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 Spatial Clustering of HIV infected in men who have sex with men in Chongqing of 2004-2015 / 中华预防医学杂志

Objective@#To analyze the spatial clustering characteristics of HIV/AIDS among men who have sex with men (MSM) in Chongqing from January 2004 to December 2015 and understand the HIV/AIDS related behaviors among MSM by interview.@*Methods@#Data related to MSM who were infected with HIV and whose present address were in Chongqing, were collected from Information System on the HIV/AIDS Prevention and Control. Information included the age when the information was inputted, address, occupation, education level, and marital status. The total number of MSM who were infected with HIV and reported was 6 604 in Chongqing. Those with unknown address were ruled out. The spatial autocorrelation analysis and the local spatial autocorrelation analysis were carried out by using ArcGIS 10.3. In addition, in November 2015 and May 2016, using a convenience sampling, we conducted one-on-one interviews among 23 MSM in the Chongqing Center for Disease Control and prevention. Inclusion criteria: Receiving voluntary counseling and testing in the urban area of Chongqing and willing to participate in the interview by oral informed consent; male and self-described as MSM. The content of the interview included basic information, sexual orientation, sexual role, the main place of making friends, the main place of sexual behavior, a long-term experience in other provinces and drug abuse.@*Results@#The HIV/AIDS reported number in Chongqing from 2004 to 2015 showed an uptrend, except in 2010. The age distribution of 6 604 cases of HIV positive patients was mainly concentrated in the 15-34 years old, about 68.5% (4 522 cases). There was a positive spatial autocorrelation in MSM, except 2005 (Moran's I=-0.046, P=0.823), form 2004 to 2015, Global Moran's I values were 0.308, 0.254, 0.335, 0.683, 0.673, 0.558, 0.620, 0.673, 0.685, 0.654 and 0.649, respectively; all P values were <0.01. The result of local spatial autocorrelation analysis showed that high-high accumulation area development in Chongqing city was divided into two stages in 2004-2015, which were Yuzhong, Jiangbei, and Shapingba district in 2004-2007 and the expanded Jiulongpo, Nan'an, and Yubei district in 2008-2015. Qualitative interviews results revealed that the age of the respondents was 20-44, and the mainly way of making friends were using mobile phone App and internet (17 participants). Most of the participants (11 participants) were making friends in the bar. The majority of respondents would ask the friends or themselves to use condoms when meeting with them the first time (19 participants), and 8 of respondents reported that they would not use condoms when their old friends refused to use condoms.@*Conclusion@#The HIV infected MSM mainly aged between 15-34 years old and the spatial distribution of HIV/AIDS among MSM was clustered in economically developed main area in Chongqing. MSM began to make friends on the Internet, and could not adhere to using condom, which indicated that we should focus on internet intervention to find more efficacious interventions.

Study on the risk of HIV transmission by heterosexual contact and the correlation factors / 中南大学学报(医学版)

OBJECTIVE@#To understand the associated factors on human immunodeficiency virus (HIV) transmission via heterosexual contact and to provide evidence for decision-maker for prevention of HIV.
@*METHODS@#Questionnaire survey was conducted in 250 HIV-positive persons to understand their socio-demographic characteristics and sexual behavior. Meanwhile, 431 persons who had heterosexual contact with the HIV carriers were traced to their HIV infection status. The factors associated with continued HIV transmission were reviewed by case-control analysis.
@*RESULTS@#Among the 432 persons, 59 were HIV-positive because of heterosexual contact. The secondary attack rate and the growth rate was 13.7% (59/431) and 0.236 (59/250), respectively. The factors associated with the spread of HIV included: the degree of knowledge on HIV/AIDS, psychological reflection after infection, the condition for condom usage among spouses, and regular sexual partners or non regular sexual partners.
@*CONCLUSION@#The secondary attack rate and the growth rate of HIV transmission by heterosexual contact are high. Improvement of the knowledge about HIV/AIDS prevention and control, enhancement of psychological education and promotion of condom usage can reduce the risk for continued HIV transmission.

