Survival of untreated HIV／AIDS patients in Tianjin / 中华临床感染病杂志

Objective To analyze the survival and influencing factors of treatment-naive HIV／AIDS patients aged 15 years or above in Tianjin.Methods The data of 973 untreated HIV／AIDS patients aged 15 years or above who were diagnosed during June 28 1996 to May 28 2017 in Tianjin were retrospectively analyzed.The survival rate of patients was calculated by the life table method , and the factors affecting the survival time were analyzed by the Cox proportional hazard model.Results There were 726 HIV carriers (74.6%) and 247 AIDS patients (25.4%).Among them, there were more males (93.7%, 912／973) than females (6.3%, 61／973); Han nationality accounted for 92.5%(900／973); the education level of most patients was high school or below (71畅0%, 691／973); half of the patients were unmarried (50.4%, 490／973); 57.7%(561／973) of the patients were infected by men who have sex with men ( MSM);62畅9%(612／973) were local residents and 37.1%(361／973) were migrants; 36.6%(356／973) cases were detected by pre-transfusion tests, and 74.5%( 725／973) had initial CD4 +T count tests.In this series, the average survival time is 11.03 years after diagnosis (95%CI 10.01-12畅05 years).The 1, 3, 5, and 10-year survival rates after diagnosis were 96.8%, 88.7%, 80.2%and 40.5%.183 cases (18畅8%) died from AIDS.Cox proportional hazard model analysis showed that compared with patients aged 15 to 35 years, patients aged 35-50 years (HR＝3.077, 95%CI 1.868-5.070) and ＞50 years (HR＝2.626, 95%CI 1畅553-4.440) had higher risk of AIDS-related deaths; compared with high school education or below , patients with college education or above ( HR＝0.562, 95%CI 0.371-0.851) had a lower risk of AIDS death; injection drug user (IDU) (HR＝0.751, 95%CI 0.316-0.909) had lower risk of death than MSM. Patients detected by the consultation ( HR＝0.463, 95%CI 0.252-0.851), special investigation ( HR＝0畅263, 95%CI 0.116-0.593), detainee physical examination ( HR＝0.055, 95%CI 0.007-0畅441) and STD clinic visits (HR＝0.033, 95%CI 0.005-0.239) had a lower risk of death than those detected by pre-transfusion tests.The initial CD4 +T lymphocyte counts were negatively correlated with the risk of AIDS-related death (P＜0.01).Conclusions The average survival time after diagnosis of untreated HIV／AIDS patients aged 15 years or above was 11.03 years in Tianjin.The age, education level, route of infection, detection of HIV infection and the initial CD 4 +T lymphocyte counts are related to the survival time after diagnosis of untreated HIV／AIDS patients.

HIV infection status and related factors in men who have sex with men in sentinel surveillance in Tianjin, 2016-2018 / 中华流行病学杂志

Objective@#To understand the HIV infection status and related factors in men who have sex with men (MSM) in Tianjin during 2016-2018.@*Methods@#According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted to collect the information about the awareness of AIDS, related behaviors, HIV infection, syphilis prevalence and HCV infection in the MSM in Tianjin with the annual sample seize of 400 between April and June during 2016-2018.@*Results@#From 2016 to 2018, a total of 1 200 MSM were surveyed. The condom use rate in anal sex was 45.4% (544/1 198) in the past 6 months. The HIV test rate in MSM recruited through network declined with year (trend χ2=42.742, P<0.001). The overall HIV infection rate was 3.3% (40/1 200). The HIV-1 infection rate was 2.6% (95%CI: 1.7%-3.5%). The overall prevalence rate of syphilis was 6.7% (80/1 200). The overall HCV infection rate was 0.8% (9/1 200). Results from multivariate logistic regression analysis showed that the risk factors associated with HIV infection in the MSM included divorced or widowed (compared with unmarried, aOR=7.137, 95%CI: 1.621-31.419) and syphilis positive group (compared with syphilis negative group, aOR=3.684, 95%CI: 1.520-8.932). The protective factors for HIV infection in the MSM included consistent use of condom in the past 6 months (compared with occasional use of condom, aOR=0.343, 95%CI: 0.126-0.932) and HIV test (compared with receiving no HIV test, aOR=0.314, 95%CI: 0.123-0.801).@*Conclusions@#The HIV infection rate in the MSM in Tianjin was high from 2016 to 2018. Syphilis prevalence status in MSM should not be neglected. The rate of consistent condom use in anal sex was low in the MSM. It is necessary to take effective measures to promote condom use and strengthen HIV test in MSM.

