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ObjectiveTo verify and promote the HIV antibody urine test in a demonstration zone for HIV prevention and control in Xinjiang， and to assess the sensitivity and specificity of the test and the willingness of the volunteers， providing a basis for evaluating and determining whether it was suitable for large-scale use in the region. MethodsStratified cluster sampling was used to select the respondents in a place in Xinjiang for questionnaire survey and sample collecting. Questionnaire results were statistically described， and multivariate logistic regression analysis was used to explore the influencing factors of willingness to use HIV-1 urine test. The results of blood ELISA antibody detection method were used as a reference to calculate the specificity， sensitivity and Kappa value of urinary HIV-1 antibody in the total population and different populations. ResultsA total of 2 504 volunteers were recruited for the urine self-testing. The sensitivity of HIV-1 antibody urine test in the total population was 94.73% （54/57）， the specificity was 100% （2 447）， the positive predictive value was 100% （54/54）， and the negative predictive value was 99.88% （2 447/2 450）. The specificity of each population group was 100% when comparing different populations. The test sensitivity was 100% in pregnant women， prostitutes and drug users， 50% （1/2） in MSM subjects， with a Kappa value of 0.796. The test sensitivity was 80% （8/10） in the volunteers， with a Kappa value of 0.878. In the satisfaction survey， 73.1% population was more likely to receive urinary rapid test than the blood fast test， 93.8% of the population was willing to recommend the rapid urinary detection to other people. More than 70% of the population was satisfied with the rapid urinary detection. The multivariate logistic regression analysis showed that age， degree of education， occupation， marital status， payment method of medical expenses， and income level were the influence factors of the purchase of urine fast reagent for the self-testing （P<0.05）. ConclusionUrinary HIV-1 antibody detection method has good reliability and public satisfaction. It is suitable for large-scale use in Xinjiang.
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Objective To investigate the current status and its influencing factors of ART coverage and VL inhibition rate of HIV/AIDS in Yining City, Xinjiang, and to provide reference for AIDS prevention and treatment. Methods The ART data for 2017-2019 years in Yining, Xinjiang was retrieved from the National AIDS Antiretroviral Treatment Information System, to analyze the changing trend of ART coverage rate and VL inhibition rate of HIV/AIDS. Logistics regression model was used to analyze the influencing factors of untreated HIV/AIDS and uninhibited VL. Results The coverage rate of antiviral treatment in Yining city from 2017 to 2019 was 73.39%, 78.06% and 87.03%, respectively. The inhibition rates of VL were 83.91%, 85.05% and 86.09%, respectively, showing an increasing trend year by year. Female, other transmission routes, positive sexual partner detection, and testing and special investigation reduced the risks of untreated HIV/AIDS, while other domicile locations, non-marital and non-commercial heterosexual contact, and unawareness of their own VL increased the risks of untreated HIV/AIDS. Female, 26-35 years old, 36-45 years old, 46~55 years old, >55 years old, primary school, junior high school, high school or technical secondary school, junior college or above, and male-male sex behavior reduced the risks of unsuppressed VL of HIV/AIDS, while other domicile locations, non-marital and non-commercial heterosexual contact, and unawareness of their own VL increased the risks of unsuppressed VL in HIV/AIDS. Conclusion The ART coverage rate and VL inhibition rate in Yining, Xinjiang rise year by year, approaching the expected target. Targeted education and supervision should be conducted to promote the realization of “90-90-90” in 2020 and “95-95-95” target in 2030.
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Objective To investigate the superinfection of human immunodeficiency virus (HIV) / hepatitis B virus (HBV) in Yining City, and to study on its prevention and control measures. Methods A total of 21 cases of HIV / HBV superinfection recorded by Yining CDC from January 2017 to October 2019 were investigated. Results In this group, the proportion of male (66.67%) was higher than that of female (33.33%), 36-60 years old and 17-35 years old (42.86% and 33.33%), junior high school and primary school and below (57.14% and 28.57%), sex workers and migrant workers (42.86% and 28.57%) were higher. The common clinical manifestations of this group were long-term fever, emaciation, general pain and so on. HIV was mainly sexually transmitted (61.90%). HBV was mainly transmitted by blood and sex (47.62% and 9.52%). The proportion of big three Yang was the highest (42.86%), followed by simple HBsAg (23.81%), small three yang (19.05%), HBsAg / anti HBC (14.29%). Conclusion In Yining City, 36-60 years old of male, junior high school and below, sex workers and migrant workers account for a relatively high proportion, and their clinical manifestations were complex, with clear features. Therefore, prevention and management should be strengthened.