Analysis of early detection of HIV infections by provider initiated HIV testing and counselling in regions with high HIV/AIDS epidemic in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand provider initiated HIV testing and counseling (PITC) in a region with high HIV/AIDS epidemic in China, and analyze its effect to early detection of HIV infections.</p><p><b>METHODS</b>Between January and December, 2013, 37 county level medical institutions were selected as the study sites, among which, 19 were public medical institutions and 18 were private institutions. According to the related regulation, procedures and contents of PITC, the study was implemented among outpatients and inpatients who seek for doctors in these medical institutions and PITC were provided for them. The 'Individual Investigation Form' was used to record the information and high-risky factors, and the respondents were taken venous blood and given HIV screening and confirmation. All available serum samples of newly found HIV/AIDS cases were tested using the BED HIV Incidence Capture Enzyme Immunoassay (BED-CEIA) to differentiate the long-term infections and new infections (early detected infections). Chi-square analysis was used to compare the differences of characteristics of newly infected patients.</p><p><b>RESULTS</b>Between January and December, 2013, a total of 37 medical institutions provided PITC. 55 164 person times were received HIV screening, among which 658 were HIV positive, and 598 were confirmed to be HIV positive. The 598 cases were all provided transferring service. The differences of age, marital status, education levels, transmission routes and testing institutions had statistical significance to early detection (χ(2) equals to 23.54, 10.50, 17.96, 21.22 and 4.80; P equals to < 0.001, 0.005, < 0.001, < 0.001 and 0.029, respectively). And the early detection proportions among patients aged from 20 to 29 and from 50 to 84 were 47.1% (114/242) and 42.1% (24/57), respectively; the proportions among single and married patients were 37.8% (56/148) and 38.9% (143/368), respectively; the proportion among patients with high school education levels were 42.6% (26/61); the proportion among patients transmitted by fixed heterosexual sexual partners was 46.0% (86/187); the proportion among private hospitals was 40.3% (58/144).</p><p><b>CONCLUSION</b>A certain proportion of HIV infections were early detected by PITC in this region. The HIV early detection proportions among specific age group and population with spouse/fixed sexual partners were relatively high.</p>

Syphilis infection and its high risk factors among men who have sex with men by different recruitment channels / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the syphilis infection and its high risk factors among men who have sex with men (MSM) recruited from different channels.</p><p><b>METHODS</b>Supported by the China-Gates Foundation HIV program from July to December 2011, we cooperated with community based organizations to conduct syphilis testing intervention among MSM from 14 cities (Beijing, Shanghai, Tianjin, Chongqing, Harbin, Shenyang, Qingdao, Xi'an, Nanjing, Wuhan, Hangzhou, Changsha, Kunming, and Guangzhou) and one province (Hainan province). Participants were recruited from different channels by the staff of local CBOs, Demographic (e.g. age, marital status, and education) and behavioral (e.g. condom use and sexual partners) data were collected using anonymous questionnaires. Blood samples were also collected to test for syphilis. A total of 34 100 MSM participated in the survey. Participants were excluded from data analysis (1 399, 4.1%) if they did not receive syphilis tests or they completed less than 80.00% of the key questions in the survey. Chi-square tests were used to understand the socio-demographic and behavioral differences between each group. Results of syphilis tests were also compared. Logistic regression models were used to test the statistical significance of these differences.</p><p><b>RESULTS</b>A total of 32 701 MSM were enrolled and received syphilis testing. The average age of participates was 30.96 ± 9.57. And among them, 2 284 cases (7.0%) were recruited from gay bathhouses, 4 774 (14.6%) from gay bars, 6 266 (19.2%) from the internet, 1 997 (6.1%) from the parks/toilets and 17 380 (53.1%) from other channels. MSM recruited from the bathhouses had the highest syphilis infection rate than other 4 groups: gaybars (4.5%, 216/4 774), internet (6.7%, 422/6 266), parks/toilets (8.3%, 166/1 997), other channels (6.4%, 1 103/17 380) (χ² = 164.58, P < 0.001). The multivariate logistic regression analysis showed that being > 20 years of age (P < 0.001), having more than 2 homosexual partners in recent 3 months (8.0% (1 408/17 714), OR (95% CI) = 1.44 (1.04-1.98)), having no sex with females in past 3 months (6.8% (1 446/21 276), OR (95% CI) = 1.25 (1.07-1.46)), and not using condom at last anal sex (8.0% (769/9 668), OR (95% CI) = 1.13 (1.03-1.25)) were associated with a higher probability of being infected with syphilis. Whereas MSM married (7.2% (456/6 305), OR (95% CI) = 0.84 (0.73-0.98)), having a college or a higher education (5.3% (829/15 684), OR (95% CI) = 0.60 (0.53-0.67)), being local residents (6.5% (1 843/28 185), OR (95% CI) = 0.73 (0.61-0.87)) and living in the local province of project cities (6.6% (170/2 593), OR (95% CI) = 0.67 (0.53-0.85)) were protective factors.</p><p><b>CONCLUSION</b>MSM who were recruited from gay bathhouses have a higher rate of syphilis infection than those in channels relatively. They are older, with low education levels and high-risk sexual behaviors. Tailored interventions are required in the future, especially for MSM from gay bathhouses.</p>

