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Objective To describe the epidemiological characteristics, investigation and treatment process of the first monkeypox cluster outbreak in Wuhan, and to provide reference for the prevention and control of monkeypox cluster outbreak in the future. Methods Field epidemiological investigation was conducted on the cases, and throat swabs, anal swabs, shingles fluid, whole blood, and serum samples were collected from the cases. Subsequently, real-time fluorescence quantitative polymerase chain reaction was employed for the detection of monkeypox virus nucleic acid and subsequent gene sequencing. Results Two cases had a high-risk exposure behavior in a hotel in Wuhan on June 2, 2023. The first case exhibited the emergence of beige papules on June 5 and sought medical treatment at a tertiary hospital in Wuhan on June 11. The Chinese Center for Disease Control and Prevention conducted tests on herpes fluid samples, which yielded positive results for the presence of monkeypox virus nucleic acid. Genetic sequencing analysis revealed that the infecting strain of the monkeypox virus in this case belonged to the West African clade B.1. Conclusion Based on epidemiological investigation and laboratory results, this monkeypox cluster outbreak may be caused by latent men with men sexual transmission. Monkeypox has the risk of both overseas importation and local transmission in our country. It is very necessary to detect, report and deal with monkeypox outbreak early.
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Objective:To systematically review the related factors of depressive symptoms among men who have sex with men(MSM)in China.Methods:CNKI,Wanfang Data,VIP,CBM,EMbase,Pubmed,CINAHL,Web of Science and the Cochrane Library were searched from inception to February 17,2023.After literature screening and data extraction,two researchers independently assessed the quality of included studies according to the Agency for Healthcare Research and Quality.Results:A total of 21 articles with 11 822 participants were includ-ed.The results of meta-analysis showed that month income ≥3 000 yuan(OR=0.59),college degree or above(OR=0.59)and high self-esteem(OR=0.83)were protective factors,sexual role as the recipient(OR=1.68),dual sexual role(OR=1.41),multiple sexual partners(OR=1.65),sexual violence experience(OR=3.44),self-rated poor health status(OR=3.93),HIV/AIDS related discrimination(OR=1.13),HIV/AIDS related stress(OR=1.11)and suicidal tendency(OR=2.86)were risk factors for depressive symptoms.Conclusion:There are many related factors to the depressive symptoms of MSM.It is necessary to carry out early intervention on the basis of personalized assessment to reduce the occurrence of depressive symptoms among MSM.
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ObjectiveTo understand the human immunodeficiency virus（HIV） infection status and related factors by using the HIV/AIDS sentinel surveillance data of men who have sex with men（MSM） in Jinhua City， Zhejiang Province. MethodsSnowball sampling method was used to recruit MSM receiving HIV sentinel surveillance from 2016 to 2021.The inclusion criteria were aged 18 years old and above， reported having anal sex with man in recent 6 months. Questionnaire-based interviews were conducted on a one-on-one basis. Data including the characteristics of demography and ethology were collected. Five milliliter of blood samples were taken after the questionnaire. HIV and syphilis was screened. The time trend was analyzed with χ2 test. Multivariate logistic regression model was used to analyze the factors associated with HIV infection status among MSM. ResultsThe positive rate of HIV was 8.0% （127/1 597）， with an increasing trend （P=0.002）， but the linear correlation was weak（r=0.075）. The positive rate of syphilis was 5.2% （83/1 597）， with no significant difference （P=0.661）.The constituent ratios showed an increasing trend （P<0.05） in using condoms consistently， finding male sexual partners through Internet or dating software， having anal sex in the past week， using condoms every time during anal sex in the past 6 months， accepting prevention services of AIDS in the last year， and the overall awareness of AIDS related knowledge. Multivariate logistic regression analysis showed that who was from national minority （OR=2.27， 95%CI： 1.08‒4.73） and from other provinces （OR=1.68， 95%CI： 1.08‒2.62）， who failed to consistently use condoms every time during anal sex in the past six months （OR=3.03， 95%CI： 2.02‒4.54）， who never accepted prevention services of AIDS in the last year （OR=2.17，95%CI：1.44‒3.27）， who don’t know the knowledge of AIDS （OR=1.86， 95%CI： 1.12‒3.07）， and who was infected with syphilis （OR=2.35， 95%CI： 1.20‒4.61） were at higher risk for HIV infection among MSM. ConclusionThe positive rate of HIV remains at a certain level among MSM in Jinhua. High-risk groups such as the patients with syphilis infections and floating population from other provinces need to be paid close attention. It is suggested to further strengthen the promotion of the use of condoms， awareness of AIDS and syphilis， warning education and comprehensive intervention services.
