Compliance of antiviral therapy and influencing factors in people living with HIV/AIDS in Nanjing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the compliance of highly active anti-retroviral therapy (HAART) and influencing factors in people living with HIV/AIDS (PLWHA) in Nanjing.</p><p><b>METHODS</b>PLWHA receiving HAART in No. 2 Hospital of Nanjing during May-June 2014 were recruited in this study. Self-administrated questionnaire was used to collect the data about HAART compliance and socio-demographic characteristics of PLWHA surveyed. Descriptive and multivariate statistical analysis were conducted to examine the effects of the factors on self-reported HAART adherence.</p><p><b>RESULTS</b>A total of 276 PLWHA were surveyed, According to the evaluation criterion of Center for Adherence Support Evaluation (CASE), 252 cases showed good compliance (91.3%). logistic regression analysis revealed that smoking, progress of the disease and side effects, reminding of taking drug and age were correlated with self-reported HAART adherence.</p><p><b>CONCLUSION</b>It is suggested to strengthen the education about antiviral therapy compliance in PLWHA with mild infection and those who are smokers and young, suffer from side effects, have no reminding methods for taking drug.</p>

Meta-analysis of HIV infection incidence and risk factors among men who have sex with men in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the incidence of HIV infection among men who have sex with men (MSM) in China.</p><p><b>METHODS</b>Meta-analysis was performed to systematically and quantitatively review all the original research papers and reports published during 2010-2015 on the incidence of HIV infection among MSM in China. Pooled incidence, pooled hazard ratios, publication bias, heterogeneity and sensitivity analysis for those studies were calculated or analyzed by using Stata 12.0 software.</p><p><b>RESULTS</b>A total of 24 studies were analyzed. Pooled incidence of HIV infection among MSM in China was 5.0/100 person year; Based on HIV case report, severe epidemic areas had higher HIV incidence than other areas (4.9/100 person year vs. 3.4/100 person year). Low education level (HR = 1.61, 95% CI: 1.21-2.15), syphilis prevalence (HR = 3.22, 95% CI: 2.21-4.70), unprotected anal sex (HR = 2.92, 95% CI: 1.51-5.63), minority ethnic group (HR = 4.01, 95% CI: 1.96-8.21), commercial sex (HR = 4.11, 95% CI: 1.47-11.46) and multiple sexual partners (HR = 2.31, 95% CI: 1.60-3.34) were the risk factors for HIV incidence.</p><p><b>CONCLUSION</b>Pooled incidence of HIV infection among MSM was 5.0% in China. Low education level, syphilis prevalence, unprotected anal sex, minority ethnic group, commercial sex and multiple sexual partners were the risk factors for HIV infection.</p>

Drop out of antiretroviral therapy in people living with AIDS/HIV and related factors in Nanjing and Yuncheng / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the incidence of drop out of antiretroviral therapy (ART) in people living with AIDS/HIV and related factors in Nanjing, Jiangsu province, and Yuncheng, Shanxi province.</p><p><b>METHODS</b>Retrospective cohort analysis was conducted. The cumulative incidence curves of drop out of ART, mortality and drug withdrawal were drawn with Kaplan-Meier method. The related factors were identified with Cox proportional hazards regression model.</p><p><b>RESULTS</b>A total of 1 006 patients were included in Yuncheng, the median length of ART follow-up was 49.59 months (QR: 20.02-92.84), and 976 patients were included in Nanjing, the median length of ART follow-up was 19.93 months (QR: 11.48-34.07). The cumulative incidence of drop out of ART at 3 months, 6 months, 1 year, 2 years, 4 years, 8 years after ART was 8.19%, 9.23%, 11.08%, 13.75%, 17.74%, 27.66% in Yuncheng, and 3.01%, 5.17%, 7.47%, 10.97%, 17.45%, 28.72% in Nanjing respectively. Age, marital status, infection route, baseline CD4 cell count, the clinical stage classified by WHO at the end of the observation were correlated with the drop out of ART.</p><p><b>CONCLUSION</b>In order to reduce the drop out of ART among people living with AIDS/HIV, it is necessary to conduct effective interventions targeting the patients with young age, the patients who divorced/widowed, the patients who were intravenous drug users, the patients with higher CD4 cell count at the beginning of ART and clinical stage III or IV at the end of the follow-up and increase the coverage of HIV test.</p>

Prevalence and associated risk factors of diabetes among ethnic Han residents in Guizhou / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the fast plasma glucose (FPG) level and the epidemiologic characteristics of diabetes in ethnic Han residents of Guizhou province.</p><p><b>METHODS</b>The survey was conducted among the ethnic Han residents aged 20-80 years, who were selected through multi stage cluster sampling in Guizhou. Basic laboratory test, physical examination were performed for each subject.</p><p><b>RESULTS</b>A total of 2 967 subjects were surveyed. The average FPG level was 5.21 mmol/L for urban residents and 5.03 mmol/L for rural residents, (P<0.001) and the average FPG level was higher in males than in females (5.23 mmol/L vs. 5.09 mmol/L, P=0.003). The FPG level increased with age (P<0.001). In urban residents, the standardized prevalence of diabetes was 6.01% (crude prevalence: 7.45%), higher in males than in females (P<0.001) and increased with age. In rural residents, the standardized prevalence of diabetes was 3.47% (crude prevalence: 3.77%) and increased with age, but there was no sex specific difference in diabetes prevalence. The awareness rate of self diabetes status was 56.59%, the treatment rate was 84.47% and the plasma glucose control rate was 41.38%. Multiple logistic regression analysis indicated that risk factors for diabetes included being male, older than 40 years, family history of diabetes, frequent physical exercise, hypertension, high triglycerid level.</p><p><b>CONCLUSION</b>The prevalence of diabetes was high in ethnic Han residents in Guizhou, the differences in diabetes prevalence between urban area and rural area was statistical significant. More than half of the patients' FPG level had not been under control after treatment. The awareness rate of self diabetes status, the treatment rate and the control rate of diabetes should be improved.</p>

Study on economic burden caused by antiretroviral treatment for people living with HIV/AIDS and influencing factors in Nanjing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the economic burden caused by antiretroviral treatment for people living with HIV/AIDS and influencing factors in Nanjing.</p><p><b>METHODS</b>People living with HIV/AIDS were divided into two groups, HIV infected patients and AIDS patients. The data about their direct medical expenditure, direct non-medical expenditure and indirect economic loss in the past year were collected. Univariate and multivariate analysis were conducted to identify the potential influencing factors.</p><p><b>RESULTS</b>The median of direct medical expenditure and total costs for 133 HIV infected patients were 1,200 yuan RMB and 1,972 yuan RMB respectively. The median of direct medical expenditure and total costs for 145 AIDS patients were 1 060 yuan RMB and 2 826 yuan RMB respectively. The differences in direct medical expenditure and total costs between HIV infected patients and AIDS patients showed no statistical significance. The results from univariate analysis indicated that the sample source influenced total costs significantly. Multivariate analysis showed that onset time and CD level were negatively correlated with direct medical expenditure. The patients infected through heterosexual contact had more direct medical expenditure than those infected through homosexual contact. The patients receiving HIV test in hospitals had more direct medical expenditure than those receiving volunteer counseling and testing.</p><p><b>CONCLUSION</b>Further efforts should be made to expand HIV testing and treatment coverage in order to detect HIV infections as early as possible. Early antiretroviral treatment should be given to HIV infected patients to maintain their immunity and reduce their medical expenditure.</p>