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ObjectiveTo analyze the prevalence of HCV antibody positive and associated factors among drug users in Dehong Prefecture， Yunnan， and to provide scientific evidence for HCV prevention. MethodsQuestionnaire surveys and serological testing were conducted among 400 drug users continuously selected from four national AIDS sentinel surveillance in Dehong Prefecture between January and July during 2014‒2021. Results11 683 drug users were included. The prevalence of HCV antibody positive was 20.2% overall， and 14.9%， 20.1%， 22.4%， 19.8%， 22.5%， 20.6%， 24.5%， 19.0% from 2014 to 2021， respectively （trend Z=-3.78， P<0.001）. Multivariable analysis indicated the following were independently associated with HCV antibody positive： that older age （OR=1.02， 95%CI： 1.02‒1.03）， male （OR=1.70， 95%CI： 1.19‒2.42）， unmarried （OR=1.64， 95%CI： 1.44‒1.87）， divorced or widowed （OR=1.73， 95%CI： 1.48‒2.02）， Jingpo ethnicity （OR=1.39， 95%CI： 1.19‒1.63）， injection drug use （OR=15.46， 95%CI： 13.13‒18.12）， and HIV infection（OR=4.96， 95%CI：4.12‒5.99）. ConclusionThe prevalence of HCV antibody positive among drug users in Dehong Prefecture is high and increases with some fluctuations during 2014 to 2021， which highlights the need to develop interventions targeting this population.
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ObjectiveTo determine the characteristics， viral load and immunological status of HIV-infected persons and their spouses who became HIV-positive， and the reasons for HIV seroconversion in 55 HIV discordant couples in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunan Province. MethodsData on the 55 couples meeting the criteria of having a previously positive spouse were retrieved from the AIDS Integrated Prevention and Control Data Information System of the China Disease Control and Prevention Information System during 2015-2021. General socio-demographic information， age at diagnosis， exposure history， CD4+T lymphocyte count， and antiviral treatment were collected. Descriptive analysis and chi-square test were used to compare the distribution of pre-HIV-positive spouses and their HIV seroconverted spouses. ResultsA total of 55 spouses from HIV discordant couples had HIV seroconversion. Of them， 72.7% （40/55） of pre-HIV-positive spouses were husbands. The most recent CD4+T lymphocyte count in the pre-HIV-positive spouses was （328.31±246.27） cells·μL-1 at the time of diagnosis of their seroconverted spouses， of which 36.3% （20/55） had a CD4+T lymphocyte count of less than 200 cells·μL-1. Furthermore， of those pre-HIV-positive spouses with low CD4+T lymphocyte count， 45.0% （9/20） had an undetectable viral load， 15.0% （3/20） <400 copies·mL-1， and 25.0%（5/20） ≥400 copies·mL-1. Additionally， 16.4% （9/55） of the pre-HIV-positive spouses did not have a viral load test. The main reasons for HIV seroconversion among HIV-negative spouses in the discordant couples were poor condom use， poor compliance with antiviral therapy， and treatment discontinuation. ConclusionThe follow-up management of HIV discordant couples should be strengthened in Dehong Prefecture， especially the monitoring of viral load levels and immunological status of pre-HIV-positive spouses， to improve their compliance with antiviral therapy and reduce treatment discontinuation， which would effectively prevent and control HIV transmission between spouses.