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Objective@#To study the epidemiological characteristics and related factors of dyslipidemia among adult residents in Xinjiang Uygur Autonomous Region (Xinjiang) in 2013-2014.@*Methods@#A total of 4 120 adult residents consisting of Han and Uygur group aged over 18 years old were selected by using a stratified cluster random sampling method in 8 counties of Xinjiang from 2013 to 2014. The related factors of dyslipidemia were collected by questionnaire and physical measurement. The total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected by enzyme method. Factors associated with dyslipidemia were analyzed by chi-squared test and a multivariate unconditioned logistic regression model adjusted for gender, urban or rural area, age-group, body mass index (BMI), central obesity, smoking, drinking, education attainment, diabetes mellitus and hypertension.@*Results@#The prevalence of dyslipidemia was 45.00% (1 854 cases). The prevalence of dyslipidemia was higher in Uygur group (47.80% (977/2 044)) than that in Han group (42.24% (877/2 076)) (χ2=12.84, P<0.001). The analysis showed that dyslipidemia was related with gender (OR=0.41, 95%CI: 0.33-0.51), urban area (OR=0.54, 95%CI: 0.39-0.76), BMI (overweight group (OR=1.52, 95%CI: 1.18-1.96); obesity group (OR=2.20, 95%CI: 1.64-2.96)), central obesity (OR=1.66, 95%CI: 1.29-2.14) and diabetes mellitus (OR=1.49, 95%CI: 1.06-2.11) in Uygur group. The analysis also showed that dyslipidemia was related with BMI (overweight group (OR=1.72, 95%CI: 1.32-2.25), obesity group (OR=2.60, 95%CI: 1.85-3.64)), central obesity (OR=1.45, 95%CI: 1.13-1.87), smoking (OR=1.46, 95%CI: 1.09-1.95), diabetes mellitus (OR=1.77, 95%CI: 1.38-2.25) and hypertension (OR=1.62, 95%CI: 1.31-2.00) in Han group.@*Conclusions@#The prevalence of dyslipidemia in Xinjiang was higher than the national average prevalence. The prevalence of dyslipidemia in Uygur group was significantly higher than that in Han group. The gender, living area, BMI, central obesity and diabetes mellitus were risk factors of dyslipidemia in Uygur group, and BMI, central obesity, smoking, diabetes mellitus and hypertension were risk factors of dyslipidemia in Han group in Xinjiang.
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Objective To understand the misreporting rate regarding the routes of transmission among the reported HIV patients in Yili prefecture of Xinjiang,since 2011.Methods An investigation focusing on the route of transmission among people living with HIV/AIDS was carried out to clarify the responsible reasons for the situation.Results The overall incorrect reporting rate on the route of transmission was 10.8％.The proportion of heterosexual transmission route was over estimated by 63.8％ to 72.0％.However,the proportion of injecting drug was underestimated by 27.5％ to 22.2％.The number of cases being confirmed as through heterosexual transmission but incorrectly reported was quite high,contributing 82.6％ of all the incorrectly reported cases.Most of the patients that incorrect reported,were moved from injecting drug use to heterosexual transmission,which contributed 79.5％ of all the total incorrectly reported cases.Results from multi-factor analysis showed that the risk related to incorrect reporting was 3.64 times in males than in females.People who anticipated to receive HIV testing were 2.23 times more than those who had not.Old-age groups were 3.511,4.053,4.415 and 6.524 times higher than those people who were aged below 16 years.Conclusions The proportion of heterosexual transmission route was over-estimated while the proportion on injecting drug use was underestimated.However,the transmission pattern had changed from injecting drug use at the early epidemic stage,to current sexual transmission mode.We recommended that more attentions should be paid to patients who were males,at older age or those who had no expectation in receiving the HIV testing,during the initial following-up stage.
