficient = 0.07), and the indirect pathway of perceived HIV-related stigma on suicidal ideation via depression was also significant (standardized pathway coefficient = 0.04). There was a partial mediating effect of depression in the association between perceived HIV-related stigma and suicidal ideation. CONCLUSIONS Our study found that both perceived HIV-related stigma and depression were associated with suicidal ideation among HIV-positive MSM in China, and that depression could serve as a mediator between HIV-related stigma and suicidal ideation. Targeted interventions regarding HIV-related stigma and depression should be taken into account to reduce suicidal ideation among HIV-positive MSM in China.
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Affiliation(s)
- Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yijin Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ling Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shu Jing
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fei Yu
- Danlan Public Welfare, Beijing, China
| | | | - Xiao-You Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Fu J, Dai Z, Wang H, Si M, Chen X, Wu Y, Xiao W, Huang Y, Yu F, Mi G, Su X. Willingness to use long-acting injectable PrEP among HIV-negative/unknown men who have sex with men in mainland China: A cross-sectional online survey. PLoS One 2023; 18:e0293297. [PMID: 37856527 PMCID: PMC10586652 DOI: 10.1371/journal.pone.0293297] [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: 05/09/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are at high risk of HIV acquisition. Long-acting injectable-pre-exposure prophylaxis (LAI-PrEP), requiring less frequent dosing, is being studied as an alternative method to daily oral HIV PrEP. With the addition of this potential new prevention method, it expands the scope for a wider user choice and is expected to increase the acceptability and uptake of HIV prevention measures. The aim of our study was to explore the willingness to use LAI-PrEP and associated influential factors. METHODS Participants were recruited from December 2020 to March 2021 through banner advertisements on web- and mobile app-based platforms on Blued, a large gay Chinese social media platform. MSM in our cross-sectional study was HIV-negative and currently lived in mainland China. Participants were asked about their willingness to use LAI-PrEP and reasons why they might be or not be willing to use LAI-PrEP. Multivariable logistic regression was used to analyze the factors associated with the willingness to use LAI-PrEP. RESULTS In total, 969 participants met the inclusion criteria and finished the survey. Nearly twenty percent (19.5%) of participants had never tested for HIV; 66.8% of MSM had multiple male partners; and 51.6% of MSM engaged in condomless sex with their partner. About three-fifths (66.3%) of MSM were aware of PrEP, and only 3.9% of MSM had used PrEP before. The willingness to use LAI-PrEP among MSM was 74.0% (95% CI: 71.4%-76.6%). MSM with higher education levels were less likely to show a willingness to use LAI-PrEP (AOR = 0.56, 95%CI: 0.38-0.84). Participants who had a history of HIV test (AOR = 1.68, 95%CI: 1.11-2.55), were willing to use daily oral PrEP (AOR = 10.64, 95%CI:7.43-15.21), had multiple male sexual partners (AOR = 1.33, 95%CI:0.93-1.90), who used rush popper(AOR = 1.49, 95%CI:1.05-2.13), and who were aware of PEP (AOR = 1.66, 95%CI: 1.02-2.70) were more likely to show willingness to use LAI-PrEP. CONCLUSIONS In our study, MSM had quite high awareness but low uptake of PrEP. As LAI-PrEP is expected to be approved for use in China in the future, our study of MSM highlights the need for key population-focused education programs about PrEP and healthy sexual behavior. This study also provides some evidence for LAI-PrEP use among the Chinese MSM population in the future.
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Affiliation(s)
- Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yijin Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fei Yu
- Danlan Public Welfare, Beijing, China
| | | | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Li M, Ren J, Luo Y, Watson R, Zheng Y, Ding L, Wang F, Chen Y. Preference for care models among older people living with HIV: cross-sectional study. BMC Public Health 2023; 23:2033. [PMID: 37853369 PMCID: PMC10585841 DOI: 10.1186/s12889-023-16941-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The number of people living with HIV (PWH) aged 50 and above is increasing. The question of care among older PWH (aged ≥ 50 years) is an increasing concern. Understanding the care preference of older people can better provide care services for them. The purpose of this study was to investigate the care preference (home-based care, self-care, institutional care, community-based care, and mutual-aid care) among older PWH and identify the factors affecting their care preference. METHODS A cross-sectional survey was conducted among older PWH (aged ≥ 50 years) about care preference from May to November 2021. We enrolled 319 participants using convenience sampling. We designed a questionnaire to assess the care preference of older PWH. The Chi-square test and Fisher's exact test were used to conduct univariate analysis of care preference. Multinomial logistic regression was used to identify factors influencing care preference. RESULTS Most older PWH (72.7%) preferred home-based care, and few (15.7%) preferred self-care. Fewer older PWH preferred community-based care (5.3%), institutional care (5.0%) and mutual-aid care (1.3%). Multivariate analysis showed that older PWH with a house, spouse and more children were more inclined to choose home-based care (p < .05). Older PWH living alone, having higher monthly income and higher HIV stigma preferred to choose self-care (p < .05). CONCLUSION Home-based care was the most preferred model of older PWH, and self-care ranked second. The number of those who preferred institutional care, community-based care and mutual-aid care were few. Nation and government should take measures to allocate care resources for older adults reasonably to better meet the care needs of older PWH. It is important to strengthen social security, reduce internalized HIV stigma, improve social support, and explore diversified care models for improving the quality of life of older PWH.
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Affiliation(s)
- Mei Li
- Department of Gynecology, The First Branch of The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianlan Ren
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yue Luo
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Roger Watson
- Health and Social Care Faculty, University of Hull, Hull, UK
| | - Yu Zheng
- Department of Rheumatism and Immunology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Li Ding
- Department of Gynecology, The First Branch of The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fulan Wang
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanhua Chen
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
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Wang Z, Wang D, Lin L, Qiu Y, Zhang C, Xie M, Lu X, Lian Q, Yan P, Chen L, Feng Y, Xing H, Wang W, Wu S. Epidemiological characteristics of HIV transmission in southeastern China from 2015 to 2020 based on HIV molecular network. Front Public Health 2023; 11:1225883. [PMID: 37942240 PMCID: PMC10629674 DOI: 10.3389/fpubh.2023.1225883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
Objective HIV/AIDS remains a global public health problem, and understanding the structure of social networks of people living with HIV/AIDS is of great importance to unravel HIV transmission, propose precision control and reduce new infections. This study aimed to investigate the epidemiological characteristics of HIV transmission in Fujian province, southeastern China from 2015 to 2020 based on HIV molecular network. Methods Newly diagnosed, treatment-naive HIV/AIDS patients were randomly sampled from Fujian province in 2015 and 2020. Plasma was sampled for in-house genotyping resistance test, and HIV molecular network was created using the HIV-TRACE tool. Factors affecting the inclusion of variables in the HIV molecular network were identified using univariate and multivariate logistic regression analyses. Results A total of 1,714 eligible cases were finally recruited, including 806 cases in 2015 and 908 cases in 2020. The dominant HIV subtypes were CRF01_AE (41.7%) and CRF07_BC (38.3%) in 2015 and CRF07_BC (53. 3%) and CRF01_AE (29.1%) in 2020, and the prevalence of HIV drug resistance was 4.2% in 2015 and 5.3% in 2020. Sequences of CRF07_BC formed the largest HIV-1 transmission cluster at a genetic distance threshold of both 1.5 and 0.5%. Univariate and multivariate logistic regression analyses showed that ages of under 20 years and over 60 years, CRF07_BC subtype, Han ethnicity, sampling in 2015, absence of HIV drug resistance, married with spouse, sampling from three cities of Jinjiang, Nanping and Quanzhou resulted in higher proportions of sequences included in the HIV transmission molecular network at a genetic distance threshold of 1.5% (p < 0.05). Conclusion Our findings unravel the HIV molecular transmission network of newly diagnosed HIV/AIDS patients in Fujian province, southeastern China, which facilitates the understanding of HIV transmission patterns in the province.
