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Drug use (DU), particularly injecting drug use (IDU) has been the main route of transmission and spread of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) among injecting drug users (IDUs). Previous studies have proven that needles or cottons sharing during drug injection were major risk factors for HIV/AIDS transmission at the personal level. Being a social behavioral issue, HIV/AIDS related risk factors should be far beyond the personal level. Therefore, studies on HIV/AIDS related risk factors should focus not only on the individual factors, but also on the association between HIV/AIDS cases and macroscopic-factors, such as economic status, transportation, health care services, etc. The impact of the macroscopic-factors on HIV/AIDS status might be either positive or negative, which are potentially reflected in promoting, delaying or detecting HIV/AIDS epidemics.
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Humans , China , Epidemiology , Drug Users , Geography, Medical , HIV Infections , Epidemiology , Injections , Models, Statistical , Principal Component Analysis , Regression Analysis , Socioeconomic Factors , Spatial AnalysisABSTRACT
Objective To analyze the hepatitis C virus (HCV) prevalence among 8 populations in 2009-2012 in China,using the HIV sentinels surveillance data.Methods Cross-sectional studies had been repeatedly conducted on HIV Sentinel Surveillance with uniformed questionnaire and collection of venous blood specimen among 8 populations including drug users (DUs),men who have sex with men (MSM),female sex workers (FSW),male STD clinic attendees,male long distance truck drivers,male mobile populations,pregnant women and young students from April to June 2009 to 2012 on the yearly base.Blood testing for HIV,syphilis and HCV infections have been routinely performed on all participants of 8 populations recruited during the surveillance period.Results HCV prevalence among drug users had been relatively high,between 40.0％-43.0％ in 2009-2012.HCV prevalence of injection drug users (IDUs) showing a slight increasing trend in the past four years from 55.0％ in 2009 to 65.0％ in 2012.HCV prevalence rates among other 7 populations maintained low remained less than 1.0％ in the past three years.Conclusion Data from sentinel surveillance programs showed that HCV prevalence of DUs maintained high but the other 7 populations at low levels in the HIV sentinel surveillance areas in China.Blood-borne was the most common transmission pathways of HCV.IDU was one of the predominant models of HCV transmission in China and continued to fuel the HCV epidemics throughout the country.
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Objective To analyze the HIV/AIDS epidemics situation among migrant population.Methods Data on HIV/AIDS cases among mobile population through case reporting system was collected from 2008 to 2011.Results The number of reported cases on HIV/AIDS among mobile population had been rising,with proportions of the total reported cases increased from 10.2％ in 2008,to 18.2％ in 2011.Sexual contacts continued to be the major route of transmission.With the increasing proportion of homosexual transmission,HIV/AIDS cases among mobile population moved from high HIV-prevalence areas in the western and central parts to low HIV-prevalence areas in the eastern part of the country.Conclusion In recent years,the number of HIV/AIDS cases among mobile population was increasing in the case reporting system.Data showed that some male rural migrants had been engaged in commercial sex activities that called for more effective intervention measures to be taken to reduce the new HIV/AIDS infections in the migrant population.
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Objective To analyze the epidemic characteristics of HIV/AIDS among men who have sex with men (MSM) from 2006 to 2010 in China,and to provide evidence for the development of prevention and control measures.Methods Through the network reporting information system.The distribution of MSM transmission was analyzed.Through sentinel surveillance system from 2006 to 2010,data was gathered and analyzed for HIV/AIDS positive rates and condom use to describe the epidemic characteristics of HIWAIDS among MSM.Results Data from HIV/AIDS case reporting system showed that the proportion of MSM transmission was on the rise (from 1.5％ in 2006 to 10.8％ in 2010),becoming the fastest growth of spreading.Compared with other routes of spreading,MSM transmission showed the following obvious characteristics: 15 to 29 years olds (54.6％),having higher culture background (senior high school graduattesed or above accounting for 69.8％),unmarried (64.8％),being cadres/teacher/doctor/retirees and students (accounted for 14.3％ and 7.9％),with high mobilityfloating population (36.2％),being urban population (72.6％),having history of blood donation without payment (26.7％ and 6.4％ ).In terms of location,they mainly lived in provinces as Beijing,Sichuan,Guangdong,Chongqing,Jiangsu,Zhejiang,Shanghai and Liaoning where economics were more developed.Data from HIV/AIDS sentinel surveillance system showed that,from 2006 to 2010,the HIV positive anti-body detection rate (median) was 3.4％ among MSM in this country,much higher than among the female sex workers.Rate on condom usage (median) was 73.2％,lower than among the female sex workers.Conclusion The proportion of HIV transmission among MSM was on the rapid rise from 2006 to 2010 in China.Through HIV/AIDS sentinel surveillance system,we found that the infection rate was high but the rate of condom usage was low among MSM.Factors as being 15 to 29 years olds,students and blood donors shold be under major concern.
