The sexual behavior characteristics and STD infection status of women who have sex with women in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study sexual behavioral characteristics, infection status of HIV and sexually transmitted infections (STDs) among women who have sex with women (WSW) in Beijing.</p><p><b>METHODS</b>A total of 150 WSWs were recruited by snowball sampling in several main types of activity sites of WSW (including NGOs, salons, bars, etc.) in Beijing during September 2010 to April 2011. Information on demographic factors, sexual behavioral characteristics, infection status of STDs, and use of medical care were collected by questionnaire investigation. Serum samples, vaginal and cervical swabs were taken for each subject to test HIV, hepatitis B (HBV), hepatitis C (HCV), syphilis, herpes simplex virus (HSV), neisseria gonorrhoeae, chlamydia trachoma, bacterial vaginosis, trichomonas vaginalis and mycotic vaginitis.</p><p><b>RESULTS</b>The age range of the subjects was from 19 to 46 years old. Approximately 82.67% (124/150) of them aged 20 to 29 years old, and 54.00% (81/150) were unmarried. Approximately 76.67% (115/150) had an education level of college degree or above, and 70.67% (106/150) were migrants. Approximately 66.66% (100/150) of the subjects considered themselves as homosexual, 28.00% (42/150) as bisexual. The age at first homosexual sex ranged from 11 to 30 years old. The median of number of female sex partners in last 1 year was 1, and 33.78% (50/148) of the subjects had 2 or more female sex partners. Approximately 20.27% (30/148) of the subjects applied sex instruments, of which 66.67% (20/30) never or seldom used condoms. Hand-clitoris and hand-vagina contacts were the main types of woman-to-woman sex, accounting for 91.22% (135/148). 12.00% (18/150) of the subjects had sex with men during last year. Among them, 50.00% (9/18) used condoms at last heterosexual sex, and 66.67% (12/18) never or seldom used condoms at last heterosexual sex in past 1 year. One subject provided paid sex service for men, and used condoms every time. In the past one year, 45.33% (68/150) of the subjects had symptoms of STDs, but only 36.76% (25/68) of them sought medical care. The infection rate of STDs was 34.67% (52/150). The infection rates of NG and GV were both 16.11% (24/149), and those of mycotic vaginitis, chlamydia trachoma, and TV were 8.72% (13/149), 4.03% (6/149), and 0.67% (1/150), respectively. The numbers of subjects tested positive for HBV, HCV, and syphilis were all 1. No subjects were found HIV positive or HSV-2 positive.</p><p><b>CONCLUSION</b>Multiple sexual partners and heterosexual sex behavior were common among WSW in Beijing. More than 1/3 of the subjects were infected with STD.</p>

Study on the incidence of HIV and associated risk factors through a prospective cohort among men who have sex with men in Beijing, China / 中华流行病学杂志

Objective To investigate the dynamic change and associated risk factors of HIV sero-conversion rate in Beijing.Methods 809 sero-negative men who have sex with men (MSM) were recruited in the cohort from August to December in 2009.HIV sero-antibody,medicinal examination and behavior questionnaire interview were carried out every six months.Results 962 MSM with overall baseline prevalence of HIV infection as 6.34％ (61/962) together with 809 seronegative MSM,were enrolled in the cohort.Of the 809 sero-negative participants,95.1％ (769/809),85.5％ ( 692/809 ) and 71.0％ ( 574/809 ) of them were retained in the 6-month,12-month and 18- month follow-up visits,with 19,29 and 17 of them became HIV sero-conversion at 6-month,12-month,and 18-month follow-up visits and the HIV incidence rates appeared to be 5.47,12.37 and 6.86 per 100 person-years respectively.The HIV incidence was 7.59 per 100 person-years in the 18 months follow-up visit.Factors including:younger than 25-years old (HR =2.32,95％CI:1.39-3.87),having more than 8 MSM partners (HR=2.50,95％CI:1.49-4.20),less than RMB 2000 Yuan every month income (HR=1.76,95％CI:1.06-2.95 ),having more than 4 homosexual partners in the last six months (HR=3.50,95％ CI:2.11 -5.81 ),showing phimosis and redundant prepuce (HR=2.47,95％ CI:1.50-4.07 ) as well as positive syphilis test (HR=2.62,95％CI:1.53-4.49) etc.,were significantly associated with HIV incidence.Conclusion High HIV incidence was shown among MSM in Beijing and had spread fast in this population,calling for more favorable prevention measures to be taken.