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Affiliation(s)
- Zhenghua Wang
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Dong Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liying Lin
- Fuzhou Institute for Disease Control and Prevention of China Railway Nanchang Bureau Group Co., Ltd., Fuzhou, China
| | - Yuefeng Qiu
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Chunyan Zhang
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Meirong Xie
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Xiaoli Lu
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Qiaolin Lian
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Pingping Yan
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Liang Chen
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Yi Feng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Xing
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Wang
- National Health Commission Key Laboratory for Parasitic Disease Prevention and Control, Jiangsu Provincial Key Laboratory for Parasites and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Shouli Wu
- Fujian Provincial Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
- School of Public Health, Fujian Medical University, Fuzhou, China
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Zhang SX, Wang JC, Li ZW, Zheng JX, Zhou WT, Yang GB, Yu YF, Wu XP, Lv S, Liu Q, Chen MX, Lu Y, Dou ZH, Zhang DW, Lv WW, Wang L, Lu ZH, Yang M, Zheng PY, Chen YL, Tian LG, Zhou XN. Impact factors of Blastocystis hominis infection in persons living with human immunodeficiency virus: a large-scale, multi-center observational study from China. Infect Dis Poverty 2023; 12:82. [PMID: 37697423 PMCID: PMC10494452 DOI: 10.1186/s40249-023-01137-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/02/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Blastocystis hominis (Bh) is zoonotic parasitic pathogen with a high prevalent globally, causing opportunistic infections and diarrhea disease. Human immunodeficiency virus (HIV) infection disrupts the immune system by depleting CD4+ T lymphocyte (CD4+ T) cell counts, thereby increasing Bh infection risk among persons living with HIV (PLWH). However, the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood. Hence, the purpose of the study was to explore the association between Bh infection risk and CD4+ T cell counts, HIV viral load (VL), and duration of interruption in antiviral therapy among PLWH. METHODS A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022. The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction, the CD4+ T cell counts in venous blood was measured using flowcytometry, and the HIV VL in serum was quantified using fluorescence-based instruments. Restricted cubic spline (RCS) was applied to assess the non-linear association between Bh infection risk and CD4+ T cell counts, HIV VL, and duration of interruption in highly active antiretroviral therapy (HARRT). RESULTS A total of 1245 PLWH were enrolled in the study, the average age of PLWH was 43 years [interquartile range (IQR): 33, 52], with 452 (36.3%) being female, 50.4% (n = 628) had no immunosuppression (CD4+ T cell counts > 500 cells/μl), and 78.1% (n = 972) achieved full virological suppression (HIV VL < 50 copies/ml). Approximately 10.5% (n = 131) of PLWH had interruption. The prevalence of Bh was found to be 4.9% [95% confidence interval (CI): 3.8-6.4%] among PLWH. Significant nonlinear associations were observed between the Bh infection risk and CD4+ T cell counts (Pfor nonlinearity < 0.001, L-shaped), HIV VL (Pfor nonlinearity < 0.001, inverted U-shaped), and duration of interruption in HARRT (Pfor nonlinearity < 0.001, inverted U-shaped). CONCLUSIONS The study revealed that VL was a better predictor of Bh infection than CD4+ T cell counts. It is crucial to consider the simultaneous surveillance of HIV VL and CD4+ T cell counts in PLWH in the regions with high level of socioeconomic development. The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections, the efficacy of therapeutic drugs, and the assessment of preventive and control strategies.
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Affiliation(s)
- Shun-Xian Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ji-Chun Wang
- Department of Science and Technology, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Zhong-Wei Li
- Gansu Province People's Hospital, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Jin-Xin Zheng
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wen-Ting Zhou
- National Health Commission (NHC) Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Guo-Bing Yang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, 730000, China
| | - Ying-Fang Yu
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiu-Ping Wu
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Shan Lv
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qin Liu
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Mu-Xin Chen
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yan Lu
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Zhi-Hui Dou
- National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing, 102206, China
| | - Da-Wei Zhang
- The People's Liberation Army 302 Hospital, Beijing, 100039, China
| | - Wen-Wen Lv
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lei Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Zhen-Hui Lu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Ming Yang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Pei-Yong Zheng
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Yue-Lai Chen
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Li-Guang Tian
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China.
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Xiao-Nong Zhou
- Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, Shanghai, 200025, China.
- School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Tian T, Fu L, Lu Z, Bian J, Zhou X, Wang B, Lin YF, Zhang Z, Liu L, Xi M, Zhen C, Dai J, Zou H. Changes in HPV prevalence, incidence, and clearance following the use of HIV pre-exposure prophylaxis (PrEP) among MSM in Xinjiang, China: An observational cohort study. J Med Virol 2023; 95:e29112. [PMID: 37750188 DOI: 10.1002/jmv.29112] [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: 07/04/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
The association between HIV pre-exposure prophylaxis (PrEP) and the natural history of human papillomavirus (HPV) has not been well documented. Our objective was to evaluate the impact of PrEP on the prevalence, incidence, and clearance of anal HPV among men who have sex with men (MSM). Sexually active, HIV-negative MSM aged 18 years and older in Xinjiang, China since September 1, 2016, were enrolled in an ongoing observational cohort study of HPV. At baseline and every 6 months, an anal swab was taken to test for HPV and a questionnaire on sociodemographic characteristics and sexual behaviors was collected. Those who consented to receive PrEP were enrolled in an open-label PrEP intervention study from November 1, 2019, to June 30, 2021. This study analyzed data from participants present in the HPV cohort between November 1, 2019, and June 30, 2021. We compared the prevalence, incidence, and clearance of anal HPV between men who received PrEP (PrEP users) and those who did not (non-PrEP users), and compared men before and after initiating PrEP. We calculated prevalence ratios (PRs), incidence rate ratios (IRRs), and clearance rate ratios (CRRs) for both comparisons. Of the 870 participants present in the HPV cohort during the period between November 1, 2019, and June 30, 2021, 859 had adequate β-globin for HPV genotype testing and were included in our study. Among them, 429 were PrEP users, while 430 were non-PrEP users. Median age was 32 years (interquartile range [IQR]: 26-38). Among PrEP users, 217 were tested for anal HPV before PrEP initiation. PrEP users had lower prevalence of HPV 45, 51, and 54 (PRs: 0.27 [95% CI: 0.09-0.80], 0.42 [0.21-0.85], and 0.41 [0.17-0.99], respectively) and lower clearance of HPV 16 (CRR: 0.31 [0.10-0.91]) compared with non-PrEP users. PrEP users exhibited lower prevalence of HPV 51 (PR: 0.31 [0.12-0.84]), lower incidence of HPV 6, 11, 16, 39 and 61 (IRRs: 0.34 [0.13-0.90], 0.26 [0.08-0.87], 0.44 [0.21-0.91], 0.21 [0.05-0.93], and 0.19 [0.04-0.82], respectively), as well as higher clearance of HPV 52 (CRR: 2.17 [1.08-4.35]) after PrEP initiation. PrEP use may lower the risk of HPV infection among MSM in Xinjiang, China. Our findings further extend the knowledge of the impact of PrEP on sexually transmitted infections.
