Factors Associated with High-Risk Behaviors among People Newly Diagnosed with HIV Through Heterosexual Contact Before & After Diagnosis in Some Areas in Henan Province

OBJECTIVE:

To understand the factors associated with high risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnoses in some areas in Henan province, and evaluate the risk of secondary transmission.

METHODS:

A face to face interview was conducted among people infected with HIV through heterosexual contact by using self-designed questionnaires during January-May in 2015.

RESULTS:

Among 361 HIV infected persons, the proportions of those with commercial heterosexual behaviors or sex with irregular sex partners decreased from 77.3%(279/361) and 28.5%(103/361) before diagnosis to 13.6% (49/361) and 2.5%(9/361) after diagnosis, the difference was significant (χ(2)=16.66,P<0.001;χ(2)= 4.80,P=0.03). The subjects surveyed always had more commercial heterosexual behaviors in Henan, Guangdong and Zhejiang provinces before and after diagnosis. After HIV infection confirmation, the condom use rates were 51.0%(25/49) for commercial heterosexual behaviors, 88.5% (184/208) for sex with regular partners and 88.9%(8/9) for sex with irregular partners, respectively. Multivariate logistic regression analysis indicated that risk behaviors associated with HIV transmission included commercial sexual behaviors, previous HIV detection and age of 35 years or older.

CONCLUSIONS:

Extramarital heterosexual behavior has posed serious challenge to the prevention and control of HIV spread. It is necessary to inform the HIV test results, improve the intervention and promote condom use in people with history of commercial sex and people aged ≥35 years.

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By:  Fan PY1, Bai YJ2, Yang WJ1, Li N1, Sun DY1, Zhu Q1, Wang Z1.

• 1Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China.
• 2Zhoukou Prefecture Centre for Disease Control and Prevention, Zhoukou 466000, China.
• Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Mar 10;37(3):367-70. doi: 10.3760/cma.j.issn.0254-6450.2016.03.015. 

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Analysis of Related Factors for HIV Transmission among 263 Pairs of Male Spouses with Positive HIV Antibodies in Zhejiang Province

OBJECTIVE:

To identify the status and risk factors of transmission in couples which males was HIV-positive in Zhejiang province.

METHODS:

A cross-sectional study was conducted among HIV-serodiscordant couple (male positive) and HIV-seroconcordant couple (male first infected). A self-designed questionnaire was complimented containing basic information, the awareness of infection and HIV-testing, sexual relationship power, self-efficacy of condom use, sex. The univariated and multivariate logistic regression methods were used to analyze the influence factors.

RESULTS:

A total of 263 couples were enrolled in this study, including 210 HIV HIV-serodiscordant couples and 53 HIV-seroconcordant couples. 

• HIV-positive males aged 30-50 accounted for 57.8% 
• and females under junior high school accounted for 79.1%
• HIV/AIDS accounted for 41.1% 

The proportion of man who were diagnosed as HIV, MSM and ever heard HIV were 61.9% (130 cases), 38.3% (80 cases) and 81.9% (172 cases), which were higher than that in HIV positive 47.2% (25 cases), 7.5% (4 cases), 64.2% (34 cases); χ(2)=3.80, 18.33, 7.86;P=0.051, 0.001, 0.005. 

The results revealed that AIDS patients had high risk to infect their spouse than HIV patients. Male patients who had ever heard " HIV" before were less likely pass virus to their wives than those who had never heard " HIV". Compared with heterosexuality man, homosexuality man' wives had high risk to get virus from their husbands. Female infected with STIs was the independent factors for HIV infection.

CONCLUSION:

Among the couples of male HIV-positive in Zhejiang Province, the risk of spouses infected with HIV virus has relationship with male disease progression, sexual orientation and awareness of AIDS knowledge. For females who infected with sexual diseases in last 6 months might be infected by their spouses.

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By:  Chen L1, Pan XH, Yang JZ, Xu Y, Wang H, Zhou X, Jiang TT, Ma QQ.

• 1Department of HIV/AIDS and STDs Control and Prevention, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China. 
• Zhonghua Yu Fang Yi Xue Za Zhi. 2016 Feb 6;50(2):158-62. doi: 10.3760/cma.j.issn.0253-9624.2016.02.011.

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Survey of Prevalence of HIV Infection, Syphilis & HCV Infection & Related Risk Behaviors among Club Drug Users in Zhejiang, 2011

OBJECTIVE:

To understand the prevalence of HIV infection, syphilis and hepatitis C infection and related risk behaviors among club drug users in Zhejiang province.