Incidence and risk factors of HIV and syphilis seroconversion among men who have sex with men in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the incidence and risk factors of HIV and syphilis seroconversion among men who have sex with men (MSM) in Beijing.</p><p><b>METHODS</b>A total of 550 MSM were recruited on the basis of community and followed up after 6 and 12 months in Beijing. Each subject was investigated by only one investigator at one time to collect information on demographics and behaviors. Blood samples were collected to test HIV and syphilis seroconversion. ELISA was used for screening test, west blotting (WB) and Particle agglutination were used for confirmatory test.</p><p><b>RESULTS</b>A total of 550 MSM investigated, among which 4.5% (25/550) were HIV-positive and 29.3% (161/550) were syphilis-positive. For 525 HIV-negative MSM, 87.0% (457/525) retained during the 12-month investigation. Seroincidence for HIV and syphilis were 3.37/100 person-years (95%CI = 1.66 - 5.08) and 9.32/100 person-years (95%CI = 5.87 - 12.77) respectively. HIV seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 7.11/100 and 0.76/100 person-years respectively. Multivariate Cox regression analysis revealed that rectal douching after homosexual anal intercourse in the past 3 months (HR = 9.23, 95%CI = 2.08 - 40.88) was significantly associated with HIV seroconversion. Syphilis seroconversions for those who met male sex partners in parks, public washrooms or bathhouses in the past 3 months were 41.77/100 and 7.97/100 person-years respectively. Syphilis seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 16.17/100 and 4.92/100 person-years respectively. In the past 3 months, meeting male sex partners in parks, public washrooms or bathhouses (HR = 4.67, 95%CI = 1.77 - 12.34) and performing rectal douching after homosexual anal intercourse (HR = 3.09, 95%CI = 1.40 - 6.83) were significantly associated with syphilis seroconversion.</p><p><b>CONCLUSION</b>The seroconversions of HIV and syphilis during the follow-up visits in this MSM cohort study in Beijing were very serious, and that the associated factors for seroconversions were rectal douching after homosexual anal intercourse and meeting male sex partners in parks, public washrooms or bathhouses.</p>

Characteristics of sexual behaviors and infection status of AIDS and other sexually transmitted diseases among men who have sex with men in 2009 in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze sexual behavior characteristics and sexually transmitted diseases such as AIDS infections in man who have sex with men (MSM) of Beijing Chaoyang district.</p><p><b>METHODS</b>Through selecting 10 MSM as seed in Chaoyang district of the existing education member companion in its main activity place, using snowball sampling to select 1008 people that 16 years old or above, nearly a year had sex with male in Chaoyang to conduct an investigation.Questionnaires were used to investigate the general conditions, characteristics of sexual behaviors, condom usage, AIDS knowledge awareness and sexually transmitted diseases history. Each participant was asked to exsanguinated 5 ml peripheral blood for applying ELISA for HIV, syphilis helicoids detection and HIV positive samples confirm test. Using χ(2) test on the statistical analysis of the data.</p><p><b>RESULTS</b>In the 1008 MSM, most of them were with the age of 20 - 29 years old (66.6%, 671/1008), giving priority to unmarried (79.1%, 797/1008), college degree and above culture during accounted for 43.3% (436/1008), 56.2% (566/1008) had both male and female sexual partners; the rate of temporary sexual partners who were one-night stand objects or friends or guest was 72.2% (226/313). The forever condom utilization rate was 29.0% (170/587) in MSM who had both male and female sexual partners, lower than that who had both male and female sexual partners (47.2%, 345/731). That the study objects of HIV infection who can use condom correctly rate was 3.6% (16/442), and that who never or occasionally used condom rate was 8.5% (24/228). AIDS, gonorrhea and other sexually transmitted diseases (to give priority to the acuteness wet wart) infection rates were 4.8% (6/124), 10.5% (13/124) and 8.9% (11/124) in those who had the history of group sex, and that was 5.9% (52/884), 1.9% (17/884) and 2.3% (20/884) in those who without the history of group sex. The research object's gonorrhea and other sexually transmitted diseases (to give priority to the acuteness wet wart) who provided commercial sex service infection rates were 7.7% (9/117) and 6.8% (8/117), significantly higher than those who did not provide a commercial sex service object of study subject (2.4% (21/891)and 2.6% (23/891)).</p><p><b>CONCLUSION</b>HIV infection is high among MSM population. Types and identification of sexual partners, and condom use are associated with HIV and STD infection.</p>