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Objective@#To investigate the marriage intention and its influencing factors among HIV-infected men who have sex with men (MSM), so as to provide the reference for formulating high-risk behavior intervention strategies and reducing the risk of HIV transmission among this population.@*Methods@#Unmarried HIV-infected MSM were sampled from newly reported HIV/AIDS patients in Gongshu District of Hangzhou City from 2020 to 2022. Participants' sociodemographic information, family status and marriage intention were collected using questionnaire surveys. Factors affecting marriage intention were identified using a multivariable logistic regression model.@*Results@#A total of 430 questionnaires were allocated and 400 valid questionnaires were recovered, with an effective recovery rate of 93.02%. The respondents had a mean age of (28.90±4.67) years, and included 271 cases with registered residence outside Hangzhou City (67.75%). There were 82 cases indicating that they would probably or definitely get married, accounting for 20.50%, including 46 cases (56.10%) aged 30 years and older, 67 cases (81.71%) engaged in commercial services/freelance work/worker and 53 cases (64.63%) being the only children. Multivariable logistic regression analysis showed that unmarried HIV-infected MSM who were aged 30 years and older (OR=2.751, 95%CI: 1.230-6.154), had a monthly income of <10 000 Yuan (5 000 to <10 000 Yuan, OR=7.010, 95%CI: 2.049-23.981; <5 000 Yuan, OR=5.229, 95%CI: 1.803-15.165), had a high school education and below (OR=5.935, 95%CI: 1.775-19.844), were the only children (OR=3.407, 95%CI: 1.468-7.910), came from families with economic conditions above the average level (OR=8.906, 95%CI: 2.070-38.308), did not disclose their sexual orientation (OR=3.298, 95%CI: 1.118-9.727), held a positive attitude towards government policies (OR=70.544, 95%CI: 14.583-341.237), had no homosexual intercourse in the past six months (OR=3.583, 95%CI: 1.278-10.044), and had not informed their sexual partners of their HIV status (OR=2.910, 95%CI: 1.228-6.897) were more willing to get married.@*Conclusion@#A certain proportion of unmarried HIV-infected MSM in Gongshu District are willing to get married, and their marriage intention is affected by age, educational level, family economic conditions, the only children or not, disclosing sexual orientation or not, having homosexual intercourse in the past six months or not, informing sexual partners of HIV status or not, and the attitude towards government policies.
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Objective@#To investigate the status of regular HIV testing and post exposure prophylaxis (PEP) behaviors among men who have sex with men (MSM) in Lishui City, Zhejiang Province, so as to provide the reference for developing targeted intervention strategies.@*Methods@#A total of 389 MSM were selected from Lishui City by convenient sampling method from April to August 2022, and demographic information, sexual behaviors, HIV testing and PEP behaviors were collected through questionnaire surveys. MSM were clustered using two step clustering analysis, and regular HIV testing and PEP behaviors among different groups of MSM were compared. Factors affecting regular HIV testing and PEP behaviors were evaluated using a multivariable logistic regression model.@*Results@#The MSM surveyed had a median age of 31.00 (interquartile range, 16.00) years. There were 146 MSM undergoing regular HIV testing, accounting for 37.53%, and 47 MSM receiving PEP, accounting for 12.08%. MSM were divided into two groups. There were 28.05% of MSM with regular HIV testing in group 1, which was lower than the 44.44% in group 2; and 22.56% receiving PEP, which was higher than the 4.44% in group 2 (both P<0.05). Multivariable logistic regression analysis identified age (OR=1.030, 95%CI: 1.011-1.050), sexual roles (both receptive and insertive, OR=2.999, 95%CI: 1.732-5.194) and homosexual behaviors in the past 6 months (use condoms every time, OR=4.567, 95%CI: 2.593-8.044) as factors affecting regular HIV testing among MSM; age (OR=0.970, 95%CI: 0.942-0.999), sexual orientation (OR=0.292, 95%CI: 0.139-0.612) and homosexual behaviors in the past 6 months (not use condoms, OR=0.135, 95%CI: 0.040-0.460; use condoms every time, OR=0.076, 95%CI: 0.018-0.326) as factors affecting PEP behaviors among MSM.@*Conclusion@#MSM with different characteristics of sexual behaviors have different preferences for HIV regular testing and PEP, with homosexual behaviors in the past 6 months, sexual roles and sexual orientation being the main influencing factors.
