Clinical application analysis of continuing nursing in nursing service for diabetic patients

The research is to establish a Continuing Nursing Project after discharge which conforming to the actual conditions of our country and explore whether such Continuing Nursing Project could effectively improve therapy compliance and blood glucose control of diabetic patients. Methods: mainly analyzing pathological mechanisms of diabetic patients and exploring the clinical effect and the complication after implementing Continuing Nursing to patients. Results: after implementing Continuing Nursing, the diabetic patients could be better at controlling their diet, the drug usage rate and exercise rate have been improved significantly, complication rate have been decreased and the clinical effect is remarkable. Conclusion: the application of Continuing Nursing in the nursing service for diabetic patients, which could effectively improve living quality and clinical symptoms of patients, deserves to be popularized

Prevalence rates of depression and anxiety in HIV-infected men who have sex with men / 中国心理卫生杂志

Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.

Coverage of HIV related follow-up intervention and antiretroviral treatment and its correlation among HIV-positive men who have sex with men of 3 cities in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the coverage of HIV related intervention and antiviral treatment among HIV-positive men who have sex with men (MSM) and to examine factors of initiating antiretroviral treatment.</p><p><b>METHODS</b>A total of 501 HIV-positive MSM were recruited by "snowballing" sampling in Chengdu (160), Chongqing (168) and Guangzhou (173) from January to June, 2013. Participants who were older than18 years, had sex with men, HIV-infected, were living in these 3 cities when survey was conducted were eligible for subjects of this survey. The data were collected by computer assisted survey, including social demography, the coverage of HIV related follow-up intervention and ART, related knowledge level, sexual behaviors in the last 6 months, as well as notification to sexual partners and family. We analyzed the influence factors for initiating ART by Multiple Unconditioned Logistic Regression.</p><p><b>RESULTS</b>Among 501 HIV-positive MSM, the ratio of CD4 counting and HIV viral load testing were 90.8% (455) and 19.4% (97), respectively. The percentage of the latest CD4 counting not more than 350 per µl was 33.0% (150/455). The coverage of initiated ART among the participants who met the qualification was 56.0% (84/150). The multivariable Logistic regression analysis showed that the possibility of not on ART among participants who were migrants increased to 5.21(2.33-11.66) times of the local residents and the possibility among participants who were diagnosed STD in the last year increased to 2.70(1.12-6.55) times of those who were not infected STD, the possibility of not on ART among participants who had sex with male occasional or commercial partner in the last 6 months increased to 2.16(1.03-4.50) times of those who hadn't, and the possibility among participants who had anal sex with condom use in the past 6 months increased to 2.68(1.10-6.50) times of those who couldn't insist using condom.</p><p><b>CONCLUSION</b>There were low coverage of series of HIV/AIDS related intervention services among HIV-positive MSM in Chengdu, Chongqi and Guangzhou. Migrants, had sex with male occasional or commercial partner, had anal sex with condom use in the past 6 months, not infected STD in the last year may be the independent risk factors for HIV-positive MSM to not initiating ART.</p>

