Assessment of data quality of intervention in population at high risk for HIV/AIDS in China, 2014-2018 / 中华流行病学杂志

Objective@#To assess the quality of data of intervention in population at high risk for HIV/AIDS, especially in female sex workers (FSWs) and men who have sex with men (MSM), in China during 2014-2018, for the purpose of improving intervention data quality.@*Methods@#Data accuracy was evaluated by sampling monthly reported intervention data and comparing the consistency of the information recorded in national HIV/AIDS prevention and treatment information system to original paper records. Data authenticity was assessed by visiting intervention sites and interviewing owners, manager and/or target groups at sites. The assessment results of both national level and provincial level were summarized by year and analyzed with descriptive statistical method. The data quality problems recognized by assessments were summed up.@*Results@#The annual concordance rate of the data recorded in information system to paper records was 94.6%(17 671/18 673) in provincial level assessment and 79.4%(558/703) in national level assessment. Up to 81.6%(8 617/10 559) and 84.4% (249/295) of all sampled intervention sites were annually evaluated as "good" in provincial and state level assessments respectively. The assessment found that the intervention data in original paper records were not completely consistent to that recorded in the information system, the deficiency of ability on intervention data management, and the insufficient coverage and effect of intervention service influenced the intervention data quality.@*Conclusions@#In general, the accuracy and authenticity of intervention data were fine in China during 2014-2018. Intervention data quality can be improved through measures of enhancing data quality management, strengthening training for the prevention and intervention in FSWs and MSM, and providing high- quality intervention service.

Follow-up of community injecting drug user cohort, 2014-2017 / 中华流行病学杂志

Objective@#To explore the methods of establishing and maintaining community injecting drug user (IDU) cohort.@*Methods@#From June 2014 to June 2017, a community survey was conducted on basis of local needle and syringe exchange site to recruit 200 HIV sero-negative IDU for a prospective cohort study in Longyang district of Baoshan city, Yunan province. Follow-up was carried out every six month to investigate high risk drug use behavior and sexual behavior, and blood samples were collected from them for the tests of HIV and HCV serum antibodies. The cohort would be opened every 12 months to replenish the cohort to 200 subjects.@*Results@#The follow up was conducted for 3 years in 229 IDUs. Cohort follow-up rate was 93.0% (213/229) for 6 months, 92.1% (211/229) for 12 months, 91.7% (200/218) for 18 months, 87.2% (190/218) for 24 months, 86.0% (172/200) for 30 months and 86.0% (172/200) for 36 months.@*Conclusion@#The community IDU cohort has a high follow-up rate.

Changes of proportion regarding consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above / 中华流行病学杂志

Objective To investigate the changes of proportion on both consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above (LFSW),in order to provide evidence for targeted intervention strategies.Methods A total of six cities-Liuzhou city and Pingnan couty of Guigang city of Guangxi Zhuang Autonomous Region,Jinghong city of Xishuangbanna Dai autonomous prefecture and Dali city of Dali Bai autonomous prefecture of Yunnan province,Zhangjiajie city and Jianghua Yao autonomous county of Yongzhou city Hunan province were involved in this study,with 60 eligible participants needed in each city,estimated through a pre-study.The first cross-sectional survey was completed from October 2012 to January 2013.Face-to-face questionnaire interview was carried out to collect information on socio-demography,work-related information and condom use situation.Blood was collected for syphilis testing.The second cross-sectional survey was carried out from June to September,2015 under the same procedure.Results A total of 371 and 403 eligible participants were included in the first and second survey,respectively.When comparing the two surveys,we noticed that the average age showed a slight change,from 42.4 years to 43.8 years old (t=3.537,P＜0.001) and the average price for every commercial sex exchange increased from 36.8 RMB to 49.5 RMB (t=11.961,P＜0.001).In the first survey,46.9％ (174/371) of the participants had more than two years of experience working as LFSW,compared to 61.3％ (247/403) in the second survcy (x2=16.125,P＜0.001).Also,46.9％ (174/371) of the participants consistently used condoms with clients in the past month in the first survey versus 64.3％ (259/403) (x2=23.641,P＜0.001) in the second one.Rates of syphilis infection were found from 15.9％ (59/371) in the first survey reduced to 7.2％ (29/403) in the second survey (x2=14.533,P＜0.001).Conclusion Compared with the first survey,the proportion of consistent condoms use showed an increase.Although the proportion of syphilis infection decreased in the second survey,the scope did not meet the criteria on syphilis,set by the government.Targeted intervention strategies on condom promotion and syphilis control should be implemented consistently in this population.

