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Objective To understand the survival status and influencing factors for HIV/AIDS patients on highly active anti-retroviral therapy (HAART) in Shandong province.Methods Both Kaplan-Meier (K-M) method and cumulative incidence function (CIF) were used to calculate the cumulative incidence of AIDS-related death respectively,and Fine-Gray model was used to identify the influencing factors related to survival time.Results Through K-M method,a higher AIDS-related cumulated death rate than the CIF,was estimated.Among all the HIV/AIDS patients who initiated HAART from 2003 to 2015 in Shandong,5 593 of them met the inclusion criteria.The cumulative incidence rate for AIDS-related death was 3.08％ in 1 year,4.21％ in 3 years,5.37％ in 5 years,and 7.59％ in 10 years respectively by CIF.Results from the F-G analysis showed that HIV/AIDS patients who were on HAART,the ones who had college degree or above (HR=0.40,95％CI:0.24-0.65) were less likely to die of AIDS-associated diseases.However,HIV/AIDS patients who were on HAART and living in the western areas of Shandong (HR=1.33,95％CI:1.01-1.89),diagnosed by medical institutions (HR=1.39,95％CI:1.06-1.80),started to receive care ≥1 year after diagnosis (HR=2.02,95％CI:1.30-3.15),their CD,cell count less than 200 cells/μl (HR=3.41,95％CI:2.59-4.59) at the time of diagnosis,with NVP in antiviral treatment (ART) regime (HR=1.36,95％CI:1.03-1.88),at Ⅲ/Ⅳ clinical stages (HR=2.61,95％CI:1.94-3.53) and CD4 cell count less than 350 cells/μl (HR=5.48,95％CI:2.32-12.72) at initiation of HAART ect.,were more likely to die of AIDS-associated diseases.Conclusions With the existence of competing risks,the cumulative incidence rate for AIDS-related death was overestimated by K-M,suggesting that competing risk models should be used in the survival analysis.Measures as early diagnoses followed by timely care and early HAART could end up with the reduction of AIDS-related death.
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Objective To understand the survival status and influencing factors for HIV/AIDS patients on highly active anti-retroviral therapy (HAART) in Shandong province.Methods Both Kaplan-Meier (K-M) method and cumulative incidence function (CIF) were used to calculate the cumulative incidence of AIDS-related death respectively,and Fine-Gray model was used to identify the influencing factors related to survival time.Results Through K-M method,a higher AIDS-related cumulated death rate than the CIF,was estimated.Among all the HIV/AIDS patients who initiated HAART from 2003 to 2015 in Shandong,5 593 of them met the inclusion criteria.The cumulative incidence rate for AIDS-related death was 3.08％ in 1 year,4.21％ in 3 years,5.37％ in 5 years,and 7.59％ in 10 years respectively by CIF.Results from the F-G analysis showed that HIV/AIDS patients who were on HAART,the ones who had college degree or above (HR=0.40,95％CI:0.24-0.65) were less likely to die of AIDS-associated diseases.However,HIV/AIDS patients who were on HAART and living in the western areas of Shandong (HR=1.33,95％CI:1.01-1.89),diagnosed by medical institutions (HR=1.39,95％CI:1.06-1.80),started to receive care ≥1 year after diagnosis (HR=2.02,95％CI:1.30-3.15),their CD,cell count less than 200 cells/μl (HR=3.41,95％CI:2.59-4.59) at the time of diagnosis,with NVP in antiviral treatment (ART) regime (HR=1.36,95％CI:1.03-1.88),at Ⅲ/Ⅳ clinical stages (HR=2.61,95％CI:1.94-3.53) and CD4 cell count less than 350 cells/μl (HR=5.48,95％CI:2.32-12.72) at initiation of HAART ect.,were more likely to die of AIDS-associated diseases.Conclusions With the existence of competing risks,the cumulative incidence rate for AIDS-related death was overestimated by K-M,suggesting that competing risk models should be used in the survival analysis.Measures as early diagnoses followed by timely care and early HAART could end up with the reduction of AIDS-related death.
