Poor Awareness of Syphilis Prevention & Treatment Knowledge among Six Different Populations in South China

BACKGROUND:

China is facing an emerging epidemic of syphilis, and the cities in south China are most affected. Knowledge is a key factor in the prevention of syphilis infection, however, little is reported about how much people know about syphilis. This study was aimed at assessing peoples' awareness status in a city located in south China.

METHODS:

Six populations were recruited for this study, including urban residents, factory workers, college students, pregnant women, female sex workers (FSWs), and men who have sex with men (MSM). A questionnaire designed by the National Center for Disease Control and Prevention was used to assess participants' awareness of syphilis knowledge. About 5 % of participants were randomly selected to conduct a telephone survey for confirming the validity of fieldwork.

RESULTS:

The study recruited 3470 participants, and 61.2 % of participants were assigned to the awareness group. College students had the smallest percentage of awareness at 51.7 % (371/718), followed by FSWs at 53.9 % (200/371), factory workers at 56.0 % (381/679), urban residents at 65.4 % (435/665), pregnant women at 66.0 % (451/683), and MSM at 81.1 % (287/354). Multivariate logistic regression analysis showed that MSM and FSWs-but not factory workers and pregnant women-had more awareness of syphilis knowledge when comparing with urban residents; however, college students presented less awareness of syphilis knowledge than urban residents. Participants of younger age, of female gender, with lower education levels and without Shenzhen hukou possessed less awareness of syphilis knowledge than those of older age, of male gender, with higher education levels and with Shenzhen hukou respectively.

CONCLUSIONS:

The percentages of awareness on syphilis knowledge found in this study are far from the benchmark set in the national 10-year plan. Tailored interventions for different subgroups to increase syphilis awareness are urgently warranted.

Full article at:   http://goo.gl/zRekFO

By:  Wu X1, Hong F2, Lan L1, Zhang C1, Feng T1, Yang Y1.

• 1Department of STD control and prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, P.R. China.
• 2Department of STD control and prevention, Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, P.R. China. hfc0755@sina.com. 
• BMC Public Health. 2016 Mar 28;16(1):287. doi: 10.1186/s12889-016-2966-4.

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Acceptability of Voluntary Medical Male Circumcision (VMMC) among Male Sexually Transmitted Diseases Patients (MSTDP) in China

Voluntary Medical Male circumcision (VMMC) is an evidence-based, yet under-utilized biomedical HIV intervention in China. No study has investigated acceptability of VMMC among male sexually transmitted diseases patients (MSTDP) who are at high risk of HIV transmission. 

A cross-sectional survey interviewed 350 HIV negative heterosexual MSTDP in Shenzhen, China; 12.0% (n = 42) of them were circumcised at the time of survey. When the uncircumcised participants (n = 308) were informed that VMMC could reduce the risk of HIV infection via heterosexual intercourse by 50%, the prevalence of acceptability of VMMC in the next six months was 46.1%. Adjusted for significant background variables, significant factors of acceptability of VMMC included: 

1. emotional variables: the Emotional Representation Subscale
2. cognitive variables derived from Health Belief Model (HBM): 
1. perceived some chance of having sex with HIV positive women in the next 12 months (perceived susceptibility), 
2. perceived severity of STD infection, 
3. perceived benefit of VMMC in risk reduction and sexual performance, 
4. perceived barriers against taking up VMMC, and 
5. perceived cue to action and self-efficacy related to taking up VMMC. 

The association between perceived severity of STD infection and acceptability was fully mediated by emotional representation of STD infection. 

The relatively low prevalence of circumcision and high acceptability suggested that the situation was favorable for implementing VMMC as a means of HIV intervention among MSTDP in China. HBM is a potential suitable framework to guide the design of future VMMC promotion. 

Future implementation programs should be conducted in STD clinic settings, taking the important findings of this study into account.