Changes of proportion regarding consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above / 中华流行病学杂志

Objective To investigate the changes of proportion on both consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above (LFSW),in order to provide evidence for targeted intervention strategies.Methods A total of six cities-Liuzhou city and Pingnan couty of Guigang city of Guangxi Zhuang Autonomous Region,Jinghong city of Xishuangbanna Dai autonomous prefecture and Dali city of Dali Bai autonomous prefecture of Yunnan province,Zhangjiajie city and Jianghua Yao autonomous county of Yongzhou city Hunan province were involved in this study,with 60 eligible participants needed in each city,estimated through a pre-study.The first cross-sectional survey was completed from October 2012 to January 2013.Face-to-face questionnaire interview was carried out to collect information on socio-demography,work-related information and condom use situation.Blood was collected for syphilis testing.The second cross-sectional survey was carried out from June to September,2015 under the same procedure.Results A total of 371 and 403 eligible participants were included in the first and second survey,respectively.When comparing the two surveys,we noticed that the average age showed a slight change,from 42.4 years to 43.8 years old (t=3.537,P＜0.001) and the average price for every commercial sex exchange increased from 36.8 RMB to 49.5 RMB (t=11.961,P＜0.001).In the first survey,46.9％ (174/371) of the participants had more than two years of experience working as LFSW,compared to 61.3％ (247/403) in the second survcy (x2=16.125,P＜0.001).Also,46.9％ (174/371) of the participants consistently used condoms with clients in the past month in the first survey versus 64.3％ (259/403) (x2=23.641,P＜0.001) in the second one.Rates of syphilis infection were found from 15.9％ (59/371) in the first survey reduced to 7.2％ (29/403) in the second survey (x2=14.533,P＜0.001).Conclusion Compared with the first survey,the proportion of consistent condoms use showed an increase.Although the proportion of syphilis infection decreased in the second survey,the scope did not meet the criteria on syphilis,set by the government.Targeted intervention strategies on condom promotion and syphilis control should be implemented consistently in this population.

HIV and syphilis infection and related medical treatment status of low-fee female sex workers in three provinces of China, 2012-2015 / 中华预防医学杂志

Objective@#To understand the HIV and syphilis infection and related treatment status of low-fee female sex workers (FSWs) in 3 provinces of China.@*Methods@#Four cross-sectional survey data of low-fee FSWs from six cities (counties) in Guangxi, Yunnan and Hunan Province between October 2012 and July 2015 were obtained from the national science and technology major special project intervention study for reducing sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) in low-fee FSWs' database, which included social demographic characteristics, sexual service characteristics and related medical care seeking behaviors, etc. A total of 2 050 subjects were included in the database.@*Results@#The age of the subjects was (35.16±9.76) years old, with a minimum age of 15 and a maximum age of 67. Those who use condoms every time in commercial sex accounted for 58.9% (n=1 206). Among the reasons of not using condom, the proportion of client reluctant to use was the highest (81.0% (n=682)). Only 38.1% (n=782) was tested for HIV in the last six months. HIV confirmed positive rate was 6.8% (n=139), previous positive accounts for 76.3% (n=106). Rate of antiviral therapy was 55.4% (n=77). By the end of 2015, the loss rate of antivirus treatment was 18.2% (n=14). Those who self-reported symptoms of sexually transmitted diseases in the last 6 months accounted for 9.4% (n=191). 50.3% (n=96) of reporters chose to go to formal hospitals, 23.0% (n=44) chose to go to private clinics and 20.4% (n=39) chose their own medication. The syphilis infection rate was 13.5% (n=277), among them, 91.3% (n=253) were asymptomatic.@*Conclusion@#Among low-fee FSWs, the rates of HIV and syphilis infection are higher, the condom consistent use rate, HIV antibodies and syphilis test rate are lower. In this group, active seeking medical idea is poor, the rate of anti-virus treatment and the rate of seeking medical treatment in formal medical institutions is low.