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Objective@#To investigate the associations between smoking and literacy on health among 4-6 grade primary school students.@*Methods@#A questionnaire survey was conducted to research on health literacy and smoking among 4-6 grade pupils in Shandong province, through a multi-stage stratified cluster random sampling method. Sociodemographic characteristics, health literacy level and smoking rate were collected from respondents. Binary logistic regression analysis was used to evaluate the association of smoking and health literacy.@*Results@#A total of 9 240 questionnaires were distributed, with the rate of valid response as 99.7%. The current smoking rate of the students was 2.6%, on higher in boys (3.1%) than in girls (2.0%). 60.8% of 4-6 grade students were found to have adequate health literacy level. Levels of literacy health in both boy and girl school students appeared 56.7% and 64.9%, respectively. Results indicated that health literacy in smokers (14.4%) was lower than that in non-smokers (62.0%). Results from the binary logistic regression analysis showed that the independent influencing factors would include grade, father’s education level, economic situation of the family, self-assessment on the school record and literacy on health (P<0.01). After controlling the other independent variables, the smoking rate was 8.62 (1/0.116) times in students with low literacy level on health, than those with high literacy level.@*Conclusions@#Literacy on health was significantly associated with smoking in the 4-6 grade pupils of Shandong province.
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Objective@#This study aimed to examine the demographic characteristics, HIV related knowledge and behavior, correlates of bisexual behavior and status of HIV infection among men who have sex with men only (MSMO) and men who have sex with both men and women (MSMW) in Shandong province.@*Methods@#According to the requirements from "National HIV/AIDS sentinel surveillance program" , a cross-sectional survey was conducted to collect information on demographics, sexual and drug use behaviors, and HIV-related services among MSM in nine sentinel surveillance sites from April to July in 2018. Blood samples were drawn for serological tests on both HIV and syphilis antibodies.@*Results@#A total of 3 474 participants were included in this study. Related information on these participants would include: average age as (31.66±9.01) years; 35.06% (1 218) married or cohabiting with a woman, 50.52% (1 755) had college or higher education, 80.11% (2 783) self-identified as gays and 14.22% (494) self-identified as bisexual men,16.87% (586) ever having sex with woman in the past 6 months, 10.51% (365) ever using drugs. HIV and syphilis prevalence rates were 2.99% (104/3 474) and 2.76%(96/3 474). Through multivariable logistic models, MSMW were more likely to be ≥35 years of age, local residents, self-identified as heterosexual/bisexual/uncertain, ever having commercial sex with man but less likely to consistently use condoms in the past 6 months, less using internet/dating software to find male sex partners and less using drugs. There was no significant differences noticed in the following areas: number of sexual partners in the last week, condom use in the last six months with commercial sex partners, with HIV or syphilis infection and self-reported history of STD in the past year between MSMO and MSMW (P>0.05). HIV-infected MSM were more likely to have the following features, ≥45 years of age, non-local residents, finding male sex partners from the bothhouses, park/toilets or from the internet/dating software, also less likely to consistently use condoms in the past 6 months, using drugs or with syphilis infection.@*Conclusions@#High prevalence of bisexual behavior as well as higher risk of HIV infection were noticed among MSM in Shandong province. It is important to strengthen related surveillance and effective intervention programs for MSM with different characteristics in Shandong province.
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A survey was conducted to analyze the HIV testing status and related influencing factors of male sexually transmitted diseases(STD) patients attending 18 county-level hospitals in Shandong Province from July 2015 to August 2016. The HIV detection rate of 1 570 subjects was 77.58% (1 218/1 570), and the HIV-antibody positive rate was 0.99% (12/1 218). Compared with general hospitals patients, urinary and anorectal patients, non-sexual patients, and patients with negative attitudes toward HIV testing, patients were more likely to be tested for HIV from specialized hospitals (OR=3.74, 95%CI:2.53-5.54), the skin and venereal section (OR=1.92, 95%CI: 1.31-2.79), the STD group (OR=2.02, 95%CI: 1.34-3.03) and patients with positive attitude (OR=15.20, 95%CI:10.74-21.52).