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ObjectiveThis study aimed to investigate the HIV genotypic subtypes and molecular transmission clusters among men who have sex with men （MSM） with newly reported HIV infections in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunnan Province， China， between 2010 and 2019. The study aimed to identify potential high-risk transmitters and provide reference data for screening， management， and intervention of infection sources. MethodsPlasma samples from newly reported HIV-positive MSM individuals in Dehong Prefecture between 2010 and 2019 were collected. The viral pol gene fragments were amplified， sequenced， and genotyped. Genetic distances （GD） between pairwise sequences were analyzed and calculated. MEGA 7.0 and Gephi were used for phylogenetic and molecular transmission network analysis. ResultsA total of 159 newly reported HIV infections among MSM were included in the study， with successful genotyping of 100 cases. Nine HIV-1 subtypes were identified， with the most prevalent being CRF01_AE subtype （52%）， followed by CRF07_BC subtype （31%）， CRF55_01B subtype （10%）， and others （7%）. Cluster analysis revealed a total network access rate of 67%， forming three transmission clusters. CRF01_AE subtype formed two transmission clusters with 38 and 3 infected individuals， while CRF07_BC subtypes formed one transmission cluster with 26 infected individuals. The transmission network within the CRF01_AE clusters exhibited a more complex relationship. Significant differences in educational level were observed between the two main transmission clusters. ConclusionThe predominant HIV subtypes among newly reported MSM cases in Dehong Prefecture between 2010 and 2019 were CRF01_AE and CRF07_BC. Significant cultural differences are observed between the main transmission clusters. Continued monitoring of genotypic subtypes and targeted interventions within transmission clusters are warranted.
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ObjectiveTo understand the epidemiological characteristics and trends of sexually transmitted diseases （STDs） in Dehong Prefecture， Yunnan Province from 2010 to 2022， so as to provide a basis for the prevention and control of STDs in Dehong Prefecture. MethodsThe 2010‒2022 epidemic cards of STD cases in Dehong Prefecture were downloaded from the China Disease Control and Prevention Information System， and descriptive analysis of the incidence rate and demographic characteristics by disease type was conducted. The syphilis screening data of various populations in Dehong Prefecture between 2014 and 2022 were obtained from the National STD Control and Management Information System， and the syphilis positivity rates of key populations were calculated. ResultsA total of 18 225 STD cases were reported in Dehong Prefecture from 2010 to 2022， and the reported incidence rate increased from 17.1/105 in 2010 to 172.0/105 in 2022， showing an increasing trend （χ2trend=42.9， P<0.001）. The number of reported cases of gonorrhea， syphilis， condyloma acuminatum， genital chlamydia infection， and genital herpes were 7 801 （42.8%）， 4 563 （25.0%）， 3 462 （18.8%）， 1 660 （9.1%）， and 775 （4.3%）， respectively. The majority of the reported STD cases were males （12 336 cases， 67.7%）， young adults aged 15 to <45 years （15 839 cases， 87.2%）， and farmers （9 230 cases， 50.7%）. The elderly group aged 65 years and over accounted for 10.5% of syphilis cases. Among different types of key populations， the highest syphilis positivity rate was found among men who have sex with men （10.1%）， followed by STD clinic attendees （8.1%）， and the syphilis positivity rates among clandestine prostitutes， voluntary counseling and testing population， drug addicts， and drug rehabilitation center/re-education through labor center population were 2.2%， 1.6%， 1.4%， and 1.3%， respectively. ConclusionFrom 2010 to 2022， the STD epidemic in Dehong Prefecture showed a rapidly increasing trend， with a higher incidence of gonorrhea and syphilis， and a higher syphilis positivity rate among men who have sex with men， drug addicts， clandestine prostitutes， and STD clinic patients. In the future， publicity， education and behavioral interventions for these groups should be strengthened to reduce the prevalence and transmission of STDs.
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ObjectiveTo investigate the factors that influence the first CD4+T lymphocyte counts in newly reported HIV-infected cases aged 50 and above in Dehong Prefecture of Yunnan Province during 2016 to 2021， and to understand the patient immune status and disease progression so as to provide scientific basis for HIV prevention and control strategies in the future. MethodsData was collected from the national HIV/AIDS information system. Multivariate logistic regression was used for the analysis of factors affecting the first CD4+T lymphocyte counts. ResultsA total of 642 cases of HIV infection were newly reported， among them， 571 cases had CD4+T lymphocyte counts and 200 cases （35.03%） had CD4+T lymphocyte counts <200 cells·μL-1. Patients who were in the 50-59 age group， male， divorced or widowed， and less educated were more likely to have CD4+T lymphocyte counts <200 cells·μL-1. Compared with active testing consultants， forced reeducation through labor or drug rehabilitation cases were less likely to have CD4+T lymphocyte counts <200 cells·μL-1. ConclusionThere is no obvious upward trend in newly reported HIV infected persons aged 50 years and above in Dehong Prefecture during 2016 to 2021. However， the situation of CD4+T lymphocyte counts <200 cells·μL-1 is still serious. Attention should be paid to the key groups： male， Chinese nationality， farmers， Han nationality， married or divorced， junior high school education or below， and heterosexual transmission. It is necessary to strengthen the intervention in people aged 50 and above and improve the detection efficiency.