Risk of HIV infection and its factors among men who have sex with men: a geosocial networking application-based survey in Beijing of China, 2017 / 中华预防医学杂志

Objective@#To assess risk of HIV infection and its risk factors among men who have sex with men (MSM) in Beijing, China.@*Methods@#We conducted a cross-sectional online survey in October, 2017. Inclusion criteria of participants were: aged 18 year or more; resided in Beijing; conducted homosexual activities in past six months; self-reported HIV status as negative or unclear. Demographic information, HIV test history, social media use, and high-risk sexual behaviors were collected by a self-reporting questionnaire, and a HIV risk assessment tool was used to assess HIV risk of MSM, 5 388 particpants were finally enrolled in the study. Logistic regression model was used to analyze factors associated with risk of HIV infection.@*Results@#Of the total 5 388 participants, most were 18-29 years old (64.35%), and the proportion of medium and high HIV risk score was 40.36%. The odds of medium and high HIV risk score among MSM who logged onto the app 1-20 times per week and>20 times per week were higher comparing with those who logged onto the app<1 time per week (OR=1.22, 95%CI: 1.02-1.46; OR=1.69, 95%CI: 1.38-2.06, respectively); MSM who completed college or higher education had lower probability of medium and high HIV infection risk, comparing with those who only had high school education level (OR=1.25, 95%CI:1.09-1.43) or junior or below education level (OR: 1.27, 95%CI: 1.05-1.53); MSM who did not conduct HIV test in past year had lower risk of medium and high HIV infection risk comparing with MSM who conducted HIV test in past year (OR=0.87, 95%CI: 0.77-0.99), and those who reported their HIV infection status unclear had higher probability of medium and high HIV infection risk than MSM who reported their HIV infection status negative (OR: 1.63, 95%CI: 1.44-1.86).@*Conclusion@#The proportion of MSM who were in medium and high HIV infection risk score was high in Beijing. Lower level of education, high frequency of social media use, conducted HIV test in past year, and unclear of their own HIV infection status were associated with medium and high level of HIV infection risk.

Quality of network direct reporting of information about intervention service in population at high risk for HIV infection in China, 2013-2014 / 中华流行病学杂志

Objective To analyze the problems in the network direct reporting of information about intervention service conducted in population at high risk for HIV infection in China during 2013-2014,and provide evidence for the improvement of the network direct reporting of the intervention information.Methods The wrong records of the intervention service in population at high-risk were collected from national AIDS prevention and treatment information system.The wrong records,including those found at county (district) level and those found at state level,were analyzed with descriptive statistical method.Results A total of 1 066 wrong records were found during 2013-2014,and average annual wrong record rate was ＜0.1％.Up to 71.3％ (760/1 066) of wrong records occurred in the first half year.The wrong records in eastern,central and western areas accounted for 14.9％ (159/1 066),22.6％ (241/1 066) and 62.5％ (666/1 066) of the total respectively.More wrong records were found in the intervention information for men who have sex with men and injecting drug users than in those for female sex workers.Among the total wrong records,86.4％ (921/ 1 066) were found at county level and 13.6％ (145/1 066) were found at state level.The wrong records were mainly "annual number of persons receiving the first HIV test" and "annual number of persons covered by intervention".Common causes of wrong records were underreporting and delay,staff fault,miscalculation and misunderstanding.Conclusion In general,the wrong record rate in intervention information for population at high risk for HIV infection reported directly through network was low in China.It is necessary to strengthen the recording of the intervention service,the quality control of statistics and network direct reporting and staff training to improve the quality of reported data of intervention service.

