A qualitative study on high risk behaviors and related factors of reported HIV/AIDS cases aged 60 years and above in some areas of Henan province / 中华流行病学杂志

Objective To understand the major high risk behaviors and related factors among reported HIV/AIDS cases aged ≥60 years in some areas of Henan province.Methods In Dengzhou,Xunxian county of Hebi and Xiangcheng county of Xuchang,where the reported number and proportion of HIV/AIDS cases aged ≥60 years were high,a face to face interview was conducted among the cases aged ≥60 years during July-August in 2016.The information about the high risk behaviors before HIV infection confirmation were collected by using a semi-structured questionnaire.Results A total of 33 HIV/AIDS cases aged ≥60 years were interviewed,including 28 males and 5 females.Their average age was 67.4 years.The infection route was sexual contact.The main findings revealed that the main factor for HIV infection in elder males was commercial heterosexual behavior with local female sex workers.The condom use rate was low.The poor awareness of the knowledge about AIDS prevention could explain why the elderly could not recognize the risk of HIV infection.There were also homosexual and bisexual behaviors in elder male HIV/AIDS patients.Late detection of HIV transmission among couples was the main cause of HIV infection in elder women.Conclusions The major epidemiological related factors for HIV infection in the elderly in some areas of Henan were unsafe sex behavior and the poor awareness of knowledge about AIDS prevention.A targeted strategy should be taken to control the spread of HIV in the elderly.

Effectiveness of prevention of mother to child HIV transmission in Henan province, 2002-2013 / 中华流行病学杂志

Objective To evaluate the effectiveness of the intervention on preventing mother to child transmission of HIV and identify the influencing factors.Methods The data regarding the pregnant women and their infants were collected,including demographic characteristics,pregnancy and delivery,access to antiviral therapy,HIV infection status at age 18 months and survival of infants between 2002 and 2013 through follow-up,Multivariate logistic regression model were used to identify the influencing factors.Results By the end of 2013,a total of 8 621 554 pregnant women received HIV test,among them 2 264 were infected with HIV.The positive rate of HIV is 0.03％.The HIV positive rate decreased year by year (x2=4.871,P=0.027).A total of 1 530 infants were born from 2002 to 2013,among them 1 384 survived and 92 died at age of 18 months,and 54 were lost for follow up.Sixty infants were tested to be HIV-positive,1 324 infants were tested to be HIV-negative.The mother to child transmission rate was 4.34％,the corrective mother to child transmission rate was 6.33％.Receiving HIV prevention service in early pregnancy (OR=0.26,95％ CI:0.09-0.77),standardized antiviral therapy OR=0.42,95％CI:0.21-0.82),artificial feeding (OR=0.06,95％CI:0.02-0.21) might be the mam protective factors,episiotomy on delivery (OR=3.91,95％ CI:1.74-8.80) might be the risk factors.Conclusion The HIV tested positive rate remained to be low and decreased year by year in pregnant women in Henan,but the mother to child HIV transmission rate was high.It is necessary to improve the prevention of mother to child HIV transmission.

A qualitative study on high risk behaviors and related factors of reported HIV/AIDS cases aged 60 years and above in some areas of Henan province / 中华流行病学杂志

Objective To understand the major high risk behaviors and related factors among reported HIV/AIDS cases aged ≥60 years in some areas of Henan province.Methods In Dengzhou,Xunxian county of Hebi and Xiangcheng county of Xuchang,where the reported number and proportion of HIV/AIDS cases aged ≥60 years were high,a face to face interview was conducted among the cases aged ≥60 years during July-August in 2016.The information about the high risk behaviors before HIV infection confirmation were collected by using a semi-structured questionnaire.Results A total of 33 HIV/AIDS cases aged ≥60 years were interviewed,including 28 males and 5 females.Their average age was 67.4 years.The infection route was sexual contact.The main findings revealed that the main factor for HIV infection in elder males was commercial heterosexual behavior with local female sex workers.The condom use rate was low.The poor awareness of the knowledge about AIDS prevention could explain why the elderly could not recognize the risk of HIV infection.There were also homosexual and bisexual behaviors in elder male HIV/AIDS patients.Late detection of HIV transmission among couples was the main cause of HIV infection in elder women.Conclusions The major epidemiological related factors for HIV infection in the elderly in some areas of Henan were unsafe sex behavior and the poor awareness of knowledge about AIDS prevention.A targeted strategy should be taken to control the spread of HIV in the elderly.