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Affiliation(s)
- Tian Tian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Junye Bian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yi-Fan Lin
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zewen Zhang
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Lirong Liu
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Miaomiao Xi
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Chen Zhen
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Jianghong Dai
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Southwest Medical University, Luzhou, China
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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Luo Q, Wu Z, Mi G, Xu J, Scott SR. Using HIV Risk Self-Assessment Tools to Increase HIV Testing in Men Who Have Sex With Men in Beijing, China: App-Based Randomized Controlled Trial. J Med Internet Res 2023; 25:e45262. [PMID: 37656500 PMCID: PMC10504623 DOI: 10.2196/45262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 07/13/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) in China hold a low-risk perception of acquiring HIV. This has resulted in an inadequate HIV testing rate. OBJECTIVE This study aims to investigate whether administering HIV risk self-assessments with tailored feedback on a gay geosocial networking (GSN) app could improve HIV testing rates and reduce sexual risk behaviors in Chinese MSM. METHODS We recruited MSM from Beijing, China, who used the GSN platform Blued in October 2017 in this 12-month double-blinded randomized controlled trial. From October 2017 to September 2018, eligible participants were randomly assigned to use a self-reported HIV risk assessment tool that provided tailored feedback according to transmission risk (group 1), access to the same HIV risk assessment without feedback (group 2), or government-recommended HIV education materials (control). All interventions were remotely delivered through the mobile phone-based app Blued, and participants were followed up at 1, 3, 6, and 12 months from baseline. The number of HIV tests over the 12-month study was the primary outcome and was assessed using an intention-to-treat analysis with an incident rate ratio (IRR). Unprotected anal intercourse (UAI) over 6 months was assessed by a modified intention-to-treat analysis and was the secondary outcome. All statistical analyses were conducted in SAS 9.3 (SAS Institute, Inc.), and a P value <.05 was considered statistically significant. RESULTS In total, 9280 MSM were recruited from baseline and were randomly assigned to group 1 (n=3028), group 2 (n=3065), or controls (n=3187). After follow-up, 1034 (34.1%), 993 (32.4%), and 1103 (34.6%) remained in each group, respectively. Over 12 months, group 1 took 391 tests (mean of 2.51 tests per person), group 2 took 352 tests (mean of 2.01 tests per person), and controls took 295 tests (mean of 1.72 tests per person). Group 1 had significantly more HIV testing than the control group (IRR 1.32, 95% CI 1.09-4.58; P=.01), while group 2 did not differ significantly from the controls (IRR 1.06, 95% CI 0.86-1.30; P=.60). The proportion of UAI was not statistically different among different groups, but all 3 groups had UAI, which declined from baseline. CONCLUSIONS Repeated HIV risk assessments coupled with tailored feedback through GSN apps improved HIV testing. Such interventions should be considered a simple way of improving HIV testing among MSM in China and increasing awareness of HIV status. TRIAL REGISTRATION ClinicalTrials.gov NCT03320239; https://clinicaltrials.gov/study/NCT03320239.
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Affiliation(s)
- Qianqian Luo
- School of Nursing, Binzhou Medical University, Yantai, China
| | - Zunyou Wu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guodong Mi
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Blued City Holdings, Ltd, Beijing, China
| | - Jie Xu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sarah Robbins Scott
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Tan T, Bai C, Lu R, Chen F, Li L, Zhou C, Xiang X, Zhang W, Ouyang L, Xu J, Tang H, Wu G. HIV-1 molecular transmission network and drug resistance in Chongqing, China, among men who have sex with men (2018-2021). Virol J 2023; 20:147. [PMID: 37443039 PMCID: PMC10339625 DOI: 10.1186/s12985-023-02112-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 07/02/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Over the past few years, HIV transmission among men who have sex with men (MSM) in China has increased significantly. Chongqing, located in the southwest of China, has the highest prevalence of HIV among MSM in the country. METHODS Blood samples were taken from 894 MSM in Chongqing who had recently been diagnosed with HIV-1 infection and had not yet started getting treatment. In order to determine the distribution of HIV-1 subtypes, transmitted drug resistance, and assessments of molecularly transmitted clusters, we sequenced the Pol genes and employed them in phylogenetic analysis. The genetic distance between molecular clusters was 1.5%. To find potential contributing factors, logistic regression analyses were performed. RESULTS Of the 894 HIV-1 pol sequences acquired from study participants, we discovered that CRF07_BC (73.6%) and CRF01_AE (19.6%) were the two most prevalent HIV-1 genotypes in Chongqing among MSM, accounting for 93.2% of all infections. In addition, CRF08_BC (1.1%), B subtype (1.0%), CRF55_01B (3.4%), and URF/Other subtypes (1.3%) were less frequently observed. Among MSM in Chongqing, transmitted drug resistance (TDR) was reported to be present at a rate of 5.6%. 48 clusters with 600 (67.1%, 600/894) sequences were found by analysis of the molecular transmission network. The distributions of people by age, sexual orientation, syphilis, and genotype were significantly differentially related to being in clusters, according to the multivariable logistic regression model. CONCLUSION Despite the low overall prevalence of TDR, the significance of genotypic drug resistance monitoring needs to be emphasized. CRF07_BC and CRF01_AE were the two main genotypes that created intricate molecular transmission networks. In order to prevent the expansion of molecular networks and stop the virus's spread among MSM in Chongqing, more effective HIV intervention plans should be introduced.
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Affiliation(s)
- Tianyu Tan
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Chongyang Bai
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Rongrong Lu
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Fangfang Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Long Li
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Chao Zhou
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Xu Xiang
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Wei Zhang
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Ling Ouyang
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Jing Xu
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Guohui Wu
- Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China.
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Gao M, Hu S, Zhao X, You T, Jit M, Liu Y, Qiao Y, Zhao F, Wang C. Health and economic impact of delaying large-scale HPV vaccination and screening implementation on cervical cancer in China: a modelling study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 36:100768. [PMID: 37547038 PMCID: PMC10398607 DOI: 10.1016/j.lanwpc.2023.100768] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/14/2023] [Accepted: 03/28/2023] [Indexed: 08/08/2023]
Abstract
Background Current uptake of HPV vaccination and screening in China is far below World Health Organization 2030 targets for cervical cancer elimination. We quantified health and economic losses of delaying large-scale HPV vaccination and screening implementation in China. Methods We used a previously validated transmission model to project lifetime health benefits, costs, effectiveness, and timeline for cervical cancer elimination of alternative scenarios, including combining HPV vaccination initiated from 2022 to 2030 with screening in different modalities and coverage increase rates, as well as screening alone. All women living or projected to be born in China during 2022-2100 were considered. We employed a societal perspective. Findings Regardless of vaccine type, immediate large-scale vaccination initiated in 2022 and achieving 70% coverage of HPV-based screening in 2030 (no-delay scenario) would be the least costly and most effective. Compared with the no-delay scenario, delaying vaccination by eight years would result in 434,000-543,000 additional cervical cancer cases, 138,000-178,000 deaths, and $2863-4437 million costs, and delay elimination by 9-10 years. Even with immediate vaccination, the gradual scale-up of LBC-based screening to 70% coverage in 2070 would result in 2,530,000-3,060,000 additional cases, 909,000-1,040,000 deaths, and $5098-5714 million costs compared with no-delay scenario, and could not achieve elimination if domestic 2vHPV or 4vHPV vaccines are used (4.09-4.21 cases per 100,000 woman in 2100). Interpretation Delaying large-scale HPV vaccination and/or high-performance screening implementation has detrimental consequences for cervical cancer morbidity, mortality, and expenditure. These findings should spur health authorities to expedite large-scale vaccine rollout and improve screening. Funding Bill & Melinda Gates Foundation (INV-031449 and INV-003174) and CAMS Innovation Fund for Medical Sciences (CIFMS) (2021-I2M-1-004).
