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Objective@#This study aimed to examine the demographic characteristics, HIV related knowledge and behavior, correlates of bisexual behavior and status of HIV infection among men who have sex with men only (MSMO) and men who have sex with both men and women (MSMW) in Shandong province.@*Methods@#According to the requirements from "National HIV/AIDS sentinel surveillance program" , a cross-sectional survey was conducted to collect information on demographics, sexual and drug use behaviors, and HIV-related services among MSM in nine sentinel surveillance sites from April to July in 2018. Blood samples were drawn for serological tests on both HIV and syphilis antibodies.@*Results@#A total of 3 474 participants were included in this study. Related information on these participants would include: average age as (31.66±9.01) years; 35.06% (1 218) married or cohabiting with a woman, 50.52% (1 755) had college or higher education, 80.11% (2 783) self-identified as gays and 14.22% (494) self-identified as bisexual men,16.87% (586) ever having sex with woman in the past 6 months, 10.51% (365) ever using drugs. HIV and syphilis prevalence rates were 2.99% (104/3 474) and 2.76%(96/3 474). Through multivariable logistic models, MSMW were more likely to be ≥35 years of age, local residents, self-identified as heterosexual/bisexual/uncertain, ever having commercial sex with man but less likely to consistently use condoms in the past 6 months, less using internet/dating software to find male sex partners and less using drugs. There was no significant differences noticed in the following areas: number of sexual partners in the last week, condom use in the last six months with commercial sex partners, with HIV or syphilis infection and self-reported history of STD in the past year between MSMO and MSMW (P>0.05). HIV-infected MSM were more likely to have the following features, ≥45 years of age, non-local residents, finding male sex partners from the bothhouses, park/toilets or from the internet/dating software, also less likely to consistently use condoms in the past 6 months, using drugs or with syphilis infection.@*Conclusions@#High prevalence of bisexual behavior as well as higher risk of HIV infection were noticed among MSM in Shandong province. It is important to strengthen related surveillance and effective intervention programs for MSM with different characteristics in Shandong province.
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Objective@#To understand the survival status of AIDS patients after initiation of antiretroviral treatment (ART) in Shandong province during 2003 to 2017, and to determine the factors associated with survival status.@*Methods@#A retrospective cohort study was conducted among AIDS patients initially received antiretroviral therapy from 2003 to 2017. The epidemiological characteristics of the subjects were described, and life tables were used to estimate the survival rates, the influencing factors were analyzed by Cox regression model.@*Results@#A total of 9 813 cases were enrolled in this study, of the subjects, the median age was 34.9±11.0 years. The median of baseline CD4+ T lymphocyte count was 300.0(P25-P75: 163.0, 428.0)cells/μl, and 83.2% of them were at clinical stage Ⅰ (World Health Organization, WHO). The cumulative survival rates were 97.7%, 96.7%, 95.8% and 93.7%, 1, 3, 5, and 10 years after the initiation of ART respectively. Multivariate Cox regression model analysis showed that the risk of the mortality among those infected through homosexual behavior was 38% lower than that of patients infected via blood or other routes, and HR was 0.62 (95%CI: 0.43-0.89). Higher education level had lower mortality risk(the mortality risk of those with university degree or above was lower, compared to those with primary and lower cultural level, HR=0.41, 95%CI: 0.26-0.65). At baseline, AIDS patients at clinical stage Ⅰ(WHO) had lower mortality risk than those who were at clinical stageⅡ, Ⅲ, and Ⅳ(WHO). Lower baseline CD4+ T lymphocyte count had higher mortality risk.@*Conclusions@#Survival rate was higher after initial antiretroviral therapy among AIDS patients in Shandong province. CD4+ T lymphocyte count level, WHO clinical stage, and presence or absence of clinical symptoms at baseline are the main factors influencing the survival time of AIDS patients after ART.
