Prostitutes, prostitution and STD/HIV transmission in mainland China.

China's opening to the world has enabled massive social and economic transformations and the liberalization of many policies, but also the rise of coincident social problems and diseases. A revival of wide-scale female prostitution since the 1980s has now accelerated to a nationwide dilemma. Prostitutes have long been considered to be reservoirs, if not 'vectors' for the transmission of sexual diseases. A well established STD epidemic in the last decade, plus the presence of growing HIV infections in China now, underscore the need to evaluate the prostitute's role in STD and HIV propagation. This report examines unobtrusive data on female prostitutes in the People's Republic of China through an analysis of prison records from eight sexually segregated prisons (six in Sichuan Province and two in Guizhou Province), two female re-education institutions, and arrest records for convicted prostitutes from four counties in Sichuan Province and Chengdu City (also in Sichuan). Collectively, these data represent 2057 female prostitution cases, and span the years 1988-1990. Demographics are examined to enable a profile of the prostitute as based on data reviewed, and this is contrasted to the stereotype of the prostitute as described in government propaganda against prostitution. STD prevalence rates in the samples are examined and contrasted to two other studies on STDs in nonprostitution populations made available to the authors. Prostitute arrest records reveal a majority had active STD infection[s] at the time of their apprehension, with gonorrhea being the most common bacterium; in many instances, prostitutes also had a history of other sexually transmitted diseases. Thus, data examined support the notion of prostitution as an agent in STD transmission. Presence of HIV infection in prostitutes could not be corroborated through sampled records, nor could prostitution itself be confirmed as an agent in HIV transmission at present. However, given the type of clients serviced by prostitutes in China, a prostitute's own risk of HIV infection is discussed. Control measures by the Chinese government to curb prostitution are examined at both national and provincial levels. Questions are raised as to the effectiveness of present tactics as adjunctive strategies in reducing STD infection and HIV risk in the prostitution population.

Prospective, double-blind, concurrent, placebo-controlled clinical trial of intravenous ribavirin therapy of hemorrhagic fever with renal syndrome.

A prospective, randomized, double-blind, concurrent, placebo-controlled clinical trial of intravenous ribavirin (loading dose of 33 mg/kg, 16 mg/kg every 6 h for 4 days, and 8 mg/kg every 8 h for 3 days) was conducted in 242 patients with serologically confirmed hemorrhagic fever with renal syndrome (HFRS) in the People's Republic of China. Mortality was significantly reduced (sevenfold decrease in risk) among ribavirin-treated patients, when comparisons were adjusted for baseline risk estimators of mortality (P = .01; two-tailed). HFRS typically consists of five consecutive but frequently overlapping clinical phases. Only occurrence of oliguric phase and hemorrhage was associated with severity of clinical disease in the placebo group. Ribavirin therapy also resulted in a significant reduction in the risk of entering the oliguric phase and experiencing hemorrhage. The only ribavirin-related side effect was a well-recognized, fully reversible anemia after completion of therapy.

[Using urinary diagnostic indices to evaluate acute renal failure in epidemic hemorrhagic fever].

The urinary diagnostic indices were used to evaluate acute renal failure in 118 cases with epidemic hemorrhagic fever (EHF). When the renal failure was mainly caused by acute tubular necrosis, it would occur earlier and persist longer. The authors suggested that the indices are helpful in documenting the severity and identifying the characteristics of acute renal failure in EHF. The mechanisms for developing acute renal failure in EHF was discussed.

[Processes of pathologic coagulation and fibrinolysis in epidemic hemorrhagic fever with renal lesion].

The processes of coagulation, anticoagulation and fibrinolysis as well as renal function were studied in 114 cases with epidemic hemorrhagic fever (EHF). The results showed that there were pathological coagulation and fibrinolysis and abnormal renal function in EHF. Comparing with normal controls, there was statistical significance (P less than 0.05) with the exception of fibrinogen. The degree of abnormality corresponded with the severity of the disease. With the observation of serial curves of these processes and renal function, we found out that there was correlation between them. Correlation analysis suggested that pathological coagulation and fibrinolysis could cause renal lesion or exacerbate it (P less than 0.05). The lesion affects mainly the glomerular filtration; whether it affects the tubular function or not is uncertain.