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Affiliation(s)
- Meng Gao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shangying Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuelian Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingting You
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- School of Public Health, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yang Liu
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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An W, Tang X, Xiao X, Aku W, Wang H. Status and factors associated with patient activation and its relationship with HIV clinic outcomes among Yi minority people living with HIV in Liangshan, China: a cross-sectional study. Front Public Health 2023; 11:1114561. [PMID: 37397752 PMCID: PMC10309002 DOI: 10.3389/fpubh.2023.1114561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Patient activation is determined by an individual's knowledge, skills and confidence in managing his/her health. It is vital for people living with HIV (PLWH) to enhance their self-management skills and health outcomes, especially those from low- and middle-income regions, since they are at higher risk of worse health outcomes. However, literature from those regions is limited, especially in China. OBJECTIVES This study aimed to explore the status and factors associated with patient activation among Yi minority PLWH in Liangshan, China and to determine whether patient activation is associated with HIV clinic outcomes. METHODS This cross-sectional study included 403 Yi minority people living with HIV in Liangshan between September and October 2021. All participants completed an anonymous survey measuring sociodemographic characteristics, HIV-related information, patient activation and illness perception. Multivariate linear regression and multivariate binary logistic regression were used to explore factors associated with patient activation and the association between patient activation and HIV outcomes, respectively. RESULTS The Patient Activation Measure (PAM) score was low (mean = 29.8, standard deviation = 4.1). Participants with negative illness perception, low income, and self-rated antiretroviral therapy (ART) effect based on self-perception were most likely to have a lower PAM score (β = -0.3, -0.2, -0.1, respectively; all p < 0.05); those with having disease knowledge learning experiences and an HIV-positive spouse were more likely to have a higher PAM score (β = 0.2, 0.2, respectively; both p < 0.001). A higher PAM score (AOR=1.08, 95% CI: 1.02, 1.14) was associated with viral suppression, mediated by gender (AOR=2.25, 95% CI: 1.38, 3.69). CONCLUSION Low patient activation level among Yi minority PLWH impacts HIV care. Our findings indicate patient activation is associated with viral suppression for minority PLWH in low- and middle-income settings, suggesting that tailored interventions enhancing patient activation may improve viral suppression.
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Affiliation(s)
- Wenhong An
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xuefeng Tang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xueling Xiao
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Waha Aku
- Red Ribbon Antiviral Care Center, Zhaojue County People's Hospital, Liangshan, China
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, China
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Jing C, Wei T, Ning W, Fang Z, Gang X, Xingzhi W, Guoqiang Z, Min W. Treatment persistence of bictegravir/emtricitabine/tenofovir alafenamide and efavirenz + lamivudine + tenofovir disoproxil among HIV-1 patients newly starting treatment in Hunan Province in China. BMC Infect Dis 2023; 23:396. [PMID: 37308847 DOI: 10.1186/s12879-023-08359-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Though bictegravir/emtricitabine/tenofovir (BIC/FTC/TAF) have been regulatory approved and included in the National Reimbursement Drug List in China, due to the affordability concern, generic version of efavirenz + lamivudine + tenofovir (EFV + 3TC + TDF) is still recommended as the first-line therapy in the clinical guideline and widely used in clinical practice. The aim of the study is to assess the persistence with first-line BIC/TAF/TAF and EFV + 3TC + TDF in newly treated HIV-1 patients in the real-world setting in Hunan Province in China. METHODS A retrospective analysis of the medical records of HIV patients initiating first-line antiretroviral therapy in the First Hospital of Changsha in January 1st, 2021-July 31st, 2022 was conducted. Persistence was assessed as the number of days on the therapy from the index until treatment discontinuation or end of data availability. Kaplan-Meier Curves and Cox Proportional Hazard models were used to evaluate the discontinuation rates. Subgroup analysis was performed excluding BIC/FTC/TAF patients with treatment discontinuation due to economic reason, and EFV + 3TC + TDF patients with a viral load > 500,000 copies/mL. RESULTS A total of 310 eligible patients were included in the study, with 244 and 66 patients in the BIC/FTC/TAF group and EFV + 3TC + TDF group, respectively. Compared with EFV + 3TC + TDF patients, BIC/FTC/TAF patients were older, more living in the capital city currently, and had significantly higher total cholesterol and low-density level (all p < 0.05). No significant difference was shown in the time to discontinuation between BIC/FTC/TAF patients and EFV + 3TC + TDF patients. After excluding BIC/FTC/TAF patients with treatment discontinuation due to economic reason, EFV + 3TC + TDF group were shown to have a significantly higher risk of discontinuation than BIC/FTC/TAF group (hazard ratio [HR] = 11.1, 95% confidence interval [CI] = 1.3-93.2). After further removing the EFV + 3TC + TDF patients with a viral load > 500,000 copies/mL, the analysis showed similar results (HR = 10.1, 95% CI = 1.2-84.1). 79.4% of the EFV + 3TC + TDF patients discontinued treatment due to clinical reasons, while 83.3% of the BIC/FTC/TAF patients discontinued treatment due to economic reasons. CONCLUSIONS Compared with BIC/FTC/TAF, EFV + TDF + 3TC patients were significantly more likely to discontinue the first-line treatment in Hunan Province in China.