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Objective@#To understand the survival status of AIDS patients after initiation of antiretroviral treatment (ART) in Shandong province during 2003 to 2017, and to determine the factors associated with survival status.@*Methods@#A retrospective cohort study was conducted among AIDS patients initially received antiretroviral therapy from 2003 to 2017. The epidemiological characteristics of the subjects were described, and life tables were used to estimate the survival rates, the influencing factors were analyzed by Cox regression model.@*Results@#A total of 9 813 cases were enrolled in this study, of the subjects, the median age was 34.9±11.0 years. The median of baseline CD4+ T lymphocyte count was 300.0(P25-P75: 163.0, 428.0)cells/μl, and 83.2% of them were at clinical stage Ⅰ (World Health Organization, WHO). The cumulative survival rates were 97.7%, 96.7%, 95.8% and 93.7%, 1, 3, 5, and 10 years after the initiation of ART respectively. Multivariate Cox regression model analysis showed that the risk of the mortality among those infected through homosexual behavior was 38% lower than that of patients infected via blood or other routes, and HR was 0.62 (95%CI: 0.43-0.89). Higher education level had lower mortality risk(the mortality risk of those with university degree or above was lower, compared to those with primary and lower cultural level, HR=0.41, 95%CI: 0.26-0.65). At baseline, AIDS patients at clinical stage Ⅰ(WHO) had lower mortality risk than those who were at clinical stageⅡ, Ⅲ, and Ⅳ(WHO). Lower baseline CD4+ T lymphocyte count had higher mortality risk.@*Conclusions@#Survival rate was higher after initial antiretroviral therapy among AIDS patients in Shandong province. CD4+ T lymphocyte count level, WHO clinical stage, and presence or absence of clinical symptoms at baseline are the main factors influencing the survival time of AIDS patients after ART.
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Objective To analyze the epidemiological characteristics,dynamic trend of development and related influencing factors of hepatitis C in Shandong,China,2007-2016,also to provide epidemiological evidence for prevention and control of HCV.Methods National surveillance data of hepatitis C from 2007 to 2016 in Shandong was used,with distribution and clustering map of hepatitis C drawn at the county level.Panel Poisson regression was used to explore the influencing factors of hepatitis C at the city level.Results The incidence of hepatitis C in Shandong increased from 1.49/100 000 in 2007 to 4.72/100 000 in 2016,with the high incidence mainly clustered in the urban regions in Jinan,Zibo,Weihai et al.and surrounding vicinities.Majority of the cases were young adults,with 53.16％ (14 711/27 671) of them being farmers.Results from the Multiple panel Poisson regression analysis indicated that factors as:population density (aIRR=1.07,95％ CI:1.05-1.10),number of hospital per hundred thousand people shared (aIRR=1.16,95％CI:1.08-1.24),expenditure of medical fee in rural (aIRR=1.21,95％CI:1.08-1.37) and the proportion of the tertiary industry (aIRR=1.08,95％ CI:1.07-1.09) were all correlated to the incidence of hepatitis C.Conclusions The incidence of hepatitis C had been increasing rapidly in recent years,in Shandong.Prevention and control of HCV should focus on high risk population.In addition,rural,especially in areas with lower economics provision should be under more attentions,so as to find more concealed cases for early treatment.