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Objective@#To obtain HIV incidence among injection drug users (IDU) and female sex workers (FSW) in Dehong Prefecture, Yunnan Province during 2009-2017.@*Methods@#We recruited drug users and female sex workers from all sentinel surveillance sites across Dehong Prefecture during 2009-2017. A total of 10 480 IDU and 18 126 FSW in Dehong Prefecture were recruited by fingerprint technique. Data about drug uses, commercial sexual behavior, sociodemographic characteristics was collected by structured questionnaire. HIV-positive patients who were long-term infected or with CD4+ T cell count was ≤200 were not included for further HIV incidence testing. Also, those who self-identified as on antiretroviral treatment (ART) or AIDS cases were also excluded. A total of 841 and 157 plasma specimens from IDU and FSW that met the inclusion criterion were finally included, respectively. Limiting antigen avidity enzyme immunoassay(LAg-Avidity EIA) were performed to calculate the HIV incidence among these two sub-populations.@*Results@#A total of 3 444 IDU were HIV-positive, among which 884 (25.7%) were Burmese with age of (30.4±7.7), and 2 560 were Chinese with age of (36.6±7.3). Among 228 HIV-positive FSW, 109 (47.8%) were Burmese with age of (27.1±6.3), 119 (52.5%) were Chinese with age of (29.9±11.1). For IDU, the estimated HIV incidence among Burmese in 2009-2010, 2011-2012, 2013-2014, 2015-2017 was 4.20% (95%CI: -0.55%-8.95%), 7.75% (95%CI: 2.95%-12.55%), 11.79% (95%CI: 5.38%-18.20%), 10.30% (95%CI: 5.67%-14.94%), respectively, while Chinese were 3.11% (95%CI: 1.59%-4.64%), 0.03% (95%CI: -0.03%-0.08%), 1.55% (95%CI: 0.54%-2.57%), 0.58% (95%CI: -0.06%-1.04%), respectively. In 2009-2011, 2012-2014, 2015-2017, estimated HIV incidence among Burmese FSW was 0.22% (95%CI: -0.21%-0.64%), 1.24%(95%CI: 0.15%-2.32%), 0.55%(95%CI: 0.01%-1.08%). Whereas, estimated HIV incidence among Chinese FSW was 0.62% (95%CI: 0.25%-0.98%), 0.11% (95%CI: -0.04%-0.26%), 0.22% (95%CI: 0-0.44%).@*Conclusion@#HIV incidences among Chinese IDU and FSW are on the downward trend, while Burmese IDU and FSW seem to be gaining momentum.
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Objective To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures,Yunnan province.Methods Data of survival of IDUs with AIDS in Dehong were collected from "Chinese National Comprehensive HIV/AIDS and Care Information System" in December,2014.Results There were 987 IDUs who should receive MMT,the majority of them were males (94.6％,934/987),aged 35-44 years (53.0％,523/987) and farmers (77.2％,762/987).Among the 987 IDUs,60.2％ (592/987) received no MMT.Multivariate logistic regression analysis showed that being female (OR=2.66,95％CI:1.21-5.87),in Jingpo ethnic group (OR=3.05,95％CI:1.97-4.71) were the major risk factors for receiving no MMT;not being farmers (OR=0.46,95％CI:0.31-0.70),in Dai ethnic group (OR=0.53,95％CI:0.36-0.79),diagnosed HIV infection history ≥ 10 years (OR=0.60,95％CI:0.45-0.81) were the major protective factors for receiving no MMT.The reasons for receiving no MMT included long distance journey (289,48.8％),fear of exposure (124,20.9％),poor daily medication compliance (59,10.0％),fear of side effects (47,7.9％),others (73,12.3％).Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high.Being female and farmer,in Jingpo ethnic group,low educational level,short diagnosed HIV infection history were influencing factors for receiving no MMT.The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.