Study on the relationship between behavioral factors,psychological status and HIV infection among men who have sex with men in Beijing / 中华流行病学杂志

Objective To study the prevalence and risk factors of human immunodeficiency virus (HIV) among men who have sex with men (MSM) in Beijing. Methods A sample of 550 MSM was recruited between March and June in 2008 in Beijing. Interviewer-administered interviews were conducted to collect information on demographics and behaviors. Blood samples were collected to test for HIV,syphilis,HBsAg and HCV infections. Chi-square test and logistic regression model were used to identify risk factors associated with HIV infection. Results Of the 550 eligible MSM surveyed,HIV prevalence appeared to be 4.5% (25/550). Data from multivariate logistic regression analysis demonstrated that factors as reporting unprotected anal intercourse with causal male sexual partners in the last month (X~2=11.381,P=0.001),rectal douching after homosexual anal intercourse in the past three months (X~2=5.326,P=0.021),feeling sad in the last month (X~2=8.809,P=0.003) were significantly associated with HIV infection. Conclusion Health education on safer sex behavior and mental health care should be taken to hinder the speed of HIV transmission among MSM.

Study of HIV-1 Drug Resistance in Patients Receiving Free Antiretroviral Therapy in China / 中国病毒学

To investigate the prevalence of drug-resistance mutations, resistance to antiretroviral drugs, and the subsequent virological response to therapy in treatment-naive and antiretroviral-treated patients infected with HIV/AIDS in Henan, China, a total of 431 plasma samples were collected in Queshan county between 2003 and 2004, from patients undergoing the antiretroviral regimen Zidovudine + Didanosine + Nevirapine (Azt+Ddi+Nvp). Personal information was collected by face to face interview. Viral load and genotypic drug resistance were tested. Drug resistance mutation data were obtained by analyzing patient-derived sequences through the HIVdb Program (http://hivdb.stanford.edu). Overall, 38.5% of treatment-naive patients had undetectable plasma viral load (VL), the rate significantly increased to 61.9% in 0 to 6 months treatment patients (mean 3 months) (P＜0.005) but again significantly decrease to 38.6% in 6 to 12 months treatment patients (mean 9 months) (P＜0.001) and 40.0% in patients receiving more than 12 months treatment (mean 16 months) (P＜0.005). The prevalence of drug resistance in patients who had a detectable VL and available sequences were 7.0%, 48.6%, 70.8%, 72.3% in treatment-na(1)ve, 0 to 6 months treatment, 6 to 12 months treatment, and treatment for greater than 12 months patients, respectively. No mutation associated with resistance to Protease inhibitor (PI) was detected in this study. Nucleoside RT inhibitor (NRTI) mutations always emerged after non-nucleoside RT inhibitor (NNRTI) mutations, and were only found in patients treated for more than 6 months, with a frequency less than 5%, with the exception of mutation T215Y (12.8%, 6/47) which occurred in patients treated for more than 12 months. NNRTI mutations emerged quickly after therapy begun, and increased significantly in patients treated for more than 6 months (P＜0.005), and the most frequent mutations were K103N, V106A, Y181C, G190A. There had been optimal viral suppression in patients undergoing treatment for less than 6 months in Queshan,Henan. The drug resistance strains were highly prevalent in antiretroviral-treated patients, and increased with the continuation of therapy, with many patients encountering virological failure after 6 months therapy.

