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Objective@#To evaluate the effect of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM in Guangzhou, during 2010-2017, using a dynamic compartmental model.@*Methods@#A dynamic compartmental model was developed to describe the HIV situation among MSM in Guangzhou. This model was parameterized on data from published literature or surveillance programs from the Guangzhou CDC. The Matlab 7.0 software was used for coding and analysis on collected data. HIV prevalence was analyzed among MSM under the status quo data and estimated the impact by the "Internet Plus" AIDS prevention services project.@*Results@#HIV prevalence would have increased to 22.75% in 2017, and the total number of new HIV infections would have been 11 038, from 2010 to 2017, using the data status quo. Under the Guangzhou "Internet Plus" AIDS prevention services project, the prevalence of HIV among MSM from 2010 to 2017 was estimated to be 8.44%, 9.68%, 10.65%, 11.34%, 11.73%, 11.83%, 11.71% and 11.43% in Guangzhou, which were similar to the surveillance data. The total number of new infections in the past 8 years under the "Internet Plus" scenario was estimated to be 4 009. The "Internet Plus" program would have prevented 7 029 (63.68%) new infections during 2010-2017 as compared to the number, status quo.@*Conclusions@#The fitting result of dynamic compartmental model seemed more reasonable, which was applicable to predict HIV epidemic among MSM in Guangzhou, suggesting that the increase of HIV prevalence had been curbed since the "Internet Plus" project which was launched in 2010, and the "Interner Plus-based AIDS Comprehensive Prevention Service System" had achieved the purpose as planned, epidemiologically.
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Objective@#To evaluate the effectiveness of the "Internet Plus-based AIDS Comprehensive Prevention Service System" among men who have sex with men in Guangzhou.@*Methods@#Data through case-reporting and follow-up programs on MSM HIV/AIDS in Guangzhou was collected from the China Information System for Disease Control and Prevention, which including those from the referral and follow-up treatment compliance programs in 2008-2014 (pre-treatment) and 2017-2018 (post-treatment). According to the types of care services, three groups were set as: with "Internet Plus" service, with 'HIV counseling/testing service’ or with 'routine medical service’. General Estimating Equation (GEE) was used to analyze the follow up situation of HIV/AIDS cases, annually. Cox proportional hazard regression model was used to analyze the proportions of treatment referral, within the 30 days of diagnosis.@*Results@#Before the implementation of immediate treatment after HIV diagnosis, 90.6% (707/780) of the HIV/AIDS cases received the first follow up program including the CD4+ T cells counts (CD4) test service within 90 days of diagnosis, in the "Internet Plus-based HIV/AIDS care service" group presented 1.19 times (95%CI: 1.14-1.25) of the routine medical service group. The implementation of immediate treatment after HIV diagnosis, compared with the routine medical service group, the "Internet Plus" service group presented 1.71 times (95%CI: 1.03- 2.83) more treatment referrals within the 30 days of diagnosis, when the first testing CD4 was ≤200 cells/μl. Compared with the routine medical service group, the HIV counseling and testing service group showed 1.37 times (95%CI: 1.20-1.56) more of the treatment referrals within the 30 days of HIV diagnosis, after the first testing CD4 counts as >200 cells/μl.@*Conclusion@#Standardized care and follow-up service should be promoted as soon as the referral and treatment programs were set after the diagnosis was made, under the "Internet Plus-based AIDS Comprehensive Prevention Service System" for the MSM population, in Guangzhou.