Health economic evaluation of AIDS response / 中华预防医学杂志

During the past over 20 years of AIDS response in China, different fields from the international society and domestic sources provide significant amounts of resources for China's AIDS response. The investment, distribution and use of these resources and their effect has become the concern of the society. The health economic evaluation method is used to scientifically answer these questions, which is also the motivation of the evaluation studies. Based on several studies on health economic evaluation of AIDS response in this issue, concepts and issues related to this area are summarized. It is important for the readers to make a point of health economics evaluation, and it is also of great importance to know its limitations to provide the basis for future proper use of AIDS health economic evaluation results.

A study on the health economic evaluations of prevention of mother-to-child HIV transmission in Dehong prefecture, Yunnan province, China from 2004 to 2013 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To conduct health economic evaluation of the prevention of mother-to-child HIV among pregnant women in Dehong prefecture, Yunnan province, China from 2004 to 2013.</p><p><b>METHODS</b>Data on cost were collected mainly from the annual prevention of mother-to-child transmission (PMTCT) reporting system of Dehong prefecture, and supplemented by HIV PMTCT-related resource allocation data from local health bureau. Effectiveness indexes were from local continuous HIV surveillance system and annual reported data. Cost-effectiveness and cost-utility analysis were used to conduct the health economic evaluation.</p><p><b>RESULTS</b>From 2004 to 2013, 283980 pregnant women were screened for HIV, 2 059 were detected as positive, and the HIV positive rate was 0.73%. The total cost of the PMTCT program was 14 227 000 RMB after discounting, and the unit cost of positive case finding was 4 200 RMB. A total of 26 cases of adults and 325 infants were avoided HIV infection, and the cost-effectiveness ratio (CER) was 40 500 RMB/case. The total obtained quality adjusted life years (QALY) from the program was 8 911.5, each one of which cost 1 600 RMB/QALY. If the feeding pattern were breast feeding, CER would be 42 800 RMB/case and each one of QALY would cost 2 200 RMB.</p><p><b>CONCLUSION</b>Based on the cost-effectiveness and cost-utility analysis, the HIV PMTCT of Dehong prefecture had economic value, which indicates that continued investment is needed to strengthen local HIV PMTCT work.</p>

A cost-utility study on HIV/AIDS 'one-stop service' pilot at county level / 中华预防医学杂志