Quality of network direct reporting of information about intervention service in population at high risk for HIV infection in China, 2013-2014 / 中华流行病学杂志

Objective To analyze the problems in the network direct reporting of information about intervention service conducted in population at high risk for HIV infection in China during 2013-2014,and provide evidence for the improvement of the network direct reporting of the intervention information.Methods The wrong records of the intervention service in population at high-risk were collected from national AIDS prevention and treatment information system.The wrong records,including those found at county (district) level and those found at state level,were analyzed with descriptive statistical method.Results A total of 1 066 wrong records were found during 2013-2014,and average annual wrong record rate was ＜0.1％.Up to 71.3％ (760/1 066) of wrong records occurred in the first half year.The wrong records in eastern,central and western areas accounted for 14.9％ (159/1 066),22.6％ (241/1 066) and 62.5％ (666/1 066) of the total respectively.More wrong records were found in the intervention information for men who have sex with men and injecting drug users than in those for female sex workers.Among the total wrong records,86.4％ (921/ 1 066) were found at county level and 13.6％ (145/1 066) were found at state level.The wrong records were mainly "annual number of persons receiving the first HIV test" and "annual number of persons covered by intervention".Common causes of wrong records were underreporting and delay,staff fault,miscalculation and misunderstanding.Conclusion In general,the wrong record rate in intervention information for population at high risk for HIV infection reported directly through network was low in China.It is necessary to strengthen the recording of the intervention service,the quality control of statistics and network direct reporting and staff training to improve the quality of reported data of intervention service.

The situation and associated factors of facility-based HIV testing among men who sex with men in Beijing / 中华预防医学杂志

Objective@#To understand the prevalence of facility-based HIV testing and its associated factors among men who have sex with men (MSM) in Beijing city.@*Methods@#An application-based cross-sectional survey was employed to understand HIV site test situation and associated factors. The survey was carried out from May 14th to 21st, 2016. Users of a smart phone application for gay dating were recruited and those eligible for this survey were investigated with an online self-administered questionnaire. Information of demographics, sexual behaviors, facility-based HIV testing history and recreational drug abuses were collected. The multivariate logistic regression was used to make comparison among different groups and assess associated factors.@*Results@#A total of 7 494 participants were enrolled in the survey with mean age of (28.81 ± 7.38) years, 87.14% (6 530/7 494) sought sexual partners through internet. The proportion of facility-based HIV testing in 1 year was 42.55% (3 189/7 494), MSM who were 25-29 years had higher proportion of facility-based HIV testing in 1 year, the proportion was 45.56%(1 104/2 423). Among MSM who could insist in using condom during anal sex (50.46% (1 539/3 050)), the proportion of HIV site testing in 1 year was higher. The MSM who reported seeking healthcare for symptoms of a sexually transmitted infections (STIs) in the past year or ever using recreational drug had higher proportion of facility-based HIV testing, the proportions were 56.81% (409/720) and 52.00% (1 340/4 917), respectively. Compared with alone cohabitation, cohabitating was associated with decreased odds of HIV facility-based testing in past 1 year(odds ratio (OR)= 0.79, P<0.001). Compared with homosexual sexual orientation, bisexual sexual orientation was associated with decreased odds of facility-based HIV testing (OR=0.83, P=0.004). With the increasing of number of male anal sex partners, the odds of HIV facility-based testing was increasing (OR=1.31, P<0.001) But with the decreasing of the frequency of condom using with male anal sex partners, the odds of facility-based HIV testing was decreasing (OR=0.85, P=0.014). Using recreational drugs (OR=1.36, P<0.001) and seeking healthcare for symptoms of a STI in the past 1 year (OR=1.73, P<0.001) were associated with decreased odds of HIV site testing.@*Conclusion@#MSM in Beijing had lower proportion of facility-based HIV testing in past 1 year. Multiple anal sex partners, using recreational drugs, seeking healthcare for symptoms of a STI in the past year, cohabitating, bisexual sexual orientation, and lower frequency of condom using with male anal sex partners were associated with the odds of HIV facility-based testing in past 1 year.