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Affiliation(s)
- Cao Jing
- Division of Infectious Diseases, the First Hospital of Changsha, Changsha, Hunan, China
| | - Tang Wei
- Division of Infectious Diseases, the First Hospital of Changsha, Changsha, Hunan, China
| | - Wang Ning
- Division of Infectious Diseases, the First Hospital of Changsha, Changsha, Hunan, China
| | - Zheng Fang
- Division of Infectious Diseases, the First Hospital of Changsha, Changsha, Hunan, China
| | - Xiao Gang
- Division of Infectious Diseases, the First Hospital of Changsha, Changsha, Hunan, China
| | | | - Zhou Guoqiang
- Division of Infectious Diseases, the First Hospital of Changsha, Changsha, Hunan, China.
| | - Wang Min
- Division of Infectious Diseases, the First Hospital of Changsha, Changsha, Hunan, China
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Li Y, Zhang F, Dou Z, Zheng W, Ai P, Bao M, Han C, Xiang K, Qin Q. Sexual behaviours and correlates of condom use among HIV-discordant couples from eastern China: a cross-sectional study. BMJ Open 2023; 13:e071195. [PMID: 37308275 DOI: 10.1136/bmjopen-2022-071195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVES To investigate sexual behaviours among HIV-discordant heterosexual couples and assess the correlates of condom use at the couple level. DESIGN Cross-sectional study. SETTING Seven prefectures along the Yangtze River in the Anhui Province, China. PARTICIPANTS We included 412 participants aged 18 years or older (206 married HIV-discordant couples). PRIMARY AND SECONDARY OUTCOME MEASURES In this study, sexual behaviours included marital or extramarital sex in the past 6 months, as well as the frequency of marital sex and condom use (always, sometimes or never) if having marital sex in the past 6 months. We used stepwise ordinal logistic regression modelling to determine the correlates of condom use. RESULTS In total, 63.1% (130 of 206) of couples had marital sex in the past 6 months, of which 89.2% (116 of 130) used condoms consistently. Couples with more marital duration (OR=1.15; 95% CI: 1.03, 1.28) were more inclined to adhere to condom use, whereas those lacking support and care (OR=0.25; 95% CI: 0.07, 0.94) and being remarried (OR=0.08; 95% CI: 0.02, 0.43) were associated with less condom use. In addition, HIV-positive respondents were more likely to have extramarital sex than HIV-negative respondents (p=0.015). CONCLUSIONS The extramarital sex of HIV-positive spouses should be considered. Implementation of interventions, such as increasing support and care between spouses to promote marital intimacy and stability, could reduce unprotected sexual behaviour.
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Affiliation(s)
- Yi Li
- School of Public Health, Fudan University, Shanghai, China
| | - Fenglin Zhang
- Department of AIDS STD Disease Control and Prevention, Anqing Center for Disease Control and Prevention, Anqing, Anhui, China
| | - Zhengdong Dou
- Department of AIDS STD Disease Control and Prevention, Wuhu Center for Disease Control and Prevention, Wuhu, Anhui, China
| | - Wei Zheng
- Department of AIDS STD Disease Control and Prevention, Huangshan Center for Disease Control and Prevention, Huangshan, Anhui, China
| | - Ping Ai
- Department of AIDS STD Disease Control and Prevention, Xuancheng Center for Disease Control and Prevention, Xuancheng, Anhui, China
| | - Ming Bao
- Department of AIDS STD Disease Control and Prevention, Chizhou Center for Disease Control and Prevention, Chizhou, Anhui, China
| | - Congming Han
- Department of AIDS STD Disease Control and Prevention, Tongling Center for Disease Control and Prevention, Tongling, Anhui, China
| | - Kexia Xiang
- Department of AIDS STD Disease Control and Prevention, Ma'anshan Center for Disease Control and Prevention, Ma'anshan, Anhui, China
| | - Qirong Qin
- Department of AIDS STD Disease Control and Prevention, Ma'anshan Center for Disease Control and Prevention, Ma'anshan, Anhui, China
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Zhang G, Yang X, Kang W, Liu T, Cheng L, Qu M, Wang X, Tang H. Pre-exposure prophylaxis uptake for high-risk men who have sex with men in China: a multi-city cross-sectional survey. AIDS Res Ther 2023; 20:32. [PMID: 37268970 DOI: 10.1186/s12981-023-00528-w] [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: 01/03/2023] [Accepted: 05/25/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) is a proven biomedical strategy to prevent HIV transmission among men who have sex with men (MSM). Despite oral PrEP is safe and effective in MSM, the use of PrEP has been discouraging, especially in high-risk MSM. And there are no relevant studies showing the use of PrEP in high-risk MSM. The purpose of this study was to get the rate of PrEP use and the factors influencing PrEP use among high-risk MSM. METHODS A cross-sectional study was conducted through an electronic questionnaire on the "i guardian Platform", and "snowballing" method was used to recruit MSM in six cities in China, including Beijing, Shenzhen, Chengdu, Changsha, Jinan and Nanjing in China, from January to April 2021. Univariate and multivariate logistic regression analysis were used to analyze the factors associated with the use of PrEP among high-risk MSM who had heard about PrEP. RESULTS Among the 1865 high-risk MSM who had heard of PrEP, the rates of those who were willing to use PrEP, had knowledge awareness of PrEP, and had used PrEP were 96.7%, 24.7%, and 22.4%, respectively. Multivariate logistic regression analysis of PrEP use in high-risk MSM showed that more PrEP was used by those who were 26 years or older (OR = 1.86, 95%CI 1.17 ~ 2.99), had master degree or above (OR = 2.37, 95% CI 1.21 ~ 4.72), had unstable work (OR = 1.86, 95% CI 1.16 ~ 2.96), had tested five or more HIV times in the past year (OR = 3.09, 95% CI 1.65 ~ 6.04), had consulted PrEP (OR = 22.05, 95% CI 14.87 ~ 33.91) and had PrEP knowledge awareness (OR = 1.90, 95% CI 1.41 ~ 2.55) (P < 0.05). CONCLUSIONS The rate of PrEP use in high-risk MSM was relatively low. PrEP was used more by high-risk MSM with unstable jobs, higher education, frequent HIV testing, and PrEP counseling. Public education on PrEP for MSM should continue to be enhanced to help them use PrEP in a timely and accurate manner.
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Affiliation(s)
- Guang Zhang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 10226, China
| | - Xue Yang
- Beijing Huilongguan Hospital, Beijing, 100096, China
| | - Wenting Kang
- Chinese Association of STD and AIDS Prevention and Control, Beijing, 100050, China
| | - Tongtong Liu
- Chinese Health Education Center, Beijing, 100011, China
| | - Lili Cheng
- Chinese Association of STD and AIDS Prevention and Control, Beijing, 100050, China
| | - Meixia Qu
- Chinese Association of STD and AIDS Prevention and Control, Beijing, 100050, China
| | - Xinlun Wang
- Chinese Association of STD and AIDS Prevention and Control, Beijing, 100050, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 10226, China.
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Zhang F, Zhu S, Tang H, Zhao D, Zhang X, Zhao G, Zhang X, Li T, Ruan L, Zhu W. Ambient particulate matter, a novel factor hindering life spans of HIV/AIDS patients: Evidence from a ten-year cohort study in Hubei, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 875:162589. [PMID: 36871737 DOI: 10.1016/j.scitotenv.2023.162589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The life spans of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients have been extended in the era of antiretroviral therapy. However, few studies have considered the influence of the environment on the life expectancy of people living with HIV/AIDS. Several studies have investigated mortality and air pollution associations, but the evidence for associations between long-term exposure to particulate matter (PM) and mortality among HIV/AIDS patients remains extremely sparse. METHODS We conceived a dynamic cohort study by enrolling people with HIV/AIDS from 103 counties in Hubei province, China from 2010 to 2019, with 23,809 persons and 78,457.2 person-years of follow-up. The county-level annual concentrations of PM2.5 and PM10 were extracted from the ChinaHighAirPollutants dataset. Cox proportional hazards models with time-varying exposures were conducted to assess the associations between PM and mortality. RESULTS Per 1 μg/m3 increased in PM2.5 and PM10 would elevate 0.69 % (95 % CIs: 0.39, 1.00) and 0.39 % (95 % CIs: 0.18, 0.59) risk of all-cause deaths (ACD) and 1.65 % (95 % CIs: 1.14, 2.17) and 0.90 % (95 % CIs: 0.56, 1.24) of AIDS-related deaths (ARD), respectively. Significantly stronger associations of PM-ARD were found in patients aged over 60 years old, with corresponding excess risk of 2.66 % (95 % CIs: 1.76, 3.58) for PM2.5 and 1.62 (95 % CIs: 1.01, 2.23) for PM10. CONCLUSIONS This study added to the existing evidence that long-term exposure to ambient PM adversely affects the life spans of HIV/AIDS patients. Hence, public health departments should take proactive measures to prevent further life loss and promote survival among those living with HIV/AIDS.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Hen Tang
- Institute of Chronic Infectious Disease Prevention and Control, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Dingyuan Zhao
- Institute of Chronic Infectious Disease Prevention and Control, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Lianguo Ruan
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, China.