Survival analysis on HIV/AIDS patients who began receiving antiretroviral therapy from 2005 to 2015 in Tianjin / 中华流行病学杂志

Objective@#To study the survival time and influencing factors of HIV/AIDS cases who began receiving antiretroviral therapy (ART) from 2005 to 2015 in Tianjin.@*Methods@#Data related to HIV/AIDS cases that receiving ART between 2005 and 2015 in Tianjin, were collected from the Chinese HIV/AIDS Basic Information Management System. A retrospective cohort study was conducted to analyze data of collection. Life table was used to calculate the survival proportion and Cox proportion hazard regression model was used to analyze the factors associated to the time of survival.@*Results@#A total of 2 057 HIV/AIDS cases were involved, including 51 died from AIDS related disease, ending up with the survival rates of 1, 3, 5 and 10 years as 98.4%, 97.8%, 97.4% and 95.8%, respectively. Results from the multivariate Cox proportion hazard regression model showed that when comparing with the cases aged<30 years, aHR (95%CI) of the cases aged 30-39 years, 40-49 years, 50 years or above appeared as 4.506 (1.226-9.059), 5.944 (1.479-13.892) and 15.958 (5.309-27.206) respectively. When comparing with the cases having no loss of follow-up during ART process, the aHR of the cases having lost of follow-up during ART was 5.645 (95%CI: 3.124-10.200). When comparing with the cases diagnosed by other institutions, the aHR of the cases diagnosed by hospitals was 3.823 (95%CI: 1.423-10.274). When compared with the cases had no hepatitis B or hepatitis C before ART, aHR of the cases with hepatitis B or C prior to ART was 2.580 (95%CI:1.210-5.502). Compared with the cases receiving ART at Ⅰ/Ⅱ clinical stages, the aHR of the cases at Ⅲ/Ⅳ clinical stages was 3.947 (95%CI: 2.167-7.188). Compared with the cases with junior high school education or below, the aHR of the cases with high school education or above was 0.440 (95%CI: 0.238-0.810). Compared with the cases diagnosed before operation, aHR of the cases from special investigation and from counseling and testing (VCT) were 0.111 (0.027-0.456) and 0.182 (0.049-0.674) respectively.@*Conclusions@#The survival rate of HIV/AIDS cases that received ART was high in Tianjin. Risk factors related to the survival of cases would include: old age when started receiving ART, loss of follow-up during ART, diagnosed by hospitals, co-infected with hepatitis B or hepatitis C and receiving ART at Ⅲ/Ⅳ clinical stages. Meanwhile, protective factors related to the survival of cases would include: having high school or above education, diagnosis was made through other special programs or from VCT services.

Evaluation of a novel HIV-1 DNA reagent in clinical application / 中华实验和临床病毒学杂志

Objective@#To evaluate the clinical application of a novel HIV-1 DNA reagent.@*Methods@#HIV-1-infected and non-infected human blood samples were selected, as well as weakly positive samples, indeterminate samples, specific samples. Compared the result of HIV-1 DNA reagent with HIV-1 infection status (refer to the National Guideline for Detection of HIV/AIDS (2015)), the accuracy of the HIV-1 DNA reagent was evaluated in clinical application; Meanwhile, the commercially available RNA quantification kit was selected as reference reagent for parallel detection, and then the consistency and differences were evaluated between HIV-1 DNA reagent and RNA quantification reagent.@*Results@#A total of 95 whole blood samples were tested by the HIV-1 DNA reagent. Taking the HIV-1 infection status as the reference standard, the result showed that the positive agreement rate was 100% (95%CI: 93.94%-100%), the negative agreement rate was 100% (95%CI: 90.26%-100%), and the overall agreement rate was 100% (95%CI: 96.19%-100%). The Kappa value was 1 (95%CI: 1.00-1.00). The HIV-1 DNA reagent could detect weakly positive samples and indeterminate samples of early infection, and could effectively distinguish false-positive samples tested by the Ag-Ab reagent. The specific samples had no false-positive result .@*Conclusions@#The result of HIV-1 DNA reagent were consistent with the HIV-1 infection status. It can be considered as equivalent to the HIV-1 detection reagent commercially available in our country. It can effectively identify the indeterminate samples in the early infection. Compared with the RNA quantification reagent, it can effectively detect HIV-1 DNA of virus reservoirs.

