Epidemiologic study on STD/HIV infections among tin mining workers in Gejiu, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To estimate human immunodeficiency virus (HIV)/sexually transmitted diseases (STDs) related knowledge, the prevalence and risk factors for HIV/STDs among tin miners in Gejiu, Yunnan Province.</p><p><b>METHODS</b>A cross-sectional study was conducted in tin miners working at 5 mining regions from March to June 2006 in Gejiu City, Yunnan Province. A total of 1796 miners were enrolled in the study, and a standardized questionnaire was administered probing socio-demographic factors, knowledge of HIV/STDs and sexual behavior. 7 ml-volume venous blood and 15 ml urine specimens were collected for HIV/STDs testing.</p><p><b>RESULTS</b>Twelve participants [0.7%] (12/1760) were identified HIV positive. While, the positive proportions for syphilis, herpes simplex virus type-2 (HSV-2), Neisseria gonorrhea and Chlamydia trachoma were 1.8% (31/1760), 9.6% (169/1760), 0.8% (14/1773), 4.8% (85/1773), respectively. The total prevalence of STDs was 14.9% (264/1776). Factors associated with HIV infection were illegal drug use (adjusted OR = 17.8; 95% CI: 4.0 - 78.8), frequencies of visiting female sex workers in the past twelve months (adjusted OR = 8.7; 95% CI: 1.9 - 39.0), tattoos (adjusted OR = 6.6; 95% CI: 1.8 - 24.0), surgical operation experiences (adjusted OR = 6.0; 95% CI: 1.6 - 22.5) and toothbrush sharing (adjusted OR = 5.6; 95% CI: 1.0 - 31.3). Factors associated with STDs infection were race (adjusted OR = 2.0; 95% CI: 1.5 - 2.7), age (adjusted OR = 1.7; 95% CI: 1.0 - 2.9), illegal drug use (adjusted OR = 2.3; 95% CI: 1.0 - 5.2), living with spouses (adjusted OR = 1.4; 95% CI: 1.1 - 1.9) and visiting female sex workers (adjusted OR = 1.9; 95% CI: 1.4 - 2.6). Only 4.1% (49/1201) of respondents aware the correct transmission routes of HIV. 21.6% (339/1569) of the miners who had previous sexual experience self-reported visiting female sex workers.</p><p><b>CONCLUSION</b>HIV and other STDs are highly prevalent amongst miners in this region. In addition, the awareness of HIV/STDs is low and multiple routes of HIV transmission, such as heterosexual intercourse and IDU, were also observed in these study subject. HIV/STDs interventions should therefore be reinforced among the miners in this region.</p>

Study on the association between vaginal douching and sexually transmitted diseases among female sex workers in a county of Yunnan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the epidemic characteristics of vaginal douching, human immunodeficiency virus (HIV) and other sexually transmitted diseases(STD) among female sex workers (FSWs) in Yunnan province.</p><p><b>METHODS</b>FSWs were recruited to be investigated on their demographic data, drug abuse and sexual behavior, HIV/AIDS knowledge and procreation health status. Venous blood were collected to test for HIV, herpes simplex virus 2 (HSV-2) and syphilis while urine specimen was for morphine, cervical secretion for Gonorrhoea and Chlamydia trachomatis, and vaginal secretion for Trichomonas.</p><p><b>RESULTS</b>A total number of 833 blood specimen were collected, in which 84 specimen were confirmed to be HIV positive with a prevalence rate of 10.1%. The prevalence rates of syphilis and HSV-2 were 8.2% and 68.4% respectively. 832 vaginal and cervical secretion specimen were collected with the prevalence rates of Gonorrhoea, Chlamydia trachomatis and Trichomonas were 11.5%, 28.2% and 11.9% respectively. In multivariate logistic analysis, the factors associated with vaginal douching were: being Han nationality, locations of sex work at middle/high level, ever heard of HIV/AIDS, emerged hypogastric pain last year, the number of sex work location > or =4.</p><p><b>CONCLUSION</b>Vaginal douching was shown a risk factor for HIV and some STD.</p>

Comprehensive evaluation on the potential risk for HIV infection in 12 villages with a history of former paid blood donation / 中华流行病学杂志

