Study on the risk of HIV transmission by heterosexual contact and the correlation factors / 中南大学学报(医学版)

OBJECTIVE@#To understand the associated factors on human immunodeficiency virus (HIV) transmission via heterosexual contact and to provide evidence for decision-maker for prevention of HIV.
@*METHODS@#Questionnaire survey was conducted in 250 HIV-positive persons to understand their socio-demographic characteristics and sexual behavior. Meanwhile, 431 persons who had heterosexual contact with the HIV carriers were traced to their HIV infection status. The factors associated with continued HIV transmission were reviewed by case-control analysis.
@*RESULTS@#Among the 432 persons, 59 were HIV-positive because of heterosexual contact. The secondary attack rate and the growth rate was 13.7% (59/431) and 0.236 (59/250), respectively. The factors associated with the spread of HIV included: the degree of knowledge on HIV/AIDS, psychological reflection after infection, the condition for condom usage among spouses, and regular sexual partners or non regular sexual partners.
@*CONCLUSION@#The secondary attack rate and the growth rate of HIV transmission by heterosexual contact are high. Improvement of the knowledge about HIV/AIDS prevention and control, enhancement of psychological education and promotion of condom usage can reduce the risk for continued HIV transmission.

Characteristics of HIV's sexual behavior and their effect on the secondary transmission rate / 中南大学学报(医学版)

OBJECTIVE@#To analyze the sexual behavior characteristics of the sexually transmitted HIV-positive people and to estimate the secondary transmission rate.
@*METHODS@#Field investigation and literature review were conducted among sexually transmitted HIV-positive people to collect general information during the last 6 months before notification of HIV infection. A mathematical model was used to estimate the secondary transmission rate.
@*RESULTS@#A total of 769 HIV-positive people were recruited for the study, 186 of them were women, 286 were men who have sex with women (MSW), 242 were men who have sex with men (MSM) and 55 were men who have sex with men and women (MSMW). During 6 months, the average sex partner among these 4 groups were 2.29, 1.61, 3.32 and 4.10, respectively; the sexual behavior frequency were 26.03, 20.97, 14.77 and 25.51, respectively; the rates of non-use of condom were 74.14%, 73.53%, 59.60% and 72.06%, respectively; the secondary transmission rate were 0.0095, 0.0151, 0.1759 and 0.1985, respectively. Under constant conditions of other factors, the secondary transmission rates decreased by 30.13%-82.00%, 23.00%-49.51%, and 16.10%-19.09%, respectively, if there was a reduction in 1 sex partner, 1 time/month for the sexual frequency and 20% of rate for non-use of condom.
@*CONCLUSION@#The HIV secondary transmission from MSMW HIV-positive people to general population was the highest. Change in sexual behavior of the HIV-positive people can decrease the HIV secondary transmission rate significantly.

A study on the risk and its determinants of HIV transmission by syringe sharing among HIV-positive drug users / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the risks and associated factors of HIV transmission by sharing syringes among HIV-positive drug users.</p><p><b>METHOD</b>The survey was conducted among HIV-positive injecting drug users (IDUs-HIV+) who received HIV counseling, testing and treatment in Changsha city Infectious Disease Hospital and Hengyang city No.3 People's Hospital from July 2012 to May 2013 to understand their socio-demographic characteristics, HIV prevalence and syringe sharing. A total of 503 IDUs-HIV+ were involved in and provided the contact list of 2 460 drug users who had the syringe sharing experience over one month with IDUs-HIV+. 420 IDUs-HIV+ among 503 were defined as infection sources due to sharing syringe with at least one drug user. Among them, 234 HIV-negative persons were in control group, and 186 HIV-positive were in cased group. A total of 1 220 drug users were followed up among 2 460 and defined as vulnerable population. The HIV transmission rate was calculated based on the HIV prevalence among vulnerable population. Based on the result of HIV transmission to vulnerable population from 420 infection sources, case-control study and the multivariate logistic regression analysis were adopted to explore the associated factors of HIV transmission among IDUs-HIV+.</p><p><b>RESULTS</b>As the sources of HIV transmission, 420 IDUs-HIV+ had an average duration of (4.5 ± 1.2) years for drug use. As a susceptible population, 1 220 drug users sharing syringes with the 420 IDUs-HIV+ had an average duration of (1.1 ± 0.5) years for drug use. There were 238 HIV-positive persons among 1 220 vulnerable drug users, with a transmission rate of 0.57. In the case-control study, the proportion of male subjects was 87.1% (162/186) in the case group, which was higher than that in the control group (77.8%, 182/234). The proportion of subjects who received support after knowing their HIV infection status was 51.1% (95/186) in the case group, which was lower than that in the control group (79.5%, 186/234). The proportion of subjects sharing syringes every time of using drugs was 47.8% (89/186) in the case group, which was higher than that in the control group (36.8%, 86/234). The proportion of subjects having AIDS awareness was 21.0% (39/186) in the case group, which was lower than that in the control group (64.5%, 151/234); the proportion of subjects having close contact with HIV-positive persons for more than 106 days was 60.2% (112/186) in the case group, which was higher than that in the control group (31.6%, 74/234). The proportion of subjects maintaining the original drug use method after being infected with HIV was 50.5% (94/186) in the case group, which was higher than that in the control group (16.7%, 39/234) (all P values < 0.05). The multivariate logistic regression analysis was carried out to analyse high correlate factors of HIV transmission by sources of transmission, and the AIDS awareness, duration of contact between sources of transmission and vulnerable population, access to support following confirmed HIV infection were protective factors, OR (95% CI) values were 0.155 (0.104-0.262), 0.170 (0.106-0.253), and 0.306 (0.189-0.450), respectively; while the frequency of syringe sharing and continuous drug use after being infected with HIV were risk factors, and the OR (95% CI) values were 3.06 (1.77-5.29), and 3.54 (2.16-5.80), respectively.</p><p><b>CONCLUSION</b>HIV transmission by IDUs-HIV+ might be contained by raising AIDS awareness, providing comprehensive psychological support, conducting needle exchange and methadone maintenance treatment and reducing syringe sharing.</p>