Evaluation on follow-up intervention program in men who have sex with men in Tianjin / 中华流行病学杂志

Objective To evaluate the behavior intervention program on men who have sex with men (MSM) in Tianjin.Methods From April 2013 to September 2017,MSM were enrolled from MSM gathering places and through mobile intemet to establish an open prospective cohort.Interventions were conducted in every follow-up meeting,while the changes of behaviors and HIV infection and syphilis incidences in the MSM before and after intervention were compared.Results A total of 1 822 MSM were interviewed at baseline survey,with 1 007 eligible MSM were enrolled in the cohort.A total of 39 new cases of HIV infection were reported,and the cumulative observation time on cohort follow-up was 2 216.96 person-year,with the HIV incidence rate as 1.76 per 100 person-years.Among them,934 MSM were sero-negative for syphilis in baseline survey.A total of 100 new cases of syphilis were reported,and the cumulative observation time of cohort follow-up was 1 959.94 person-year,the syphilis incidence rate was 5.10 per 100 person-years.With health education and intervention conducted,the awareness rate of AIDS related knowledge for MSM increased.Though the rate of anal sex increased after intervention,the rate of condom use in anal sex increased,too.The rate of condom use decreased after receiving more than 3 interventions.Data from the multivariate GEE analysis indicated that protective factors might be as follows:education level of college and above (aOR=0.81,95％CI:0.68-0.98),awareness of AIDS related knowledge (aOR=0.52,95％ CI:0.36-0.75),ever receiving condom promotion and distribution in the past six months (aOR=0.60,95％CI:0.49-0.74),being recruited from mobile intemet (aOR=0.85,95％CI:0.73-1.00)and times of cumulative intervention:one time (aOR=0.55,95％ CI:0.45-0.66),two times (aOR=0.38,95％CI:0.30-0.49),three times (aOR=0.26,95％CI:0.20-0.35),four times and above (aOR=0.24,95％CI:0.17-0.33).Diagnoses of STDs in the past six months (aOR=1.43,95％CI:1.06-1.96),using rush-poppers (aOR=1.22,95％ CI:1.02-1.47) might be risk factors.Conclusions After continuous behavior intervention,the incidence of HIV infection and syphilis were at a low level in the MSM cohort in Tianjin.Their awareness rate of AIDS related knowledge and the rate of condom use increased.But there are still many risk factors influencing the unprotected anal sex in MSM.We should continuously carry out behavioral intervention programs to prevent unprotected anal sex among MSM.

Risk factors related to HIV new infections among men who have sex with men in a cohort study / 中华流行病学杂志

Objectives To analyze and understand the risk factors related to HIV new infections among men who have sex with men (MSM).Methods A longitudinal observational study among MSM was conducted to collect information on HIV related behaviors and sero-conversion.Univariate and multivariate generalized estimating equations (GEE) were used to discuss the risk factors for HIV new infection.Results A total number of 4 305 MSM were followed during 2013-2015.Among those self-reported MSM who are seeking partners on the Interner tended to have higher proportion on receptive anal intercourse and consistent condom use during anal intercourse than the subgroups seeking their partners in gay bars or bathrooms.HIV incidence among followed MSM during the study period appeared as 4.3/100 person years,with adjusted RR (aRR) of HIV infection for receptive anal intercourse as group 2.20 (95％ CI:1.49-3.24) times than that of insertion anal intercourse group.Those who used rush-poppers (aRR=1.55,95％CI:1.10-2.17),unprotected anal intercourse (aRR=2.24,95％ CI:1.62-3.08),and those with syphilis infection (aRR=2.95,95％ CI:2.00-4.35) were also risk factors for HIV new infections.After controlling other factors,the relationship between the ways of seeking partners and HIV new infection was not statistical significant.Conclusion Risk factors for HIV new infection among MSM appeared complex and interactive,suggesting that further studies are needed to generate tailored strategies for the prevention of HIV epidemic among MSM population.