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Objective@#To study the prevalence and correlates of unprotected sexual intercourse within HIV serodiscordant couples in Dehong prefecture, Yunnan Province, China, in 2014.@*Methods@#This study was based on the follow-up investigation of "the AIDS cohort of seronegative spouses of HIV-infected individuals in Dehong prefecture" in 2014. The 1 520 participants were HIV seronegative spouses from all five counties/cities of Dehong prefecture who voluntarily participated in the cohort. Inclusion criteria included: having a HIV-positive spouse; ≥16 years of age; having had sexual intercourse with spouse in the past year; and being a resident of Dehong prefecture. Information on HIV-positive spouses were also collected through the local AIDS epidemic database. Chi square analysis was performed to compare differences in the rates of unprotected sexual intercourse between participants with different characteristics and lifestyle choices. Multivariable logistic regression model analysis was performed to determine correlates with unprotected sexual intercourse.@*Results@#The 1 520 participants had a mean age of 38.7±9.4, compared with 39.7±8.9 for their HIV-positive spouses. Among the HIV-positive spouses, 77.8% (1 183/1 520) had been infected for more than 3 years, and 87.6% (1 332/1 520) had received antiretroviral therapy. The prevalence of unprotected sexual intercourse within serodiscordant couples over the past 12 months was 16.1% (244/1 520). The prevalence of unprotected sexual intercourse correlated with the level of education of HIV-negative spouses (illiterate vs. middle school and above, OR=1.58, P=0.044), the number of years since diagnosis of HIV-positive spouses (short vs. long, OR=1.6, P=0.006), antiretroviral therapy of HIV-positive spouses (no vs. yes, OR=2.78, P<0.001), the frequency of sexual intercourse per month (high vs. low, OR=1.66, P=0.019), and whether the couple had children (no vs. yes, OR=1.72, P=0.007).@*Conclusion@#The prevalence of unprotected sexual intercourse within serodiscordant couples in Dehong prefecture was relatively high in 2014. Factors found to correlate with the occurrence of unprotected sexual intercourse within these couples included illiteracy of HIV-negative spouses, short time since diagnosis of HIV-positive spouses and lack of antiretroviral therapy, high frequency of sexual intercourse and no children.
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Objective To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures,Yunnan province.Methods Data of survival of IDUs with AIDS in Dehong were collected from "Chinese National Comprehensive HIV/AIDS and Care Information System" in December,2014.Results There were 987 IDUs who should receive MMT,the majority of them were males (94.6％,934/987),aged 35-44 years (53.0％,523/987) and farmers (77.2％,762/987).Among the 987 IDUs,60.2％ (592/987) received no MMT.Multivariate logistic regression analysis showed that being female (OR=2.66,95％CI:1.21-5.87),in Jingpo ethnic group (OR=3.05,95％CI:1.97-4.71) were the major risk factors for receiving no MMT;not being farmers (OR=0.46,95％CI:0.31-0.70),in Dai ethnic group (OR=0.53,95％CI:0.36-0.79),diagnosed HIV infection history ≥ 10 years (OR=0.60,95％CI:0.45-0.81) were the major protective factors for receiving no MMT.The reasons for receiving no MMT included long distance journey (289,48.8％),fear of exposure (124,20.9％),poor daily medication compliance (59,10.0％),fear of side effects (47,7.9％),others (73,12.3％).Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high.Being female and farmer,in Jingpo ethnic group,low educational level,short diagnosed HIV infection history were influencing factors for receiving no MMT.The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.