Full article at:  http://goo.gl/HkI1lS

By:  

Xixin Wang, Joseph T. F. Lau, Yoona Kim 
Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China

Zixin Wang, Joseph T. F. Lau 

Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China

Tiejian Feng 

Shenzhen Center for Chronic Disease Control, Shenzhen, China

Joseph T. F. Lau 

Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou, China

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A Comparison Between Respondent-Driven Sampling and Time-Location Sampling among Men Who Have Sex with Men in Shenzhen, China

Men who have sex with men (MSM) are a key population for HIV control and prevention in China. It is difficult to acquire representative samples of this hidden population. Respondent-driven sampling (RDS), based on peer referral, and time-location sampling (TLS) based on random selection of venue-day-time periods, are among the most commonly used sampling methods. However, differences in HIV-related characteristics of MSM recruited by these two methods have not been fully evaluated. 

We compared sociodemographics, risk behaviors, utilization of HIV-related intervention services, and HIV/syphilis infection rates between samples of 621 RDS MSM and 533 TLS MSM in Shenzhen, China in 2010. We found that the HIV prevalence was comparable in RDS and TLS MSM. TLS recruited larger proportions of more marginalized MSM than RDS: MSM recruited by TLS were older, less educated and more likely to be migrants (without Shenzhen hukou registration), to be non-gay identified and to engage in risky sexual behaviors. 

On the other hand, MSM recruited by TLS were more likely to have been covered by HIV-related intervention services. To conclude, in Shenzhen, TLS is more effective to reach the marginalized population of MSM. But because TLS can only reach MSM who physically attend venues and HIV-related intervention services are already commonly available at gay venues in Shenzhen, RDS is more informative for allocating prevention efforts than TLS. 

Furthermore, researchers and public health authorities should take into account the different sample compositions of RDS and TLS and apply sampling methods consistently when evaluating trends over time.

Via: http://goo.gl/Z8MMId Purchase full article at: http://goo.gl/xX0uqo

By:  Zhao J1, Cai R, Chen L, Cai W, Yang Z, Richardus JH, de Vlas SJ.

• 1Shenzhen Center for Disease Control and Prevention, No. 8 Longyuan Road, Longzhu Avenue, Nanshan District, Shenzhen, 518055, China.

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Determinants of Recent HIV Testing among Male Sex Workers & Other Men Who Have Sex with Men in Shenzhen, China

We recruited 510 male sex workers (also referred as 'money boys' (MBs) and 533 other men who have sex with men (MSM) to investigate determinants of recent (last year) HIV testing in Shenzhen, China. 

• Overall, 43% of MBs and 48% of other MSM reported having been tested for HIV in the last year. 
• The most important determinant of testing among MBs was having multiple anal sex partners; 
• among other MSM, the most important determinants were having a homosexual orientation and having a history of sexually transmissible infection. 

For MBs, education programs are needed to increase their awareness of actual HIV risk. For other MSM, destigmatising programs are needed.

Via: http://ht.ly/ScXG3

By: Cai R, Cai W, Zhao J, Chen L, Yang Z, Tan W, Zhang C, Gan Y, Zhang Y, Tan J, Richards JH, De Vlas SJ.

Outcomes of antiretroviral treatment in HIV-infected adults: a dynamic and observational cohort study in Shenzhen, China, 2003–2014

Below: CD4 cell count response after antiretroviral treatment (ART) initiation. (A) Median (IQR) CD4 cell count increase from ART initiation, stratified by immunological success and failure. (B) Median (IQR) CD4 cell count increase from ART initiation, stratified by baseline CD4 cell count.

In China, the number of people infected with HIV is 740 000 in estimation. Among these, a cumulative 436 817 people living with HIV/AIDS had been identified up to December 2013, including 173 825 people with AIDS. Since the China National Free Antiretroviral Treatment Program (NFATP) was established in 2003, the remarkable acceleration in treatment has been obvious. By December 2013, more than 278 000 people have received first-line highly active antiretroviral therapy (HAART). Along with the increasing treatment coverage, overall mortality rates have fallen from 39.3 deaths per 100 person-years in 2000 to 14.2 deaths per 100 person-years in 2009. All HIV-infected individuals who meet the national treatment criteria are eligible to receive treatment, and treatment has been implemented in all 31 provinces, autonomous regions and municipalities in China.

The limitations of previous studies reporting the effects of HAART in developing countries were the relatively small sample sizes or short durations of follow-up. Fortunately, our study reports the 10-year outcomes of virological and immunological treatment failure rates and their associated risk factors for all adult patients enrolled in the NFATP in Shenzhen.

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