ABSTRACT
Objective:To determine the prevalence of facility-based HIV testing and its associated factors among men who have sex with men （MSM） in Shanghai. Methods:From June 2018 to December 2020， MSM were recruited by a community organization “Shanghai CSW&MSM Center （SCMC）”. A total of 3 251 MSM were included as follows： being 18 years old and above， being HIV-negative or with unknown HIV status， living in Shanghai， had homosexual behavior in the past year， and completed informed consent. Using a self-designed questionnaire， we performed an online survey powered by www.wjx.cn to collect information on demographics， sexual behavior， and facility-based HIV testing. A total of 3 240 valid questionnaires were collected. Univariate and multivariate logistic regression were used to determine the factors associated with facility-based HIV testing. Results:A total of 3 240 MSM participated in the study with mean age of （29.7±6.2） years .The prevalence of facility-based HIV testing was 63.2% （2 049/3 240）， Multivariate logistic regression showed that the participants with a college degree or above were less likely to have facility-based HIV testing（OR=0.73，P=0.008）， compared to those with lower educational background. The proportion of the MSM who sought sexual partners through the internet received facility-based testing was 68.7%. Compared to the participants with the sexual role being 0 （only be penetrated）， those being 0.5 （both penetrated and be penetrated） and 1 （only penetrated） were both more likely to have the HIV testing （both P<0.05）. Those who used condoms during the last homosexual behavior were more likely to be tested than those who did not （OR=1.39， P=0.001）. Those who had been diagnosed with sexually transmitted diseases were more likely to be tested than those who did not （OR=2.05， P<0.001）. The participants who had used HIV self-testing kits in the past were more likely to be tested than those who did not （OR=2.31， P<0.001）. Conclusion:MSM in Shanghai have lower utilization of facility-based HIV testing， which may be improved by strengthening the advocacy of facility-based HIV testing services through the internet and peer education， and innovating service models.
ABSTRACT
Objective To introduce and conduct effectiveness evaluation of peer-group level care and management mode in people living with HIV and AIDS(PLHAs)in Jing'an District, Shanghai. Methods We recruited PLHAs who were managed by Jing'an District and participated in the peer-group care activities from 2015 to 2016, and collected their data of general conditions, behavior, antiretroviral therapy, life quality, social support, mental status and medical modes, and then conducted effectiveness evaluation of the mode by multivariate logistic regression model and linear regression model. Results A total of 300 PLHAs were included with 150 cases in each group. PLHAs in target group had higher proportion of antiretroviral therapy[82.7%(124/150)and 64.7%(97/150)]. In addition, they got higher scores in mental health(48.5±9.2 and 43.9±10.6)and social support(28.7±8.2 and 24.8±6.6), and lower scores in depressive severity index(0.5±0.1)and avoidance of medical modes(16.1±3.0 and 17.0±2.5). Multivariate analysis showed that PLHAs in target group had less sex partners(zero partner, OR = 2.1, 95%CI:1.1-3.9;one partner, OR = 3.6, 95%CI:1.9-6.8)and increased condom use(no sex, OR = 5.3, 95%CI:2.4-11.7;complete use, OR = 10.6, 95%CI:4.7-24.1;random miss, OR = 5.1, 95%CI:1.8-14.8)in the last 12 months. Conclusion The effect of peer-group level care and management mode is significantly good in promoting behavior change, enhancing health concern and increasing antiretroviral therapy.
ABSTRACT
[Objective]To ascertain the status and related factors of antiretroviral therapy adherence and analyze the influence of management mode on adherence in HIV infected patients in Jing' an District, Shanghai. [Methods]We recruited 150 HIV infected patients who participated in the "peer group care"activities (target group) and those from another 150 patients who did not (control group) but received antiviral treatment during the period from 2015 to 2016 (221 cases in total) into the study. We collected data on general conditions, behavioral way, antiretroviral therapy adherence, life quality, social support, mental status and medical coping modes, and analyzed the related factors of antiretroviral therapy adherence by linear regression model. [Results]The 221 HIV infected patients were included, with 124 in target group and 97 in control group. The proportion of good antiretroviral therapy adherence was 86.0％, with 91.9％ in target group and 78.4％ in control group. Multiple analysis showed that the related factors of antiretroviral therapy adherence were management mode (β = 1.871, P < 0.001) , disposable income per month (β = 0.600, P = 0.001) , social support utilization (β = 0.174, P = 0.044) and yield attitude of medical coping modes (β =-0.153, P = 0.003). [Conclusion]Antiretroviral therapy adherence of HIV infected patients in Jing'an District should be further improved. "Peer group level care and management mode"could effectively promote the increase of antiretroviral therapy adherence; however, it should be improved and perfected in the aspects of its coverage and content.