The changing trends of HIV/AIDS in an ethnic minority region of China: modeling the epidemic in Liangshan prefecture, Sichuan Province / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study was to investigate the HIV current situation in Liangshan prefecture, in order to predict prevalence and transmission trends.</p><p><b>METHODS</b>Region-specific population, behavior, serosurveillence, and policy/program data (from 1995 to 2010) were gathered from various local and national organizations and applied to the Asian Epidemic Model (AEM) and used to derive estimates of future HIV prevalence, epidemic trends, and outcomes of intervention strategies.</p><p><b>RESULTS</b>The AEM projections for 2020 included increased number of people living with HIV (PLHIV; to 136 617), increased HIV prevalence (2.51%), and 8037 deaths from acquired immunodeficiency syndrome (AIDS) in this region. However, the overall HIV incidence rate (per 10 000) was projected to decline from 27 in 2015 to 22 in 2020, largely due to a predicted decrease in HIV infection rate (per 10 000) from 658 in 2013 to 621 in 2020 among intravenous drug users. In contrast, the cases of HIV infection per 10 000 was projected to increase from 420 in 2010 to 503 in 2020 among men who have sex with men, and from 8 in 2010 to 15 in 2020 among the general population. The predominant risk factor for HIV transmission over the next decade in Liangshan was casual sex. Community-based outreach strategies to reduce injected drug use and casual sex, and to promote condom use, were predicted as effective interventions to decrease HIV transmission.</p><p><b>CONCLUSION</b>Implementation of a comprehensive public health program, with targeting to the region-specific at-risk populations, will help to mitigate HIV/AIDS spread in Liangshan.</p>

An outbreak of gastroenteritis caused by poisonous Boletus mushroom in Sichuan, China, 2012 / 中华流行病学杂志

Objective To identify the source of infection and risk factors and to provide control measures regarding an outbreak of gastroenteritis involving 30 villagers.Who attended the same wedding party held on March 5th,2012,a survey was carried out.Methods Case was defined as having onset of vomiting,nausea,stomachache or diarrhea among the attendees of a wedding party.We randomly selected and interviewed 140 from 470 attendees on their symptoms and food exposures at the wedding.We compared food-specific attack rates (AR) for gastroenteritis in a retrospective cohort study.The leftover foods were tested for Salmonella,Shigella,and Staphylococcus aureus.The leftover Boletus mushrooms were examined and species determined by the Kunming Institute of Botany,Chinese Academy of Sciences.Results Of the 140 attendees 61％ (85) developed gastroenteritis.Case-attendees had vomiting (94％),nausea (89％),stomachache (53 ％),and diarrhea (51％).The AR among attendees who ate Boletus mushroom was 69％ (81/118),compared to 18％ (4/22) of those who did not (RR＝3.8,95％ CI:1.5-9.2).When comparing the ARs between the attendees on consumption of other foods,data did not show statistically significant differences.Among the 7 species of Boletus identified from the leftover mushrooms,3 (B.venenatus,B.sinicus and B.magnificus) were toxic.Store keepers bought dried or fresh mushrooms from local villagers who had picked up them from the mountains.Salmonella,Shigella,and Staphylococcus aureus tests on those leftover food showed negative results.Conclusion Poisonous Boletus mushroom contributed to this outbreak.We recommended that education should be targeted on mushroom-pickers regarding how to recognize the poisonous mushrooms.Regulations and laws should also be developed to facilitate the necessary process.

Acceptability and relevant impact factors of provider initiated testing counseling in Liangshan Yi autonomous prefecture of Sichuan province / 中华流行病学杂志

Objective To understand the acceptability and relevant impact factors of provider initiated testing counseling (abbreviated as PITC) in Liangshan Yi autonomous prefecture,so as to promote strategies for the sustainable development of PITC in AIDS epidemic areas.Methods Four medical institutions were selected with rates of acceptance counted.Multi-factors logistic regression was used to analyze the impact factors from the completed questionnaires.Results Among the 413respondents,197 patients accepted the PITC,with an acceptance rate as 47.7％ (95％ CI:42.9％-52.3％).Factors as being female (OR=7.283,95％CI:3.933-13.465),acceptance of publicity (OR=1.855,95％ CI:1.013-3.395),worried about being infected of HIV/AIDS (OR=2.699,95％ CI:1.616-4.506) etc.were protect factors of PITC,while those who previously received HIV testing (OR=0.226,95％CI:0.124-0.409),afraid of taking blood test (OR=0.052,95％CI:0.024-0.106),knowing more AIDS related knowledge (OR=0.446,95％ CI:0.258-0.773) would significantly reduce the rate of acceptance.Conclusion Nearly half of the outpatients from medical institutions were willing to accept PITC in Liangshan Yi prefecture,thus provided important chance for HIV screening.Ways as strengthening related counseling before and after HIV test,launching effective HIV/AIDS-related publicity and advocating correct knowledge on blood testing,etc.need to be promoted,in order to improve the acceptability of PITC.

Drug resistance and associated factors on HIV in Liangshan prefecture, Sichuan province / 中华流行病学杂志

Objective To investigate the HIV drug resistance among HIV/AIDS patients who had received highly active antiretroviral treatment (HAATR) in Liangshan prefecture and related factors.Methods This investigation was conducted from August to October 2010.Data on epidemiology,treatment,CD4 + T cell,viral load and drug resistance tests were collected.Results 233 (73.50％) had a viral load of ＜ 1000 copy/ml,with the median CD4+T cell count as 329 cell/μl.26 samples appeared to be drug resistant,with the rate as 8.20％.Among 84 patients with antiviral therapy failure,the overall drug resistance rate was 30.95％(26/84).While 24 (28.57％) were resistant to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs.Among nucleoside reverse transcriptase inhibitors (NRTI),7 (8.33％) were resistant.1 (1.19％) had protease inhibitor (PI)resistance mutations identified.Factors that significantly associated with drug resistance would include:being injecting drug users (A OR =3.37,95 ％ CI:1.06-10.66,P =0.0390),having had chronic diarrhea ＞1 month (AOR=8.38,95％ CI:1.87-37.69,P=0.0055),having had CD4+T cell＜200(AOR=3.48,95％CI:1.29-9.39,P=0.0139),being residents from Butuo area (AOR=17.68,95％ CI:4.97-62.86,P＜0.0001 ).When comparing with other areas,data from Butuo showed that people who carried Yi ethnicity (AOR=17.35,95％ CI:2.01-149.73,P=0.0095) and were literate (having had primary or higher levels of education) (AOR=0.18,95％ CI:0.08-0.42,P＜0.0001 ),being married or having cohabited relations (AOR=8.17,95％ CI:2.35-28.39,P=0.001 ) were found to be less adherent (AOR=0.05,95％ CI:0.02-0.13,P＜0.0001) to the treatment.Conclusion Successful antiviral outcomes were seen among those AIDS patients under treatment,in Liangshan prefecture.Resistance rates were significantly different in regions.For IDUs,enforcement on subjects including prevention on drug resistance,adherence to HAART and treatment for drug addiction should be strengthened and programs being integrated.