<p><b>OBJECTIVE</b>To learn the potential risk for human immunodeficiency virus (HIV) infection in 12 villages with a history of former paid blood donation, and to provide different measures for HIV/AIDS prevention and control.</p><p><b>METHODS</b>Seven indexes were selected, including HIV sero-prevalence rates, hepatitis C virus (HCV) sero-prevalence rates, HIV/AIDS KAB (knowledge, attitude and belief), proportion of paid blood/plasma donation, risks on related behavioral information on sex and HIV/AIDS infections. Rank Sum Ratio (RSR) was performed to synthetically evaluate the potential risk of HIV infection in those 12 selected villages.</p><p><b>RESULTS</b>According to the results of evaluation by 18 experts, weight coefficient of HIV sero-prevalence rate was the highest (0.28), and HIV/AIDS KAB the lowest (0.09) among the seven indexes. The results of comprehensive evaluation with RSR showed that the villages coded 01 and 02 belonged to higher level of potential risk of HIV infection, villages 09, 12, 05, 10 and 03 were at medium level while villages 04, 06, 08, 07 and 11 were at low level.</p><p><b>CONCLUSION</b>The level of potential risk for HIV infection was different in 12 villages with a history of former paid blood donation. Different measures of HIV/AIDS prevision and control should be performed according to the potential risk level for HIV infection of the 12 villages.</p>

A cross-sectional survey on human immunodeficiency virus infection in a former commercial blood donating community, Shanxi Province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To determine the sero-prevalence of and the risk factors for human immunodeficiency virus infection among residents in a former commercial blood donating community, Shanxi Province.</p><p><b>METHODS</b>A community-based cross-sectional survey was conducted among all residents aged 18 - 64 years in 4 villages in a rural county of Shanxi Province. A standardized structured questionnaire was administered to collect socio-demographic, medical and risk behavioral information. Venous blood was collected for HIV antibody testing. Generalized estimating equation with logistic regression was used to analyze the risk factors for HIV infection. Population attributable fraction was used to evaluate the role of public health in the risk factors for the incidence of HIV.</p><p><b>RESULTS</b>A total of 3062 villagers participated in the study and provided their blood samples for HIV antibody testing. 29.5% of the participants had a history of selling blood and/or plasma. Among the subgroup of former blood donors (FBDs), 71.9% sold whole blood only, 4.1% sold plasma only and 24.0% sold both. Forty HIV infected persons were identified in the four villages. HIV prevalence was 1.3%, overall, 4.1% in FBDs and 0.1% in non-FBDs in the community. Amongst the subgroup of FBDs, HIV prevalence was 1.5% for whole blood only, 21.6% for plasma only and 8.8% for both. Univariate analysis showed that village of residence, education, marital status, gender, plasma/blood donation were statistically associated with HIV seropositivity in the villagers. Other variables, such as gender, age, occupation, number of sexual partners, drug use, histories of tooth extraction, acupuncture, surgical operation and medical injection were not found to be statistically associated with HIV seropositivity. Multivariate analysis found that selling whole blood only (adjusted OR = 13.25, 95% CI: 3.02 - 58.25) and selling plasma or both (adjusted OR = 87.85, 95% CI: 22.22 - 347.27) were significantly associated with HIV seropositivity, and the additive population attributable fraction (PAF) was 89.8%. Villagers in village 03 were more likely to be HIV positive than those in village 04 (adjusted OR = 12.26, 95% CI: 1.46 - 103.00).</p><p><b>CONCLUSION</b>At present, HIV epidemic in the former commercial blood donating community has a low prevalence in Shanxi Province and the majority of HIV infections should be related to the blood and plasma donation. This study reveals the existence of HIV second-generation transmission from the infected blood donors to the general population. However, HIV had not been evidently extended from the blood/plasma donors to general population.</p>