<p><b>OBJECTIVE</b>To conduct a cost utility study on the HIV/AIDS 'one-stop service' at county level.</p><p><b>METHODS</b>Financial records and questionnaires were used to collect the information about the resource allocation and the effectiveness of antivirus treatment (ART) during the two period which were January 2012-June 2013 and July 2013-December 2013 in the three pilot counties providing 'one-stop service'. Treeage Pro 2009 was used to build the Markov model to simulate the evolution of 5 different HIV statuses, including HIV infection, AIDS, HIV infection receiving ART, AIDS receiving ART and death. And compared the cost-utility ratios between current ART process and 'one-stop service' process. National and local epidemic data and literature review were used to provide the parameters in the model, including prior probabilities of each status, transferring probabilities among each status, health utility values and investments of each status and discount rate.</p><p><b>RESULTS</b>The expenditures related with 'one-stop service' in the three counties were 2 627 339, 209 969, and 191 658 RMB, respectively between July and December, 2013. The average periods from HIV infection confirmation to ART initiation was reduced from 8 weeks to 18, 10 and 16 days, respectively. The percentage of receiving ART within 30 d among those qualified were increased from 46.7% (63/135) to 64.3% (45/70) in county A, from 40.0% (16/40) to 69.4% (25/36) in county B, and from 9.5% (4/42) to 50.0% (19/38) in county C. If current process was applied, the CUR in three counties would be 10 391.89 RMB/quality adjusted life years (QALY), 6 271.42 RMB/QALY and 3 515.94 RMB/QALY, and these would be 10 825.08 RMB/QALY, 8 522.30 RMB/QALY and 10 414.65 RMB/QALY with application of 'one-stop service'.</p><p><b>CONCLUSION</b>'one-stop service' could decrease the interval between HIV infection confirmation and ART initiation and increase the percentage of receiving ART among people living with HIV(PLHIV), more QALYs would be obtained with more resources invested.</p>

A study on the risk and its determinants of HIV transmission by syringe sharing among HIV-positive drug users / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the risks and associated factors of HIV transmission by sharing syringes among HIV-positive drug users.</p><p><b>METHOD</b>The survey was conducted among HIV-positive injecting drug users (IDUs-HIV+) who received HIV counseling, testing and treatment in Changsha city Infectious Disease Hospital and Hengyang city No.3 People's Hospital from July 2012 to May 2013 to understand their socio-demographic characteristics, HIV prevalence and syringe sharing. A total of 503 IDUs-HIV+ were involved in and provided the contact list of 2 460 drug users who had the syringe sharing experience over one month with IDUs-HIV+. 420 IDUs-HIV+ among 503 were defined as infection sources due to sharing syringe with at least one drug user. Among them, 234 HIV-negative persons were in control group, and 186 HIV-positive were in cased group. A total of 1 220 drug users were followed up among 2 460 and defined as vulnerable population. The HIV transmission rate was calculated based on the HIV prevalence among vulnerable population. Based on the result of HIV transmission to vulnerable population from 420 infection sources, case-control study and the multivariate logistic regression analysis were adopted to explore the associated factors of HIV transmission among IDUs-HIV+.</p><p><b>RESULTS</b>As the sources of HIV transmission, 420 IDUs-HIV+ had an average duration of (4.5 ± 1.2) years for drug use. As a susceptible population, 1 220 drug users sharing syringes with the 420 IDUs-HIV+ had an average duration of (1.1 ± 0.5) years for drug use. There were 238 HIV-positive persons among 1 220 vulnerable drug users, with a transmission rate of 0.57. In the case-control study, the proportion of male subjects was 87.1% (162/186) in the case group, which was higher than that in the control group (77.8%, 182/234). The proportion of subjects who received support after knowing their HIV infection status was 51.1% (95/186) in the case group, which was lower than that in the control group (79.5%, 186/234). The proportion of subjects sharing syringes every time of using drugs was 47.8% (89/186) in the case group, which was higher than that in the control group (36.8%, 86/234). The proportion of subjects having AIDS awareness was 21.0% (39/186) in the case group, which was lower than that in the control group (64.5%, 151/234); the proportion of subjects having close contact with HIV-positive persons for more than 106 days was 60.2% (112/186) in the case group, which was higher than that in the control group (31.6%, 74/234). The proportion of subjects maintaining the original drug use method after being infected with HIV was 50.5% (94/186) in the case group, which was higher than that in the control group (16.7%, 39/234) (all P values < 0.05). The multivariate logistic regression analysis was carried out to analyse high correlate factors of HIV transmission by sources of transmission, and the AIDS awareness, duration of contact between sources of transmission and vulnerable population, access to support following confirmed HIV infection were protective factors, OR (95% CI) values were 0.155 (0.104-0.262), 0.170 (0.106-0.253), and 0.306 (0.189-0.450), respectively; while the frequency of syringe sharing and continuous drug use after being infected with HIV were risk factors, and the OR (95% CI) values were 3.06 (1.77-5.29), and 3.54 (2.16-5.80), respectively.</p><p><b>CONCLUSION</b>HIV transmission by IDUs-HIV+ might be contained by raising AIDS awareness, providing comprehensive psychological support, conducting needle exchange and methadone maintenance treatment and reducing syringe sharing.</p>