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Objective To evaluate liver injury in patients with hepatitis C virus (HCV)/human immunodeficiency virus (HIV) coinfection in Dehong Prefecture,Yunnan Province.Methods A total of 4 784 HIV-infected patients were enrolled in this study.Baseline aspartate aminotransferase (AST),alanine aminotransferase (ALT) and AST-to-platelet ratio index (APRI) before HIV treatment were collected to analyze the relationship between HCV infection and liver injury.Data were analyzed by x2 test and nonparametric rank sum test when appropriate.Risk factors for liver injury were analyzed by multivariate Logistic regression.Results Totally 4 784 patients were included,of which 30.2％ (1 447/ 4 784) were anti-HCV positive,41.7％ (1 996/4 784) had liver dysfunction and 13.3％ (636/4 784) had liver cirrhosis.Prevalence of liver dysfunction (61.1％,821/1 343) and cirrhosis (24.1 ％,323/1 343) were significantly higher among anti-HCV-positive patients than anti-HCV-negative patients (31.5％,974/3 092,X2=341.223,P＜0.01;7.5％,231/3 092,X2=235.457,P＜0.01,respectively).Multivariate Logistic regression showed that anti-HCV-positive patients suffered significantly higher risk of liver dysfunction (OR=1.99,95％ CI:1.66-2.37) and liver cirrhosis (OR=2.41,95％CI:1.90-3.04).Conclusion Patients with HCV/HIV in Dehong Prefecture coinfection had a higher risk for liver injury.
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<p><b>OBJECTIVE</b>To study the incidence rate and risk factors of HIV infection among sero-negative spouses of people living with HIV/AIDS (HIV/AIDS) in Dehong prefecture, Yunnan province.</p><p><b>METHODS</b>A prospective cohort study was conducted from February 2009 to December 2014 in Dehong prefecture, Yunnan province. Questionnaire survey and HIV related tests were carried out once a year.</p><p><b>RESULTS</b>By the end of December 2014, 2 091 sero-negative spouses had been recruited, of whom 1 692 were followed-up for at least one time. RESULTS showed that 34 new HIV infections were identified within 5 494.52 person years of follow-up, for an overall incidence of 0.62 per 100 person years. HIV incidence rates appeared as 0.79 per 100 person years, 0.62 per 100 person years, 0.47 per 100 person years in 2009-2010, 2011-2012, 2013-2014, respectively. Data from the Cox proportional hazard regression model indicated that risk factors of HIV infection among sero-negative spouses of HIV/AIDS were: non-consistent condom use (HR=4.64, 95%CI: 1.89-11.40,P= 0.001), HIV/AIDS delayed antiviral retrovirus therapy (ART) for more than one year (HR=3.70, 95% CI: 1.44-9.49,P=0.007) after the HIV negative spouses were initially recruited, HIV/AIDS did not receive any ART (HR=3.62, 95% CI: 1.14-11.51,P=0.029).</p><p><b>CONCLUSIONS</b>The incidence of HIV infection among sero-negative spouses in Dehong prefecture was relatively low. Publicity on consistent condom use program should be emphasized among sero-negative spouses of HIV/AIDS, together with the timely provision of ART to those HIV/AIDS.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , China , Epidemiology , HIV Infections , Epidemiology , HIV Seronegativity , Incidence , Mass Screening , Prospective Studies , Risk Factors , Sexual Behavior , Spouses , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To understand that whether initiation of antiretroviral therapy (ART) would impact on the change and its reasons regarding the HIV-related high risk behaviors among HIV-positive clients who attending the methadone maintenance treatment (MMT).</p><p><b>METHODS</b>In-depth interviews were conducted among 34 MMT clients in Yunnan province who were under ART. The related contents would include information on general demographic charicteristics, HIV infection,MMT, number of sexual partners before and after ART, sexual behavior and frequency of condom use, drug use, needle sharing, changes in risk behaviors before and after the ART, reasons for high-risk behavior, of the clients.