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Aim: To adapt and validate an existing instrument to assess the barriers to antiretroviral treatment adherence among individuals with hiv in Córdoba, Argentina. Materials and methods: The final sample population included 180 Argentinian people. The mean age of the participants was 40.61 (sd = 12.032) years and 82.8% were men. Various internal structure and reliability and validity studies with other variables were conducted on the study population (n = 180). Results: The results of confirmatory factor analysis were consistent with the factorial structure of the original study. However, to achieve this, items that had low factorial loads and were redundant had to be eliminated. Coefficient ω values of .833 on the Information sub-scale, .759 on the Motivation subscale, and .888 on the Behavioral Skills subscale were obtained. Significant correlations were determined between the results of adherence and barriers to treatment. Conclusion: The results suggest that the instrument can be used to assess the barriers to antiretroviral treatment adherence in Córdoba, Argentina. Although further research is warranted, these results are promising.
adaptar y validar un instrumento para evaluar barreras a la adherencia antirretroviral en personas que conviven con el vih en Córdoba (Argentina). Materiales y métodos: la muestra final incluyó 180 participantes argentinos. La media de edad fue de 40.61 (de = 12.032) y el 82.8 % fueron hombres. Sobre la muestra (n = 180) se efectuaron estudios de estructura interna, confiabilidad y validez con otras variables. Resultados: el análisis factorial confirmatorio arrojó resultados congruentes con la estructura factorial del estudio original, aunque para ello fue necesario eliminar ciertos ítems que presentaban bajas cargas factoriales y que pueden ser representados por otros ítems, debido a información redundante. Se obtuvieron coeficientes ω = 0.833 en la subescala información; ω = 0.759 en la subescala motivación, y ω = 0.888 en la subescala habilidades comportamentales. Se encontraron correlaciones significativas entre los resultados de adherencia al tratamiento y barreras al tratamiento. Conclusión: aunque se requieren de mayores investigaciones, los resultados son promisorios, sugieren que el instrumento puede usarse para evaluar barreras de la adherencia al tratamiento antirretroviral en Córdoba.
adaptar e validar um instrumento de barreiras à adesão anti-retroviral em pessoas vivendo com hivem Córdoba, Argentina. Materiais e métodos: A amostra final incluiu 180 participantes argentinos. A idade média era de 40,61 anos (sd = 12,032) e 82,8% eram homens. Com a amostra (n = 180) foram realizados estudos de estrutura interna, confiabilidade e validade com outras variáveis. Resultados: a análise fatorial confirma-tória apresentou resultados adequados com a estrutura fatorial do estudo original, embora para isso tenha sido necessário eliminar alguns itens que apresentavam baixas cargas fatoriais e poderiam ser representados por outros itens devido a informações redundantes. Os coeficientes ω = 0,833 foram obtidos na subescala informação; ω = 0,759 na subescala motivação, y ω = 0,888 na subescala competências comportamentais. Correlações significativas foram encontradas entre os resultados do adherencia al tratamiento e do barreiras à adesão ao tratamento. Conclusão: embora mais pesquisas sejam necessárias, os resultados são promissores, sugerindo que o instrumento pode ser usado para avaliar as barreiras à adesão ao tratamento anti-retroviral em Córdoba, Argentina.