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Objective To explore the causes of secondary drug resistance among HIV infected persons who were receiving antiretroviral therapy in Shandong province,and provide evidence for the improvement of antiretroviral therapy strategy.Methods A case-control study was designed with 1 ∶ 2 matching on case and control groups.Household and face-to-face interview were conducted in October,2015.All the study subjects were screened from both the drug resistant database of antiretroviral therapy of Shandong provincial laboratory and national comprehensive HIV/AIDS database in Shandong.The sample size was estimated as 330 cases including 110 drug resistant and 220 non-drug resistant cases.Subjects were people living with HIV/AIDS (PLWHA) aged 15 or older and received antiretroviral therapy for more than 6 months with records of virus load (VL).Subjects who presented VL above 1 000 copies/ml would receive drug resistance testing.Subjects who were confirmed resistant to with secondary drug,were selected as case group,the rest subjects with non-secondary drug resistance would form the control group.EpiData 3.1 software and SPSS 22.0 software were used to establish a database.Related influencing factors were analyzed with non-conditional stepwise logistic regression model.Results A total of 288 cases were enrolled,including 103 in the case and 185 cases in the control groups,with average age as (37.62 ± 1.06) years and (37.90 ± 0.74)years old,respectively.Most of them were male,married/cohabitant,with education level of junior/senior high school or below and under Han nationality.Results from the multivariate logistic regression model showed that ORs (95％CI) of receiving antiretroviral therapy for 1-3 years,or more than 3 years were equal to 8,80 (3.69-21.00),3.00 (1.20-7.53),compared with receiving antiretroviral therapy less than one year,respectively.OR (95％ CI) of Among the PLWHA that with missing rate above 25.0％ on medication,the OR appeared as 15.41(4.59-51.71),compared with not missing medication.OR (95％ CI) among those who took the medicine themselves was 0.22 (0.07-0.74).Conclusions Factors as duration of treatment,missing rate on medication and taking medicine by oneself were of influence on secondary drug resistance.Other factors as duration on antiretroviral therapy longer than 1 year,missing rate above 25.0％ on medication,were related to the risk on secondary drug resistance.However,if the medicine was taken by oneself,it served as a protective factor for secondary drug resistance.It is necessary to strengthen the intervention and health education programs related to antiretroviral therapy.
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Objective To understand the characteristics of new-type drug consumption,sexual behaviors and the prevalence of HIV infection among male new-type drug users in Qingdao,Shandong province.Methods A cross sectional survey was conducted from 2015 to 2016.Participants were recruited from MSM community-based organizations (CBO) and general community through snowball method,relying on volunteers and male peer educators who were on new-type drugs themselves.Face-to-face interview was carried to collect information on drug use and sexual behaviors.Blood samples were collected to test HIV,syphilis and HCV antibodies.Urine samples were collected to test the evidence of new-type drugs.Qualitative variables and quantitative variables were analyzed using Chi-square test/Fisher's exact test and Student's t-test respectively.Multivariate logistic regression was used to analyze related factors of binary variables.Results A total of 1 034 new-type drug users were recruited,including 431 (41.7％) MSM population and 603 (58.3％) who were not MSM.Compared with the the group of people who were not MSM,people in the the MSM group were younger,unmarried and with higher level of education.The proportion of methamphetamine users were 49.7％ (214/431) and 100.0％ (603/603) among the groups of MSM or not MSM,respectively.People in the MSM group,66.8％ (288/431) used 5-Methoxy-N,N-diisopropyltryptamine (5-MeO-DIPT,"foxy") in the last six months.However,none from the not-MSM group ever used 5-MeO-DIPT.In the last six months,proportions of sharing new-type drugs with more than two people in the MSM or not groups were 87.9％ (379/431) and 97.7％ (588/602),respectively (x2=39.84,P＜0.01).Proportions of unprotected sexual behavior among the MSM or not groups were 47.5％ (285/600) and 7.4％ (32/430) respectively (x2=190.10,P＜0.01).The proportions of ‘group sex’ after using drugs among the two groups were 78.1％ (335/429) and 5.5％ (33/600) respectively (x2=573.73,P＜0.01).The prevalence rates of HIV,syphilis and HCV antibody positive among the MSM or not groups were 2.1％ and 0.2％,3.3％ and 6.3％,0.0％ and 0.3％,respectively.Conclusion The prevalence of sharing new-type drugs with more than two people was high among male new-type drug users in Qingdao city.Male new-type-drug-users who were MSM,presented both high prevalence of group sex and HIV infection,and with less condom use.Intervention measures towards this sub-population should be strengthened.