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Objective To explore the causes of secondary drug resistance among HIV infected persons who were receiving antiretroviral therapy in Shandong province,and provide evidence for the improvement of antiretroviral therapy strategy.Methods A case-control study was designed with 1 ∶ 2 matching on case and control groups.Household and face-to-face interview were conducted in October,2015.All the study subjects were screened from both the drug resistant database of antiretroviral therapy of Shandong provincial laboratory and national comprehensive HIV/AIDS database in Shandong.The sample size was estimated as 330 cases including 110 drug resistant and 220 non-drug resistant cases.Subjects were people living with HIV/AIDS (PLWHA) aged 15 or older and received antiretroviral therapy for more than 6 months with records of virus load (VL).Subjects who presented VL above 1 000 copies/ml would receive drug resistance testing.Subjects who were confirmed resistant to with secondary drug,were selected as case group,the rest subjects with non-secondary drug resistance would form the control group.EpiData 3.1 software and SPSS 22.0 software were used to establish a database.Related influencing factors were analyzed with non-conditional stepwise logistic regression model.Results A total of 288 cases were enrolled,including 103 in the case and 185 cases in the control groups,with average age as (37.62 ± 1.06) years and (37.90 ± 0.74)years old,respectively.Most of them were male,married/cohabitant,with education level of junior/senior high school or below and under Han nationality.Results from the multivariate logistic regression model showed that ORs (95％CI) of receiving antiretroviral therapy for 1-3 years,or more than 3 years were equal to 8,80 (3.69-21.00),3.00 (1.20-7.53),compared with receiving antiretroviral therapy less than one year,respectively.OR (95％ CI) of Among the PLWHA that with missing rate above 25.0％ on medication,the OR appeared as 15.41(4.59-51.71),compared with not missing medication.OR (95％ CI) among those who took the medicine themselves was 0.22 (0.07-0.74).Conclusions Factors as duration of treatment,missing rate on medication and taking medicine by oneself were of influence on secondary drug resistance.Other factors as duration on antiretroviral therapy longer than 1 year,missing rate above 25.0％ on medication,were related to the risk on secondary drug resistance.However,if the medicine was taken by oneself,it served as a protective factor for secondary drug resistance.It is necessary to strengthen the intervention and health education programs related to antiretroviral therapy.
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Lead time bias might exist in observational study for clinical outcomes.This paper summarizes the concept of lead time bias,causes and control of lead time bias by using the studies of influences of screening diagnostic test on cancer patients' survival and highly active antiretroviral therapy on HIV/AIDS patients' survival as examples for the purpose of providing thinking and methods in the control of lead time bias for the accurate evaluation of the effects of interventions,such as test and treatment,on the diseases with multi courses or phases.
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Objective This study aimed to understand the herpes simplex virus-2 (HSV-2) infection and related factors among female drug abusers in the women's compulsory drug rehabilitation center of Shandong province and to provide reference for the prevention and control of HSV-2 in these settings.Methods We screened all of 451 female drug abusers in the women's compulsory drug rehabilitation centers in of Shandong province and conducted a study using both questionnaire investigation and serological tests for HSV-2,HIV and syphilis.We also used EpiData 3.1 software to establish a database and SPSS 20.0 software to conduct the x2 test and multivariate logistic regression analysis.Results A total of 451 female drug abusers were under study.We noticed that the rates for HSV-2 infection,HIV infection and syphilis infection appeared as 72.1％ (325/451),2.2％ (10/451) and 33.5 ％ (151/451) respectively.Results from univariate analysis showed that factors as:awareness on AIDS,having temporary sex partner after using the drug,having multiple sex partners after using the drug,providing commercial services or having temporary sex practice before being detained,with syphilis infection etc.,were associated with HSV-2 infection.Data from the multivariate analysis showed that the OR (95％CI) value of HSV-2 infection was 2.90 (1.19-7.06) for those who providing commercial service,when comparing to those who did not.Compared to those who did not suffer from syphilis infection,the OR (95％CI) value of HSV-2 infection for those with syphilis infection was 2.75 (1.63-4.63).Conclusions The rate of HSV-2 infection was high in the women's compulsory drug rehabilitation center of Shandong province.We should enhance measures and promote condom use to prevent from HSV-2 and other sexually transmitted diseases among them.
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Objective To analyze the epidemiological characteristics,dynamic trend of development and related influencing factors of hepatitis C in Shandong,China,2007-2016,also to provide epidemiological evidence for prevention and control of HCV.Methods National surveillance data of hepatitis C from 2007 to 2016 in Shandong was used,with distribution and clustering map of hepatitis C drawn at the county level.Panel Poisson regression was used to explore the influencing factors of hepatitis C at the city level.Results The incidence of hepatitis C in Shandong increased from 1.49/100 000 in 2007 to 4.72/100 000 in 2016,with the high incidence mainly clustered in the urban regions in Jinan,Zibo,Weihai et al.and surrounding vicinities.Majority of the cases were young adults,with 53.16％ (14 711/27 671) of them being farmers.Results from the Multiple panel Poisson regression analysis indicated that factors as:population density (aIRR=1.07,95％ CI:1.05-1.10),number of hospital per hundred thousand people shared (aIRR=1.16,95％CI:1.08-1.24),expenditure of medical fee in rural (aIRR=1.21,95％CI:1.08-1.37) and the proportion of the tertiary industry (aIRR=1.08,95％ CI:1.07-1.09) were all correlated to the incidence of hepatitis C.Conclusions The incidence of hepatitis C had been increasing rapidly in recent years,in Shandong.Prevention and control of HCV should focus on high risk population.In addition,rural,especially in areas with lower economics provision should be under more attentions,so as to find more concealed cases for early treatment.