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Humans , Psychometrics , Research , Therapeutics , Reproducibility of Results , HIV , MethodsABSTRACT
ObjectiveTo analyze the HIV infection characteristics and influencing factors among the spouses of HIV/AIDS patients in Shanghai. MethodsA cross-sectional survey was conducted to collect demographic， behavioral， epidemiological and spousal HIV detection information of newly reported and married patients with HIV/AIDS in Shanghai from January 2018 to July 2022 in the comprehensive HIV prevention and control information system of Chinese Center for Disease Prevention and Control. Descriptive analysis was used to analyze the HIV positivity rate of the spouses of HIV patients and the influencing factors were analyzed by univariate and multivariate logistic regression models. ResultsA total of 1 233 subjects were investigated， and the first HIV-testing positivity rate of the spouses of HIV/AIDS patients was 29.3% （361/1 233）. There were statistically significant differences in the HIV-testing positivity rate among spouses of HIV/AIDS patients by different age， gender， education level， occupation， transmission route， quantity of non-marital sexual activities， quantity of homo-sexual activities， and baseline CD4 cell count level （P<0.05）. Spouses of the HIV/AIDS patients aged ≥65 years old， female， heterosexual transmission， less non-marital sex， and no history of homosexual sex had relatively high HIV positive rate. The HIV-positive detection rate of spouses in the ≥65 age group was 1.81 times higher than that in the <45 age group. The HIV-positive detection rate of spouses in the female group was 3.66 times higher than that in the male group， and the HIV-positive detection rate of spouses in the homosexual transmission group was 0.25 times higher than that of the heterosexual transmission group. ConclusionRisk awareness of HIV infection among married people with spouses should be improved. The key populations with the characteristics such as females as the first HIV-positive reporter， and heterosexual transmission should be paid special attention.Their spouses should be mobilized to conduct HIV-testing as early as possible
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OBJECTIVE To investigate the occurrence time and risk factors of anemia in patients with acquired immune deficiency syndrome （AIDS） after taking highly active antiretroviral therapy （HAART） containing zidovudine. METHODS The clinical data of 2 150 AIDS patients who were followed up in the care clinic of Liuzhou People’s Hospital from January 1， 2010 to December 31， 2022 were collected. The occurrence time of anemia was analyzed retrospectively， and the risk factors of anemia were analyzed by univariate analysis and binary Logistic regression analysis. RESULTS A total of 854 AIDS patients receiving HAART containing zidovudine were collected， and 107 patients （12.53%） developed anemia. Most of them （63.55%） developed anemia within 3 months after treatment. Baseline hemoglobin [OR＝2.944， 95%CI （1.195， 7.501）， P＝0.019]， baseline CD4+ T lymphocyte count [OR＝2.472， 95%CI （1.117， 5.469）， P＝0.026] and baseline human immunodeficiency virus-ribonucleic acid （HIV-RNA） [OR＝4.299， 95%CI （1.905， 9.705）， P＜0.001] was associated with anemia. CONCLUSIONS The median time of anemia in AIDS patients receiving HAART containing zidovudine is the second month after initiation of treatment. Baseline hemoglobin≤110 g/L， baseline CD4+ T lymphocyte E-mail：1315775863@qq.com count≤100 /mm3， and baseline HIV-RNA≥100 000 copies/mL are independent risk factors for anemia in these patients.
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Objective:To analyze the clinical characteristics of AIDS complicated with plasmablastic lymphoma (PBL).Methods:Clinical data and laboratory test of 7 AIDS patients complicated with PBL admitted to Yunnan Infectious Disease Hospital from January 2016 to October 2022 were retrospectively analyzed.Results:There were 6 male patients and 1 female patient with a median age of 48 years (41-56 years). All patients had oral and maxillofacial involvement, and only 1 case was stage Ⅱ at the initial Ann Arbor stage, while 6 cases were stage Ⅲ or higher. Six patients had systemic symptoms. All patients had a Ki-67 proliferation index greater than 80% and all presented MYC gene rearrangements, and 6 patients were positive for EBER. All patients received DA-EPOCH-based first-line chemotherapy and antiretroviral therapy (ART), Five patients initiated ART at the same time as chemotherapy, and 2 patients initiated ART before chemotherapy. Four patients achieved complete remission after chemotherapy according to PET-CT evaluation, and 3 patients died.Conclusions:Active chemotherapy combined with ART can maximize the therapeutic benefits of AIDS patients with PBL. The introduction of ART in the first chemotherapy cycle can avoid the rapid disease deterioration in the patients.
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Patients infected with human immunodeficiency virus (HIV) are prone to renal insufficiency, which may progress into end-stage renal disease (ESRD). HIV infection has been previously considered as an absolute contraindication of transplantation. The lives of HIV-positive ESRD patients can only maintained through dialysis. With the development of medicine, transplantation practitioners at home and abroad attempt to perform kidney transplantation in HIV-positive patients. Whether kidney transplantation is feasible for HIV-positive patients, whether HIV-positive donor kidneys can be used for transplantation, and the efficacy of kidney transplantation for HIV-positive patients has always been hot topics in the field of transplantation. In this article, HIV-associated nephropathy, the conditions of kidney transplantation for HIV-positive patients, the efficacy of kidney transplantation for HIV-positive patients, use of HIV-positive donor kidneys, use of immune-inducing drugs and postoperative use of immunosuppressants for HIV-positive patients were illustrated, aiming to provide reference for kidney transplantation for HIV-positive patients in clinical practice, application of HIV-positive donor kidneys and postoperative management of HIV-positive patients.