Risky sexual transmission behavior and its influencing factors among HIV-positive MSM population in Shanghai and Chengdu in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the sexual transmission behaviors among HIV-positive MSM population engaging in unprotected sexual behaviors, as well as the relationship with health conditions and partner notification.</p><p><b>METHODS</b>A total of 308 HIV-positive MSM participants engaged in unprotected sexual behaviors were recruited by "snowballing" sampling in Shanghai and Chengdu. The questionnaire covered such items as the time of HIV infection diagnosis, CD4⁺ T cells count, viral load, antiviral therapy, anxiety and depressive symptoms, sexual partner types and sexual behaviors in the past six months, disclosure to fixed sexual partners and casual sexual partners among others.</p><p><b>RESULTS</b>Of the 308 participants surveyed, the report rate of those having at least one-time sexual transmission behaviors during the past 6 months was 70.1% (216/308). Participants who had primary sexual partners and casual sexual partners following their HIV infection diagnosis accounted for 89.0% (274/308) and 68.2% (210/308) respectively. Of the aforementioned participants, 59.1% (162/274) and 94.3% (198/210) respectively had not disclosed their HIV infection to primary and casual sexual partners. Of thoes who did not disclose their HIV infection to primary sexual partners, 91.9% (147/162) reported sexual transmission behaviors. Of thoes who did not disclose their HIV infection to casual sexual partners, 89.9% (178/198) continue sexual transmission. As found in a multi-factor analysis, the infection risk exposure of those with heterosexual sexual orientation and engagement in sexual transmission behaviors was six times higher than those with homosexual orientation (aOR = 5.896, 95% CI: 1.808-19.232). For those who did not, or partially disclose their HIV infection to male casual sexual partners or commercial sexual partners, the risk exposure of further transmission was 29 times and 19 times higher than those disclose it to their sexual partners (no disclosure: aOR = 28.957, 95% CI: 7.511-65.004; partial disclosure: aOR = 18.956, 95% CI: 6.995-57.417). The highest risk came from those who continue their sexual transmission behavior within six months of their HIV infection diagnosis; the lowest risk came from those continue such behavior more than one year and within two years of their diagnosis (aOR = 0.048, 95% CI: 0.033-0.788); such risk rose to some extent for those continue such behavior over two years of their diagnosis. Compared to those without antiviral therapy, participants with the therapy pose less risk in sexual transmission behaviors.</p><p><b>CONCLUSION</b>More than two-thirds of HIV-positive MSM population who engage in unprotected sexual behaviors reported sexual transmission behaviors. In this regard, increasing antiviral therapy and promoting sexual partner disclosure constituted an effective strategy to minimize further transmission among HIV-positive MSM population. Intervention of sexual transmission behaviors should be addressed to those diagnosed of HIV infection within six months.</p>

The status of HIV disclosure to primary sexual partners and sexual behaviors among HIV-infected men who have sex with men of 3 cities in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the status of HIV disclosure to primary partners and to explore the correlates of HIV disclosure among HIV-infected men who have sex with men (MSM) in Guangzhou, Chongqing and Chengdu.</p><p><b>METHODS</b>This survey was conducted in Chengdu, Chongqing and Guangzhou by using "snowballing" sample from December, 2012 to May, 2013. Participants who were eighteen years old or elder, HIV-infected, had sex with men and lived in three cities when the survey was conducted were eligible for subjects of this survey. Primary partners and disclosure status of participants were investigated. Multiple Unconditioned Logistic Regression analysis was used to analyze the influence factors associated with HIV disclosure.Of 600 participants, 541 were excluded because of logical problem or incomplete items in questionnaire and the effective response rate was 90.2%.</p><p><b>RESULTS</b>Of the 541 HIV-positive MSM participants, the mean age was (30.2 ± 7.7) years old, 78.2% (423/541) of the participants had male primary partners.Of the 423 participants who had male primary partner, 10.9% (46/423) had wife, 58.9% (249/423) had one primary partner, and 41.1% (174/423) had two or more. The proportion of HIV disclosure to all male primary sexual partners and wife was 41.8% (177/423) and 4.5% (19/423) respectively, 20.3% (86/423) of them disclosure to some of male primary partners and 37.8% (160/423) not disclosure to any male primary partners. Participants who had HIV-positive male partners in the past 6 months (accounting for 35.2% (149/423)) were more likely to disclose HIV infection to their primary sexual partners (70.5% (105/149)) than those who had non-HIV-positive sexual partners (26.3% (72/274)) (χ(2) = 77.46, P < 0.01). Participants who had male unknown HIV-status sexual partners in the past 6 months(accounting for 52.7% (223/423)) were less likely to disclosure HIV infection to primary sexual partners (22.4% (50/223) ) than those who had already known HIV-status sexual partners (63.5% (127/200)) (χ(2) = 73.11, P < 0.01). The possibility of HIV disclosure to primary sexual partner among participants who had HIV-positive sexual partner increase to 6.36 (3.75-10.80) times of those who had HIV -negative partners, and the possibility among participants who had sexual partners of unknown HIV status decreased to 0.44 (0.25-0.76) times of those who had sexual partners of already known HIV status. Compared with having non-anal sex behaviors with male primary partner, the possibility of HIV disclosure to primary sexual partner decreased to 0.46 (0.22-0.95) times among participants who had anal sex behavior with male primary partners.</p><p><b>CONCLUSION</b>There were low proportion of HIV disclosure to primary sexual partners among HIV-infected MSM in Guangzhou, Chongqing and Chengdu.HIV disclosure to primary sexual partners may be associated with characteristics of their sexual partners, and participants who had HIV-positive male partners were more likely to disclose HIV infection to their primary sexual partners.</p>