The survival and development conditions of community-based organizations for HIV/AIDS prevention and control among men who have sex with men in three Chinese cities / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the survival and development conditions of community-based organizations (CBOs) for HIV/AIDS prevention and control among men who have sex with men (MSM) in Chinese cities including Shanghai, Hangzhou, Chongqing.</p><p><b>METHODS</b>This study employed both qualitative (focus groups) and quantitative (questionnaire survey) methods to obtain information from 15 MSM CBOs in three Chinese cities.</p><p><b>RESULTS</b>The mean work time of the 15 CBOs for HIV/AIDS prevention and control among MSM was 6.7 years (2.1-11.3 years), and the majority of their funds was from international cooperation projects (80 447 000 RMB, 73.0%) from 2006 to 2013. The survival cost of MSM CBOs apart from expenditure of activities was 2 240-435 360 RMB per year. As it was shown in the graph, the survival and development of MSM CBOs was closely related to the development of international cooperation projects. There was a few small size MSM CBOs taking part in the prevention and control of HIV/AIDS and their work content was limited before 2006. From 2006 to 2008, some international cooperation projects were launched in China, such as the China Global Fund AIDS project and the China-Gates Foundation HIV Prevention Cooperation program. As a result, the number of MSM CBOs was increased sharply, and both the scale and 2012, the performance of these programs further promote the establishment of new MSM CBOs and the development of all MSM CBOs with regard to the work places, full-time staffs, work contents, work patterns and the specific targeted population. After 2012, most international cooperation programs were completed and the local department of disease prevention and control continued to cooperate with MSM CBOs. However, the degree of support funds from the local department was different among different regions. Where the funds were below the half of program funds, the development of MSM CBOs ceased and work slowed down. Besides, there were still some constraints for the survival and development of MSM CBOs, such as insufficient funds, no legitimate identity, the outflow of talents and the unsustainable development.</p><p><b>CONCLUSION</b>The survival and development of MSM CBOs was closely related to the development of international cooperation projects in China. Some departments of disease prevention and control took over the cooperation with MSM CBOs when the international cooperation projects were completed. Given the survival cost of MSM CBOs and the constraints of MSM CBOs development, it needs further investigation on how to ensure the local departments of disease prevention and control to take over the cooperation with MSM CBOs and how to cooperate with MSM CBOs.</p>

Economic evaluation of needle and syringe exchange in two provinces of Southwest China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To measure related cost, effectiveness and benefit of needle and syringe exchange (NSP) in two provinces of Southwest China.</p><p><b>METHODS</b>Between September 2012 and February 2013, program files and questionnaires were used to collect the information about cost, effectiveness and benefit of NSP during three program years (July 2009 to June 2010, July 2010 to June 2011, July 2011 to June 2012 ) in 31 counties of two provinces of Southwest China. Unit cost indicators including cost of providing per syringe and cost of covering per IDU, number of new HIV infections avoided by providing needle and syringe exchange were used to evaluate the effectiveness of NSP, and the benefit indicators included the fees for ART, hospitalization cost and follow up of new HIV infection avoided by NSP. NEAR model was used to calculate the cases averted by NSP. Chi-square test was used to analyze the different percentage of allocation areas between two provinces.</p><p><b>RESULTS</b>Between July 2009 and June 2012, 25 374 041 yuan were totally used for NSP. In province A, the top investment area was management (1 848 485 yuan) while it was comprehensive intervention (5 452 355 yuan) in province B. The cost of providing per syringe was 3.67 yuan, and it decreased from 6.96 to 4.01 in province A and decreased from 3.38 to 2.17 in province B with the increasing needles distributed. The cost of covering per IDU was 712.71 yuan and the unit cost decreased from 882.85 to 574.95 in province A and decreased from 760.48 to 625.07 in province B with the growing number of IDUs intervened. A total of 1 307 new HIV infection were avoided by providing NSP, so 19 413.96 yuan would be used to avoid per IDU infecting HIV. A total of 367 507 488 yuan of HIV/AIDS related expenditure were avoided by NSP and the cost benefit ratio was 14.48.</p><p><b>CONCLUSION</b>NSP has a good cost-benefit ratio and should be promoted.</p>