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Objective This study aimed to understand the herpes simplex virus-2 (HSV-2) infection and related factors among female drug abusers in the women's compulsory drug rehabilitation center of Shandong province and to provide reference for the prevention and control of HSV-2 in these settings.Methods We screened all of 451 female drug abusers in the women's compulsory drug rehabilitation centers in of Shandong province and conducted a study using both questionnaire investigation and serological tests for HSV-2,HIV and syphilis.We also used EpiData 3.1 software to establish a database and SPSS 20.0 software to conduct the x2 test and multivariate logistic regression analysis.Results A total of 451 female drug abusers were under study.We noticed that the rates for HSV-2 infection,HIV infection and syphilis infection appeared as 72.1％ (325/451),2.2％ (10/451) and 33.5 ％ (151/451) respectively.Results from univariate analysis showed that factors as:awareness on AIDS,having temporary sex partner after using the drug,having multiple sex partners after using the drug,providing commercial services or having temporary sex practice before being detained,with syphilis infection etc.,were associated with HSV-2 infection.Data from the multivariate analysis showed that the OR (95％CI) value of HSV-2 infection was 2.90 (1.19-7.06) for those who providing commercial service,when comparing to those who did not.Compared to those who did not suffer from syphilis infection,the OR (95％CI) value of HSV-2 infection for those with syphilis infection was 2.75 (1.63-4.63).Conclusions The rate of HSV-2 infection was high in the women's compulsory drug rehabilitation center of Shandong province.We should enhance measures and promote condom use to prevent from HSV-2 and other sexually transmitted diseases among them.
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Objective To explore the causes of secondary drug resistance among HIV infected persons who were receiving antiretroviral therapy in Shandong province,and provide evidence for the improvement of antiretroviral therapy strategy.Methods A case-control study was designed with 1 ∶ 2 matching on case and control groups.Household and face-to-face interview were conducted in October,2015.All the study subjects were screened from both the drug resistant database of antiretroviral therapy of Shandong provincial laboratory and national comprehensive HIV/AIDS database in Shandong.The sample size was estimated as 330 cases including 110 drug resistant and 220 non-drug resistant cases.Subjects were people living with HIV/AIDS (PLWHA) aged 15 or older and received antiretroviral therapy for more than 6 months with records of virus load (VL).Subjects who presented VL above 1 000 copies/ml would receive drug resistance testing.Subjects who were confirmed resistant to with secondary drug,were selected as case group,the rest subjects with non-secondary drug resistance would form the control group.EpiData 3.1 software and SPSS 22.0 software were used to establish a database.Related influencing factors were analyzed with non-conditional stepwise logistic regression model.Results A total of 288 cases were enrolled,including 103 in the case and 185 cases in the control groups,with average age as (37.62 ± 1.06) years and (37.90 ± 0.74)years old,respectively.Most of them were male,married/cohabitant,with education level of junior/senior high school or below and under Han nationality.Results from the multivariate logistic regression model showed that ORs (95％CI) of receiving antiretroviral therapy for 1-3 years,or more than 3 years were equal to 8,80 (3.69-21.00),3.00 (1.20-7.53),compared with receiving antiretroviral therapy less than one year,respectively.OR (95％ CI) of Among the PLWHA that with missing rate above 25.0％ on medication,the OR appeared as 15.41(4.59-51.71),compared with not missing medication.OR (95％ CI) among those who took the medicine themselves was 0.22 (0.07-0.74).Conclusions Factors as duration of treatment,missing rate on medication and taking medicine by oneself were of influence on secondary drug resistance.Other factors as duration on antiretroviral therapy longer than 1 year,missing rate above 25.0％ on medication,were related to the risk on secondary drug resistance.However,if the medicine was taken by oneself,it served as a protective factor for secondary drug resistance.It is necessary to strengthen the intervention and health education programs related to antiretroviral therapy.