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Objective To explore the causes of secondary drug resistance among HIV infected persons who were receiving antiretroviral therapy in Shandong province,and provide evidence for the improvement of antiretroviral therapy strategy.Methods A case-control study was designed with 1 ∶ 2 matching on case and control groups.Household and face-to-face interview were conducted in October,2015.All the study subjects were screened from both the drug resistant database of antiretroviral therapy of Shandong provincial laboratory and national comprehensive HIV/AIDS database in Shandong.The sample size was estimated as 330 cases including 110 drug resistant and 220 non-drug resistant cases.Subjects were people living with HIV/AIDS (PLWHA) aged 15 or older and received antiretroviral therapy for more than 6 months with records of virus load (VL).Subjects who presented VL above 1 000 copies/ml would receive drug resistance testing.Subjects who were confirmed resistant to with secondary drug,were selected as case group,the rest subjects with non-secondary drug resistance would form the control group.EpiData 3.1 software and SPSS 22.0 software were used to establish a database.Related influencing factors were analyzed with non-conditional stepwise logistic regression model.Results A total of 288 cases were enrolled,including 103 in the case and 185 cases in the control groups,with average age as (37.62 ± 1.06) years and (37.90 ± 0.74)years old,respectively.Most of them were male,married/cohabitant,with education level of junior/senior high school or below and under Han nationality.Results from the multivariate logistic regression model showed that ORs (95％CI) of receiving antiretroviral therapy for 1-3 years,or more than 3 years were equal to 8,80 (3.69-21.00),3.00 (1.20-7.53),compared with receiving antiretroviral therapy less than one year,respectively.OR (95％ CI) of Among the PLWHA that with missing rate above 25.0％ on medication,the OR appeared as 15.41(4.59-51.71),compared with not missing medication.OR (95％ CI) among those who took the medicine themselves was 0.22 (0.07-0.74).Conclusions Factors as duration of treatment,missing rate on medication and taking medicine by oneself were of influence on secondary drug resistance.Other factors as duration on antiretroviral therapy longer than 1 year,missing rate above 25.0％ on medication,were related to the risk on secondary drug resistance.However,if the medicine was taken by oneself,it served as a protective factor for secondary drug resistance.It is necessary to strengthen the intervention and health education programs related to antiretroviral therapy.
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Lead time bias might exist in observational study for clinical outcomes.This paper summarizes the concept of lead time bias,causes and control of lead time bias by using the studies of influences of screening diagnostic test on cancer patients' survival and highly active antiretroviral therapy on HIV/AIDS patients' survival as examples for the purpose of providing thinking and methods in the control of lead time bias for the accurate evaluation of the effects of interventions,such as test and treatment,on the diseases with multi courses or phases.
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Objective This study aimed to understand the herpes simplex virus-2 (HSV-2) infection and related factors among female drug abusers in the women's compulsory drug rehabilitation center of Shandong province and to provide reference for the prevention and control of HSV-2 in these settings.Methods We screened all of 451 female drug abusers in the women's compulsory drug rehabilitation centers in of Shandong province and conducted a study using both questionnaire investigation and serological tests for HSV-2,HIV and syphilis.We also used EpiData 3.1 software to establish a database and SPSS 20.0 software to conduct the x2 test and multivariate logistic regression analysis.Results A total of 451 female drug abusers were under study.We noticed that the rates for HSV-2 infection,HIV infection and syphilis infection appeared as 72.1％ (325/451),2.2％ (10/451) and 33.5 ％ (151/451) respectively.Results from univariate analysis showed that factors as:awareness on AIDS,having temporary sex partner after using the drug,having multiple sex partners after using the drug,providing commercial services or having temporary sex practice before being detained,with syphilis infection etc.,were associated with HSV-2 infection.Data from the multivariate analysis showed that the OR (95％CI) value of HSV-2 infection was 2.90 (1.19-7.06) for those who providing commercial service,when comparing to those who did not.Compared to those who did not suffer from syphilis infection,the OR (95％CI) value of HSV-2 infection for those with syphilis infection was 2.75 (1.63-4.63).Conclusions The rate of HSV-2 infection was high in the women's compulsory drug rehabilitation center of Shandong province.We should enhance measures and promote condom use to prevent from HSV-2 and other sexually transmitted diseases among them.