METHODS:

The drug users were interviewed with questionnaires in 2011 to collect the information about their demographic characteristics, sexual behaviors, drug use behaviors and the utilization of intervention services. Blood samples were collected from them to detect HIV, syphilis and HCV antibodies.

RESULTS:

A total of 3 253 drug users were surveyed, in which 1 298 were club drug users, accounted for 39.9%. The proportion of club drug users was high in northern and central Zhejiang, in females, in age group≤25 years, in local residents and in those having commercial sexual behaviors during previous 12 months. Of the 1 298 club drug users, 91.2% were methamphetamine users, 0.1% were infected with HIV (95% CI: 0.0%-0.2%), 8.1% suffered from syphilis (95% CI: 6.6%-9.6%), 17.3% were infected with HCV (95% CI: 15.2%-19.4%). Among the interviewed club drug users, 12.7% were aware of AIDS, 9.2% had injecting drug use histories, 29.6% reported having commercial sex during the previous 12 months, only 33.4% received free condom and counsel, 14.0% received HIV test. Multivariate logistic regression analysis indicated that living in central and southern Zhejiang was associated with syphilis prevalence, HCV infection and injecting drug use behavior, being female was associated with syphilis prevalence. Injecting drug use and commercial sex during the previous 12 months were associated with HCV infection, and injecting drug use and commercial sex during the previous 12 months were associated with each other. Among the 1 285 club drug users, males, local residents in Zhejiang and those who never received free condom or counsel were more likely to have commercial sex.

CONCLUSION:

The prevalence of syphilis and HCV infection are high and unprotected sexual behaviors are common among the club drug users in Zhejiang, but less intervention services were received by them, suggesting that more attention should be paid to the prevention and control of HIV, HCV infections and syphilis in club drug users by taking effective intervention measures and increasing intervention coverage.

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By:  Pan X1, Jiang J2, He H3, Chen L2, Yang J2, Zhang H3, Wang N4.

• 1Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; Email: xhpan@cdc.zj.cn.
• 2Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
• 3Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University.
• 4National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.
• Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Sep;36(9):934-40. 

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High Prevalence of HIV among Men Who Have Sex with Men in Zhejiang, China

Objectives

To examine the prevalence of HIV and risk behaviours among men who have sex with men (MSM) and to explore the feasibility of using respondent-driven sampling in this population in order to conduct customised interventions among MSM in the future.

Design

Cross-sectional study.

Setting

Zhejiang, China.

Participants

1316 MSM.

Primary and secondary outcome measures

HIV prevalence rates and factors associated with HIV infection; sociodemographic and behavioural information of participants, syphilis prevalence rates.

Results

The adjusted prevalence of HIV and syphilis were 13.8% and 11.4%, respectively. Multivariate analysis showed that higher educational level, support treatment of HIV, negative syphilis are protective factors of HIV infection. MSM who had heterosexual behaviour before and whose primary sexual partner was HIV-positive were less likely to be infected with HIV compared with their counterparts, while frequency of sexual behaviour with primary sexual partner was positively associated with HIV infection.

Conclusions

This survey confirmed a high HIV prevalence among MSM in Zhejiang province. MSM are extremely vulnerable to HIV infection and comprehensive interventions are urgently needed to slow the spread of HIV among MSM.

Full article at:   http://goo.gl/0eWBz4

By:   Xiaohong Pan,1 Minni Wu,2 Qiaoqin Ma,1 Hui Wang,1 Wenzhe Ma,2 Shidian Zeng,3 Junfang Chen,4 Yan Zhang,5Dandan Miao,2 Xin Zhou,1 Tingting Jiang,1 Lin He,1 Yan Xia,1 Zhihang Peng,2 and Shichang Xia1

¹Center for Disease Control and Prevention of Zhejiang Province, Hangzhou, Zhejiang, China

²Department of Epidemiology & Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China

³Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, China

⁴Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China

⁵Ningbo Center for Disease Control and Prevention, Ningbo, Zhejiang, China

Correspondence to Dr Shichang Xia; Email: nc.jz.cdc@aixhchs

 

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Prevalence & Correlates of HIV Infection & Sexually Transmitted Infections in Female Sex Workers (FSWs) in Shanghai, China

In 2009, we examined HIV and sexually transmitted infections (STIs) in 750 female sex workers (FSWs) in Shanghai using a cross-sectional survey. 