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430071, China.
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Nie L, Hua W, Liu X, Pang X, Guo C, Zhang W, Tian Y, Qiu Q. Associated Factors and Immune Response to the Hepatitis B Vaccine with a Standard Schedule: A Prospective Study of People with HIV in China. Vaccines (Basel) 2023; 11:vaccines11050921. [PMID: 37243025 DOI: 10.3390/vaccines11050921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Hepatitis B (HB) vaccination is recommended for people with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). We aimed to assess the immune response to the HB vaccine and associated factors using the standard vaccination schedule among people with HIV (PWH) in China. A prospective study was carried out from 2016 to 2020 in Beijing, China. PWH were given three 20 μg doses of recombinant HB vaccine at 0, 1, and 6 months. Blood samples were taken within 4-6 weeks after each dose to evaluate the anti-HBs levels. A total of 312 participants completed vaccination and serologic testing. The seroconversion (anti-HBs ≥ 10 IU/L) rates following the first, second, and third doses of the vaccine were 35.6% (95% CI: 30.3-40.9%), 55.1% (95% CI: 49.6-60.7%), and 86.5% (95% CI: 82.8-90.3%), respectively, and the geometric means of the anti-HBs titers were 0.8 IU/L (95% CI: 0.5-1.6 IU/L), 15.7 IU/L (95% CI: 9.4-26.3 IU/L), and 241.0 IU/L (95% CI: 170.3-341.1 IU/L), respectively. In multivariate analysis, after three doses of vaccination, age, CD4 cell count, and HIV-RNA viral load were significantly associated with strong, moderate, and weak response, respectively. These findings confirm that these personal health conditions are related to the HB response. HB vaccination in PWH using the standard schedule was still highly effective in the context of early treatment initiation, especially among participants aged 30 years and younger.
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Affiliation(s)
- Li Nie
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Wei Hua
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Xiuying Liu
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Xinghuo Pang
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Caiping Guo
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Wei Zhang
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Yakun Tian
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Qian Qiu
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
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Wang X, Li Y, Li J, Hao W. Emerging patterns of substance abuse and related treatment in China. Curr Opin Psychiatry 2023:00001504-990000000-00065. [PMID: 37191649 DOI: 10.1097/yco.0000000000000878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW The situation of China drug use has seen dramatic changes in recent years. The aim of this review is to give a perspective of the current situation of drug abuse, the problems associated with it, and the strategy to control it in China. RECENT FINDINGS The number of registered drug users and newly discovered drug users had declined for 5 consecutive years, Moreover, the scaling down of drug trafficking and drug-related crimes had been seen for recent years. There are four main drug treatment modalities in China. The drug abuse and its related problems in China face new challenges, including the impact of the coronavirus disease 2019 pandemic, the role of compulsory treatment is overemphasized, the voluntary treatment facilities and community treatment cannot meet the requirements of Chinese society, and the coordination among government departments in drug control and treatment in China need to improved. SUMMARY With years of the joint efforts, the overall drug situation kept improving. The drug abuse and its related problems in China still is a problem, and require effective and immediate interventions.
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Affiliation(s)
- Xuyi Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan
| | - Yuanrong Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan
| | - Jin Li
- State Key Laboratory of Toxicology and Medical Countermeasures; Beijing Key Laboratory of Neuropsychopharmacology, Beijing, China
| | - Wei Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan
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Zhao T, Liu H, Bulloch G, Jiang Z, Cao Z, Wu Z. The influence of the COVID-19 pandemic on identifying HIV/AIDS cases in China: an interrupted time series study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 36:100755. [PMID: 37360868 PMCID: PMC10072954 DOI: 10.1016/j.lanwpc.2023.100755] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/23/2023] [Accepted: 03/16/2023] [Indexed: 04/08/2023]
Abstract
Background The COVID-19 pandemic has caused significant global public health challenges, and impacted HIV testing and reporting worldwide. We aimed to estimate the impact of COVID-19 polices on identifying HIV/AIDS cases in China from 2020 to 2022. Methods We used an interrupted time series (ITS) design and seasonal autoregressive integrated moving average intervention (SARIMA Intervention) model. Monthly reported data on HIV/AIDS cases were extracted from the National Bureau of Disease Control and Prevention of China from January 2004 to August 2022. Data on Stringency Index (SI) and Economic Support Index (ESI) from January 22, 2020 to August 31, 2022 were extracted from the Oxford COVID-19 Government Response Tracker (OxCGRT). Using these, a SARIMA-Intervention model was constructed to evaluate the association between COVID-19 polices and monthly reported HIV/AIDS case numbers from January 2004 to August 2022 using auto.arima () function from R. The absolute percentage errors (APEs) compared the expected numbers generated by the SARIMA-Intervention model with actual numbers of HIV/AIDS, and was the primary outcome of this study. A second counterfactual model estimated HIV/AIDS case numbers if COVID-19 hadn't occurred in December 2019, and the mean difference between actual and predicted numbers were calculated. All statistical analyses were performed in R software (version 4.2.1) and EmpowerStats 2.0 and a P < 0.05 was considered statistically significant. Findings The SARIMA-Intervention model indicated HIV/AIDS monthly reported cases were inversely and significantly correlated with stricter lockdown and COVID-19 related polices (Coefficient for SI = -231.24, 95% CI: -383.17, -79.32) but not with economic support polices (Coefficient for ESI = 124.27, 95% CI: -309.84, 558.38). APEs of the SARIMA-Intervention model for prediction of HIV/AIDS cases from January 2022 through August 2022, were -2.99, 5.08, -13.64, -34.04, -2.76, -1.52, -1.37 and -2.47 respectively, indicating good accuracy and underreporting of cases during COVID-19. The counterfactual model estimates between January 2020 and August 2022 an additional 1314 HIV/AIDS cases should have been established monthly if COVID-19 hadn't occurred. Interpretation The COVID-19 pandemic influenced the allocation and acquisition of medical resources which impacted accurate monthly reporting of HIV in China. Interventions that promote continuous HIV testing and ensure the adequate provision of HIV services including remote delivery of HIV testing services (HIV self-testing) and online sexual counseling services are necessary during pandemics in future. Funding Ministry of Science and Technology of the People's Republic of China (The grant number: 2020YFC0846300) and Fogarty International Center, National Institutes of Health, USA (The grant number: G11TW010941).