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Objective: This study aimed to look into the clinical characteristics and prognosis of patients with human immunodeficiency virus (HIV) -associated diffuse large B-cell lymphoma (DLBCL) . Methods: Retrospective review of the clinical data of 63 HIV-infected patients with DLBCL diagnosed at Chongqing University Cancer Hospital between July 2008 and August 2021. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. The Cox proportional hazards model was used for multivariate analysis. Results: In 63 patients with HIV-associated DLBCL, 57 (90.5% ) were men, and the median age was 49 (23-87) years. The most common pathological subtype was the germinal center B-cell-like lymphoma (74.6% ) ; 46.0% (29/63) were combined with extranodal lesions. Seventeen of 63 (27.0% ) patients had large masses (≥7.5 cm) . Twenty of 63 (31.7% ) patients had B symptoms. The median CD4(+) T cell count was 203 (4-1022) ×10(6)/L. A total of 49% (25/51) patients had CD4(+) cell count <200×10(6)/L, 56.9% (33/58) had high (3-5) International Prognostic Index (IPI) scores, and 43.1% (25/58) had low (0-2) IPI scores. Further, 78% (46/59) were diagnosed with Ann Arbor Stage Ⅲ/Ⅳ, and 25.4% (16/63) didn't receive chemotherapy. A total of 22.2% (14/63) of patients received less than four cycles of chemotherapy, and 52.4% (33/63) received four or more cycles of chemotherapy. Among patients undergoing chemotherapy, 61.7% (29/47) received R-CHOP-like regimens, and 38.3% (18/47) used CHOP-like regimens. The 1-, 2-, 3-, and 5-year overall survival (OS) rates were 65.0% , 53.8% , 47.1% , and 43.5% , respectively. Univariate analysis revealed that age ≥ 60 years (P=0.012) , Eastern Cooperative Oncology Gruop Performance Status (ECOG-PS) score 2-4 points (P=0.043) , IPI score 3-5 points (P=0.001) , β(2)-MG elevation (≥5.5 mg/L) (P=0.007) , and systemic chemotherapy cycles less than four times (P<0.001) were the negative prognostic factors affecting the OS of patients. The Cox multivariate analysis depicted that age ≥60 years (HR=2.272, 95% CI 1.110-4.651, P=0.025) , IPI score 3-5 points (HR=3.562, 95% CI 1.794-7.074, P<0.001) , ECOG-PS score 2-4 points (HR=2.675, 95% CI 1.162-6.153, P=0.021) , and number of cycles of chemotherapy<4 (HR=0.290, 95% CI 0.176-0.479, P<0.001) were independent risk factors for adverse prognosis of OS. Conclusion: HIV-associated DLBCL is the most common HIV-related tumor, is most commonly seen in men, and has a high 1-year mortality rate. Chemotherapy combined with antiretroviral therapy can improve patient prognosis.
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Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , HIV Infections , Lymphoma, Large B-Cell, Diffuse/drug therapy , Prednisone/therapeutic use , Prognosis , Retrospective Studies , Rituximab/therapeutic use , Survival Rate , Vincristine/therapeutic useABSTRACT
OBJECTIVES@#The epidemic of acquired immune deficiency syndrome (AIDS) among men who have sex with men (MSM) is severe in China. And MSM has now become a key population for the infection and transmission of AIDS. At present, the bottleneck of AIDS prevention and control among MSM population is low rate of continuous condom use and high incidence of unsafe sexual behavior. Inductive summarization of the literature revealed that the most critical reason for low rate of continuous condom use among the MSM population was condom-related stigma. Although many studies mentioned condom-related stigma among MSM populations, there has been no any definition of MSM-related condom stigma and no measurement for it. Therefore, the paper aims to explore barriers to condom use among MSM, then construct the conceptual and operational definition of "MSM-related condom stigma" through Meta synthesis and concept synthesis, and provide a new perspective for AIDS prevention and control among MSM.@*METHODS@#Based on evidence-based method, "PICoS" framework and Meta-synthesis was used to include the literatures. Then, we used synthesized qualitative evidence from included studies to construct the concept and operational definition of MSM-related condom stigma by the means of thematic analysis and concept synthesis.@*RESULTS@#According to the results of the concept synthesis, MSM-related condom stigma refers to any taboos or misbeliefs about condom use or feeling ashamed or embarrassed to talk about using condoms which perceived by individuals at the individual, interpersonal, and social levels.It was demonstrated through 4 sub-themes at operational level: a symbol of distrust, a symbol of HIV/sexual transmitted infections (STIs) prevention, a symbol of an embarrassing topic, and a symbol of violating the traditional cognition of sexual intercourse. According to the Social-ecological Model (SEM), a symbol of distrust refers to that the MSM population believes that not using condoms represents mutual trust between sexual partners, while using condoms is difficult to express intimacy, trust and loyalty between sexual partners. A symbol of HIV/STIs prevention at the interpersonal level refers to that the MSM population believes that condom use is a "symbol" for the prevention or infection of AIDS; on the one hand, if someone proposes to use condoms, he may be considered infected with