Participants (mean age 27 years) were interviewed and tested for HIV and selected STIs. Prevalence was: HIV 0·13%, chlamydia 14·7%, gonorrhoea 3·5% and syphilis 1·3%. 

In a demographic multivariate model, younger age, higher income and originating from provinces other than Zhejiang and Shanghai were independently associated with STI. In a social and sexual behavioural model, women working in small venues with fewer clients per week, use of drugs, and higher price charged per sex act indicated a greater risk for STI. 

Although HIV appears rare in Shanghai FSWs, chlamydial infection is common, especially in women aged <25 years (prevalence 19·6%). Since STI and HIV share similar risk factors, preventive intervention measures should be implemented immediately based on the venues and characteristics of FSWs to prevent future spread of HIV.

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By: Remis RS1, Kang L2, Calzavara L1, Pan Q2, Liu J1, Myers T1, Ren J2, Tang X3; Shanghai Health District Research Group.

• 1Dalla Lana School of Public Health,University of Toronto,Toronto,Canada.
• 2Shanghai Centre for Disease Control and Prevention,Shanghai,People's Republic of China.
• 3Hongkou District Centres for Disease Control and Prevention,Shanghai,People's Republic of China.  

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Rates & Risk Factors Associated with the Progression of HIV to AIDS among HIV Patients from Zhejiang, China between 2008 and 2012

The objective of this study was to determine the rate of acquired immune deficiency syndrome (AIDS) in Zhejiang province and to identify specific factors associated with progression of this disease.

This study utilized a retrospective cohort to identify the specific factors involved in the progression of human immunodeficiency virus (HIV) to AIDS. We collected data of patients existing in care between 2008 and 2012 from the national surveillance system databases. We performed our analyses using a multivariate Cox proportional hazards model.

This study included 9216 HIV-positive patients (75.6 % male), which yielded 12,452 person-years (py) of follow-up-data. The AIDS progression rates were 33.9 % (2008), 33.6 % (2009), 38.1 % (2010), 30.6 % (2011) and 25.9 % (2012). We observed a significant reduction in the rate of progression Of HIV to AIDS post-2010 (Pearson χ ²  = 4341.9, P < 0.001). The cumulative AIDS progression incidence rates were 33.4, 35.4, 36.4, 37.0 and 37.04 per 100 py in 1 each of the 5 years of follow-up. This study found that age was an independent risk factor for the progression of HIV to AIDS. Compared with patients infected with HIV by homosexual transmission, patients infected with HIV by heterosexuals transmission or blood transfusion had a reduced hazard ratio (HR) for progression to AIDS (heterosexual transmission: HR = 0.695, 0.524, P = 0.007; blood transfusion: HR = 0.524, P = 0.015). Diagnosed with HIV from 2011 to 2012 and having a higher CD4+ cell count (350–500 cells/mm ³ ; or >500 cells/mm ³ ) at baseline were independently associated with lower rates of HIV progression to AIDS [HR = 0.382, 0.380, 0.187, P < 0.001]. Patients with a CD+ T-cell count of 200–350 cells/mm ³ or greater than 350 cells/mm ³ were less likely to develop AIDS following HIV diagnosis than were those patients without HAART treatment.

This study found a high progression rate from HIV to AIDS in HIV patients residing within Zhejiang province from 2008 to 2010. This rate decreased after 2010, which coincided with the new criteria for HAART treatment, which likely contributed to the observed reduction in the rate of progression. Initiation of HAART with higher CD4+ T-cell count may reduce rate of AIDS progression. Based on our results, we conclude that efficient strategies for HIV screening, as well as early diagnosis and treatment are necessary to reduce the progression of HIV to AIDS.

Below:  AIDS progression rates by baseline CD4+ cell count among 2008–2012: this figure demonstrated the progression of HIV to AIDS among patients with different CD4+ T-cell count

Below:  AIDS progression rates by mode of transmission among 2008–2012: this figure demonstrated the progression of HIV to AIDS among patients with different transmission routes

Read full article at: http://ht.ly/SGCJe 

By: Lin Chen^1*, Jiezhe Yang¹, Renjie Zhang¹, Yun Xu¹, Jinlei Zheng¹, Jianmin Jiang¹, Jun Jiang¹, Lin He¹, Ning Wang², Philip Chun Yeung³ and Xiaohong Pan⁴

¹ Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, China

² National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China

³ Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong

⁴ Department of HIV/AIDS Prevention and Control, Zhejiang Provincial Center for Diseases Control and Prevention, 3399 Binsheng Road, Hangzhou, Zhejiang, People’s Republic of China

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