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Objective@#To analyze the characteristics of levels related to the risk through self-evaluation system, among MSM users in Guangzhou, between 2015 and 2017.@*Methods@#Between 2015 and 2017, data was collected from the users of a self-evaluation system network related to HIV infection, based on the previous 'HIV health risk appraisal model’. Information on risk factors was collected to calculate the scores and levels of risks and to estimate the incidence of HIV. Taking the reference of R value on risks as (R=0.9-1.1) in general population. The ones with very low risk, with low risk, moderate risk, high risk and very high risk were set as R≤0.5, 0.5<R≤0.9, 0.9<R≤1.1, 1.1< R≤2.0 and R>2.0, respectively. The scores of modifiable risk factors were compared with different subgroups of MSM.@*Results@#A total of 4 601 MSM were involved in this study, with the following features presented as: aged 16-64 (28.38±7.11) years, proportions of residence from Guangzhou, Guangdong province or other provinces as 38.6%(1 776/4 601)、35.4%(1 629/4 601) and 26.0%(1 197/4 601), 59.6%(2 742/4 601) received bachelor or above degrees. 81.3%(3 741/4 601) of them claimed as having homosexual orientation. R values of risk level on very low risk, low risk level, moderate risk, high risk and very high risk appeared as 12.9%(594/4 601), 50.9%(2 342/4 601), 17.0%(783/4 601), 14.8%(682/4 601) and 4.3%(200/4 601), respectively. Scores of modifiable risk factors decreased year by year (P<0.05), among MSM in this study. In either of the groups that experiencing insertive or receptive sex, the ones with heterosexual orientation presented the highest scores of modifiable risk factors (P<0.05).@*Conclusions@#The risk levels on HIV infections called for special attention among the users of the self-evaluation network system. Among the MSM that carrying either insertive or receptive sex role, the ones with heterosexual orientation had the highest risk levels and scores of modifiable risk factors in Guangzhou. Further study should be explored to better understand the causes of related risks.
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Objective@#This article was to evaluate the applicability and feasibility of "Lingnanzhun" -an "Internet Plus-based HIV Self-testing Tool" targeting MSM in Guangzhou. Hopefully, the results could be used to improve the existing HIV testing services and to support the implementation and scale-up of HIV self-testing programs.@*Methods@#Data were collected from a survey on HIV testing preferences among the Internet-using MSM in April to June, 2015. Univariate and multivariate logistic regression analysis were applied to identify factors associated with the use of HIV self-testing service provided by Lingnanzhun. Information related to the users of Lingnanzhun during September 2014 and December 2018 was also collected.@*Results@#769 MSM were recruited as participants. Of them, age distribution was 16-77(28.6±6.8) years old, 88.3%(679/769) were unmarried, 42.2%(325/769) were registered residents of Guangzhou, 82.1%(631/769) had university or college education. Among them, 195 (25.4%) used the HIV self- testing program of Lingnanzhun while 574 (74.6%) using the clinic service. Compared with the clinic service users, the Lingnanzhun users showed the following characteristics: longer experience in the MSM community ≥10 years (32.8% vs. 20.9%, 64/195 vs. 120/574); having male casual sexual partners ≥2 (42.1% vs. 29.6%, 82/195 vs. 170/574); having group sex (6.2% vs. 2.6%, 12/195 vs. 15/574) and having commercial sex with men (13.8% vs. 3.0%, 27/195 vs. 17/574). Data from the Lingnanzhun users showed that a total of 3 000 users had practised 5 038 times of self HIV-testings. 11.4% (343/3 000) of the Lingnanzhun users had never been tested.@*Conclusions@#It was applicable and feasible to provide Internet-based HIV self-testing service to MSM as a significant complement to the traditional facility-based HIV testing services. It was also useful in accessing those who were having higher risk or had never received HIV testing so as to increase the testing uptake and the frequency.