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Objective To analyze the sex specific mortality in HIV/AIDS patients receiving highly active antiretroviral therapy (HAART) and risk factors in Xinjiang Uyghur autonomous region (Xinjiang),and provide evidence for the evaluation of the effect of HAART.Methods A retrospective analysis was conducted on the mortality and survival of 8 061 male cases and 6 001 female cases of HIV infection,who received HAART during July 2004-June 2013 in Xinjiang.The information of the cases were downloaded from national antiretroviral therapy reporting sub-system in national HIV/AIDS reporting system.Cox proportional hazard model was used to identify the risk factors of deaths.Results The male cases were older and had lower CD4 value at baseline compared with the female cases.The major transmission route was injecting drug use in males,but sexual contact in females.The overall mortality of the male cases was higher than that of the females,which was 10.87/100 person-years during the first three month after receiving HAART,and 7.00/100 person-years two years later in males,but 4.77/100 person-years during the first three month and 3.00/100 person-years two years later in females.The results from Cox analysis showed that the risk factors were the CD4 value at baseline and transmission route.Compared with the cases who had lower CD4 value (CD4＜200 cells/μl) at baseline,the HR for the cases who had higher CD4 value (CD4 ≥ 350 cells/μl) was 4.08 (95％ CI:2.96-5.62) in males and 5.11 (95％CI:3.16-8.35) in females.Compared with sexual transmission,the HR for IDUs was 1.99 (95％CI:1.66-2.40) in males and 1.77 (95％ CI:1.24-2.52) in females.The results of cumulative survival analysis showed that in conventional treatment group (CD4＜350 cells/μl),the five year survival rates were 81％ and 87％ for the males and females infected through sexual contact and 66％ and 75％ for the males and females infected through injecting drug use,and in early treatment group (CD4≥350 cells/μl),the five year survival rates were 97％ and 98％ for the males and females infected through sexual contact and 86％ and 97％ for the males and females infected through injecting drug use.Conclusion In Xinjiang,the higher mortality in male HIV infection cases receiving HAART was related with lower CD4 value at baseline and higher infection rate through injecting drug use.Besides the weak intention for treatment and poor compliancy would be the deeper risk factors.
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Objective To understand cognition status about AIDS prevention knowledge of urban and rural residents in Xinjiang Yili state ,and to provide a scientific basis for formulating measures of AIDS publicity ,education ,prevention and control for the fu-ture .Methods For simple random sampling with Database of country infectious diseases special projectsthat Yili state has been successfully uploaded ,obtain the required sample ,then conducted questionnaire survey .Results In 1 101 respondents ,cognition rate about AIDS prevention knowledge of urban and rural residents was 79 .02% ,the higher level regions of AIDS epidemic classifi-cation ,respondent in the higher cognition rate ;the cognition status about blood transmission ,mother-to-child transmission was bet-ter ,the sexual transmission was poorer .Male ,16 to 30 years old ,Uygur ,the higher education level of respondents ,AIDS prevention knowledge in relatively good condition status .Conclusion The cognition status about AIDS prevention knowledge in Xinjiang Yili state basic meet the national standards ,but remains to be improved .We should enhance AIDS prevention knowledge education cope with high age group ,Kazakhs and other ethnic minorities ,low education level of the respondents ,it should also focus on strengthe-ning the publicity education and proper guidance with non-transmission .According to different popular level classification ,publicity and education should be carryed out combined with local actual formulation is more advantageous to measure .
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<p><b>OBJECTIVE</b>To analyze the mortality and risk factors among HIV/AIDS patients receiving highly active antiretroviral therapy (HAART) in the Xinjiang Uyghur Autonomous Region (XUAR).</p><p><b>METHODS</b>The objects of study were all HIV/AIDS adult patients who had received HAART in XUAR. The proceeding information was uploaded to the national ART reporting system which was a branch of the national HIV/AIDS reporting system. A retrospective cohort study was conducted among these patients who were treated during July 2004 to June 2013 in XUAR. Mortality rates and cumulative survival rates were calculated. Cox proportional hazard model was conducted to examine the risk factors for deaths.