Impact of antiretroviral therapy on drug-using and high risk sexual behaviors among HIV-positive methadone maintenance treatment clients: a qualitative study / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand that whether initiation of antiretroviral therapy (ART) would impact on the change and its reasons regarding the HIV-related high risk behaviors among HIV-positive clients who attending the methadone maintenance treatment (MMT).</p><p><b>METHODS</b>In-depth interviews were conducted among 34 MMT clients in Yunnan province who were under ART. The related contents would include information on general demographic charicteristics, HIV infection,MMT, number of sexual partners before and after ART, sexual behavior and frequency of condom use, drug use, needle sharing, changes in risk behaviors before and after the ART, reasons for high-risk behavior, of the clients.</p><p><b>RESULTS</b>The average age of the interviewees was 38.5 years, and most of them were male (70.6%). The clients under this study all admitted that the frequencies of unsafe sex and needle sharing did not increase after the ART initiation, with the main reasons as increasing HIV related awareness, the use of methadone, high accessibility of free condoms and access to clean needles etc. However, 12 of 34 reported being relapsed and 3 reported inconsistent condom use. The interaction of ART and dosage of methadone were connected to the episodes of relapsing and the ART optimism would result in inconsistent condom use.</p><p><b>CONCLUSION</b>No evidence supported that the ART initiation would increase the risk behaviors among the HIV-infected MMT clients. However, attention needs to be paid to the new challenges caused by high expectation of ART.</p>

Impacts of antiretroviral treatment on drug use and high risk sexual behaviors among HIV-positive MMT clients / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the impacts of antiretroviral treatment on drug use and high risk sexual behaviors among HIV-positive MMT clients.</p><p><b>METHODS</b>A cross-sectional study was conducted in patients undergoing ART (ART-experienced) and patients not undergoing ART (ART-naive) attending MMT in 5 clinics in Yunnan Honghe and Dehong prefectures in 2014. A questionnaire was designed to collect socio-demographic characteristics, ART and MMT information and sexual and drug use behaviors within 3 months before the investigation was conducted. Logistic regression analysis was conducted to identify the predictors for drug use and risky sexual behaviors.</p><p><b>RESULTS</b>A total of 328 cases were included in the analysis, among which 202 were ART-experienced and 126 were ART-naÏve. Among 152 respondents who were sexually active, 61 (40.1%) reported having unprotected sex (UPS) with their regular partners in the prior 3 months. A total of 57.6% (189/328) of the respondents used drugs in the prior 3 months. Multiple logistic regression analysis revealed that younger than 35 years old (OR = 3.57, 95% CI: 1.23-10.37), fertility desire (OR = 4.47, 95% CI: 1.49-13.41), partner being HIV-positive (OR = 4.62, 95% CI: 1.80-11.86), length of MMT attendance less than 5 years (OR = 2.92, 95% CI: 1.14-7.53), agreed that it was necessary to use condom no matter the viral load is high or low (OR = 0.14, 95% CI: 0.04-0.51) were protective factors of UPS in the prior 3 months. Multiple logistic regression analysis revealed that being Han (OR = 0.46, 95% CI: 0.24-0.89), feeling having good health status (OR = 0.39, 95% CI: 0.18-0.85), being enrolled in ART (OR = 0.32, 95% CI: 0.17-0.60) were protective factors for drug use in the prior three months, having contact with drug using friends (OR = 4.41, 95% CI: 2.31-8.29), having experience of missing an MMT dose (OR = 3.47, 95% CI: 1.92-6.29), and not satisfied with current MMT dose (OR = 13.92, 95% CI: 3.24-59.93) were risk factors for drug use during the prior three months.</p><p><b>CONCLUSION</b>ART was not associated with risky sexual behavior and drug use in the prior 3 months in this population. Future interventions should promote ART among this population, and provide education at the same time to prevent the emergence of cross infections and drug-resistant strains.</p>

Implementation of intervention programs on AIDS-related sexual transmission in China / 中华流行病学杂志