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<p><b>BACKGROUND</b>Men who have sex with men (MSM) have been impacted by HIV and now as an important driver of the HIV/AIDS epidemic in China. This study collected HIV sentinel surveillance system data on the MSM population to describe the characteristics and trends of the HIV epidemic among MSM in China from 2003 to 2011.</p><p><b>METHODS</b>Data on HIV prevalence and risk behaviors from 2003 to 2011 were obtained from the national HIV sentinel surveillance database.</p><p><b>RESULTS</b>MSM sentinel surveillance data for 2011 showed that proportions of MSM who consistently used condoms during anal sex in the last six months and at last anal sex encounter were 43.3% and 74.1%, respectively. Between 2005 and 2011 there were no significant changes in the proportion of consistent condom use. The proportion of MSM who had multiple male sex partners in the last six months increased. Overall HIV prevalence over the years showed a rising trend from 0.9% in 2003 to 6.3% in 2011. The syphilis antibody positive rate was 7.8% in 2011. In addition, the proportion of MSM in heterosexual marriages was rising, AIDS awareness was also increasing, and the proportion of MSM who had taken an HIV test in the last year and was aware of the results rose. The proportion who had received intervention services in the last year stabilized.</p><p><b>CONCLUSIONS</b>HIV prevalence in MSM populations is rapidly and widely distributed. MSM who are in heterosexual marriages may be a bridge group transmitting HIV to their heterosexual partners. The risky sexual behavior among MSM will remain a serious and important driver of China's AIDS epidemic over the next period of time. Intervention need to be strengthened, as does the effective implementation of measures to control AIDS and prevent it from spreading further.</p>
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Adolescent , Adult , Humans , Male , Middle Aged , Young Adult , China , Epidemiology , HIV Infections , Diagnosis , Epidemiology , Homosexuality, Male , PrevalenceABSTRACT
Objective To effectively monitor the time trend of HIV prevalence and epidemic among injecting drug users ( IDUs ), female sex workers (FSWs), sexually transmitted disease (STD)clinic attendants, men who have sex with men (MSM) and pregnant women etc., to provide information for evaluation on strategies regarding comprehensive HIV prevention and effectiveness of intervention, in China. Methods Cross-sectional studies had been repeatedly conducted on sentinel surveillance program with uniformed questionnaire and collection of venous blood specimen among IDUs, FSWs, STD clinic attendants, MSM and pregnant women, from 1995 to 2009. Results HIV prevalence (median) among IDUs had been increasing rapidly since 1996, reaching the plateau (19.2%) in 1999-2000, then gradually decreasing in 2001-2003, and leveling off since 2004 in those relatively hard-hit epidemic provinces. HIV prevalence among drug users had increased a bit since 2001, achieving high level (2.9%) in 2004 before leveling off, showing a slight downward trend in the past two years among the medially-hit epidemic provinces, while it maintained at a low level in those low epidemic provinces. HIV prevalence (median) among FSWs had been slightly increasing,reaching a high level ( 1.5% ) in 1999, then decreased and maintained at a low level in relatively hard-hit provinces. HIV prevalence among FSWs maintained at a low level in medially-hit and low epidemic provinces. HIV prevalence(median) among STD clinic attendants had been maintained at a lower level, lower than 0.7%. HIV prevalence among MSM had been consistently greater than 1%, and was increasing year by year, becoming one of the most important drivers of the HIV/AIDS epidemic over the past years. HIV prevalence (median) among pregnant women had slightly been increasing since 1997, then leveling off over the past years in those relatively hard-hit provinces (0.3%). HIV prevalence among pregnant women had maintained at a low level in the medial and low epidemic provinces. Conclusion Data from sentinel surveillance programs showed a leveling-off situation on HIV prevalence rates among IDUs, FSWs, sexually transmitted infections clinic patients and pregnant women. However, HIV prevalence among MSM had increased significantly since 2005, indicating the high speed of transmission among this population. Epidemic among IDUs had still been concentrated in those relatively hard-hit epidemic provinces. As for FSWs and STD patients, the overall epidemic remained at low level, but the areas of epidemic kept expanding.