</p><p><b>RESULTS</b>The proportion for death, lost, referral and withdrawal were 8.5% (1 200/14 062), 2.5% (351/14 062), 0.9% (121/14 062)and 15.4% (2 162/14 062) respectively. The P25, P50 and P75 of baseline CD4(+)T lymphocyte was 144.00, 244.50 and 331.00/µl, respectively. The overall mortality rate was 4.98/100 person-years. The cumulative survival rate of ART treatment after 1-5 years were 0.94,0.91,0.88, 0.84 and 0.81. The mortality rate had a significant difference among different population. The male (6.58/100 person-years) was higher than the female(2.87/100 person-years), the people who infected tuberculosis (TB) (9.79/100 person-years) was higher than those non TB (4.12/100 person-years), the people whose CD4(+)T lymphocyte count less than 200/µl (7.67/100 person-years) was higher than other groups, the people who were transmitted through injection (7.61/100 person-years) was higher than those sexual transmission (3.10/100 person-years), the people whose HB less than 80 g/L (13.84/100 person-years) was higher than those more than 80 g/L (4.74/100 person-years) (χ(2) values were 154.62, 177.47, 309.73, 228.99 and 84.27. P < 0.01). The risk of death of the one with the baseline CD4(+)T lymphocyte ≤ 200/µl was 3.61 (2.73-4.78) times of the one with the baseline CD4(+)T lymphocyte >350/µl. The risk of death of the one having more than 4 baseline symptom categories was 3.62 (2.42-5.42) times of the one having less than 3 baseline symptom categories. The risk of death of the one with baseline HB ≥ 80 g/L was 2.84 (2.21-3.64) times of the one with the baseline HB <80 g/L. The risk of death of the male was 1.48 (1.25-1.75) times of the female. The risk of death of the one infected TB was 1.39(1.18-1.64) times of the one not infected TB. The risk of death of the one injecting drugs was 1.84 (1.56-2.17) times of the one not injecting drugs.</p><p><b>CONCLUSION</b>From 2004 to 2013, the mortality rate was low among HIV/AIDS patients receiving ART in XUAR. The mortality risk factors were low CD4 T cell count, having more baseline symptom categories, low HB level, injection drug transmission, male and TB infection, all these factors had positive correlation with death.</p>
Subject(s)
Adult , Female , Humans , Male , Acquired Immunodeficiency Syndrome , Antiretroviral Therapy, Highly Active , CD4 Lymphocyte Count , CD4-Positive T-Lymphocytes , China , Cohort Studies , Communicable Diseases , HIV Infections , Prognosis , Proportional Hazards Models , Retrospective Studies , Risk Factors , TuberculosisABSTRACT
<p><b>OBJECTIVE</b>To investigate gay identity status of men who have sex with men(MSM) in Xinjiang, and analyze its association with sexual behaviors.</p><p><b>METHODS</b>From May to August in 2013, an anonymous questionnaire survey with convenience sampling was conducted among MSM in Urumqi, Kashgar, Aksu and Yining cities of Xinjiang. Those who were ≥ 16 years of age and claimed to have male-to-male sex behaviors were eligible for the survey. A total of 1 467 participants were recruited. Chi square analysis was performed for examining the association between ego-identity, social-identity and relevant sexual behaviors. Selected variables associated with ego-identity, social-identity in the univariate analysis were subsequently assessed in a multivariate analysis using logistic regression.</p><p><b>RESULTS</b>The MSM with positive ego-identity accounted for 44.7% (656/1 467), and positive social-identity accounted for 29.1% (427/1 467). For ego-identity, Uyghur MSM were less positive than Han MSM (OR (95%CI) was 0.43 (0.32-0.58) ) ; those who were over 20 years of age when accepting their sexual orientation were less positive than those who were younger than 20 years of age when accepting their sexual orientation (OR (95%CI) was 0.61 (0.47-0.80) );and homosexuals were more positive than bisexuals (OR (95%CI) was 1.98 (1.50-2.61) ). For social-identity, Hui MSM were less positive than Han MSM (OR (95%CI) was 0.61 (0.42-0.88) ); those whose education level was higher than college were less positive than those with junior high education (OR (95%CI) was 0.60 (0.40-0.89) ); famers/herdsmen were more positive than students (OR (95%CI) was 4.17 (2.13-8.17) ); the divorced/widowed were more positive than the singles (OR (95%CI) was 2.40 (1.34-4.29) ); those who were over 20 years of age when accepting their sexual orientation were less positive than those who were younger than 20 years of age when accepting their sexual orientation (OR (95%CI) was 0.59 (0.44-0.81) ). Among the MSM with negative ego-identity and negative social-identity, the proportion of planning to get married with women was 66.8% (267/400) and 76.5% (306/400), respectively, which were higher than those with positive ego-identity (33.2% (133/400)) and positive social-identity (23.5% (94/400)) ; their proportion of intending to have offspring was 62.0% (287/463) and 73.4% (340/463), respectively, which were higher than those with positive ego-identity and social-identity (38.0% (176/463), 26.6% (123/463)) (χ(2) = 39.61 and 7.90, respectively, both P values were <0.05). Among the MSM with negative social-identity, the proportion of looking for male sexual partners in toilets or parks was 18.1% (188/1 040), in bathhouse or sauna was 17.3% (180/1 040), and through internet was 82.0% (853/1 040), which were higher than those with positive social-identity (8.9% (38/427), 9.8% (42/427) and 61.6% (263/427)) (χ(2) = 66.78, P < 0.01).</p><p><b>CONCLUSION</b>In 2013, the gay identity of MSM in Xinjiang was relatively poor, and the factors associated with it included ethnicity, occupation, marital status and education level. The MSM with negative identity tended to involve in risk sexual behaviors, and had increased risk of HIV infection.</p>