A comprehensive surveillance on HIV among 1237 men who have sex with men in thirteen cities of Yunnan / 中华流行病学杂志

Objective To understand the knowledge,risk behaviors and HIV prevalence in men who have sex with men (MSM) in thirteen cities.Methods Target samples were chosen using the snowball-rolling method,with transverse KABP and HIV-antibody testing developed for those MSM in thirteen cities of Yunnan.Results A total of 1237 valid questionnaires and 1129 blood samples were collected.Basic knowledge on HIV and the rate of the response was 93.2％.81.1％ of the respondents had anal sex with male parmers in the last six months,of them 49.7％ could persistently using condoms in each anal sex episode.29.0％ of the respondents had sex with female partners in the last six months.The HIV prevalence among the studied MSM was 8.2％ and the prevalence of syphilis among them was 3.9％.Most risky factors of those MSM infected by HIV would include:not persistently use condom when having sex and co-infection of syphilis.Conclusion Both rates of HIV infection associated risk behaviors and HIV prevalence were high in MSM under study that called for more work on HIV prevention and control MSM in Yunnan.

Current situation and influential factors concerning the sexual transmission of HIV in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the current situation of the sexual transmission of HIV in Dehong prefecture, analyze the influential factors, and provide support for drafting pertinent preventive interventions in the future.</p><p><b>METHODS</b>We had analyzed the data of case report from 2005 to 2007, and the prostitutes surveillance data from 2003 to 2007. A special survey was conducted from October 26 to November 7, 2007. Totally 685 people including prostitutes, the clients of prostitutes, people who were HIV positive and their partners, key insiders were interviewed in order to better understand the influential factors related to sexual transmission of HIV.</p><p><b>RESULTS</b>Among 1636 cases reported from January 1 to September 20, 2007, 52% were infected through sexual transmission. Among 586 cases infected through sexual transmission, 40.6% had commercial sexual behavior and 28.6% had unmarried sexual behavior. And the average rate of condom use was below 30%. The prostitutes' surveillance data from 2003 to 2007 showed that the HIV positive rate in prostitutes was 3.3% - 5.5%. The rate of condom use in the last month was 29.4% - 84.4% during commercial sexual activity, but it was 9.5% - 34.8% with fixed sexual partners. Although the rate of HIV and AIDS-related knowledge among prostitutes was 95.0%, there were still many misunderstanding regarding certain aspects of HIV and AIDS awareness.</p><p><b>CONCLUSION</b>Sexual transmission has become one of the main transmission routes of HIV in Dehong prefecture. The main factors involved in the sexual transmission of HIV in Dehong prefecture might include the wide spreading of sexual services, cohabitation among unmarried couples, having multiple partners, casual sexual behavior, and the low rate of condom use.</p>

Analysis of the epidemiologic patterns of HIV transmission in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To uncover the transmission patterns of the HIV epidemic in Dehong prefecture.</p><p><b>METHODS</b>The reviewed case reports, data of sentinel surveillance, testing and special survey were analyzed by SAS 8.0 program. The transmission patterns were modeled by utilizing data including sizes of the whole population and the high risk groups, high risk behavior data from 1989 to 2007, and the population index such as sex ratio and fertility rate.</p><p><b>RESULTS</b>In 2005, case reports showed the proportion of people infected with HIV through sexual contact was 39.1%, and 46.9% in 2006. Among 1636 cases reported between January 1 to September 20, 2007, the proportion of people infected with HIV through sexual contact was 52%. From 1989 to 2007, the proportion of HIV infection among drug users was declining, while HIV infection through sexual contact was rising after standardizing the population tested/surveyed. The Asian Epidemic Model has shown that the proportions of incident HIV infections through sexual transmissions were 50.6%, 52.3% and 52.7% respectively from 2005 to 2007. Correspondingly, the proportions of incident cases by injecting drug user were 48.9%, 47.2% and 46.7% respectively during this period. Moreover, the Workbook method has shown that, among adults living with HIV in 2007, 50.3% were infected through injecting drugs and 48.4% through unsafe sexual activity.</p><p><b>CONCLUSION</b>The rapid rise in HIV infections through injecting drug in Dehong prefecture has been initially curbed. HIV epidemic has already witnessed a change from predominantly through drug injecting-related activity to an almost equally fuelled epidemic by sexual and drug-related transmission.</p>

Analysis for epidemic trend of acquired immunodeficiency syndrome in Yunnan Province of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand epidemiologic characteristics and changes in epidemic trend of human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) in different areas and populations of Yunnan Province.</p><p><b>METHODS</b>Seroepidemiological studies were conducted in injection drug users (IDUs), women sex workers, whoring goers, patients with sexually transmitted disease (STD), patients with tuberculosis, pregnant women and blood donors with sentinel surveillance, ad hoc investigations, regular case-finding and data collection during 1989 to 2003 in Yunnan Province.</p><p><b>RESULTS</b>Relatively high prevalence of HIV/AIDS was firstly found in IDUs from border areas of the province in 1989. By December of 2003, totally 14 905 cases with HIV infection were reported in 121 counties of 16 prefectures in Yunnan Province. Prevalence of HIV infection ranged from 21.2% to 27.8% in IDUs, over 40% in IDUs from six areas, and 1.23% to 6.67% and 0.3% to 1.8% in underground prostitutes and whoring goers, respectively. Prevalence of HIV infection was 2.1% to 2.7%, 10.8% in specific areas, in male patients with STD, and was 0.14% to 0.25% in pregnant women during 1993 to 2002 and increased to 0.37% in 2003. Prevalence of HIV infection ranged 1.5% to 1.6% in patients with tuberculosis and 0.01% in blood donors during 1999 to 2000 and increased to 0.07% in 2003.</p><p><b>CONCLUSIONS</b>Epidemic of HIV infection began in late 1980s in Yunnan, then spread from border areas to inland through IDUs, maintaining a higher prevalence in them to date. Sexual transmission of HIV/AIDS showed an increasing trend in them, with a low prevalence in general population, but appeared a wide spread in local areas.</p>