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Affiliation(s)
- Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Gabriella Bulloch
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Zhen Jiang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaobing Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zunyou Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Yu F, Hsiao YH, Park S, Kambara K, Allan B, Brough G, Hwang TF, Dang N, Young B, Patel R, Maldonado A, Okoli C. The Influence of Anticipated HIV Stigma on Health-related Behaviors, Self-rated Health, and Treatment Preferences Among People Living with HIV in East Asia. AIDS Behav 2023; 27:1287-1303. [PMID: 36348191 PMCID: PMC10036452 DOI: 10.1007/s10461-022-03865-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/09/2022]
Abstract
Long-acting injectable regimens for HIV treatment have been developed which are less frequent, more discreet, and more desirable for some people living with HIV (PLHIV) and may help reduce stigma-related barriers to HIV treatment. However, there is little information on the relationship between reported stigma and preference for these newer treatments. We characterized anticipated, experienced, and internalized HIV stigma and examined the associations with treatment preferences among an international sample of PLHIV. Data came from the international, web-based, cross-sectional study called "Positive Perspectives" conducted among PLHIV aged ≥ 18 years in 25 geographic locations during 2019 (n = 2389). Descriptive analyses were stratified among East Asian (n = 230) vs. non-Asian (n = 2159) participants. Results showed that prevalence of anticipated stigma was significantly higher among East Asian than non-Asian participants (72.2%[166/230] vs. 63.8%[1377/2159], p = 0.011). A significantly higher percentage of East Asian (68.7%[158/230]) than non-Asian participants (43.3%[935/2159] indicated that someone finding their HIV pills would cause them much "stress or anxiety" (p < 0.001). Actions taken by some PLHIV to prevent unwanted disclosure included restricting who they shared their HIV status with, hiding their HIV pills, or even skipping a dose altogether because of privacy concerns. Overall, 50.0%[115/230] East Asian participants believed HIV would reduce their lifespan and 43.0%[99/230] no longer planned for their old age because of HIV. Anticipated stigma was strongly associated with receptivity to non-daily regimens. Concerted efforts to reduce stigma and deliver flexible treatment options that address the unmet treatment needs of PLHIV, including confidentiality concerns, may improve their health-related quality of life.
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Affiliation(s)
- Fei Yu
- Danlan Beijing Media Limited, Beijing, China
| | | | | | - Keita Kambara
- Japanese Network of People living with HIV/AIDS, Tokyo, Japan
| | - Brent Allan
- Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Sydney, Australia
- International Council of AIDS Service Organizations (ICASO), Toronto, Canada
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Guo J, Kang W, Liu T, Xu J, Tang H, Lyu F, Zhang G. Analysis of Knowledge Level and Use of Antiretroviral Pre-Exposure and Post-Exposure Prophylaxis Among MSM - China, 2019-2022. China CDC Wkly 2023; 5:292-296. [PMID: 37139146 PMCID: PMC10150747 DOI: 10.46234/ccdcw2023.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/22/2023] [Indexed: 05/05/2023] Open
Abstract
What is already known on this topic? Men who have sex with men (MSM) in China have a high rate of human immunodeficiency virus (HIV) infection. Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have been shown to be effective in preventing HIV, which may help to contain the HIV epidemic among MSM. What is added by this report? This study found that knowledge and usage of PrEP were low among MSM, indicating that this population is at high risk for HIV infection. Promotion of PrEP and PEP among MSM is necessary to reduce the risk of HIV infection in this population. What are the implications for public health practice? PrEP and PEP are novel HIV prevention strategies that have been demonstrated to be effective and safe. To further reduce HIV transmission among MSM in China, it is necessary to promote the use of PrEP and PEP.
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Affiliation(s)
- Jiahuan Guo
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenting Kang
- Chinese Association of STD & AIDS Prevention and Control, Beijing, China
| | - Tongtong Liu
- Chinese Center for Health Education, Beijing, China
| | - Jie Xu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fan Lyu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guang Zhang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Guang Zhang,
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Bouey JZH, Han J, Liu Y, Vuckovic M, Zhu K, Zhou K, Su Y. A case study of HIV/AIDS services from community-based organizations during COVID-19 lockdown in China. BMC Health Serv Res 2023; 23:288. [PMID: 36973805 PMCID: PMC10042409 DOI: 10.1186/s12913-023-09271-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION People living with HIV (PLHIV) relied on community-based organizations (CBOs) in accessing HIV care and support during the COVID-19 pandemic in China. However, little is known about the impact of, and challenges faced by Chinese CBOs supporting PLHIV during lockdowns. METHODS A survey and interview study was conducted among 29 CBOs serving PLHIV in China between November 10 and November 23, 2020. Participants were asked to complete a 20-minute online survey on their routine operations, organizational capacity building, service provided, and challenges during the pandemic. A focus group interview was conducted with CBOs after the survey to gather CBOs' policy recommendations. Survey data analysis was conducted using STATA 17.0 while qualitative data was examined using thematic analysis. RESULTS HIV-focused CBOs in China serve diverse clients including PLHIV, HIV high-risk groups, and the public. The scope of services provided is broad, ranging from HIV testing to peer support. All CBOs surveyed maintained their services during the pandemic, many by switching to online or hybrid mode. Many CBOs reported adding new clients and services, such as mailing medications. The top challenges faced by CBOs included service reduction due to staff shortage, lack of PPE for staff, and lack of operational funding during COVID-19 lockdowns in 2020. CBOs considered the ability to better network with other CBOs and other sectors (e.g., clinics, governments), a standard emergency response guideline, and ready strategies to help PLHIV build resilience to be critical for future emergency preparation. CONCLUSION Chinese CBOs serving vulnerable populations affected by HIV/AIDS are instrumental in building resilience in their communities during the COVID-19 pandemic, and they can play significant roles in providing uninterrupted services during emergencies by mobilizing resources, creating new services and operation methods, and utilizing existing networks. Chinese CBOs' experiences, challenges, and their policy recommendations can inform policy makers on how to support future CBO capacity building to bridge service gaps during crises and reduce health inequalities in China and globally.
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Affiliation(s)
- Jennifer Z H Bouey
- Department of Global Health, School of Health, Georgetown University, 3700 Reservoir Road NW, Washington, DC, 20057, USA.
- RAND Corporation, Santa Monica, CA, USA.
| | - Jing Han
- Ditan Infectious Disease Hospital, Beijing, China
| | - Yuxuan Liu
- Department of Global Health, School of Health, Georgetown University, 3700 Reservoir Road NW, Washington, DC, 20057, USA
| | - Myriam Vuckovic
- Department of Global Health, School of Health, Georgetown University, 3700 Reservoir Road NW, Washington, DC, 20057, USA
| | - Keren Zhu
- RAND Corporation, Santa Monica, CA, USA
| | | | - Ye Su
- Home of Red Ribbon, Beijing, China
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Zhang K, Chan PSF, Li X, Fang Y, Cai Y, Zou H, Cao B, Cao H, Hu T, Chen Y, Wang Z. Low Behavioral Intention to Use Any Type of HIV Testing and HIV Self-Testing among Migrant Male Factory Workers Who Are at High Risk of HIV Infection in China: A Secondary Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5029. [PMID: 36981938 PMCID: PMC10048950 DOI: 10.3390/ijerph20065029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
This study investigated the prevalence of and factors associated with behavioral intention to take up any type of HIV testing and HIV self-testing (HIVST) in the next six months among male migrant workers, who were at high risk of HIV infection, in Shenzhen, China. This was a secondary data analysis. A total of 363 subjects who had sexual intercourse with non-regular female sex partners and/or female sex workers in the past six months were selected. Logistic regression models were fitted for data analysis. About 16.5% of participants reported having used HIV testing in their lifetime and 12.7% for HIVST. Among the participants, 25.6% and 23.7% intended to take up any type of HIV testing and HIVST in the next six months, respectively. Significant factors associated with the behavioral intention to take up HIV testing and HIVST included individual-level factors based of the Health Belief Model (e.g., perceived benefit, perceived cue to action, perceived self-efficacy) and interpersonal-level factors (e.g., frequency of exposure to health-related content or HIV and STI-related content on short video apps). This study provided practical implications for designing interventions to increase the uptake of HIV testing and HIVST among migrant workers.