HIV or have unsafe sex experiences, thus, making it difficult to propose condom use; on the other hand, if they believe that sexual partners are "AIDS free" (often a wrong perception, such as sexual partners may have the risk of AIDS infection although they do not have AIDS), it is considered that condom use is completely unnecessary. The environmental level includes a symbol of an embarrassing topic and a symbol of violating the traditional cognition of sexual intercourse. A symbol of an embarrassing topic refers to the MSM population feels shame about topics related to sexual behavior and is embarrassed to carry/buy/propose condom use or be ashamed to engage in conversations about whether to use condoms during sexual behavior. And a symbol of violating the traditional cognition of sexual intercourse: The MSM population have limitations in their perception of "sex" or "sexual behavior" and believe that real sex (behavior) is unobstructed contact between the bodies and exchange between all body fluids.@*CONCLUSIONS@#The concept of MSM-related condom stigma is proposed for the first time, and its operational definition is given. The concept includes 3 levels and 4 dimensions. It is helpful to understand MSM people's attitude and cognition towards condoms, and adds indicators with cultural sensitivity and behavioral sensitivity to the behavioral intervention for AIDS in the future.
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Humans , Male , Acquired Immunodeficiency Syndrome/prevention & control , Coitus , Condoms , HIV Infections/prevention & control , Homosexuality, Male , Sexual Partners , Sexual and Gender MinoritiesABSTRACT
Acquired immune deficiency syndrome (AIDS) can cause various opportunistic infections clinically due to severe defects in the body’s cellular immune function. Cryptococcosis is a common serious opportunistic infection in AIDS patients. With the promotion and popularization of high activity antiretroviral therapy (HAART) programs worldwide, the mortality rate of AIDS-related cryptococcosis has been significantly decreased. After initiating antiviral therapy, some patients experienced recurrence and aggravation of clinical symptoms during anti-cryptococcal treatment. The body has an inflammatory response to the excessive immune regulation of cryptococcal antigens, which is called cryptococcus-related immune reconstitution inflammatory syndrome (C-IRIS). C-IRIS seriously affects the quality of life and prognosis of patients. This article reviews the clinical features, pathogenesis and the latest treatment and management strategies of C-IRIS in AIDS patients.
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Objective:To investigate the ocular characteristics and treatment prognosis of ocular immune reconstruction inflammatory syndrome (IRIS) in patients with cytomegalovirus retinitis (CMVR) complicated with acquired immunodeficiency syndrome (AIDS).Methods:A serial case-observational study was conducted.Seventeen eyes from 15 male 21-to 43-year-old AIDS patients combined with CMVR, who were diagnosed with IRIS at Beijing You'an Hospital, Capital Medical University from February 2016 to December 2018 were included.The best corrected visual acuity (BCVA) of patients was recorded, and the intraocular pressure and anterior segment was measured with a non-contact tonometer and a slit-lamp microscope, respectively.The ocular fundus was observed by fundus photography and optical coherence tomography (OCT). Reverse transcription polymerase chain reaction was used to measure the cytomegalovirus deoxyribonucleic acid (CMV-DNA) content in the aqueous humor during the occurrence of IRIS.The flow cytometry was employed to determine the peripheral blood CD4 + T lymphocyte count before highly active antiretroviral therapy (HAART) and during the occurrence of IRIS.All patients were followed for 3 to 25 months, with an average of 15 months.The HAART time of patients was 17 to 104 days, with an average of (66.1±27.4) days.Patients with anterior segment inflammatory reactions were given the anti-inflammatory and mydriatic treatment.Patients with severe vitreous opacity were intravitreally injected with 4 mg of triamcinolone.Patients with macular edema were given 0.5 mg intravitreal injection of conbercept.The study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Beijing You'an Hospital, Capital Medical University (No.[2017]11). Written informed consent was obtained from each patient prior to any examination. Results:Anterior segment inflammation (Tyndall effect, KP, post-iris adhesion) was found in 9 eyes, vitreous opacities to varying degrees in 11 eyes, and macular edema in 2 eyes.The CMV-DNA content was negative (<500 copies/ml) in 15 eyes.The CD4 + T lymphocyte count in peripheral blood during IRIS was 67 (51, 99) cells/μl, which was significantly higher than 17(6, 20) cells/μl before HAART treatment ( Z=-4.48, P<0.01). Two of the 15 AIDS patients had tuberculosis.The BCVA of the patients was improved from 0.30 (0.10, 0.55) before treatment to 0.50 (0.35, 0.60) after treatment, and the difference was statistically significant ( Z=-2.34, P=0.019). Conclusions:The anterior and posterior segment may be involved in IRIS patients with AIDS and CMVR, and the corresponding ocular treatment is effective.
