Factors influencing HIV infection in men who have sex with men in China.

To identify risk factors for HIV infection among men who have sex with men (MSM) and to provide a theoretical basis for prevention interventions. Between December 2011 and August 2012, a case-control study was conducted among MSM who underwent voluntary counselling and testing for HIV. Confirmed HIV-positive MSM were included in the case group, and HIV-negative MSM were included in the control group. Information on possible risk factors was collected by a survey questionnaire and a qualitative interview. The results of a conditional logistic regression showed that the following were influencing factors for HIV infection: average monthly income between 2001 and 3000 Yuan (odds ratio (OR)=6.341, 95% CI: 1.714-12.544), only sometimes using condoms when having anal sex with men in the last 6 months (OR=7.601, 95% CI: 1.359-23.083), having HIV-positive sex partners (OR=5.273, 95% CI: 1.572-17.691), rectal trauma with bleeding in the last 6 months (OR=2.947, 95% CI: 1.308-6.638), not using condoms at last sexual encounter (OR=1.278, 95% CI: 1.012-5.595), engaging in commercial sex (OR=5.925, 95% CI: 1.923-13.890) and having more than 16 sex partners in the last 6 months (OR=1.175, 95% CI: 1.021-1.353). These seven factors were the risk factors of HIV infection (OR>1). However, having anal sex less than 10 times in the previous 1 month (OR=0.002, 95% CI: 0.000-0.287) was a protective factor against HIV infection among MSM (OR<1), and insertive (OR=0.116, 95% CI: 0.000-0.236) (OR<1) anal intercourse influenced HIV infection. Interventions should be targeted at MSM whose average monthly income is between 2001 and 3000 Yuan, and who engage in commercial sex. In addition, the importance of using condoms at every sexual encounter should be emphasised in health education, as should the treatment of rectal trauma with bleeding. Finally, MSM should decrease the number of sex partners and frequency of anal sex to decrease the rate of HIV infection.

[Estimation on the HIV-1 incidence among high risk groups using the pooling RNA technique].

OBJECTIVE: To timely identify the HIV-1 infection in window-period and to estimate the HIV-1 incidence among people who came for voluntary counseling and testing (VCT) service as well as men who have sex with men (MSM), respectively. METHODS: HIV antibody negative samples that were determined by screening tests between January and October 2012, were collected and tested with pooling HIV-1 RNA testing technique (2-staged pooling by 50:1, 10:1). Positive cases were followed-up for HIV antibody testing while HIV incidence was calculated under Ron Brookmeyer' s method, among VCT and MSM populations. RESULTS: Among 1400 HIV antibody negative samples of VCT, two showed HIV-1 RNA positive during the antibody window period with the HIV-1 incidence as 1.87% per year (95% CI: 1.23%-2.65% ). Among 500 HIV antibody negative samples from MSM population, two showed HIV-1 RNA positive in the antibody window period, with HIV-1 incidence as 5.31% per year (95% CI: 3.52%-7.45% ). CONCLUSION: Pooling HIV-1 RNA testing seemed a powerful tool for HIV antibody testing in the window-period. Measures should be taken to strengthen the HIV diagnostic programs among MSM and other high risk groups,during the HIV antibody window-period. More frequent detection approach as pooling HIV-1 RNA testing might be a good choice.

[Association of diabetes and early failure of arteriovenous fistula in the end stage of renal diseases].

OBJECTIVE: To determine the association of diabetes and glycemic control with early failure of native arteriovenous fistula(AVF). METHODS: 266 patients with end stage renal diseases(ESRD) were recruited and divided into non-diabetic group (165), HbA1C < 7% group (51) and HbA1C > or = 7% group (50). Clinical indicators and early failure of AVF were examined. RESULTS: In total, 63 (23.7%) patients had AVF early failure. The AVF early failure occurred in 18. 1% of patients in the non-diabetic group and 21.6% of patients in the HbA1C < 7% group, significantly less than that in the HbA1C > or = 7% group (44%). The COX regression model showed that increased HbA1C, total cholesterol (TC) and decreased high-density lipoprotein (HDL)increased the risk of AVF failure. CONCLUSION: The levels of glycemic and serum lipid subfractions are associated with AVF early failure in ESRD patients. Good control of glycemic and lipid can lower the rates of AVF early failure.