</p><p><b>RESULTS</b>The average age of the interviewees was 38.5 years, and most of them were male (70.6%). The clients under this study all admitted that the frequencies of unsafe sex and needle sharing did not increase after the ART initiation, with the main reasons as increasing HIV related awareness, the use of methadone, high accessibility of free condoms and access to clean needles etc. However, 12 of 34 reported being relapsed and 3 reported inconsistent condom use. The interaction of ART and dosage of methadone were connected to the episodes of relapsing and the ART optimism would result in inconsistent condom use.</p><p><b>CONCLUSION</b>No evidence supported that the ART initiation would increase the risk behaviors among the HIV-infected MMT clients. However, attention needs to be paid to the new challenges caused by high expectation of ART.</p>
Subject(s)
Adult , Female , Humans , Male , China , Epidemiology , Condoms , HIV Infections , Epidemiology , Methadone , Therapeutic Uses , Needle Sharing , Opiate Substitution Treatment , Qualitative Research , Risk-Taking , Safe Sex , Sexual Behavior , Sexual Partners , Substance-Related Disorders , Drug Therapy , Unsafe SexABSTRACT
<p><b>OBJECTIVE</b>To explore the impacts of antiretroviral treatment on drug use and high risk sexual behaviors among HIV-positive MMT clients.</p><p><b>METHODS</b>A cross-sectional study was conducted in patients undergoing ART (ART-experienced) and patients not undergoing ART (ART-naive) attending MMT in 5 clinics in Yunnan Honghe and Dehong prefectures in 2014. A questionnaire was designed to collect socio-demographic characteristics, ART and MMT information and sexual and drug use behaviors within 3 months before the investigation was conducted. Logistic regression analysis was conducted to identify the predictors for drug use and risky sexual behaviors.</p><p><b>RESULTS</b>A total of 328 cases were included in the analysis, among which 202 were ART-experienced and 126 were ART-naÏve. Among 152 respondents who were sexually active, 61 (40.1%) reported having unprotected sex (UPS) with their regular partners in the prior 3 months. A total of 57.6% (189/328) of the respondents used drugs in the prior 3 months. Multiple logistic regression analysis revealed that younger than 35 years old (OR = 3.57, 95% CI: 1.23-10.37), fertility desire (OR = 4.47, 95% CI: 1.49-13.41), partner being HIV-positive (OR = 4.62, 95% CI: 1.80-11.86), length of MMT attendance less than 5 years (OR = 2.92, 95% CI: 1.14-7.53), agreed that it was necessary to use condom no matter the viral load is high or low (OR = 0.14, 95% CI: 0.04-0.51) were protective factors of UPS in the prior 3 months. Multiple logistic regression analysis revealed that being Han (OR = 0.46, 95% CI: 0.24-0.89), feeling having good health status (OR = 0.39, 95% CI: 0.18-0.85), being enrolled in ART (OR = 0.32, 95% CI: 0.17-0.60) were protective factors for drug use in the prior three months, having contact with drug using friends (OR = 4.41, 95% CI: 2.31-8.29), having experience of missing an MMT dose (OR = 3.47, 95% CI: 1.92-6.29), and not satisfied with current MMT dose (OR = 13.92, 95% CI: 3.24-59.93) were risk factors for drug use during the prior three months.</p><p><b>CONCLUSION</b>ART was not associated with risky sexual behavior and drug use in the prior 3 months in this population. Future interventions should promote ART among this population, and provide education at the same time to prevent the emergence of cross infections and drug-resistant strains.</p>
Subject(s)
Humans , Anti-HIV Agents , China , Condoms , Cross-Sectional Studies , HIV Infections , HIV Seropositivity , Organometallic Compounds , Protective Factors , Risk Factors , Risk-Taking , Sexual Behavior , Sexual Partners , Substance-Related Disorders , Unsafe SexABSTRACT