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Objective To understand the status on AIDS awareness,AIDS-related behaviors,risk factors on HIV infection status among 15-90 years or older men at the sexually transmitted disease clinics.Methods Data from the 2009 and 2010 national sentinel surveillance system,regarding men attending sexually transmitted disease clinics was collected from Guangdong,Guangxi,Henan,Sichuan,Yunnan and Jiangxi provinces,where the AIDS epidemic among 15-90 years or older population was serious.Data was uploaded to National Center for AIDS/STD Control and Prevention (NCAIDS) through the comprehensive AIDS control and prevention information system.Data was then analyzed by SPSS 18.0.Results A total of 64 003 pieces of data were collected.Among them,8783 ( 13.7％ ) were related to men at ≥ 50 years or older,and to men 15-49 years older were 55 220.The rates on the awareness of AIDS knowledge were from 69.6％ vs.80.1％,on frequently having had commercial sexual contacts in the last three months were between 34.1％vs.36.6％,on having had casual sexual contact in the last three months were 18.7％ vs.28.4％,on having had homosexual anal intercourse as 0.7％ vs.1.4％.The rates of taking HIV antibody testing in the last year (14.3％ vs.17.1％ ) among this population were all significantly lower than the rate among the 15 to 49 years age group.However,the HlV-positive rate among the older age group (fifty years of age or older) was significantly higher than the rate among 15 to 49 year age group ( 1.1％ vs.0.7％ ).Regard the fifty years of age or older men.Data from the multivariate logistic regression analysis demonstrated that factors as:having regular partner (OR=0.588,P=0.034),having homosexual anal intercourse (OR=5.226,P=0.006) were associated with positivities of HIV antibody.Conclusion High-risk sexual behaviors,including homosexual anal intercourse were the major risk factors for men at ≥50 years or older age,related to the infection of HIV.
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Objective Using the HIV positive paid blood donors (PBDs) as example, to investigate the impact of the delayed diagnosed HIV/AIDS patients on the calculated median incubation of AIDS. Methods Information was retrospectively collected on HIV/AIDS patients who were infected through paid blood donation. Data was from the national HIV/AIDS case reporting system. The time of diagnosed HIV/AIDS after the screening was defined as delayed diagnoses. All the cases were diagnosed between Jan. 1st 1995 and the end of the screening were classified as group 1, while the cases diagnosed between Jan. 1st 1995 and Dec. 31st 2010 were classified as group 2.Kaplan-Meier method was used to calculate the median AIDS incubation of cases from the two groups. Results from the two groups on theft incubation periods were compared. Results From the data of group 1, we noticed that the median AIDS incubation was 9.62 years but the 95％ CI were not provided in the results of SAS software. When using the data from group 2,we found that the median AIDS incubation was 9.83 years, with the 95％CI as 9.73 to 9.83 years. Conclusion Our data showed that, if excluding the delayed diagnosed cases, the AIDS incubation periods were shorter and biased.
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Objective To analyze the HIV/AIDS epidemic situation and related behavioral components among young students in the last years and to provide information for integrated control and prevention programs. Methods Data on young students (1 5-24 years) through case reporting system was collected from 2006 to 2009 and continuous sentinel surveillance data regarding 6 national sentinel sites carried out from 2006 to 2009 was also collected. The sentinel sites would include universities, junior college and secondary vocational colleges registered students, using cluster sampling phases method. Self-administered questionnaire survey and blood (HIV antibody testing and syphilis antibody testing) tests were carried out, with the sample size was about 800 cases per site per year. Results The number of case report on HIV/AIDS among the young students of 15-24 years age group had been rising. Similar trend was also observed on the number of reported cases over the years, accounting for the proportions of the total number of reported cases, as 0.39%, 0.50%, 0.83%and 1.02% respectively from 2006 to 2009. Sexual contacts continued to be the major route of transmission, with the increasing proportion of homosexual transmission. In the 6 national sentinel sites of young students which continuous surveillance was conducted during the period from 2006 to 2009, data showed the following facts as: proportion (median) of objects who admmited to have had sex, were: 4.3%, 4.5 % and 6.1%, proportions (median) of commercial sex occurred in the past year were: 0.3%, 0.2% and 0.3%; proportions (median) of MSM occurred in the past year were: 0.7%,0.2% and 0.2%; median of HIV antibody positive rate and syphilis antibody positive rate were 0%;median of awareness rate on HIV/AIDS were: 49.0%, 75.0% and 80.5%; proportion (median) of monitor objects who received intervention services in the past year were: 44.2%, 54.3% and 50.2% respectively. Conclusion In recent years, the HIV / AIDS number through case reporting system on the young students under 15-24 years age group, was increasing, but the HIV prevalence among young students was still relatively low, in general. The main transmission was sexual. Some young students had been engaged in commercial sex and MSM activities. Health education should be strengthened to increase the awareness of young students on AIDS/STD prevention. It is necessary to take more effective intervention measures to decrease new infection and control HIV/AIDS epidemic among young students.