A study on the effectiveness of prevention of mother-to-child HIV, syphilis, and hepatitis B transmission among pregnant women in Dehong prefecture,Yunnan province, China from 2011 to 2013 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To demonstrate the effectiveness of prevention of mother-to-child HIV, syphilis, and hepatitis B transmission among pregnant women in Dehong prefecture, Yunnan province, China from 2011 to 2013.</p><p><b>METHODS</b>Data were collected mainly from the continuous HIV surveillance system and prevention of mother-to-child transmission (PMTCT) reporting system of Dehong prefecture, and supplemented by annual reported data on HIV, syphilis, and hepatitis B PMTCT to know the general demographic characteristics, HIV testing and counseling service, PMTCT service, and other medical services. Data were presented as absolute numbers and proportions.</p><p><b>RESULTS</b>From 2011 to 2013, the number of pregnant women participating in HIV, syphilis, and hepatitis B testing in Dehong prefecture increased and the HIV testing rates were 99.2% (18 694/18 854), 99.9% (22 047/22 060) and 99.9% (21 751/21 756), the syphilis testing rates were 56.0% (10 550/18 854), 99.6% (21 980/22 060) and 99.9% (21 751/21 756), and the hepatitis B testing rates were 60.2% (11 358/18 854), 99.6% (21 974/22 060) and 99.9% (21 751/21 756). From 2011 to 2013, the HIV positive rates were 0.87% (327/37 787),0.82% (319/38 817) and 0.85% (315/37 261), the syphilis positive rates were 0.05% (10/18 520),0.12% (43/36 817) and 0.11% (40/35 888), the hepatitis B positive rates were 2.46% (456/18 520), 2.23% (794/35 547) and 2.14% (739/34 468), respectively. The rates of HIV-positive pregnant women giving birth in hospitals were 99.2% (128/129), 100.0% (141/141) and 100.0% (141/141). From 2011 to 2013, the proportions of HIV-positive pregnant women receiving antiretroviral therapy were 99.2% (128/129), 99.3% (140/141) and 99.3% (140/141), respectively. And the treatment rate of syphilis-positive pregnant women were 71% (5/7), 89% (16/18) and 97% (32/33). The rates of hepatitis B immunoglobulin injection among new-borns of hepatitis B-positive pregnant women were 92.9% (263/283), 99.7% (612/614) and 99.4% (629/633). The estimated rates of mother-to-child transmission of HIV were 2.28%, 2.30% and 3.00%, respectively.</p><p><b>CONCLUSION</b>There was an increasing trend of HIV, syphilis, and hepatitis B testing rate and the positive rate kept at a low level. The proportions of HIV-positive pregnant women receiving HIV, syphilis, and hepatitis B PMTCT services increased annually, while the proportion of HIV MTCT kept at an overall low level from 2011 to 2013, which indicated its effectiveness of HIV PMTCT work during recent years in Dehong prefecture,Yunnan province, China.</p>