Objective To analyze the implementation of intervention programs targeted on AIDS high risk sexual transmission groups since 2008,when the relative prevention and control information systems on HIV/AIDS were developed.Methods Data from both aggregated interventions and sentinel surveillance programs from 2008 to the end of 2014 were used.Descriptive statistics were performed to analyze the trends of implementation on high risk groups including men who have sex with men,female sex workers (FSW) and migrant workers.Results From 2008 to 2012,the monthly average numbers receiving intervention programs and the average monthly coverage rate on intervention for MSM,increased from 49000 to 252000,and from 8.6％ to 78.5％ respectively.The FSW related indicators increased from 329 000 to 625 000,and from 30.9％ to 87.0％ respectively.Above indexes on the two populations had dropped slightly in 2013 and 2014.Sentinel surveillance data showed that knowledge and behavior indicators observed from the MSM and FSW populations increased annually.The coverage of intervention programs on migrant workers increased from 4.7％ to almost 10.0％,but the surveillance data on migrant men showed that the knowledge and behavior indicators were still lower than the other high-risk groups.Conclusion Intervention related to sexual transmission on HIV/AIDS among high-risk populations were effectively implemented,with some achievements seen.However,as sexual contact currently became the main route of AIDS epidemic,new challenges called for serious attention.

Comparison between methods as polling booth survey and face-to-face interview in understanding the high-risk behavior among HIV-positive clients of female sex workers / 中华流行病学杂志

<p><b>OBJECTIVE</b>Face-to-face interview (FTFI) and polling booth survey (PBS) were applied to compare the high risk behavior among HIV-positive clients of female sex workers (CFSWs).</p><p><b>METHODS</b>This study was conducted in antiretroviral therapy (ART) out-patients centers in Hengyang city, where clients who had been informed on their HIV-positive status for 6 months or longer were recruited. FTFI was first used to tackle on 8 sensitive questions related to sexual behavior, followed by PBS to poke on the same questions. Results from FTFI and PBS were then compared.</p><p><b>RESULTS</b>Compared with FIFI, results in the PBS showed higher proportion of participants who reported "having had history of sexually transmitted diseases before knowing that they were infected with HIV" (40.6% vs. 24.2%) but lower proportions on "frequency of having sex with regular sexual partner less than 4 times per month" and "using condoms consistently with regular sexual partners in past 6 months (44.4% vs. 63.0%)". There were no significant differences in the remaining 5 questions shown in the results from the two methods.</p><p><b>CONCLUSION</b>HIV-positive CFSWs continued to practice unsafe sexual behaviors after knowing their HIV related status. Compared with FTFI, PBS seemed to have revealed higher proportion of unsafe sex behaviors, so as to generated more reliable data. While comparing with PBS, the traditional FTFI might have underestimated the risk behaviors among those HIV-positive CFSWs.</p>

A case-control study on the causes of new HIV infection among heroin addicts attendees at the methadone maintenance treatment clinics / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the routes and factors associated with HIV new infection of heroin addicts who had been attending the methadone maintenance treatment (MMT) program.</p><p><b>METHODS</b>A 1 : 1 nested case-control study was implemented with the cases (new HIV infections) and controls (HIV negative) selected from the treatment cohort of China MMT clients. Questionnaire was developed to collect information on demographic characters, behaviours on drug use, sexual behaviour, daily dosage of methadone intake, adherence to MMT, and psychological problems. Univariate analysis and multivariate condition logistic regression were used to identify factors associated with HIV infection.</p><p><b>RESULTS</b>108 (54 paired) clients on MMT were recruited, with 76 males and 32 females. Among them, 95 were Han Chinese and 13 were minorities, with average time of drug use as 12.1 ± 5.0 years. Among 54 new HIV infections, 33 were infected through sharing needles, 12 were through sexual contact and 9 unidentified. Results from multivariate condition logistic regression indicated that having longer duration of heroin use before on MMT (More than 10 years vs. less than 10 years,OR = 20.9, 95% CI:1.62-269.34, P = 0.02), shared needles in the last 6 months (OR = 276.7, 95%CI:5.65-> 999.99, P < 0.01) were risk factors while better adherence (More than 0.5 vs. less than 0.5,OR = 0.07, 95%CI:0.42-0.87, P = 0.04) and living with families (OR = 0.002, 95% CI:0.001-0.94, P < 0.01) were protective factors.</p><p><b>CONCLUSION</b>Sharing needles was the main route of HIV new infection among those clients that were on MMT. Factors as having received more support from both family and community, improvement of adherence to MMT, reducing the frequency of injection etc., could reduce the risk of HIV infection among those MMT clients.</p>