Study on the change of unsafe sexual behaviors and its determinants in HIV-positive persons after being notified as HIV seropositive / 中华流行病学杂志

Objective To study the change of unsafe sexual behaviors and its determinants in HIV-positive persons after being notified as HIV seropositive.Methods Questionnaires were employed in HIV-positive persons whose testing results being notified over 1 year in Changsha and Hengyang between March 2013 and July 2013.Results Interview was carried out on 268 HIV-positive persons who reported having considerable variability in unsafe sexual behaviors.The incidence of unsafe sexual behaviors declined from 98.8％ to 12.7％ after being notified as HIV seropositive.Risk factors related to unsafe sexual behaviors after the notification would include gender (men OR=0.443,95％CI:0.209-0.937) and living with sexual partner (OR=2.549,95％CI:1.053-6.174).Conclusion Notification regarding one's HIV seropositivity could considerably reduce the incidence of unsafe sexual behaviors in HIV-positive persons,however,women and those who were living with sexual partners seemed likely to keep practicing unsafe sexual behavior,thereafter.

Effects of HIV status notification on reducing the risk of sexual transmission of HIV in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The risk of HIV sexual transmission is much higher among people unaware of their HIV status than among those aware. Only a few studies have indicated that the incidence of unsafe sex can be reduced when people know their HIV status. This study was to investigate this effect in China.</p><p><b>METHODS</b>A cohort study consisting of two surveys was conducted at two different times among a group of people living with HIV/AIDS, whose status was newly diagnosed with HIV via sexual contact, in Shanghai, Chongqing, and Kunming. The first survey was conducted among 823 people tested positive for HIV before notifying them of the HIV status. The second survey was conducted among 650 HIV-positive people at six months following the first survey (after notification of HIV status). The scope of survey covered unsafe sex practices, number of unsafe sexual partners, and frequency of unsafe sexual behaviors over the prior six months. Unsafe sex is defined as unprotected anal or vaginal sex with partners who are HIV positive or whose HIV status is unknown.</p><p><b>RESULTS</b>The proportion of unsafe sex was reduced by about 85% after HIV status notification. The risk of HIV sexual transmission was 15 times higher among persons unaware of their HIV status than among those aware. Approximately 95% of new sexually transmitted HIV infections stemmed from 56% of the infected persons unaware of their HIV status in China.</p><p><b>CONCLUSION</b>Timely HIV status notification has the potential to significantly reduce unsafe sex among HIV-infected persons and reduce the risk for HIV transmission via unsafe sex.</p>

Effect of MMT on reducing the transmission of HIV among IDUs / 中国艾滋病性病

Objective To study the effect of methadone maintenance treatment(MMT) on reducing HIV infection among injecting drug users(IDUs) in Yueyang city of Hunan province.Methods Local IDUs were provided with MMT along with peer education and behavior interventions,and they were tested for HIV antibody to evaluate the effect of MMT after one year treatment.Results Of the 113 IDUs who were negative at the entry,none turned to be positive after one year treatment and the negative partners of 22 IDUs with positive HIV antibody remained negative one year later,and the negative rate of urine test maintained at 76.10%.Conclusion MMT combined with peer education and behavior interventions will decrease the use of heroin,prevent HIV infection among IDUs and reduce their partners' susceptibility to HIV.