Evaluation on follow-up intervention program in men who have sex with men in Tianjin / 中华流行病学杂志

Objective To evaluate the behavior intervention program on men who have sex with men (MSM) in Tianjin.Methods From April 2013 to September 2017,MSM were enrolled from MSM gathering places and through mobile intemet to establish an open prospective cohort.Interventions were conducted in every follow-up meeting,while the changes of behaviors and HIV infection and syphilis incidences in the MSM before and after intervention were compared.Results A total of 1 822 MSM were interviewed at baseline survey,with 1 007 eligible MSM were enrolled in the cohort.A total of 39 new cases of HIV infection were reported,and the cumulative observation time on cohort follow-up was 2 216.96 person-year,with the HIV incidence rate as 1.76 per 100 person-years.Among them,934 MSM were sero-negative for syphilis in baseline survey.A total of 100 new cases of syphilis were reported,and the cumulative observation time of cohort follow-up was 1 959.94 person-year,the syphilis incidence rate was 5.10 per 100 person-years.With health education and intervention conducted,the awareness rate of AIDS related knowledge for MSM increased.Though the rate of anal sex increased after intervention,the rate of condom use in anal sex increased,too.The rate of condom use decreased after receiving more than 3 interventions.Data from the multivariate GEE analysis indicated that protective factors might be as follows:education level of college and above (aOR=0.81,95％CI:0.68-0.98),awareness of AIDS related knowledge (aOR=0.52,95％ CI:0.36-0.75),ever receiving condom promotion and distribution in the past six months (aOR=0.60,95％CI:0.49-0.74),being recruited from mobile intemet (aOR=0.85,95％CI:0.73-1.00)and times of cumulative intervention:one time (aOR=0.55,95％ CI:0.45-0.66),two times (aOR=0.38,95％CI:0.30-0.49),three times (aOR=0.26,95％CI:0.20-0.35),four times and above (aOR=0.24,95％CI:0.17-0.33).Diagnoses of STDs in the past six months (aOR=1.43,95％CI:1.06-1.96),using rush-poppers (aOR=1.22,95％ CI:1.02-1.47) might be risk factors.Conclusions After continuous behavior intervention,the incidence of HIV infection and syphilis were at a low level in the MSM cohort in Tianjin.Their awareness rate of AIDS related knowledge and the rate of condom use increased.But there are still many risk factors influencing the unprotected anal sex in MSM.We should continuously carry out behavioral intervention programs to prevent unprotected anal sex among MSM.

Risk factors related to HIV new infections among men who have sex with men in a cohort study / 中华流行病学杂志

Objectives To analyze and understand the risk factors related to HIV new infections among men who have sex with men (MSM).Methods A longitudinal observational study among MSM was conducted to collect information on HIV related behaviors and sero-conversion.Univariate and multivariate generalized estimating equations (GEE) were used to discuss the risk factors for HIV new infection.Results A total number of 4 305 MSM were followed during 2013-2015.Among those self-reported MSM who are seeking partners on the Interner tended to have higher proportion on receptive anal intercourse and consistent condom use during anal intercourse than the subgroups seeking their partners in gay bars or bathrooms.HIV incidence among followed MSM during the study period appeared as 4.3/100 person years,with adjusted RR (aRR) of HIV infection for receptive anal intercourse as group 2.20 (95％ CI:1.49-3.24) times than that of insertion anal intercourse group.Those who used rush-poppers (aRR=1.55,95％CI:1.10-2.17),unprotected anal intercourse (aRR=2.24,95％ CI:1.62-3.08),and those with syphilis infection (aRR=2.95,95％ CI:2.00-4.35) were also risk factors for HIV new infections.After controlling other factors,the relationship between the ways of seeking partners and HIV new infection was not statistical significant.Conclusion Risk factors for HIV new infection among MSM appeared complex and interactive,suggesting that further studies are needed to generate tailored strategies for the prevention of HIV epidemic among MSM population.