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Objective To understand the characteristics and trends of HIV and syphilis infections among drug users. Methods Information was collected regarding HIV and syphilis epidemics, as well as on high risk behaviors from the HIV/AIDS surveillance system. Source of information was from HIV/AIDS case- reporting, sentinel surveillance and trend estimation, related to the changes of distribution among HIV positive drug users prevalence rates on HIV and syphilis together with their high risk behaviors. Results Scale number on drug users remained stable in the past six year (from 2003-2009), while the proportion of drug users decreased from 44.2% in 2005 to 25.8% in 2009. Based on the information from HIV/AIDS case reporting system, HIV sentinel surveillance data showed that the HIV prevalence of drug users was quite different from those of Southwestern to Northeastern parts of China. The HIV prevalence in Southwestern China was much higher than that of the Northeastern areas. Sentinel surveillance data showed that the average positive rates were 6.2% and 3.7% on HIV and syphilis , among the drug users. As for injecting drug users (IDU), the average rates on HIV antibody syphilis and HCV were 9.2% and 4.0% respectively. Series surveillance data indicated that the HIV epidemic expanded quickly among drug users from 1995-1999 but became plateaued after 2000 among the IDUs. HIV antibody positive rate remained at 9.0%-10.0% in the past three years while syphilis fluctuated between 3.5%-4.5% in the past three years. Conclusion Drug users and IDUs still remained an important driven factor for HIV/AIDS epidemic in China, suggesting more specific strategies and methods should be developed, based on the characteristics and trends of HIV epidemic, to optimize the allocation HIV prevention and control resources.
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<p><b>OBJECTIVE</b>To monitor the time trend of behaviors change related to HIV/AIDS epidemic and HIV prevalence, and to provide information and basis for comprehensive HIV prevention responses and evaluation of intervention effectiveness among female sex workers in China.</p><p><b>METHODS</b>During the year of 2004 to 2008, a series of cross-sectional surveys were conducted among female sex workers in community recruited in both entertainment places and in street, during the defined timeframe, a face-to-face interview was conducted with uniformed questionnaire; while, the venous blood specimen was collected. The sample size was 400 per site per survey.</p><p><b>RESULTS</b>In 15 continuous national HIV comprehensive surveillance sites among female sex workers from 2004 to 2008, the median of HIV prevalence was 0.0%; Prevalence (median) of syphilis respectively: 0.5%, 1.8%, 1.6%, 1.8% and 1.0%. The median of target subjects who used condom in the last commercial sex was: 81.8%, 80.5%, 84.6%, 87.0% and 88.9% respectively; the median of always used condom in commercial sex during the last month: 65.8%, 59.6%, 60.3%, 59.8% and 73.7%. The median of awareness rate on HIV/AIDS transmission of female sex workers was: 74.3%, 84.1%, 65.2%, 66.0% and 74.3%. The median of target subjects who attended HIV VCT services were: 12.4%, 20.4%, 25.8%, 25.3% and 31.7%. The median of the proportion of female sex workers who reached intervention in last year respectively: 46.4%, 76.1%, 72.1%, 95.0% and 90.8%.</p><p><b>CONCLUSION</b>Condom use and HIV awareness rate need to enhance further among female sex workers. The proportion of female sex workers who attended VCT and knew their HIV testing result and the proportion of female sex workers who reached intervention in last year both increase. HIV prevalence rate among female sex workers is generally low, but high risk behaviors are still alarming. It is necessary to take more comprehensive and effective prevention measures and intervention.</p>
Subject(s)
Adult , Female , Humans , Young Adult , China , Epidemiology , Cross-Sectional Studies , HIV Infections , Epidemiology , Sentinel Surveillance , Sex Work , Unsafe SexABSTRACT
<p><b>OBJECTIVE</b>To investigate the proportion of HIV related death cause, and its years of potential life lost (YPLL) and work years of potential life lose (WYPLL) in project counties.</p><p><b>METHOD</b>According to the protocol of the third national death causes surveillance and HIV related death causes surveillance, retrospective study was implemented including baseline investigation of deaths' name list, demography information, door-to-door interview and death causes deduction in Gejiu, Ruili and Longchuan county in Yunnan province, Yangdong county in Guangdong province, Luzhai county in Guangxi zhuang Autonomous Region, Weishi and Zhecheng county in Henan province, Xishui county in Hubei province and Gu'an county in Hebei province.</p><p><b>RESULTS</b>The study was conducted among nine counties located in seven provinces. A total of 118 719 cases were included, raw mortality was 5.83 per thousand, 2002 death cases were related to HIV, which contributed 1.67% of total deaths. The average age of HIV death was 38.03 yearsow, which was earlier than the non-HIV-related life-span (63.10 years). The YPLL and WYPLL of HIV death was 33.80 years and 20.50 years, respectively, which had contributed the second highest average YPLL.</p><p><b>CONCLUSION</b>HIV has an important proportion among all death causes, and has contributed severe average YPLL and WYPLL.</p>