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Objective @#To analyze the characteristics of HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou, and the influencing factors for new infection and local infection, so as to provide the evidence for AIDS prevention and control.@*Methods @#From 2017 to 2019, the newly reported HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou were recruited, and their demographic information, previous sexual behaviors and history of HIV testing were collected in the questionnaire survey. The multivariate logistic regression model was used to analyze the influencing factors for new infections and local infections. @*Results @#A total of 522 participants from 668 newly reported HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou during this period were surveyed．Among 522 cases, 263 ( 50.38% ) were aged 40 years or above, 218 ( 41.76% ) were married, 326 ( 62.45% ) had an educational level of junior high school or below, and 340 ( 65.13% ) were not local. Among 504 cases whose infection time could be determined, 72 ( 14.29% ) were newly infected within one year; age of 40 years below ( OR=4.148, 95%CI: 1.956-8.795 ), history of HIV testing ( OR=2.049, 95%CI: 1.163-3.609 ) and history of sexually transmitted diseases ( OR=2.169, 95%CI: 1.076-4.374 ) were risk factors for new infection. Among 454 cases whose infection location could be determined, 267 ( 58.81% ) were infected in Hangzhou; educational level of high school or below ( OR=2.538, 95%CI: 1.252-5.145 ) , Hangzhou residence ( OR=7.835, 95%CI: 4.227-14.353 ), living in Hangzhou for a year or over ( OR=18.960, 95%CI: 8.755-41.060 ) and monthly income of 3 000 yuan or over ( OR=2.630, 95%CI: 1.546-4.474 ) were risk factors for local infection. @*Conclusions @#The HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou are mainly floating population and less educated. The newly infected cases are more likely to be young and middle-aged people and patients with sexually transmitted diseases, the locally infected cases are more likely to be people with permanent residence, less educated and high income.
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Objective@#To learn HIV related stigma and its associated factors among the patients on antiretroviral therapy ( ART ) in Wenshan Prefecture, Yunnan Province, so as to provide evidence for eliminating HIV discrimination.@*Methods@#A total of 419 subjects were recruited by convenience sampling from three ART clinics in Wenshan City and Maguan County between October 2017 and January 2018. HIV/AIDS Related Stigma and Discrimination Scale developed by Li Xianhong et al was employed. The multivariate linear regression model were used to explore the influencing factors for HIV stigma. @*Results@#The median scores of disclosure concern, public rejection, family stigma, internalized stigma, health service providers＇ stigma were 24.00, 6.00, 10.00, 20.00, 2.00, respectively, and the overall was 68.00. The multivariate linear regression analysis showed that female patients ( standardized β=0.135 ) , patients with opportunistic infection ( standardized β=0.120 ), patients had no HIV infected family member ( standardized β=-0.128 ) , patients without family support ( standardized β=-0.175 ) , patients received gift from ART clinics ( standardized β=0.124 ) , patients scored lower in ART knowledge ( standardized β=-0.117 ) were likely to scored higher in HIV stigma. @*Conclusions@#The stigma on disclosure concern and internalized stigma dimensions are grievous among ART patients in Wenshan Prefecture. Gender, opportunistic infection, HIV infection in family, family support, receiving incentive gifts from clinics and awareness of ART are associated with HIV stigma.
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Objective To determine the status of HIV/AIDS-related knowledge, attitude and behavior in college students, and to provide the theoretical basis for strategy of control and prevention. Methods By using random cluster sampling method, we conducted an anonymous online questionnaire survey on a total of 917 young students in Songjiang District of Shanghai. Results The awareness rate of HIV/AIDS-related knowledge was 71.8% among 903 responders. 11.1% of the students had sexual experience, and the rate was higher in male students than in female students(χ2 = 10.549, P < 0.01). The average age of first sexual intercourse was 18.4±1.3 years old, and 60.0% of the students used condom when having sex for the first time. In this survey, only 28.2% were willing to take anonymous HIV antibody urine test, and 1.8% of the students had been tested for HIV. Conclusion The overall awareness rate of knowledge of prevention and control of HIV/AIDS, the rate of condom use, and the willingness to take anonymous HIV antibody urine test are low among young college students in Songjiang District of Shanghai. We suggest to carry out targeted health education activities and to expand coverage of HIV testing by promoting the anonymous HIV antibody urine test for control the spread of HIV/AIDS among young students.