Club-based drug use and its associated risk factors among HIV-positive methadone maintenance treatment clients / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe club-based drug use and to explore the determinants on those HIV-positive methadone maintenance treatment (MMT) clients.</p><p><b>METHODS</b>This study was conducted in 5 MMT clinics in Yunnan province and 612 MMT clients who met the survey criteria were recruited for the study. Urine sample was tested as a biological marker to identify if heroin, methamphetamine, methylene-dioxy-methyl-amphetamine, buprenorphine or benzodiazepine had been used.</p><p><b>RESULTS</b>The average age among the 612 clients was 38.9 ± 6.3 years. Among these, 78.9% were males, with the average years of education as 8.0 ± 3.4 years. There were 60.5% clients who had good relationship with their families. 153 (25.0%) clients reported having used club-related drugs in the last 12 months. Results from the urine test showed that the positive rate on morphine was 14.4%, while the positive rate for club-related drugs was 26.6%. Factors as residential area, casual sexual partners, retention on MMT and occasionally use of heroin were associated with urine results on club-related drugs and the prevalence of self-reported club drug use (P < 0.05).</p><p><b>CONCLUSION</b>Club-related drug use was common among HIV-positive MMT clients. Inspection and supervision for club-related drugs and the education and intervention programs on related high risk behaviors should be strengthened.</p>

Study on the adherence and related determinants among HIV-positive clients under methadone maintenance treatment in Dali,Yunnan province from 2005 to 2013 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the adherence and related determinants among HIV-positive methadone maintenance treatment(MMT)clients in Dali,Yunnan province from 2005 to 2013.</p><p><b>METHODS</b>Cases were selected from the "National MMT Information Management System". The main information included demographic, drug abuse behaviors prior to enrollment, MMT treatment and highly active antiretroviral therapy (HAART). Detailed medication records were collected to calculate the adherence to MMT. Multivariate unconditional logistic regression was conducted to analyze the impact factors of adherence.</p><p><b>RESULTS</b>The MMT adherence rate of 480 subjects is 58.11%. Data from the multivariate unconditional logistic regression indicated that among those HIV-positive MMT clients that on HAART program (OR = 1.52, 95% CI:1.03-2.24), related factors as:having stable job(OR = 1.69, 95% CI:1.11-2.56), having compulsory history prior to enrollment in MMT (OR = 1.78, 95% CI:1.04-3.04) were likely to have higher rate on MMT adherence, whereas clients who showed positive result in the last urine morphine test (OR = 0.38, 95% CI:0.24-0.59) were associated with lower rate on MMT adherence.</p><p><b>CONCLUSION</b>In order to improve the rate of adherence to MMT among those HIV-positive MMT clients, the coverage of HAART needed to be expanded and new approaches in combining MMT and HAART developed. Education and intervention efforts should be focused on clients who currently were jobless, those with last urine morphine testing as positive or had never received compulsory treatment.</p>

The prevalence and associated factors with depression and anxiety among the patients attending the community-based methadone maintenance treatment program in China / 中华疾病控制杂志

Objective To understand the prevalence and the factors associated with depression and anxiety among patients attending the community-based methadone maintenance treatment(MMT) program.Methods 9 MMT clinics in 3 provinces were randomly selected,in which 1 301 MMT patients who met the criteria of recruitment were all interviewed.A cross-sectional study by administrative questionnaire was employed to investigate the demographics,drug abuse and MMT treatment status of the respondents.The 1301 respondents were also evaluated for depression and anxiety by SDS(Self-Rating Depression Scale) and SAS(Self-Rating Anxiety Scale) respectively.ANOVA and multivariate linear regressions analysis was used to verify the factors associated with depression and anxiety respectively.Results The prevalence of depression and anxiety among the MMT patients were 38.3%(498/1 301) and 18.4%(239/1 301).The multivariates linear regression analysis indicated that at the level of ?=0.05,gender,employment status were associated with depression,while gender,employnment status,educational level,drug abuse and methadone daily dosage were associated with anxiety.Conclusions There are certain proportions of MMT clients who suffer from depression and anxiety.The MMT clinic staff should put more emphasis on the efforts to reduce psychological disorders and its potential risks by enhancing psychological councelling,intervention and social support towards the MMT patients.