Effectiveness of prevention of mother to child HIV transmission in Henan province, 2002-2013 / 中华流行病学杂志

Objective To evaluate the effectiveness of the intervention on preventing mother to child transmission of HIV and identify the influencing factors.Methods The data regarding the pregnant women and their infants were collected,including demographic characteristics,pregnancy and delivery,access to antiviral therapy,HIV infection status at age 18 months and survival of infants between 2002 and 2013 through follow-up,Multivariate logistic regression model were used to identify the influencing factors.Results By the end of 2013,a total of 8 621 554 pregnant women received HIV test,among them 2 264 were infected with HIV.The positive rate of HIV is 0.03％.The HIV positive rate decreased year by year (x2=4.871,P=0.027).A total of 1 530 infants were born from 2002 to 2013,among them 1 384 survived and 92 died at age of 18 months,and 54 were lost for follow up.Sixty infants were tested to be HIV-positive,1 324 infants were tested to be HIV-negative.The mother to child transmission rate was 4.34％,the corrective mother to child transmission rate was 6.33％.Receiving HIV prevention service in early pregnancy (OR=0.26,95％ CI:0.09-0.77),standardized antiviral therapy OR=0.42,95％CI:0.21-0.82),artificial feeding (OR=0.06,95％CI:0.02-0.21) might be the mam protective factors,episiotomy on delivery (OR=3.91,95％ CI:1.74-8.80) might be the risk factors.Conclusion The HIV tested positive rate remained to be low and decreased year by year in pregnant women in Henan,but the mother to child HIV transmission rate was high.It is necessary to improve the prevention of mother to child HIV transmission.

Factors associated with high-risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnosis in some areas in Henan province / 中华流行病学杂志

Objective To understand the factors associated with high risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnoses in some areas in Henan province,and evaluate the risk of secondary transmission.Methods A face to face interview was conducted among people infected with HIV through heterosexual contact by using self-designed questionnaires during January-May in 2015.Results Among 361 HIV infected persons,the proportions of those with commercial heterosexual behaviors or sex with irregular sex partners decreased from 77.3％(279/361) and 28.5％(103/361) before diagnosis to 13.6％ (49/361) and 2.5％(9/361) after diagnosis,the difference was significant (x2=16.66,P＜0.001;x2=4.80,P=0.03).The subjects surveyed always had more commercial heterosexual behaviors in Henan,Guangdong and Zhejiang provinces before and after diagnosis.After HIV infection confirmation,the condom use rates were 51.0％(25/49) for commercial heterosexual behaviors,88.5％ (184/208) for sex with regular partners and 88.9％(8/9) for sex with irregular partners,respectively.Multivariate logistic regression analysis indicated that risk behaviors associated with HIV transmission included commercial sexual behaviors,previous HIV detection and age of 35 years or older.Conclusions Extra-marital heterosexual behavior has posed serious challenge to the prevention and control of HIV spread.It is necessary to inform the HIV test results,improve the intervention and promote condom use in people with history of commercial sex and people aged ≥35 years.

Survival analysis of the AIDS patients under 14 years of age and receiving antiretroviral treatment in Henan province from 2003 to 2014 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the survival status and influencing factors of the AIDS patients under 14 years of age and receiving antiretroviral treatment in Henan Province.</p><p><b>METHODS</b>Database of children AIDS patients receiving ART were download from China information system for disease preventioin and control-AIDS, AIDS cases from January, 2003 to June, 2014 were selected to be analyzed. Demographic characteristics baseline laboratory inclusion criteria: F First time receive national free ART during study; aged 14 years or below; and with relatively complete baseline information and follow-up information. 1 037 cases were selected. Patient information about survival status, death, demographic characteristics, and baseline laboratory test results were analyzed. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by COX proportional hazard model.</p><p><b>RESULTS</b>A total of 1 037 AIDS children-cases ((9.52 ± 3.56) years old) which included 628 boys and 409 girls were recruited in the study, 939 cases survived 1 to 9 years from starting ART treatment and 98 cases died. Accumulated survival rate of AIDS children receiving ART from 1 year to 9 years were 96.11%, 94.17%, 92.74%, 91.28%, 90.54%, 89.47%, 88.52%, 88.52%, 86.84%, respectively. Results of multivariate analysis showed baseline count of CD4⁺ T lymphocyte (HR = 0.51, 95% CI: 0.36-0.72), duration from confirmation to the initial ART time (HR = 0.85, 95% CI: 0.75-0.97) and hemoglobin level (HR = 2.26, 95% CI: 1.09-4.70) were influence factors for survival time of AIDS children patients receiving ART.</p><p><b>CONCLUSION</b>Survival rate of AIDS children aged 14 years or below and receiving ART in Henan Province was relatively high. Timely surveillance of CD4⁺ T and the hemoglobin level of the AIDS patients so as to timely launch HARRT could extend survival time of AIDS patients.</p>