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Objective@#To analyze the characteristics of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM who frequently using the Internet in Guangzhou.@*Methods@#An online survey was conducted among MSM who were recruited through gay-website portals between August and September, 2018 in Guangzhou, to collect information regarding the use of and attitudes on the "Interner Plus-based AIDS Comprehensive Prevention Service System" . Logistic regression was used to explore the association between the use of Internet intervention tools and related behavioral characteristics. Information on the awareness of AIDS, HIV testing, and condomless anal sex behavior were compared between the core or non-core services users.@*Results@#A total of 777 Internet-based MSM were recruited as participants including 638 men (82.1%) as core service users. MSM were satisfied in using the the "Interner Plus-based AIDS Comprehensive Prevention Service System" while more than 80.0% of the users felt that the tools were helpful in: increasing the HIV awareness, promoting test uptake, and reducing those related risk behavior. Comparing with those who did not use the tools, the users showed higher rates in practising condomless anal intercourse (1.50-1.86 times), commercial sex with men (11.60-21.21 times), and unprotected vaginal intercourse (13.62-20.67 times), in the last 6 months. Proportions of core service users appeared as: [96.6% vs. 74.8%, aOR (95%CI): 8.80 (4.85-15.97)] on HIV testing, [56.4% vs. 22.3%, aOR (95%CI): 4.54 (2.94-7.02)] on regular HIV testing and [86.2% vs. 80.6%, aOR (95%CI): 1.75 (1.06-2.89)] on awareness of HIV knowledge respectively, which were all significantly higher than the non-core service users.@*Conclusions@#The frequent Internet using MSM in Guangzhou claimed to have had high acceptance and satisfaction on the local Internet HIV intervention service tools. The "Internet Plus-based AIDS Comprehensive Prevention Service System" had effectively reached the high-risk subgroups of MSM, increasing the awareness on related risk and promoting testing on HIV.
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Objective To study the characteristics of social relations and relative factors among MSM in Guangzhou.Methods Data was collected through a cross-sectional study in Guangzhou from November 2016 to May 2017.Sample size was estimated and participants were recruited from the voluntary counseling and testing services (VCT) which were set for MSM population,by nongovernmental organizations (NGOs) and the Centers for Disease Control and Prevention (CDC).Social ties and demographic characteristics of the respondents and their sexual partners were analyzed through both Chi square test and generalized estimating equations (GEE).Results A total of 1 073 MSM,together with their nominated 4 301 partners were successfully recruited and involved in this study.Age (OR=1.2,P=0.01) and non-internet based intercourse (OR=1.65,P＜0.01) were easy to form close relation with strong ties.Compared with MSM traditional venues (chess and cards room,tea room bathhouse,club),general public venue (bars,KTV,parks,shopping malls,schools,restaurants) (OR=1.46-3.12,P＜0.01) showed close relation with strong ties.Our finding showed that MSM at the age of 18-25 preferred to build weak ties with the older MSM,while the 26-30-year-olds and 31-40-year-olds prefer to establish weak ties with younger partners but the 41-50-year-olds preferred to develop weak ties with one that were ten years younger.Conclusions Clusters were noticed in the MSM populations when grouping and making friends with ones at different age.Characteristics regarding the relationship between sexual partners in choosing venues and ways of dating were different.Targeted intervention programs need to be explored innovatively.