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OBJECTIVE@#To understand the differences between young male students who have sex with men (MSM) with and without human immunodeficiency virus (HIV)-infection in acquired immure deficiency syndrome (AIDS)-related knowledge and behavior, and to provide a scientific reference to make targeted and effective measures in AIDS prevention.@*METHODS@#Using snow balling sampling combined with participants' referral, we conducted a questionnaire survey among 548 young MSM students (in whom there were both HIV-positive and HIV-negative) in Harbin, Tianjin, Xi'an, and Chongqing cities from April 2017 to March 2018. The chi-square test and binary Logistic regression were used to compare the differences in AIDS-related knowledge and behavior between males with and without HIV-infection.@*RESULTS@#A total of 583 questionnaires were obtained, of which 548 were valid, with an effective rate of 94.0%. Having a junior college education or below (P=0.002), a monthly consumption level of less than 2 000 RMB (P=0.021), and living off campus (P=0.004) were associated with being tested positive for HIV. In any period of schooling, receiving AIDS prevention education was a protective factor for HIV infection [Primary school OR=0.203 (0.073－0.561), junior high school OR=0.287 (0.142－0.581), senior high school OR=0.271 (0.142－0.518), and university OR=0.322 (0.168－0.616)]. There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public"(P=0.907) and "AIDS-related Knowledge for Youth"(P=0.782), with the awareness rate all about 90%. There was a statistical difference in the need for some specific knowledge (For "AIDS prevention and treatment policy", P=0.012, for "Ways to identify and prevent high-risk sexual behavior", P < 0.001). HIV-positive males had a younger age of first sexual activity (P=0.006), had more sexual partners in the early (P < 0.001) and had lower frequency of condom use (P < 0.001). However, there was no statistical difference in the later number of sexual partners (P=0.247) and the frequency of condom use (For regular sex partners, P=0.735, and for casual sex partners, P=0.765), which might be related to the change of sexual behavior characteristics caused by HIV infection (For regular sex partners, P < 0.001, and for casual sex partners, P=0.006).@*CONCLUSION@#There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public" and "AIDS-related Knowledge for Youth", which were both lower than 95% required by the state. However, the specificity in the knowledge needs was certainly shown. There was no significant difference in the recent sexual behavior between the two groups, but HIV positive students were more likely to have high-risk sexual behaviors in the early stage, so we should strengthen and move forward the sex education and AIDS prevention education with adjusted contents, and prevent high-risk sexual behaviors within young MSM students in the early stage.
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Adolescent , Humans , Male , HIV , HIV Infections/prevention & control , Health Knowledge, Attitudes, Practice , Homosexuality, Male , Sexual Behavior , Sexual and Gender Minorities , Students , Surveys and QuestionnairesABSTRACT
Abstract INTRODUCTION: It is believed that delays in diagnosis and treatment of Visceral Leishmaniasis (VL) contribute significantly to the burden of VL lethality in Brazil. METHODS: This study included several parts: a descriptive cross-sectional study of the individual characteristics of deaths from disease; a descriptive ecological study of the spatial distribution of deaths from disease; and an ecological analytical study to evaluate the association between disease lethality rates and the demographic, socioeconomic, and health indicators. The study population comprised all cases diagnosed throughout the country per the National Disease Notification System (SINAN) and the total number of disease deaths recorded in the Mortality Information System (SIM) from 2007 to 2012. RESULTS: Of the 223 deaths from disease captured by pairing the databases, 59.1% were reported as "death from other causes". There were significant associations between VL lethality rate and municipalities with the highest proportion of vulnerable individuals (rate ratio (RR)=1.18, 95% confidence interval (CI): 1.01-1.27), with VL lower incidence rate (RR=0.62, 95% CI: 0.58-0.67) and a higher incidence rate of Acquired Immune Deficiency Syndrome (AIDS) (RR=1.20, 95% CI: 1.17-1.51). CONCLUSIONS: Linking the SINAN and SIM databases allowed the inclusion of 14% of otherwise underreported deaths from VL for the study period, showing that this method is useful for the surveillance of VL-related deaths. The size of the municipal population, proportion of the vulnerable population, incidence of disease, and the incidence of AIDS were associated with municipal lethality rates related to VL in Brazil.