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Objective@#To analyze the epidemic features of male HIV-infected and AIDS patients by sexual transmission in Shandong Province.@*Methods@#Data on HIV-infected people and AIDS patients (HIV/AIDS) were derived from HIV/AIDS Comprehensive Response Information Management System. To analysis the epidemiological data of male HIV/AIDS by sexual transmission reported in Shandong Province from 1997 to 2016.@*Results@#A total of 8 584 HIV/AIDS were reported by heterosexual transmission or homosexual transmission from 2007 to 2016. 2 421 cases were reported by heterosexual transmission and 6 163 cases were reported by homosexual transmission. Among cases infected by heterosexual transmission. The average age of cases infected by heterosexual transmission was (38.13±12.39) and (31.62±10.22) among cases who infected by homosexual transmission (t=24.95, P<0.001). 84 cases were reported by homosexual transmission and 138 cases by heterosexual transmission from 2007 to 2008, and 6 079 cases were reported by homosexual transmission and 2 283 cases by heterosexual transmission from 2009 to 2016. A total of 770 cases were dead after reported. Among the dead cases, 337 cases were infected by homosexual transmission and 433 cases by heterosexual transmission (χ2=328.21, P<0.001). 61.4% of the dead cases by heterosexual transmission were no longer than 6 months after reported and 54.3% in homosexual transmission (χ2=3.96, P=0.047).@*Conclusion@#Homosexual transmission has been the main transmission of HIV/AIDS in Shandong Province. Epidemiological features and social demographic characteristics of each sexual transmission were different. As part of HIV cases developed to death in 6 months.
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Objective@#To describe the confirmation process and long-term follow-up results of 1 case of HIV with long term progression.@*Methods@#The subject was a HIV infected man aged 27 years old. The first HIV antibody positive was detected by ELISA in August 7th, 2013. Close contacts were identified as 3 homosexual partners who had been contacted before infection and the first sexual partner had been unable to get in touch. Adopting the first epidemiological survey questionnaire of AIDS comprehensive prevention and control information system in China, the investigators conducted face-to-face surveys on the general demographic characteristics and behavioral characteristics of the subject. After the first ELISA test result was positive, 4 rapid detections of colloid selenium, ELISA, western-blot, CD4+T and viral load test were followed up (August 14th, 21st, 30th and September 16th, 2013). Long term follow-up was performed to detect CD4+T and viral load to observe the progress of the case after the diagnosis of infection.@*Results@#The duration of sexual behavior was from 2011 to 2012 between the subject and his 1st sexual partner. During the study, repeated HIV antibody ELISA test results were negative. Sexual behavior maintained from January to April 2013 between the subject and his 2nd partner and the last one unprotected homosexual acts took place in April 2013. After the traceability survey, the 2nd sexual partner was an AIDS patient who had antiretroviral therapy in the anti HIV treatment module of AIDS comprehensive prevention information system. The subject and his 3rd partner maintained their sexual behavior from May to October 2013. The two ELISA tests of the 3rd partner were negative. Because of the need for hospital operation in August 7, 2013, the subject was tested for HIV antibody by ELISA and the result was positive while western blot test showed that the HIV-1 antibody was not confirmed (band type was gp160/gp120/p24). In the subsequent follow-up, 4 rapid detections of colloid selenium, ELISA and western-blot were conducted and all the results were positive (western-blot band type was gp160/gp120/gp41/p24/p17). Results of continuous follow-up for 5 years showed that the first four CD4+T cell counts were as follows: 520, 616, 834, 879. The following 22 CD4+T counts sustained at a high level and the median was 895 cells/μl. A total of 5 follow-up visits were conducted to detect viral load exceeding 1 000 copies/ml and the remaining 19 test results were lower than 1 000 copies/ml except that no viral load was detected in 2 follow-up visits. The result of homology analysis showed that the HIV types of the case and its 2nd sexual partner were all HIV-1 CRF_01AE. The similarity of gag region gene was 97.5%. So we inferred that the 2nd sexual partner was its source of infection, and the case was infected at the end of April 2013 with the last unprotected homosexual behavior.@*Conclusion@#The infected person was found to be an early HIV infection. Continuous follow-up test results indicated that the case belonged to a HIV long-term nonprogressor.