Epidemiologic study on human immunodeficiency virus infection among children in a former paid plasma donating community in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Illegal plasma collecting activities in mid 1990s caused a large number of human immunodeficiency virus (HIV) infections in rural areas of central-eastern China. Although most of these activities have been stopped, there were few reports on secondary transmission from infected former plasma donors to their spouses and from infected mothers to their children. This study was to determine the extent of HIV infections among young children in a rural community with a large proportion of plasma donors.</p><p><b>METHODS</b>A survey was conducted among children aged under 7 years in a former plasma donating community in September 2000: finger blood was collected for HIV antibody testing. Another survey was repeated among children aged under 8 years and their families in the same community in April 2001: urine samples were collected for HIV testing. HIV positive children and samples of HIV negative children, whose mothers were positive based on 2001 survey, were followed up until September 2002 to investigate HIV seroconversion, disease progression and HIV strain analysis. Questionnaires were administered to collect information on children's delivery, breast feeding, medical history and their parents' commercial blood donation history and HIV status.</p><p><b>RESULTS</b>Among 169 children surveyed in 2000, 10 (5.9%) were HIV positive. Of 224 children, 11 were positive in 2001. The overall prevalence rate in the two surveys was 5.0% (17/337) when counting 56 repeated children only once. Of children born to HIV positive mothers, 28.9% were infected. A seroconversion rate of 2.5 per 100 child-years was observed by following up 28 HIV negative children. No statistically significant associations were found between children's HIV infection and their histories of blood transfusion, surgery, immunization injection or medical injections. All infections were HIV-1 subtype B' strain, the average dispersion rate is 7.4%. DNA sequence analysis showed a close relationship between the seroconverted children and their infected mothers.</p><p><b>CONCLUSIONS</b>HIV vertical transmissions in the rural former plasma donating community was significant. Intervention measures should be taken to prevent further transmission. It was estimated that the HIV spread in this community occurred in 1994 or even earlier. Many infected people are developing AIDS now: treatment and care are urgently needed for these sick people.</p>

A cross-sectional survey on hepatitis C virus infection among residents aged 18-59 years in a former commercial blood donating community, Shanxi Province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine sero-prevalence of and risk factors for hepatitis C virus infection (HCV) among residents aged 18-59 years in a former commercial blood donating community, Shanxi province.</p><p><b>METHODS</b>A community-based cross-sectional survey was conducted among 660 randomly selected residents aged 18-59 years from 12 villages in a rural county of Shanxi province. Structured questionnaire was administered to collect socio-demographic,medical and risk behavioral information. 7 ml-volume venous blood was collected for HCV antibody testing.</p><p><b>RESULTS</b>The overall HCV sero-prevalence rates were 8.2% and 27.7% among former commercial blood donors in the community. Data from multivariate logistic regression analysis showed that people ever selling blood (adjusted OR = 14.28, 95% CI: 6.83-29.87) and receiving blood transfusion (adjusted OR = 8.66,95% CI: 2.31-32.47) were the primary risk factors for HCV infection. Subgroup analysis in blood donors explored that ever selling plasma (adjusted OR = 8.56,95% CI: 2.87-25.54) was the risk factor for HCV infection. Villagers who stopped selling blood in 1994 and thereafter were less likely to be HCV positive than those stopping selling blood before 1994 (adjusted OR = 0.32,95% CI: 0.11-0.93). Female donors had a lower risk than male ones (adjusted OR = 0.28, 95% CI: 0.10-0.83).</p><p><b>CONCLUSION</b>A HCV epidemic was once existing in rural community residents in the province that former commercial blood/plasma donation was the main reason for HCV epidemic in the community. It is urgent to make efficient measures to prevent HCV secondary transmission and provide patients with care and treatment to this community.</p>

An epidemiological study on sexual transmission of human immunodeficiency virus among pre-marital group in Yining city, Xinjiang / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the human immunodeficiency virus (HIV) status through heterosexual transmission in Yining city and to provide information on effective intervention measures.</p><p><b>METHODS</b>Cohort of HIV sero-discordant couples identified from 1997 to 2000 was formed. Proportional risk model was used to analyze the time of HIV sero-conversion and the related factors. All the recruiters were under informed consent.</p><p><b>RESULTS</b>Through following on 22 sero-discordant couples, we found that the incidence density (ID) of HIV sero-conversion was 32.49/100 person-year (PY) with 33.74/100 PY for women. In the proportional hazard model, the course of sero-conversion was only 2.43 years and the frequency of sexual contact was statistically significant (>or= 3 times/week vs. < 3 time/week: RR = 1.984, 95% CI: 1.045 - 3.767), indicating this factor was related to the hazard of HIV sero-conversion. However, the viral load of HIV infections has no such effect on HIV sero-conversion of their spouses. In addition, the ratio of CD4(+)/CD8(+) was lower in spouses of HIV sero-conversion than that in spouses of HIV non-sero conversion (t test: t = 4.77, P < 0.01).</p><p><b>CONCLUSION</b>In order to control HIV transmission among general population, we suggested that HIV/AIDS counseling and testing be developed for pre-marital people in the region with high HIV prevalence.</p>