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Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Leishmaniasis, Visceral , Socioeconomic Factors , Brazil , Incidence , Cross-Sectional Studies , Middle AgedABSTRACT
OBJECTIVE@#To understand the current cognition of acquired immunodeficiency syndrome (AIDS) occupational protection among the managers of multi-level stomatology medical institutions in efforts to provide a reference for formulating technical standards for occupational protection.@*METHODS@#Eighteen managers of oral medical institutions were individually interviewed in-depth using asemi-structured questionnaire on issues related to AIDS occupational protection using the phenomenological research method. Nvivo 12.0 software was used to code and analyze the interview data, and relevant themes were extracted.@*RESULTS@#Three themes were extracted from the data. Occupational protection measures for AIDS in dental medical institutions mainly based on the aspects of standardized operation, standardized prevention, and post-exposure treatment. However, the implementation of these protective measures was often inadequate. Occupational protection training for AIDS was carried out regularly at dental medical institutions, but the training effect was not generally tracked. Several limitations in AIDS occupational protection management; these limitations included the lack of a specific occupational protection system, the difficulty of AIDS screening for outpatients, and the difficulty of AIDS occupational protection supervision.@*CONCLUSIONS@#Oral medical institutions should strengthen their occupational protection training and supervision approaches and formulate unified occupational protection standards to reduce occupational exposure and improve hospital management quality and efficiency.
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Humans , Acquired Immunodeficiency Syndrome , Cognition , Occupational Exposure , Oral Medicine , Surveys and QuestionnairesABSTRACT
With the advent of highly active antiretroviral therapy (HAART), acquired immune deficiency syndrome (AIDS) has gradually evolved from an incurable terminal disease to a controllable chronic disease. Due to the extended survival of AIDS patients, chronic renal failure and (or) chronic liver failure have become the main cause of death, and AIDS patients with chronic liver failure are constantly complicated with hepatitis C virus (HCV) infection. Human immunodeficiency virus (HIV) infection was previously considered as a contraindication for liver transplantation. With the deepening of medical cognition and improvement of surgical management experience, the quantity of HIV positive liver transplantation recipients has been steadily elevated and high long-term survival rate has been achieved. Nevertheless, the 3-, 5-, and 10-year survival rates after liver transplantation of HIV combined with HCV positive patients remain extremely low. In this article, the development of liver transplantation in HIV positive patients, the disease progression of HIV combined with HCV positive patients, and the treatment for the recurrence of viral hepatitis C after the operation were summarized.
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@#Introduction: Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical deterioration experienced by some HIV-infected patients in response to antiretroviral therapy (ART). There is still limited published data on IRIS from this region including Malaysia. This study aimed to determine IRIS prevalence, clinical manifestations and possible predictors among HIV-infected patients in an infectious disease centre in Peninsular Malaysia. Method: This retrospective study was conducted in Hospital Sungai Buloh involving secondary data of 256 HIV-infected patients who were initiated on ART in the year 2017. Medical record of each patient was reviewed for up to 12 months following ART initiation to identify IRIS diagnosis which was made by the treating physician. Relevant clinical and laboratory information were retrieved from hospital electronic database. Results: IRIS has occurred in 17.6% of patients. Infections by Mycobacterium tuberculosis (53.3%), Pneumocystis jirovecii (11.1%) and Talaromyces marneffei (6.6%) were the commonest three aetiologies of IRIS. Subacute lupus erythematosus was the only non-infectious IRIS identified. Baseline HIV viral load, CD4+ T-cell count and haemoglobin level between IRIS and non-IRIS patients were significantly different. Risk of developing IRIS was increased seven times in patients with CD4+ T-cell count < 100 cells/µL and four times in patients with HIV RNA viral load > 5.5 log10 copies/ml prior to ART initiation. Conclusion: Mycobacterium tuberculosis infections were the highest IRIS manifestation. Although rare, non-infectious IRIS does occur and should be part of the differential diagnosis. Patients with positive predictors should be appropriately monitored for possible IRIS development once initiated on ART.