Survival analysis of AIDS patients of 15 years or above years old after initiation antiretroviral treatment in Henan province during 2005 to 2014 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the survival rate of AIDS patients after receiving antiretroviral therapy(ART) in Henan province and to determine factors associated with survival status.</p><p><b>METHODS</b>Database of AIDS patients receiving ART were downloaded from China Information System for Disease Preventioin and Control-AIDS, retrospective study method was conducted to analyze the information.</p><p><b>INCLUSION CRITERIA</b>initially received national free ART during January, 2005 to December, 2014; aged 15 years or above; and with relatively complete baseline information and follow-up information. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by Cox proportional hazard model.</p><p><b>RESULTS</b>Total 30 376 AIDS patients were enrolled in this study. During the follow-up period, a total of 3 927 cases died from HIV/AIDS related diseases. The mortality of all patients was 3.2/100 person year. After 1, 5, 10 years after the initiation of ART, the rates of accumulate survival rate were 93.7%, 85.3%, and 78.4%, respectively. Stepwise regression was used to conduct the time multiple factors analysis, the results showed that man (HR=1.28, 95%CI: 1.20-1.37), older age (HR=1.20, 95% CI: 1.16-1.24), others marital status except marrage or cohabitation (HR=1.20,95% CI: 1.12-1.29), more number of symptoms (HR=1.11, 95%CI: 1.07-1.14), initial treatment were main stavudine (D4T) or zidovudine (AZT)+ didanosine(DDI)+ nevirapine (NVP) or efevirenz (EFV) (HR=1.12, 95% CI: 1.04-1.20), missing drug in the past 7 days (HR=18.36,95%CI: 17.08-19.74) among AIDS patients had high mortality risk, homosexuality sexual transmission (HR=0.59, 95% CI: 0.40-0.87), higher baseline count of CD4(+)T lymphocyte (relative to 0-200 cells/µl group, HR (95%CI) were 0.57 (0.53-0.62), 0.43(0.37-0.49), 0.33 (0.27-0.40) in 201-350 cells/µl group, 351-500 cells/µl group, and ≥501 cells/µl group, respectively), higher educations (HR=0.89, 95% CI: 0.83-0.95) had low mortality risk.</p><p><b>CONCLUSION</b>Survival rate was higher after initial antiretroviral treatment among AIDS patients in Henan province. AIDS patient will have shorter survival time after antiviral treatment under one or more following conditions: higher age, male, initial treatment with D4T or AZT + DDI + NVP or EFV, lower baseline CD4 (+) T lymphocyte count, ever missed antiviral drugs in past 7 days of latest follow-up.</p>

Analysis on HIV suppression effect after initiating antiretroviral treatment and related factors among AIDS patients in Henan province during 2008 and 2013 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To compare the HIV suppression rate after initiating antiretroviral treatment(ART) among AIDS patients at different immunological levels and to analyze the related factors.</p><p><b>METHODS</b>Data on AIDS patients initially starting antiretroviral therapy during 2008 and 2013 were collected from Chinese HIV/AIDS integrated control system. All the participants were divided into early treatment group(baseline CD4(+)T cell counts between 351/µl and 500/µl) and conventional treatment group(baseline CD4(+)T cell counts ≤ 350/µl). The rates of comprehensive virologic suppression at different time nodes after the initiation of ART were analyzed accordingly. Unconditional logistic regression model was adopted to examine the factors associated with the failure of viral suppression after 6 months after initiation of ART.</p><p><b>RESULTS</b>A total of 16 103 cases were selected, among which, 1 581 cases were early treatment group, and 14 522 cases were conventional treatment group. A total of 9 428 cases were males, 6 675 cases were females, and the sex ratio was 1.41: 1. The age was 47.2 ± 11.7, and 71.55% (11 522/16 103) of cases were married or cohabiting, 57.22% (9 214/16 103) were transmitted by blood. 81.26% (13 086/16 103) were cures in the township or village treatment institution, and 77.17% (12 426/16 103) received the ART regimen as Stavudine(D4T) or Zidovudine(AZT)+Lamivudine(3TC)+Nevirapine(NVP) or Efevirenz(EFV). After 0.5, 1, 2, 3, 4, 5 and 6 years after the initiation of ART, the rates of virologic suppression in the conventional treatment cohort were 72.6% (3 008/4 144), 73.9% (4 758/6 443), 74.1% (3 641/4 915), 74.9% (2 819/3 766), 76.1% (1 729/2 272) and 78.2% (492/629), respectively. While the rates of viral suppression in the early treatment cohort at the same time nodes were 65.5% (315/481), 65.4% (448/685), 68.8% (223/324), 66.0% (155/235), 71.4% (110/154) and 61% (30/49), respectively, and the differences between the two groups were significant (P < 0.05) except at the fourth year. Non-conditional logistic regression analysis showed that in the conventional treatment group, factors associated with low HIV suppression rate were male (OR = 1.23, 95%CI:1.07-1.42) , longer time interval from confirmed HIV infection to received ART (OR = 1.26, 95%CI:1.16-1.36) , using D4T/AZT+ DDI +NVP/EFV as initial treatment regimen (OR = 3.00, 95%CI:2.26-3.98) and nearly missing doses for 7 days at treatment of six months (OR = 1.97, 95%CI:1.22-3.18) and factors associated with high HIV suppression rate were infected through homosexual transmission route (OR = 0.57, 95%CI:0.35-0.90) and treated in the county level medical institution or above (OR = 0.61, 95%CI:0.50-0.75) . Among early treatment group, cases who received treatment at county level medical institution or above had high HIV suppression rate (OR = 0.43, 95%CI:0.23-0.80) and objects with longer time interval from confirmed HIV infection to receive ART had low HIV suppression rate (OR = 1.43, 95%CI:1.09-1.88).</p><p><b>CONCLUSION</b>The viral suppression efficacy among AIDS patients with different baseline immunologic levels after treatment was similarly satisfactory. AIDS cases who received ART at county level medical institution or above had better viral suppression effect and patients with longer time interval from confirmation to treatment had poor HIV suppression effect.</p>