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Objective This study aimed to analyze the behavior change and related factors regarding HIV/STD epidemics among female sex workers (FSWs) in Qingdao city.Methods According to the requirements set by the "National HIV/AIDS sentinel surveillance program",information on demographics,sexual and drug use behaviors,and HIV-related services among female sex workers (FSWs) was collected from ten consecutive annual cross-sectional surveys from 2006 to 2015.Blood samples were drawn for serological tests on both HIV and syphilis antibodies.Results Data from the sampled FSWs over the ten years,a higher proportion of participants who were aged 30 or more,married or cohabited and on-call FSW were followed.The prevalence of syphilis increased significantly from 1.0％ (4/420) in 2006 to 13.3％ (53/400) in 2015 (trendx2=54.22,P＜0.001).Rates on illicit drug use were ranging from 12.0％ (48/400) and 55.5％ (222/400) while the rate on consistent condom use with clients in the last month showed decreasing,with trendx2=170.62,P＜0.001.The proportion of HIV-related knowledge score ≥ 6 (trend x2 =152.96,P＜ 0.001),or ever been tested for HIV (trendx2=114.87,P＜0.001) were both significantly increased over the last ten years.Between 2009 and 2015,results from the annual stratified analysis showed that the FSWs who used drugs were more likely than the FSWs who were non-drug users less consistently using condoms with clients in last month and being syphilis positive (P＜0.05).On-call FSWs were more likely to be syphilis positive (P＜0.05) than the non on-call FSWs.Conclusions The prevalence of syphilis among FSWs in Qingdao city had been rising over the last ten years,with synthetic drug abuse as an important risk factor.Better targeted surveillance and intervention efforts among those drug-using FSWs seemed important to reduce the epidemics.
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Objective To analyze the status and its factors associated with HIV/AIDS“90-90-90”-treatment-target in Shandong province,China.Methods Data regarding testing,treatment on HIV/AIDS in Shandong province by December 31,2015 was collected.Chi-square test and logistic regression model were used to analyze related factors associated with the “90-90-90”-treatment-target.Results Of the 11 700 estimated HIV/AIDS,61.2％ were diagnosed,of whom 74.4％ had received Highly active antiretroviral therapy (HAART).More than 80％ of the HIV/AIDS on HAART reached the criteria on viral suppression.HIV/AIDS infected by homosexual contacts were less likely to seek for diagnosis (P＜0.05).HIV/AIDS lived in Qingdao city (OR=1.30,95％CI:1.05-1.60),Yantai city (OR=1.53,95％CI:1.02-2.31) and Weihai city (OR=1.96,95％CI:1.07-3.58) were more likely to receive HAART.HIV/AIDS patients that infected through homosexual or (OR=O.12,95％CI:0.06-0.24) or heterosexual contacts (OR =0.13,95 ％CI:0.07-0.26),through injecting drug use (OR =0.08,95％CI:0.03-0.17) or being diagnosed at the custodial institutions (OR=0.29,95％CI:0.21-0.41)were less likely to receive HAART.HIV/AIDS patients who received HAART at medical institutions (OR=1.81,95％ CI:1.05-3.47) were more likely to meet the level of Viral load (VL) suppression.However,those who were infected through homosexual (OR=0.43,95％ CI:0.25-0.75) or heterosexual contacts (OR =0.49,95％CI:0.28-0.81) or diagnosed at the custodial institutions (OR =0.48,95％CI:0.28-0.80) were less likely to meet the criteria set for VL suppression.Conclusions There was a gap between the status of testing/treatment and the target on HIV/AID “90-90-90”-treatment,especially on the target set for testing,in Shandong Province.Both HIV testing and comprehensive care services need to be strengthened.