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Objective@#To learn the knowledge, attitude and behaviors of AIDS of men who have sex wth men ( MSM ) in a gay bathhouse, so as to provide evidence for AIDS prevention and control among MSM.@*Methods@#From April to June of 2017, the MSM in a gay bathhouse in Wuhan were investigated. Demographic information, awareness of AIDS related knowledge, attitude towards HIV infection, dating ways and purposes, and high-risk sexual behaviors were collected and analyzed.@*Results@#Among 278 MSM responded, 235 ( 84.53% ) were aware of the basic knowledge of AIDS. The awareness rates of " transfusion with HIV blood will be infected ", " sharing syringes with HIV infected people will be infected ", "proper use of condoms can reduce the spread of AIDS ", " only having sex with one partner ( or few partners ) can reduce the spread of AIDS " were more than 90%, while the awareness rate of " high risk of HIV infection in gay bathhouses " was only 56.12%. Most respondents cared about the HIV infection situation of MSM, accounting for 74.46% ( 207 cases ) ; most denied or did not know the condition of friends infected with HIV, accounting for 82.37% ( 229 cases ) . The main purpose of coming to gay bathhouses was to find sexual partners, accounting for 87.41% ( 243 cases ) . About 52.16% had sexual behaviors with both heterosexual and homosexual partners, and 66.21% of them did not often or never use condoms when having sex with heterosexual partners. @*Conclusions@#The MSM in a gay bathouse have lower awareness of HIV infection situation and their partners, both heterosexual and homosexual behaviors, and lower proportion of insisting on condom use.
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Objective @#To analyze the influencing factors for the molecular network transmission clusters of HIV/AIDS, and to provide scientific evidence for the precise prevention and control of AIDS. @*Methods@#A case-control study was conducted. The HIV/AIDS cases reported from January 2017 to June 2019 in Huzhou with strong clustering of HIV molecular transmission were recruited as the case group, and the residents with same gender, similar age ( ±three years ) and HIV negative in the same community and period were matched ( 1∶4 ) as the control group. Demographic characteristics, AIDS related knowledge and sexual behaviors were collected by a questionnaire survey. The Cox regression model was used to analyze the influencing factors for HIV/AIDS molecular network transmission cluster.@*Results @#There was 100 people in the case group and 400 people in the control group, the differences between them in age, sex, marital status, place of residence and educational level were not statistically significant ( P>0.05 ) . The results of multivariate Cox regression analysis showed that awareness of AIDS related knowledge ( HR=0.145, 95%CI: 0.059-0.352 ) was a protective factor for molecular network transmission clusters of HIV/AIDS; men who have sex wth men ( MSM, HR=9.614, 95%CI: 4.645-19.901) , seeking homosexual partners through the internet (HR=16.321, 95%CI: 7.016-32.968) and having syphilis ( HR=3.314, 95%CI: 1.073-10.232 ) were risk factors for molecular network transmission clusters of HIV/AIDS.@*Conclusions@#The awareness of AIDS related knowledge, MSM, seeking homosexual partners through the internet and suffering from syphilis are the influencing factors for molecular network transmission clusters of HIV/AIDS.
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Objective@#To analyze the epidemiological characteristics of newly diagnosed HIV/AIDS cases aged 50 years or over in Zhejiang Province from 2015 to 2019, so as to provide reference for the development of prevention and control strategies.@*Methods @#The data of newly diagnosed HIV/AIDS cases in Zhejiang Province were collected through the China HIV/AIDS Comprehensive Response Information Management System, and the demographic characteristics, infection routes,regional distribution and time distribution of the cases were analyzed. @*Results@#A total of 6 726 HIV/AIDS patients were recruited in this study, and the number of new patients from 2015 to 2019 showed an increasing trend ( P <0.05 ) . The number of participants diagnosed at the age of 50-59, 60-69 and 70-91 years old were 3 433( 51.04% ), 2 242 ( 33.33% ) and 1 051 ( 15.63% ). The majority of them were males ( 5 180, 77.01% ) , married ( 4 286, 63.72% ) , Zhejiang residents ( 5 304, 78.86% ) , and lived in rural areas ( 4 095, 60.88% ) . In terms of exposure history,6 586 cases ( 97.92% ) were infected by sexual contact. Among the 5 083 males infected by sexual contact, 82.63% were through heterosexual contact, 94.79% had extramarital sex partners, among whom 76.61% were commercial sex partners. The married women patients who confirmed HIV positive accounted for 75.44%. There were increasing trends in the proportion of the cases living in rural areas, male cases infected through heterosexual contact and those with extramarital and commercial sex partners, and female cases with their husbands positive along with age ( P <0.05 ) . @*Conclusions@#The number of newly diagnosed HIV/AIDS cases aged ≥50 years is increasing in Zhejiang Province. Many of them live in rural areas. Commercial sexual contact is the main route of HIV transmission among males and further lead to HIV transmission within couples.