Quality evaluation of hospitalized hepatitis C cases reporting in Henan province, 2014 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the network reporting quality of hepatitis C cases in Henan province in 2014.</p><p><b>METHODS</b>The data of hepatitis C case reporting was collected from selected medical institutions in Henan province in 2014. According to current reporting standards, the evaluation of reporting rate, the timely reporting rate, the underreporting rate, the false reporting rate and the anti HCV positive and HCV-RNA positive reporting rate of hepatitis C cases were evaluated.</p><p><b>RESULTS</b>A total of 2 778 hospitalized hepatitis C cases in 170 medical and health institutions were surveyed, the reporting rate was 84.10%, the timely reporting rate was 100.00%, the underreporting rate was 15.90%, the false reporting rate was 13.17% and the anti-HCV positive and HCV-RNA positive reporting rate was 91.06%. The coincidence rate of diagnosis and reporting was 58.61%, the coincidence rate of acute or chronic cases was 30.93%. More clinical diagnosed cases were underreported. The coincidence rate of laboratory confirmed cases reporting were low. The diagnosis and reporting coincidence rate was low in provincial medical institutions.</p><p><b>CONCLUSION</b>In Henan, the hepatitis C case reporting rate was high, the anti-HCV positive and HCV-RNA positive reporting rate needs to be improved. The coincidence rate of hepatitis C reporting was low. Underreporting and false reporting still existed. The quality of hepatitis C reporting in provincial medical and health institutions needs to be improved.</p>

Prevalence of hepatitis C virus antibody among newly reported HIV infection cases in Henan, 2012-2014 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the prevalence of antibody to hepatitis C virus (anti-HCV) among newly reported HIV infection cases in Henan province, 2012-2014.</p><p><b>METHODS</b>HIV-1 BED incidence test and anti-HCV test were conducted in newly diagnosed HIV infection cases in Henan, which were reported through national AIDS information system between 1 July 2012 and 30 June 2014.</p><p><b>RESULTS</b>The data of 4 267 newly reported HIV-1 infection cases were analyzed, the positive rate of anti-HCV was 13.19% (563/4 267). The anti HCV was highest in those infected with HIV through injection drug use (77.27%), the anti-HCV positive rates in those infected with HIV through blood donation/transfusion, heterosexual contact, homosexual contact and mother-to-child transmission were 15.06%, 15.81%, 3.74% and 8.96%, respectively. Kaifeng (32.04%), Nanyang (14.67%), Shangqiu (25.00%), Zhumadian (25.00%) and Zhoukou (18.86%) were the first five prefectures with the high anti-HCV positive rates. The anti-HCV positive rate in BED positive patients (recent HIV-1 infections) was 7.50% (86/1 146). The multivariate logistic regressions analysis revealed that BED negative, aged >40 years, being farmer, HIV infection though injection drug use and living in in Kaifeng, Nanyang, Shangqiu, Zhumadian and Zhoukou were the risk factors for HCV infection.</p><p><b>CONCLUSION</b>The positive rate of anti-HCV declined between 2012-2014 in newly reported HIV infection cases in Henan, but the positive rate of anti-HCV was high in risk population and in some areas.</p>