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Objective To analyze the spatiotemporal characteristics of HIV/AIDS in Shandong province,2009-2015.Methods Data on HIV/AIDS between 2009 and 2015 were derived from the Shandong provincial HIV/AIDS Comprehensive Response Information Management System at the end of 2015.All the data were geographically referenced based on 139 spatial units in the related counties of Shandong province.Electronic maps were obtained from China CDC.Global Moran's I statistics and LISA statistics were used to detect the global and local spatial distribution patterns of HIV/AIDS in Shandong.Space-time scan statistics method,based on the Poisson Model,was used to detect the space-time clusters of HIV/AIDS.Results A total of 9 144 HIV/AIDS cases were reported during 2009-2015 in Shandong province.The scope of spatial distribution on HIV/AIDS expanded annually and concentrated in certain areas.Spatial distribution of HIV/AIDS in 2009 was randomized,and results showed spatial autocorrelation at the county level,during 2010-2015.Spatial hotspot-clusters mainly appeared in Tianqiao,Shizhong and Licheng districts of Jinan city,and Shinan,Laoshan districts of Qingdao city.Results from the Space-time scan analysis identified 5 spatiotemporal clusters in 2013-2015,including 1 most likely cluster and 4 secondary clusters which involving Lixia,Shizhong,Huaiyin and Tianqiao districts of Jinan city (RR=11.29,LLR=1 592.84,P＜0.001).The covered counties in secondary clusters appeared in Shinan,Shibei and Licang districts of Qingdao city (RR=7.35,LLR=682.40,P＜0.001),Weicheng and Kuiwen districts of Weifang city (RR=7.33,LLR=363.49,P＜0.001),Zhifu and Laishan districts of Yantai city (RR=7.66,LLR=117.63,P＜0.001),Zhoucun and Zhangdian districts of Zibo city (RR =6.09,LLR=268.68,P＜0.001)respectively.Conclusion HIV/AIDS cases in Shandong province appeared clustering features in both dimensions of time and space.Prevention efforts were needed to focus on HIV/AIDS highly clustered areas,such as Jinan city,Qingdao city,Zibo city,Weifang city and Yantai city.
RESUMO
Objective This study aimed to analyze the behavior change and related factors regarding HIV/STD epidemics among female sex workers (FSWs) in Qingdao city.Methods According to the requirements set by the "National HIV/AIDS sentinel surveillance program",information on demographics,sexual and drug use behaviors,and HIV-related services among female sex workers (FSWs) was collected from ten consecutive annual cross-sectional surveys from 2006 to 2015.Blood samples were drawn for serological tests on both HIV and syphilis antibodies.Results Data from the sampled FSWs over the ten years,a higher proportion of participants who were aged 30 or more,married or cohabited and on-call FSW were followed.The prevalence of syphilis increased significantly from 1.0％ (4/420) in 2006 to 13.3％ (53/400) in 2015 (trendx2=54.22,P＜0.001).Rates on illicit drug use were ranging from 12.0％ (48/400) and 55.5％ (222/400) while the rate on consistent condom use with clients in the last month showed decreasing,with trendx2=170.62,P＜0.001.The proportion of HIV-related knowledge score ≥ 6 (trend x2 =152.96,P＜ 0.001),or ever been tested for HIV (trendx2=114.87,P＜0.001) were both significantly increased over the last ten years.Between 2009 and 2015,results from the annual stratified analysis showed that the FSWs who used drugs were more likely than the FSWs who were non-drug users less consistently using condoms with clients in last month and being syphilis positive (P＜0.05).On-call FSWs were more likely to be syphilis positive (P＜0.05) than the non on-call FSWs.Conclusions The prevalence of syphilis among FSWs in Qingdao city had been rising over the last ten years,with synthetic drug abuse as an important risk factor.Better targeted surveillance and intervention efforts among those drug-using FSWs seemed important to reduce the epidemics.