HIV-specific T cell immunity across the entire HIV genome in Chinese men who have sex with men / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Man who has sex with man (MSM) is one of the high risk groups for spreading HIV/AIDS. It was reported that the most prevalent human immunodeficiency virus type 1 (HIV-1) strain among MSM is subtype B; however, T cell immunity remains unknown across the HIV-1 B genome in this population.</p><p><b>METHODS</b>Using Elispot assay with synthetic peptides spanning the sequence of HIV-1 consensus B, HIV-1-specific cytotoxic T-cell lymphocyte responses were quantified among 3 treated and 19 untreated HIV-1 infected MSM from Beijing, China. Cross-sectional association between viral loads and cellular immune responses were analyzed.</p><p><b>RESULTS</b>Peptide pools corresponding to each HIV-1 protein were used for Env, Gag, Pol, Nef, Tat/Rev, Vpr/Vpu and Vif. The results showed that the magnitude of T cell responses in the 3 treated HIV(+) MSM group [median, 770 spot forming cells (SFCs) per 10(6) peripheral blood mononuclear cells (PBMCs)] might be significantly lower than that in the 19 untreated HIV(+) MSM group (median, 6175 SFCs per 10(6) PBMCs). Nef, Gag and Pol are the most frequently targeted HIV-1 antigens; and 16 subjects (73%) were identified with vigorous T cell immunity against each of these three proteins. The overall magnitude of T cell immunity closely related to its breadth (r = 0.72, P < 0.05) and was inversely but weakly associated with viral loads (r = -0.15). Further analysis showed that both Gag (r = -0.24) and Pol specific T cells (r = -0.12) contributed to this inverse association whereas Nef specific T cells showed no association with viral loads.</p><p><b>CONCLUSIONS</b>The magnitude of HIV-1 specific T cells is inversely but weakly associated with viral loads among MSM; HIV-specific T cell responses against conservative sequences (Gag and Pol) are the main contributors to this association among Chinese HIV(+) MSM. These findings have important implications for vaccine design.</p>

Subtype and sequence analysis of human immunodeficiency virus type-1 strains in Guangdong province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate subtype and genetic analysis of human immunodeficiency virus type-1 (HIV-1).</p><p><b>METHODS</b>DNA sequences were amplified by nested-PCR from uncultured peripheral blood mononuclear cells (PBMC) obtained from 100 HIV-1 patients from Guangdong Province. The C2 to V3 region of the envelope glycoprotein gp120 of HIV-1 was sequenced directly. The analysis of the gene-based phylogenetic tree and variation of amino acid were carried out by using Wisconsin software package or genetics computer group (GCG).</p><p><b>RESULTS</b>DNA fragments were amplified from 75 PBMC samples by using nested polymerase chain reaction (PCR). Sequence analysis showed that there were 3 HIV-1 subtypes or circulating recombinant forms (CRF): CRF01-AE (n = 44), CRF-BC (n = 27) and B' (n = 4).</p><p><b>CONCLUSIONS</b>Three HIV-1 subtypes or circulating recombinant forms: CRF01-AE, CRF-BC and B' might be circulating in Guangdong Province. Findings from this study suggested that several subtypes might exist in Guangdong Province and the epidemic situation of AIDS be serious. It should be a challenge for Guangdong Province in treating patients, preventing and controlling AIDS in the future.</p>