Analysis of characteristics and therapy of clients in the extension methadone maintenance therapy clinic / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the characteristics and retention situation of clients in extension clinic of methadone maintenance therapy.</p><p><b>METHODS</b>From December 20, 2010 to March 10, 2011, the system sampling method was used to get the cases. A total of 462 heroin addicts from 22 methadone maintenance therapy clinics and extension clinics located in Mangshi, Ruili, Longchuan, Yingjiang, Lianghe of Dehong prefecture, Yunnan province were interviewed, and the demographic characteristics, quality of life, urine testing results for morphine of the patients between the extension MMT clinic and standard MMT clinic were also collected and compared. A cohort study was conducted to analyze retention situation of the new clients with Kaplan Meier method during 9 months treatment.</p><p><b>RESULTS</b>Of the 462 cases, 239 cases were from standard MMT clinic, and 223 cases were from the extension MMT clinic. Among them, 117 cases were new research objects into the group during the investigation. Among the clients of extension MMT clinic, 96.7% (147/152) of them were males, 37.5% (57/152) were Dai nationality, and 61.2% (93/152) were married, 38.8% (59/152) with primary school education, 95.4% (145/152) lived with their family or relatives, 96.7% (147/152) could arrive at the clinic from their habitation within 15 minutes. The positive detection rates 72% (13/18), 71% (24/34), 58% (30/52), 29% (15/52), 14% (6/44), 14% (4/29), 15% (5/34), 17% (6/35), 6% (2/33), 16% (5/31) of urine-morphine testing among new clients of extension MMT clinics decreased as the period of treatment lengthened (χ(2) = 61.04, P < 0.05). The period of retention of the clients in extension MMT clinics was 175-days averagely, with an average retention 122 days of when withdrawing. The retention rates of the clients were 52% (37/71)and 61% (28/46) at 9th month of the extension MMT clinics and standard MMT clinics respectively. There was no difference in the retention rate between those of two types of clinics (χ(2) = 0.82, P = 0.37) .</p><p><b>CONCLUSION</b>Most of the clients in extension MMT clinics lived with their family or relatives, and spent less time on the way to the clinics. After 9 months methadone maintenance therapy, the quality of life of clients in extension clinics was improved while addiction among them decreased. The extension clinic was an effective strategy for retention in remote areas.</p>

Prevalence and risk factors of syphilis in men who have sex with men in 16 districts in China / 中华皮肤科杂志

Objective To examine the prevalence of and risk factors for syphilis among men who have sex with men (MSM) in 16 cities/districts, 6 provinces in China. Methods Based on a previous survey on the entertainment place and population size of MSM, a cross-sectional study was conducted in 2007 using non-probability sampling method among MSM in 16 cities/districts in China.Information about the demography,risk behavior and syphilis infection was collected through questionnaires from MSM. Univariate and multivariate stepwise logistic regression model was constructed to evaluate independent factors associated with syphilis. Results A total of 4211 participants were recruited. The mean age of these participants was 28 years. Among them, 66.7% were self identified as homosexual, 72.5% were unmarried, and 76.4% had an education beyond senior middle school; in the past 6 months, 8.7% had sexual contact with more than 10 male sex partners, 5.6% had ever paid for male sex service, 11.3% had provided commercial sex service to males, and 18.9% had sexual contact with females, while condom was consistently used in only 36.3% of male-to-male anal sexual behavior. Syphilis was diagnosed in 10.6% of these participants. The risk factors independently associated with syphilis included being older than 25 years (adjusted OR = 1.7; 95% CI:1.3-2.0), local residency (adjusted OR = 1.3; 95% CI: 1.0-1.7), being recruited from a bar or a park (adjusted OR = 1.3; 95% CI: 1.1-1.7), having ever paid for a male sex service(adjusted OR = 1.5; 95% CI: 1.0-2.1),inconsistent condom use during male-to-male anal sexual behavior(adjusted OR = 1.2; 95% CI: 1.0-1.5 ), self reported sexually transmitted infection history (adjusted OR = 1.3; 95% CI: 1.0-1.7). Conclusions There is a high prevalence of syphilis in MSM in the 16 Chinese cities where male-to-male commercial sex service and unsafe sexual behavior are common. Further efforts are urgently needed to scale-up the prevention of and treatment program for syphilis among MSM, which should include syphilis and HIV screening as well as education on the use of condom.

Analysis of correlation between female HIV prevalence and policy resources invested for the prevention of mother-to-child transmission / 中国艾滋病性病

Objective To analyze correlation between female HIV prevalence and policy resources invested for the prevention of mother-tochild transmission(PMTCT).Methods Local policy documents concerning PMCTC published in different periods of time were collected from 4 HIV endemic counties in China,and their main components were analyzed in terms of their correlation with the recent infection rate in local women in general and single and married women of child bearing age in particular.Results The policy resources invested for PMTCT by the county governments had a logarithmic correlation with the female HIV infection rates.Conclusion With the rise of female HIV infection rates,policy resources invested for PMTCT has been increased,but after a rapid increase,recent female HIV infection has exerted little influence on the investment of policy resources.