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Objective To understand the characteristics of new-type drug consumption,sexual behaviors and the prevalence of HIV infection among male new-type drug users in Qingdao,Shandong province.Methods A cross sectional survey was conducted from 2015 to 2016.Participants were recruited from MSM community-based organizations (CBO) and general community through snowball method,relying on volunteers and male peer educators who were on new-type drugs themselves.Face-to-face interview was carried to collect information on drug use and sexual behaviors.Blood samples were collected to test HIV,syphilis and HCV antibodies.Urine samples were collected to test the evidence of new-type drugs.Qualitative variables and quantitative variables were analyzed using Chi-square test/Fisher's exact test and Student's t-test respectively.Multivariate logistic regression was used to analyze related factors of binary variables.Results A total of 1 034 new-type drug users were recruited,including 431 (41.7％) MSM population and 603 (58.3％) who were not MSM.Compared with the the group of people who were not MSM,people in the the MSM group were younger,unmarried and with higher level of education.The proportion of methamphetamine users were 49.7％ (214/431) and 100.0％ (603/603) among the groups of MSM or not MSM,respectively.People in the MSM group,66.8％ (288/431) used 5-Methoxy-N,N-diisopropyltryptamine (5-MeO-DIPT,"foxy") in the last six months.However,none from the not-MSM group ever used 5-MeO-DIPT.In the last six months,proportions of sharing new-type drugs with more than two people in the MSM or not groups were 87.9％ (379/431) and 97.7％ (588/602),respectively (x2=39.84,P＜0.01).Proportions of unprotected sexual behavior among the MSM or not groups were 47.5％ (285/600) and 7.4％ (32/430) respectively (x2=190.10,P＜0.01).The proportions of ‘group sex’ after using drugs among the two groups were 78.1％ (335/429) and 5.5％ (33/600) respectively (x2=573.73,P＜0.01).The prevalence rates of HIV,syphilis and HCV antibody positive among the MSM or not groups were 2.1％ and 0.2％,3.3％ and 6.3％,0.0％ and 0.3％,respectively.Conclusion The prevalence of sharing new-type drugs with more than two people was high among male new-type drug users in Qingdao city.Male new-type-drug-users who were MSM,presented both high prevalence of group sex and HIV infection,and with less condom use.Intervention measures towards this sub-population should be strengthened.
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Objective This study aimed to understand the herpes simplex virus-2 (HSV-2) infection and related factors among female drug abusers in the women's compulsory drug rehabilitation center of Shandong province and to provide reference for the prevention and control of HSV-2 in these settings.Methods We screened all of 451 female drug abusers in the women's compulsory drug rehabilitation centers in of Shandong province and conducted a study using both questionnaire investigation and serological tests for HSV-2,HIV and syphilis.We also used EpiData 3.1 software to establish a database and SPSS 20.0 software to conduct the x2 test and multivariate logistic regression analysis.Results A total of 451 female drug abusers were under study.We noticed that the rates for HSV-2 infection,HIV infection and syphilis infection appeared as 72.1％ (325/451),2.2％ (10/451) and 33.5 ％ (151/451) respectively.Results from univariate analysis showed that factors as:awareness on AIDS,having temporary sex partner after using the drug,having multiple sex partners after using the drug,providing commercial services or having temporary sex practice before being detained,with syphilis infection etc.,were associated with HSV-2 infection.Data from the multivariate analysis showed that the OR (95％CI) value of HSV-2 infection was 2.90 (1.19-7.06) for those who providing commercial service,when comparing to those who did not.Compared to those who did not suffer from syphilis infection,the OR (95％CI) value of HSV-2 infection for those with syphilis infection was 2.75 (1.63-4.63).Conclusions The rate of HSV-2 infection was high in the women's compulsory drug rehabilitation center of Shandong province.We should enhance measures and promote condom use to prevent from HSV-2 and other sexually transmitted diseases among them.