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Objective To understand the characteristics and dynamic of HIV-1 subtype distribution in men who have sex with men (MSM) in Guangzhou between 2008 and 2015.Methods HIV-1 RNAs were extracted from serum samples of the individuals newly diagnosed with HIV-1 infection among MSM living in Guangzhou between 2008 and 2015.The pol gene segments of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and were sequenced.Subsequently,the phylogenetic tree was reconstructed using pol sequences of samples and references together and the subtype of HIV-1 was determined.The distributions of HIV-1 subtypes detected in MSM with different demographic characteristics in different years were compared.Results A total of 2 210 pol gene segments were successfully obtained from 2 473 serum samples of the MSM.The average age of 2 210 MSM was 30.19 years with standard deviation of 8.22 years,the unmarried MSM and those in Han ethnic group accounted for 73.39％ and 90.81％,respectively.The proportion of subtype CRF07_BC (38.10％) was highest,followed by CRF01_AE (34.84％),CRF55_01B (14.62％),B (6.06％),URFs (3.58％),CRF59_01B (2.17％) and other subtypes (0.63％).The annual proportions of subtype B (P=0.000,99％CI:0.000-0.000),CRF07_BC (x2=14.965,P=0.036),CRF55_01B (x2=18.161,P=0.011) and URFs (P=0.001,99％ CI:0.000-0.001) were significantly different.The proportion of subtype B showed a gradual decrease from 14.08％ to 4.33％ (P=0.000,99％ CI:0.000-0.000),while the proportion of URFs rapidly increased from 0％ to 6.40％ (P=0.000,99％CI:0.000-0.000).The rate of URFs was significantly higher in farmers and migrant workers than in other groups (P=0.017,99％ CI:0.014-0.020) and the rate of URFs was higher in individuals who had multi sexual partners (x2=5.733,P=0.017).Conclusions CRF07_BC and CRF01_AE were the predominant HIV-1 subtypes and multiple subtypes co-circulated among MSM in Guangzhou between 2008 and 2015.The recombinations of HIV-1 continue to occur in MSM.Strengthening behavioral intervention for farmers,migrant workers and individuals who have multi sexual partners has the important epidemiological significance against the emerging and circulating of the novel recombinant virus among MSM in Guangzhou.
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Objective To study the characteristics of social relations and relative factors among MSM in Guangzhou.Methods Data was collected through a cross-sectional study in Guangzhou from November 2016 to May 2017.Sample size was estimated and participants were recruited from the voluntary counseling and testing services (VCT) which were set for MSM population,by nongovernmental organizations (NGOs) and the Centers for Disease Control and Prevention (CDC).Social ties and demographic characteristics of the respondents and their sexual partners were analyzed through both Chi square test and generalized estimating equations (GEE).Results A total of 1 073 MSM,together with their nominated 4 301 partners were successfully recruited and involved in this study.Age (OR=1.2,P=0.01) and non-internet based intercourse (OR=1.65,P＜0.01) were easy to form close relation with strong ties.Compared with MSM traditional venues (chess and cards room,tea room bathhouse,club),general public venue (bars,KTV,parks,shopping malls,schools,restaurants) (OR=1.46-3.12,P＜0.01) showed close relation with strong ties.Our finding showed that MSM at the age of 18-25 preferred to build weak ties with the older MSM,while the 26-30-year-olds and 31-40-year-olds prefer to establish weak ties with younger partners but the 41-50-year-olds preferred to develop weak ties with one that were ten years younger.Conclusions Clusters were noticed in the MSM populations when grouping and making friends with ones at different age.Characteristics regarding the relationship between sexual partners in choosing venues and ways of dating were different.Targeted intervention programs need to be explored innovatively.
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Objective To understand the characteristics and dynamic of HIV-1 subtype distribution in men who have sex with men (MSM) in Guangzhou between 2008 and 2015.Methods HIV-1 RNAs were extracted from serum samples of the individuals newly diagnosed with HIV-1 infection among MSM living in Guangzhou between 2008 and 2015.The pol gene segments of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and were sequenced.Subsequently,the phylogenetic tree was reconstructed using pol sequences of samples and references together and the subtype of HIV-1 was determined.The distributions of HIV-1 subtypes detected in MSM with different demographic characteristics in different years were compared.Results A total of 2 210 pol gene segments were successfully obtained from 2 473 serum samples of the MSM.The average age of 2 210 MSM was 30.19 years with standard deviation of 8.22 years,the unmarried MSM and those in Han ethnic group accounted for 73.39％ and 90.81％,respectively.The proportion of subtype CRF07_BC (38.10％) was highest,followed by CRF01_AE (34.84％),CRF55_01B (14.62％),B (6.06％),URFs (3.58％),CRF59_01B (2.17％) and other subtypes (0.63％).The annual proportions of subtype B (P=0.000,99％CI:0.000-0.000),CRF07_BC (x2=14.965,P=0.036),CRF55_01B (x2=18.161,P=0.011) and URFs (P=0.001,99％ CI:0.000-0.001) were significantly different.The proportion of subtype B showed a gradual decrease from 14.08％ to 4.33％ (P=0.000,99％ CI:0.000-0.000),while the proportion of URFs rapidly increased from 0％ to 6.40％ (P=0.000,99％CI:0.000-0.000).The rate of URFs was significantly higher in farmers and migrant workers than in other groups (P=0.017,99％ CI:0.014-0.020) and the rate of URFs was higher in individuals who had multi sexual partners (x2=5.733,P=0.017).Conclusions CRF07_BC and CRF01_AE were the predominant HIV-1 subtypes and multiple subtypes co-circulated among MSM in Guangzhou between 2008 and 2015.The recombinations of HIV-1 continue to occur in MSM.Strengthening behavioral intervention for farmers,migrant workers and individuals who have multi sexual partners has the important epidemiological significance against the emerging and circulating of the novel recombinant virus among MSM in Guangzhou.