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Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Paul Shing-fong Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xinyue Li
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Yong Cai
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
- Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen 518060, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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49
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Guo Z, Feng A, Zhou Y, Gao Y, Sun Y, Chen Y, Zhou X, Zou H. Geosocial networking mobile applications use and HIV and other sexually transmitted infections among men who have sex with men in Southern China: A cross-sectional study. Front Public Health 2023; 11:1063993. [PMID: 36844866 PMCID: PMC9944389 DOI: 10.3389/fpubh.2023.1063993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/18/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Men who have sex with men (MSM) are increasingly using geosocial networking (GSN) mobile applications (apps) to socialize in the community. Our study aimed to compare sexual behaviors between app-using MSM (app users) and non-app-using MSM (non-app users), and evaluate the association between app use and sexually transmitted infections (STIs). Methods Eligible MSM were recruited from January to August 2017 in three metropolitan cities: Guangzhou, Shenzhen and Wuxi. A self-completed tablet-based questionnaire was collected about socio-demographic characteristics, sexual behaviors and app use. Blood samples were collected to test for HIV and syphilis. Rectal swabs taken by nurses and urine samples taken by participants themselves were collected to test for gonorrhea and chlamydia. Anogenital warts were checked by a clinician. Chi square tests and logistic regression were used to compare the prevalence of STIs and the characteristics between app users and non-app users. Results A total of 572 MSM were included in our analysis, 59.9, 25.7, and 23.4% MSM were recruited from Guangzhou, Shenzhen, and Wuxi, respectively. The majority of participants were 20-29 years old (61.7%). 89.0% of MSM had ever used at least one GSN app, and 63.8% MSM had anal intercourse (AI) partners found via apps. Among app users, 62.7% spent <30 min on apps per day on average in the past 6 months. Compared with non-app users, app users were more likely to have an education level of college and above [adjusted OR (AOR) 3.36, 95% confidence interval (CI) 1.65-7.03], have regular sex partners (2.40, 1.16-5.19), have two or more casual sex partners (2-5: 2.90, 1.21-6.90; ≥6: 13.91, 3.13-82.90), have condomless anal intercourse (CAI) with casual sex partners in the past 6 months (2.50, 1.28-5.04), do not know their last sex partners' HIV status (2.16, 1.13-4.21), have tested for HIV in the past year (2.09, 1.07-4.09) and be circumcised (4.07, 1.29-18.42). Prevalence of HIV (8.3 vs. 7.9%, P = 0.93), syphilis (6.9 vs. 11.1%, P = 0.34), gonorrhea (5.1 vs. 6.3%, P = 0.90), chlamydia (18.5 vs. 12.7%, P = 0.36), and anogenital warts (4.9 vs. 4.8%, P = 1.00) were similar between app users and non-app users. Conclusions GSN app users were more likely to have high-risk sexual behaviors, but the prevalence of HIV and other STIs were similar to non-app users. Longitudinal studies comparing the incidence of HIV/STIs between long-term app users and non-app users may be necessary to clarify the impact of app use on HIV/STIs risk.
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Affiliation(s)
- Zhihui Guo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Anping Feng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yiguo Zhou
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Yanxiao Gao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yinghui Sun
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuanyi Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Jiang Y, Liu L, Yuan Z, Liu A, Cao J, Shen Y. Molecular identification and genetic characteristics of Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in human immunodeficiency virus/acquired immunodeficiency syndrome patients in Shanghai, China. Parasit Vectors 2023; 16:53. [PMID: 36739387 PMCID: PMC9899406 DOI: 10.1186/s13071-023-05666-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/13/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Opportunistic infections are a ubiquitous complication in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are common opportunistic intestinal pathogens in humans. In China, despite the number of HIV/AIDS patients being extremely large, only a few studies have investigated opportunistic infections caused by intestinal pathogens in this patient population. The aims of this study were to elucidate the occurrence and genetic characteristics of Cryptosporidium spp., G. duodenalis, and E. bieneusi in HIV/AIDS patients. METHODS We collected fecal specimens from 155 HIV/AIDS patients (one from each patient). All of the specimens were examined for the presence of the pathogens by genotyping using polymerase chain reaction and sequencing of the small subunit ribosomal RNA gene for Cryptosporidium spp.; the triosephosphate isomerase, β-giardin and glutamate dehydrogenase genes for G. duodenalis; and the internal transcribed spacer region of the rRNA gene for E. bieneusi. The Cryptosporidium-positive specimens were further subtyped by polymerase chain reacion and sequencing of the 60-kDa glycoprotein gene. RESULTS Six (3.9%), three (1.9%), and eight (5.2%) HIV/AIDS patients were positive for Cryptosporidium spp., G. duodenalis, and E. bieneusi, respectively. No statistical differences were observed in occurrence rate between the groups by gender, clinical symptom (diarrhea), and CD4+ cell count. Four Cryptosporidium species were identified: Cryptosporidium hominis (n = 2), Cryptosporidium parvum (n = 1), Cryptosporidium meleagridis (n = 1), and Cryptosporidium andersoni (n = 2). Furthermore, two C. hominis subtypes (IeA12G3T3 and IaA28R4) were detected. Three G. duodenalis-positive specimens were successfully amplified and sequenced at the triosephosphate isomerase and β-giardin loci, which led to the identification of assemblages C and B, respectively. Seven genotypes (D, Type IV, EbpC, Peru11, EbpD, A, and I) were identified in E. bieneusi-positive specimens. CONCLUSIONS Our findings should increase awareness of AIDS-related opportunistic intestinal pathogens, and indicate the need for routine examination in clinical practice for the detection of Cryptosporidium spp., G. duodenalis, and E. bieneusi. Homology analyses of the three intestinal pathogens at the nucleotide and/or amino acid levels indicated their zoonotic potential.
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Affiliation(s)
- Yanyan Jiang
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, 200025 Shanghai, China
| | - Li Liu
- grid.8547.e0000 0001 0125 2443Shanghai Public Health Clinical Center, Shanghai Medical College, Fudan University, 201508 Shanghai, China
| | - Zhongying Yuan
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, 200025 Shanghai, China
| | - Aiqin Liu
- grid.410736.70000 0001 2204 9268Department of Parasitology, Harbin Medical University, Harbin, 150081 China
| | - Jianping Cao
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, 200025 Shanghai, China
| | - Yujuan Shen
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, 200025 Shanghai, China
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