A survey on high-risk behaviors and HIV infection among men having sex with men who use drugs in Tianjin in 2016 / 中华预防医学杂志

Objective@#To analyze the characteristics of high risk sexual behaviors and HIV infectious status among men who have sex with men (MSM) who use drugs in Tianjin in 2016.@*Methods@#From April to December in 2016, MSM who use drugs in Tianjin were targetedly and extensively mobilized to receive testing by snowball sampling method. The inclusion criteria were as follows: men aged 18 years old and above; have had oral or anal sex with men in the last 6 months; have had drug abuse history in the last 6 months, including the use of rush poppers, 5-Methoxy-diisopropyltryptamine (5-MeO-DiPT), and Methamphetamine Synthesis substances; and with no mental disorder or mental deficiency. In this study, 302 MSMs were recruited to collect information of social demographic characteristics, drug abuse situation, sexual behavior after drug use, HIV test and the infectious status was collected through the online questionnaire, and the descriptive analysis was conducted.@*Results@#From January to December 2016, a total of 302 subjects were recruited, among whom 194 (64.2%) aged 21-30 years old, 223 (73.8%) were unmarried and 28 (9.3%) were students. In the past 6 months, 297 (98.3%) used rush poppers, 31 (10.3%) used 5-MeO-DiPT, and 14(4.6%) used Methamphetamine Synthesis substances. The proportion of having sex after using the three types of drugs were 87.9% (n=261), 83.9% (n=26) and 92.9% (n=13), 85.5% (n=254), 87.1% (n=27) and 92.9% (n=13) of the subjects reported the sexual pleasure and sexual desire increased after using drugs, respectively. After using the three types of the drugs,58.6% (n=174), 83.9% (n=26) and 92.9% (n=13) of the subjects reported the duration of each sexual activity prolonged. In the past 3 months,48.3% (n=146) had stable sexual partners, 72.5% (n=219) had temporary sexual partners and 12.3% (n=37) had group sexual behaviors. 41 out of 302 subjects were HIV positive with the HIV positive rate at 13.6%.@*Conclusion@#Most of the MSM who use drugs were young, and always had sex when they use drugs. There is a relatively high HIV prevalence in this population.

Analysis of survival and influencing factors of HIV/AIDS patients in Tianjin, 2004-2014 / 中华流行病学杂志

Objective To understand the survival and influencing factors of HIV/AIDS patients in Tianjin.Methods The data of HIV/AIDS cases reported in Tianjin during 2004-2014,which were collected from National AIDS Prevention and Control Information System,were analyzed by using life table and Kaplan Meier method to calculate survival time and the survival rate,and univariate and multivariate Cox regression analysis was conducted to identify the influencing factors for survival time.Results For the 2 775 HIV/AIDS patients,1 year,3 years,5 years,10 years and 11 years cumulative survival rates were 91％,88％,86％,79％ and 79％ respectively.The risk of death in AIDS patients was higher than that in people living with HIV (x2=107.622,P＜0.001);Factors affecting the survival of people living with HIV were the first time CD4 value and antiviral treatment,and the influencing factors for survival of AIDS patients were the infection route,detection ways,first time CD4 value and antiviral treatment.Conclusion Early detection and early treatment can obviously reduce the risk for death of people living with HIV/AIDS.To improve the survival of HIV/ AIDS patients,it is necessary to strengthen the early detection and early treatment of HIV infection.

Factors associated with lost of follow-up of men who have sex with men in a gay bathhouse cohort study in Tianjin, 2012-2015 / 中华流行病学杂志