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Objective To understand the human immunodeficiency virus (HIV) infection status and syphilis prevalence among men who have sex with men (MSM) receiving voluntary counseling and testing appointed through a web-based registering system and related factors.Methods The MSM receiving web appointed HIV counseling and testing from 2011 to 2012 in Guangzhou were recruited and a questionnaire survey was conduct among them to obtain the information about their demographic characteristics and sexual behavior.Binary and multivariate logistic regression model were used to identify the factors associated with HIV infection or syphilis prevalence.Results A total of 4 904 MSM were enrolled in the study,the average age of the MSM was (28.77 ± 7.24) years,and 70.3％ of them had high education level;the unmarried MSM accounted for 72.7％.The HIV infection rate and syphilis prevalence were 8.7％ and 4.4％ respectively.The co-infection rate of HIV and Treponema pallidum was 1.2％ (59/4 904).About one in three MSM did not use condom at latest homosexual behavior,43.5％ did not use condoms at each homosexual behavior in the past three months.Lower education level,occupation (worker or farmer),non-consistent condom use at each sex with men in the past three months,receiving HIV test or not and Treponema pallidum infection were associated with HIV infection.Age ≥40 years,lower education level,multi male sex partners in the past three months and HIV infection were associated with Treponema pallidum infection.Conclusion MSM receiving web appointed HIV counseling and testing had high prevalence of risk behaviors and high HIV infection rate,but had low previous HIV testing rate.It is necessary to strengthen the promotion of HIV test through web based appointment and conduct target behavior intervention in older MSM with lower education level.
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Objective To analyze the influencing factors on AIDS-related deaths among HIV/AIDS patients in Guangzhou,Guangdong province.Methods A retrospective cohort was formed,based on available data of HIV/AIDS patients between 1991 and 2013 in Guangzhou,that were gathered from the Chinese AIDS Prevention and Control Information System.Cox proportional hazard model was used to identify the influencing factors for AIDS-related deaths.Results Data showed that factors as:existence of full-bloom AIDS when HIV infection was diagnosed (HR =2.717,95％ CI:2.039-3.621),diagnose of AIDS was made in the hospitals (HR=1.516,95％ CI:1.159-1.981),never received no CD4 count testing (HR=4.866,95％CI:3.674-6.444),no drugs were provided to those who met the criteria for treatment (HR=12.213,95％CI:8.467-17.616),and patients at aged ≥40 years when HIV infection was diagnosed etc.,were related to the risk for AIDS deaths.The risk of AIDS-related death was also high in those who did not meet the treatment criteria or receiving no treatment,when compared to those who had received the antiviral treatment (HR=1.936,95％ CI:1.145-3.272).Conclusion Factors as:earlier diagnosis of HIV/AIDS cases,provision of CD4 count testing and antiviral treatment to more cases etc,could decrease the risk for AIDS-related deaths and improve the survival rate on HIV/AIDS cases.