RÉSUMÉ
Objective To apply Estimation and Projection Package (EPP) and Spectrum models for the estimation and projection on HIV/AIDS epidemics in areas with relatively low HIV/AIDS prevalence in China,and to explore the influences of antiretroviral therapy (ART) on the outputs of the models.Methods Taizhou prefecture in Zhejiang province was selected as the study site.Social and demographic data as well as all the information on HIV/AIDS epidemics in Taizhou prefecture were collected,managed,input to EPP and Spectrum models to estimate and project the HIV/AIDS epidemic in Taizhou prefecture.Impact of ART on the HIV/AIDS epidemic was also assessed.Results According to the estimates from both EPP and Spectrum model,the HIV/AIDS epidemic in Taizhou prefecture was at a relatively low level.HIV prevalence rates among men having sex with men (MSM) and injection drug users (IDU) were relatively high and rapidly increasing.It was estimated that 1773 (1384-2449) people were living with HIV in 2010 in Taizhou prefecture,with an overall HIV prevalence of 0.03％ (0.02％-0.04％).ART had reduced and would continue to reduce new HIV infections and AIDS deaths,but had no significant impact on the overall HIV prevalence and the numbers of people living with HIV and adults who were in need of ART.Conclusion EPP and Spectrum models seemed to be suitable and useful tools for estimation and projection on HIV/AIDS in Taizhou prefecture,and the results could provide reference for the further studies in other areas with a relatively low epidemic level of HIV/AIDS.ART appeared effective for HIV/AIDS prevention and control.
RÉSUMÉ
Objective To understand the risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province. Methods Newly reported HIV infections from May 2008 through March 2010 in Taizhou prefecture were invited to participate in a cross-sectional survey which requested numbers and contact information of individuals with whom they had had high risk contacts as well as risk behavioral acts with them. Persons having had risky contacts with HIV-infected cases were thereof approached to participate in this survey and to receive HIV testing.Those who tested positive for HIV were subject to further round of the surveys. Results A total of 267 HIV cases were newly reported during this study period. Among them, 191 participated in the survey and served as 'index cases', including 158 cases identified from routine HIV surveillance programs and 33 cases identified from the present survey. Heterosexual transmission was the primary transmission route (74.9%, or 143/191 ), followed by homosexual transmission ( 19.4%, or 37/191 )and injection drug use (5.8%, or 11/191 ). These 191 HIV cases reported a total of 1152 individuals with whom they had had risky contacts. They were able to provide contact information of 461 risk contacts. Of them, 129 received HIV testing and 61 (47.3%) tested positive for HIV. HIV prevalence was the highest among spouses or long-term sex partners of HIV cases (45.6%, or 47/103) and malesex partners of HIV-infected men having sex with men (MSM) (60.0%, or 12/20). Condom use wasvery low among them, with only 33.9% consistently using condoms for sex. Conclusion Newlyreported HIV infections in Taizhou prefecture reported a large and complicated risk behavioral networks and low condom use, suggesting a potential risk of HIV among these connected people,especially among MSM. Much efforts are needed to intervene these high risk subgroups and high risk behavioral networks.
RÉSUMÉ
Objective To study the prevalence of human immunodeficiency virus(Hiv),sexually transmitted infection(Sti),risk behavior and the sexual neworks among men who have sex with men (MSM)in Taizhou city，Zhejiang province.Methods cross-sectional Astudy was applied with venue-based sampling in 2 MSM gathering sites in Taizhou.'Informed Consent'principle was applied and MSM were studied through a structured questionnaire．Blood samples were collected from thee who accepted free and confidential HIV/STI counseling and then tested for HIV,syphilis,HCV and HsV-2 antibodies with ELISA.HIV positive sera were certified with western blot．Results 106 MSM were investigated and 97 qualified questionnaires were collected.25.0％(23/92)of these MSM have ever had l female sex partner while 47.8％(44/92)had 2 or more.14.3％(13/91)of them reported having had 1 male partner who had engaged in anal sex and 80.2％(73/91)had 2 or more.22.1％(19／86)of therh had partieipated in group sex but 62.5％(55／88)of them did not always use condom when having analintercourse.15.1％(14／93) of them had l orfll sex partner while 75.3％(70／93)having 2 or more.38.9％(37／95)of them had sex with female sex worker,and 35.5％(33／93)had sex with male-to-male sex worker.15.3％(13/85)0f them had once been male-to-male sex worker themselves.3.9％(3/77)of them were found HIV positive in blood tests,with 24.7％(18/73)positive of syphilis,15.1％(11/73)positive ofHSV-2 but HCV appeared to be negative.46 csses reported their egocentric recognition networks,with mean degree of 5.91(ranging0-10),and mesa density of 0.548(ranging 0．000-1.000).43 sexual networks were identified,with mean degree of 2.70(ranging 0-10),and mean density of 0.246(ranging 0.000-1.000).Conclusion Risk behaviors,such as multiple sex partners，IOW proportion of condom use and commercial sex engagement both with heterosexuals and homosexuals,were extensively existed among MSM in Taizhou,and the prevalence of HIV/STI was relatively high.Their sexual networks seemed complicated but there might be in place of some sukstantiaUy isolated MSM groups with high risk of Hlv/sTl infection.More study should be applied to identify the relationship between scxual networks and HIV/STI transmigsion.