<p><b>OBJECTIVE</b>To compare follow-up and administration of HIV-infected local Chinese and Burmese in Dehong prefecture of Yunnan province, for scientific development of prevention and control measures.</p><p><b>METHODS</b>14 270 HIV-infected local Chinese and 5 436 HIV-infected Burmese reported from 1989 to December 31, 2013 in Dehong prefecture were recruited as the subjects of study, comparing the differences of follow-up and management, CD4⁺ T lymphocyte count tests and antiretroviral therapy (ART) between the two groups.</p><p><b>RESULTS</b>The proportion of HIV-infected Burmese identified in Dehong prefecture was 27.6% (5 436/19 706) during 1989-2013. The number had been growing rapidly from 17.1% in 1989-2003, 12.4% in 2004 and 14.7% in 2005 to over 51.4% in 2012, hitting 59.4% in 2013 (trends χ² = 1 732.84, P < 0.000 1). The proportion of HIV-infected Burmese among case reports of various characteristics kept rising over the years. By the end of 2013, 8 095 HIV-infected local Dehong residents and 5 326 HIV-infected Burmese were still alive. 95.8% of them were under follow-up, 88.5% having CD4⁺ T lymphocyte count tests, and 78.3% under ART. Among the HIV-infected B urmese, only 19.2% of them were under follow-up, 13.0% having CD4⁺ T lymphocyte count tests, and 6.1% under ART, significantly lower than the local Dehong residents (P < 0.000 1).</p><p><b>CONCLUSION</b>The proportion of follow-up and administration, CD4⁺ T lymphocyte count tests, and ART of HIV-infected Burmese was low in Dehong prefecture, Yunnan province, which called for more effective follow-up and administration measures.</p>
Subject(s)
Humans , Anti-HIV Agents , Therapeutic Uses , Asian People , CD4 Lymphocyte Count , China , Follow-Up Studies , HIV Infections , Drug Therapy , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To understand the characteristics and retention situation of clients in extension clinic of methadone maintenance therapy.</p><p><b>METHODS</b>From December 20, 2010 to March 10, 2011, the system sampling method was used to get the cases. A total of 462 heroin addicts from 22 methadone maintenance therapy clinics and extension clinics located in Mangshi, Ruili, Longchuan, Yingjiang, Lianghe of Dehong prefecture, Yunnan province were interviewed, and the demographic characteristics, quality of life, urine testing results for morphine of the patients between the extension MMT clinic and standard MMT clinic were also collected and compared. A cohort study was conducted to analyze retention situation of the new clients with Kaplan Meier method during 9 months treatment.</p><p><b>RESULTS</b>Of the 462 cases, 239 cases were from standard MMT clinic, and 223 cases were from the extension MMT clinic. Among them, 117 cases were new research objects into the group during the investigation. Among the clients of extension MMT clinic, 96.7% (147/152) of them were males, 37.5% (57/152) were Dai nationality, and 61.2% (93/152) were married, 38.8% (59/152) with primary school education, 95.4% (145/152) lived with their family or relatives, 96.7% (147/152) could arrive at the clinic from their habitation within 15 minutes. The positive detection rates 72% (13/18), 71% (24/34), 58% (30/52), 29% (15/52), 14% (6/44), 14% (4/29), 15% (5/34), 17% (6/35), 6% (2/33), 16% (5/31) of urine-morphine testing among new clients of extension MMT clinics decreased as the period of treatment lengthened (χ(2) = 61.04, P < 0.05). The period of retention of the clients in extension MMT clinics was 175-days averagely, with an average retention 122 days of when withdrawing. The retention rates of the clients were 52% (37/71)and 61% (28/46) at 9th month of the extension MMT clinics and standard MMT clinics respectively. There was no difference in the retention rate between those of two types of clinics (χ(2) = 0.82, P = 0.37) .</p><p><b>CONCLUSION</b>Most of the clients in extension MMT clinics lived with their family or relatives, and spent less time on the way to the clinics. After 9 months methadone maintenance therapy, the quality of life of clients in extension clinics was improved while addiction among them decreased. The extension clinic was an effective strategy for retention in remote areas.</p>