Objective To understand the rate of follow-up lost in men who have sex with men (MSM) in a gay bathhouse cohort study in Tianjin and the associated factors.Methods The open cohort study in gay bathhouse was launched in 2012 in Tianjin,and the MSM for baseline survey were recruited from January to June 2012,while the follow up was carried out every six months.A questionnaire survey and HIV test were conducted in the study.The MSM who were HIV negative in the baseline survey in 2012 were used for follow up lost analysis.Univariate and multivariate logistic regression analysis were conducted to identify the factors associated with the lost of follow-up.Results A total of 658 gay bathhouse patrons were recruited in the baseline survey,at the end of 42-month follow-up period,173 of them dropped out (26.3％).Multivariate analysis showed that the MSM who were local residents (OR=0.552,95％CI:0.377-0.808),in Han ethnic group (OR=0.197,95％CI:0.066-0.593),having received HIV test in the last year (OR=0.481,95％CI:0.326-0.710),were male sex workers (OR=0.127,95％CI:0.028-0.585),and believed to be at high risk for HIV infection (OR=0.285,95％ CI:0.125-0.647).They were more likely to receive follow-up but the MSM who were aged ≥35 years (OR=1.891,95％CI:1.022-3.500) were more likely to be lost in the follow-up.Conclusion The lost rate of follow-up in MSM in the gay bathhouse cohort was high in Tianjin.Age,household registration,history of HIV test,the awareness of the risk to be infected with HIV and commercial homosex were factors associated with the follow-up rate in the MSM.It is necessary to conduct similar cohort study in targeted population on the basis of findings of this study.

Analysis of survival and influencing factors of HIV/AIDS patients in Tianjin, 2004-2014 / 中华流行病学杂志

Objective To understand the survival and influencing factors of HIV/AIDS patients in Tianjin.Methods The data of HIV/AIDS cases reported in Tianjin during 2004-2014,which were collected from National AIDS Prevention and Control Information System,were analyzed by using life table and Kaplan Meier method to calculate survival time and the survival rate,and univariate and multivariate Cox regression analysis was conducted to identify the influencing factors for survival time.Results For the 2 775 HIV/AIDS patients,1 year,3 years,5 years,10 years and 11 years cumulative survival rates were 91％,88％,86％,79％ and 79％ respectively.The risk of death in AIDS patients was higher than that in people living with HIV (x2=107.622,P＜0.001);Factors affecting the survival of people living with HIV were the first time CD4 value and antiviral treatment,and the influencing factors for survival of AIDS patients were the infection route,detection ways,first time CD4 value and antiviral treatment.Conclusion Early detection and early treatment can obviously reduce the risk for death of people living with HIV/AIDS.To improve the survival of HIV/ AIDS patients,it is necessary to strengthen the early detection and early treatment of HIV infection.

Factors associated with lost of follow-up of men who have sex with men in a gay bathhouse cohort study in Tianjin, 2012-2015 / 中华流行病学杂志

Objective To understand the rate of follow-up lost in men who have sex with men (MSM) in a gay bathhouse cohort study in Tianjin and the associated factors.Methods The open cohort study in gay bathhouse was launched in 2012 in Tianjin,and the MSM for baseline survey were recruited from January to June 2012,while the follow up was carried out every six months.A questionnaire survey and HIV test were conducted in the study.The MSM who were HIV negative in the baseline survey in 2012 were used for follow up lost analysis.Univariate and multivariate logistic regression analysis were conducted to identify the factors associated with the lost of follow-up.Results A total of 658 gay bathhouse patrons were recruited in the baseline survey,at the end of 42-month follow-up period,173 of them dropped out (26.3％).Multivariate analysis showed that the MSM who were local residents (OR=0.552,95％CI:0.377-0.808),in Han ethnic group (OR=0.197,95％CI:0.066-0.593),having received HIV test in the last year (OR=0.481,95％CI:0.326-0.710),were male sex workers (OR=0.127,95％CI:0.028-0.585),and believed to be at high risk for HIV infection (OR=0.285,95％ CI:0.125-0.647).They were more likely to receive follow-up but the MSM who were aged ≥35 years (OR=1.891,95％CI:1.022-3.500) were more likely to be lost in the follow-up.Conclusion The lost rate of follow-up in MSM in the gay bathhouse cohort was high in Tianjin.Age,household registration,history of HIV test,the awareness of the risk to be infected with HIV and commercial homosex were factors associated with the follow-up rate in the MSM.It is necessary to conduct similar cohort study in targeted population on the basis of findings of this study.