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Objective This study aimed to analyze the behavior change and related factors regarding HIV/STD epidemics among female sex workers (FSWs) in Qingdao city.Methods According to the requirements set by the "National HIV/AIDS sentinel surveillance program",information on demographics,sexual and drug use behaviors,and HIV-related services among female sex workers (FSWs) was collected from ten consecutive annual cross-sectional surveys from 2006 to 2015.Blood samples were drawn for serological tests on both HIV and syphilis antibodies.Results Data from the sampled FSWs over the ten years,a higher proportion of participants who were aged 30 or more,married or cohabited and on-call FSW were followed.The prevalence of syphilis increased significantly from 1.0％ (4/420) in 2006 to 13.3％ (53/400) in 2015 (trendx2=54.22,P＜0.001).Rates on illicit drug use were ranging from 12.0％ (48/400) and 55.5％ (222/400) while the rate on consistent condom use with clients in the last month showed decreasing,with trendx2=170.62,P＜0.001.The proportion of HIV-related knowledge score ≥ 6 (trend x2 =152.96,P＜ 0.001),or ever been tested for HIV (trendx2=114.87,P＜0.001) were both significantly increased over the last ten years.Between 2009 and 2015,results from the annual stratified analysis showed that the FSWs who used drugs were more likely than the FSWs who were non-drug users less consistently using condoms with clients in last month and being syphilis positive (P＜0.05).On-call FSWs were more likely to be syphilis positive (P＜0.05) than the non on-call FSWs.Conclusions The prevalence of syphilis among FSWs in Qingdao city had been rising over the last ten years,with synthetic drug abuse as an important risk factor.Better targeted surveillance and intervention efforts among those drug-using FSWs seemed important to reduce the epidemics.
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Objective This study aimed to analyze the behavior change and related factors regarding HIV/STD epidemics among female sex workers (FSWs) in Qingdao city.Methods According to the requirements set by the "National HIV/AIDS sentinel surveillance program",information on demographics,sexual and drug use behaviors,and HIV-related services among female sex workers (FSWs) was collected from ten consecutive annual cross-sectional surveys from 2006 to 2015.Blood samples were drawn for serological tests on both HIV and syphilis antibodies.Results Data from the sampled FSWs over the ten years,a higher proportion of participants who were aged 30 or more,married or cohabited and on-call FSW were followed.The prevalence of syphilis increased significantly from 1.0％ (4/420) in 2006 to 13.3％ (53/400) in 2015 (trendx2=54.22,P＜0.001).Rates on illicit drug use were ranging from 12.0％ (48/400) and 55.5％ (222/400) while the rate on consistent condom use with clients in the last month showed decreasing,with trendx2=170.62,P＜0.001.The proportion of HIV-related knowledge score ≥ 6 (trend x2 =152.96,P＜ 0.001),or ever been tested for HIV (trendx2=114.87,P＜0.001) were both significantly increased over the last ten years.Between 2009 and 2015,results from the annual stratified analysis showed that the FSWs who used drugs were more likely than the FSWs who were non-drug users less consistently using condoms with clients in last month and being syphilis positive (P＜0.05).On-call FSWs were more likely to be syphilis positive (P＜0.05) than the non on-call FSWs.Conclusions The prevalence of syphilis among FSWs in Qingdao city had been rising over the last ten years,with synthetic drug abuse as an important risk factor.Better targeted surveillance and intervention efforts among those drug-using FSWs seemed important to reduce the epidemics.
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OBJECTIVE@#To discuss a effective method of nasal septum deviation.@*METHOD@#One hundred and sixteen subjects with nasal septum deviation were divided into treatment group (69 subjects) and control group (47 subjects) randomly. The combination therapy of correction of deviated nasal septum and plasma radiofrequency ablation were used in the treatment group. The combination therapy of deviated nasal septum and partial inferior turbinectomy were used in the control group. The data were analyzed by statistical method.@*RESULT@#The effective rate of physical signs and symptoms of the treatment group was 100.0%, while the control group was 85.1%. There was significant difference of two effective rates (P < 0.05). Furthermore, hyperventilation and nasal adhesion were not happened in treatment group 6 months after treatments.@*CONCLUSION@#The correction of deviated nasal septum and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was easy for observation as well as the minimal tissue damage. The combination therapy method was according with the principle of functional minimally invasive surgery.