Meta-analysis on the positive rate of HIV among MSM with bathhouse as the major venue of sexual practice / 中华流行病学杂志

Objective To explore the positive rates on HIV among men who have sex with men (MSM) who took bathhouse as the major place for sexual practice in China,between 2010 and 2015.Methods Articles published between 2010 and 2015 from CNKI,Wanfang Data,CJFD and PubMed were collected and Stata 12.0 software was used for Meta-analysis.Results A total of 14 articles were selected.Random effects model was employed to calculate the pooled positive rate according to statistical tests for homogeneity with the result f=88.1％.The pooled positive rate appeared as 10.3％,with 95％CI as 7.7％-13.0％.Publication bias was assessed by Egger's test and funnel plot.After stratified analysis on factors as:sample size,year,region and methods on recruitment,the pooled positive rate of HIV appeared higher in people living in the coastal provinces than those in the inland provinces.Conclusion The pooled positive rate of HIV identified from the bathhouses appeared higher than that from other places through,the national HIV sentinel surveillance data,with coastal higher than that in the inland provinces.Bathhouse was recognized as the key place to be caried on intervention programs for the MSM population.

Meta-analysis on the positive rate of HIV among MSM with bathhouse as the major venue of sexual practice / 中华流行病学杂志

Objective To explore the positive rates on HIV among men who have sex with men (MSM) who took bathhouse as the major place for sexual practice in China,between 2010 and 2015.Methods Articles published between 2010 and 2015 from CNKI,Wanfang Data,CJFD and PubMed were collected and Stata 12.0 software was used for Meta-analysis.Results A total of 14 articles were selected.Random effects model was employed to calculate the pooled positive rate according to statistical tests for homogeneity with the result f=88.1％.The pooled positive rate appeared as 10.3％,with 95％CI as 7.7％-13.0％.Publication bias was assessed by Egger's test and funnel plot.After stratified analysis on factors as:sample size,year,region and methods on recruitment,the pooled positive rate of HIV appeared higher in people living in the coastal provinces than those in the inland provinces.Conclusion The pooled positive rate of HIV identified from the bathhouses appeared higher than that from other places through,the national HIV sentinel surveillance data,with coastal higher than that in the inland provinces.Bathhouse was recognized as the key place to be caried on intervention programs for the MSM population.

HIV infection incidence among men who have sex with men in common bathing pool in Tianjin: a cohort study / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate incidence of HIV infection and identify associated risk factors among men who have sex with men (MSM) in common bathing pools in Tianjin.</p><p><b>METHODS</b>A prospective cohort study was conducted among the MSM recruited in a common bathing pool in Tianjin from 2011 to 2013. A total of 733 MSM were surveyed to obtain the information about their sociodemographic characteristics, HIV-related knowledge awareness and sexual behaviors, and subsequent follow-up surveys were carried out every four months. Cox regression analysis was conducted to identify the risk factors for HIV infection.</p><p><b>RESULTS</b>A total of 59 HIV infection cases were found in the 2.5-years follow-up survey. The cumulative follow-up time was 7384.9 person-months. The incidence rate of HIV infection was 9.59/100 person-year. The multivariate Cox regression analysis showed that young age, low score of HIV/AIDS knowledge awareness (HR=1.82, 95%CI:1.03-2.66), having two and more sexual partners during past 6 months (HR=1.74, 95%CI: 1.26-2.58) and syphilis (HR=2.36, 95%CI:1.31-3.27) were significantly associated with HIV infection in this MSM cohort.</p><p><b>CONCLUSIONS</b>Low score of HIV/AIDS knowledge awareness, young age, having two and more sexual partners during past 6 months and syphilis were the risk factors for HIV infection in MSM in common bathing pools. It is necessary to strengthen the HIV surveillance and intervention in this population.</p>

Change of risky sexual behaviors among men who have sex with men before and after recent identification of HIV diagnosis / 中华流行病学杂志

Objective To assess the change of sexual behaviors before and after HIV was recently identified among men who have sex with men(MSM). Methods A retrospective study was conducted on recently identified HIV-infected MSM in Chengdu and Tianjin. A face-to-face questionnaire interview was administrated to collect sexual behaviors within six months,before and after HIV was diagnosed. Differences in sexual behavior before and after the diagnosis were assessed, using the McNemar χ 2 test. Logistic regression analysis was conducted to identify predictors for sexually risk behaviors. Results Of 129 HIV-infected MSM under survey,the average age was 31.8 years and the main venue in seeking male sex partners was through Internet. The proportions of MSM with unprotected anal intercourse (UAI) decreased from 70.5% before diagnosis to 16.3% after diagnosis and the percentage of having more than 1 partner decreased from 66.7%before diagnosis to 33.3%after diagnosis. After the diagnosis was made,there appeared a significant decrease in the percentage of persons who had one main partner from 72.9% to 55.0% and having casual partners declined from 62.8% to 31.0%. Data from multiple logistic regression analysis revealed that risk factors as UAI before diagnosis,more than 1 partner after diagnosis and having one main partner,were all significantly associated with UAI after diagnosis. After the diagnosis was made for UAI,risk factors for‘having more than 1 partner’after diagnosis,would include:using Internet to seek for sexual partners,after diagnosis,having one main partner but not disclosing to him. Conclusion After the diagnosis was made,most HIV-infected MSM would reduce their high risk sexual behaviors but some continued to practice UAI.

Change of risky sexual behaviors among men who have sex with men before and after recent identification of HIV diagnosis / 中华流行病学杂志

Objective To assess the change of sexual behaviors before and after HIV was recently identified among men who have sex with men(MSM). Methods A retrospective study was conducted on recently identified HIV-infected MSM in Chengdu and Tianjin. A face-to-face questionnaire interview was administrated to collect sexual behaviors within six months,before and after HIV was diagnosed. Differences in sexual behavior before and after the diagnosis were assessed, using the McNemar χ 2 test. Logistic regression analysis was conducted to identify predictors for sexually risk behaviors. Results Of 129 HIV-infected MSM under survey,the average age was 31.8 years and the main venue in seeking male sex partners was through Internet. The proportions of MSM with unprotected anal intercourse (UAI) decreased from 70.5% before diagnosis to 16.3% after diagnosis and the percentage of having more than 1 partner decreased from 66.7%before diagnosis to 33.3%after diagnosis. After the diagnosis was made,there appeared a significant decrease in the percentage of persons who had one main partner from 72.9% to 55.0% and having casual partners declined from 62.8% to 31.0%. Data from multiple logistic regression analysis revealed that risk factors as UAI before diagnosis,more than 1 partner after diagnosis and having one main partner,were all significantly associated with UAI after diagnosis. After the diagnosis was made for UAI,risk factors for‘having more than 1 partner’after diagnosis,would include:using Internet to seek for sexual partners,after diagnosis,having one main partner but not disclosing to him. Conclusion After the diagnosis was made,most HIV-infected MSM would reduce their high risk sexual behaviors but some continued to practice UAI.

Change of risky sexual behaviors among men who have sex with men before and after recent identification of HIV diagnosis / 中华流行病学杂志

<p><b>OBJECTIVE</b>To assess the change of sexual behaviors before and after HIV was recently identified among men who have sex with men (MSM).</p><p><b>METHODS</b>A retrospective study was conducted on recently identified HIV-infected MSM in Chengdu and Tianjin. A face-to-face questionnaire interview was administrated to collect sexual behaviors within six months, before and after HIV was diagnosed. Differences in sexual behavior before and after the diagnosis were assessed, using the McNemar χ(2) test. Logistic regression analysis was conducted to identify predictors for sexually risk behaviors.</p><p><b>RESULTS</b>Of 129 HIV-infected MSM under survey, the average age was 31.8 years and the main venue in seeking male sex partners was through Internet. The proportions of MSM with unprotected anal intercourse (UAI) decreased from 70.5% before diagnosis to 16.3% after diagnosis and the percentage of having more than 1 partner decreased from 66.7% before diagnosis to 33.3% after diagnosis. After the diagnosis was made, there appeared a significant decrease in the percentage of persons who had one main partner from 72.9% to 55.0% and having casual partners declined from 62.8% to 31.0% . Data from multiple logistic regression analysis revealed that risk factors as UAI before diagnosis, more than 1 partner after diagnosis and having one main partner, were all significantly associated with UAI after diagnosis. After the diagnosis was made for UAI, risk factors for 'having more than 1 partner' after diagnosis, would include:using Internet to seek for sexual partners, after diagnosis, having one main partner but not disclosing to him.</p><p><b>CONCLUSION</b>After the diagnosis was made, most HIV-infected MSM would reduce their high risk sexual behaviors but some continued to practice UAI.</p>