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Objective@#To understand characteristics of men who have sex with men (MSM) who applied for HIV antibody self-testing reagents through "AIDS self-testing" column of a WeChat official account named "Dark Blue Public Health Center" in Tianjin City, so as to provide insights into exploring online modes of HIV antibody self-testing for MSM.@*Methods@#Data of MSM who were 18 years old or above, currently lived in Tianjin City, had sex with men in the past six months and applied for HIV antibody self-testing reagents through "AIDS self-testing" column from May 2018 to December 2022 were collected. Demographic characteristics, results return and positive findings were descriptively analyzed.@*Results@#Data of 2 064 MSM were collected, including 1 052 MSM aged 20 to 29 years (50.97%), 1 522 unmarried MSM (73.74%), 545 workers (26.41%), 1 385 MSM with college education or above (67.10%), and 315 MSM without testing for HIV antibody in the past (15.26%). A total of 6 470 self-testing reagents were applied, and 5 942 testing results were returned, with a return rate of 91.84%. There were 33.28% (687/2 064) of the applicants applying for 66.32% (4 291/6 470) reagents multiple times. There were 73 MSM with positive results, accounting for 1.23%.@*Conclusions@#The MSM applying for HIV antibody self-testing reagents through "AIDS self-testing" are mainly young and highly educated, including some who have never tested for HIV. However, attention should be paid to duplicate applications and the return rate should be increased.
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Objective@#To investigate the molecular transmission network characteristics of HIV-1 among men who have sex with men (MSM) in Shaoxing City, Zhejiang Province, so as to provide insights into AIDS prevention and control among MSM.@*Methods@#Newly reported HIV/AIDS cases among MSM in Shaoxing City were selected from January 2021 to September 2023. Plasma samples before the antiviral treatment were collected. The HIV-1 pol gene was amplified using reverse transcription PCR and nested PCR to construct phylogenetic trees for gene subtype analysis. The HIV-TRACE method was used to construct a molecular transmission network with a genetic distance of 1.5% to analyze clustering and the characteristics of cases within molecular clusters.@*Results@#A total of 216 HIV/AIDS cases among MSM were included, and 179 qualified sequences were obtained. The predominant HIV-1 subtypes were CRF07_BC and CRF01_AE, with 95 and 66 cases, respectively. At 1.5% genetic distance, 20 molecular clusters were formed, with 61 nodes and 58 edges. A total of 61 sequences were connected to the transmission network (34.08%). HIV/AIDS cases among MSM from all the counties (cities, districts) in Shaoxing City were included in the network. There was the largest molecular cluster with ≥10 nodes, involving 12 cases from five counties (cities, districts), 3 medium-sized molecular clusters with 4 to 5 nodes, and the 16 small-sized molecular clusters with 2 or 3 nodes. Seven cases with high risk of transmission, each with ≥4 edges, were all CRF07_BC subtypes. Among them, two cases were from the large molecular cluster, and five cases were from the same molecular cluster composed of cases from Shengzhou City and Xinchang County.@*Conclusions@#The predominant HIV-1 subtypes among MSM in Shaoxing City were CRF07_BC and CRF01_AE. There was cross-regional HIV transmission, and potential transmission risk might exist in Shengzhou City and Xinchang County.
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Objetivo: analizar los factores asociados con el uso inconsistente del preservativo masculino en hombres VIH negativos que tienen sexo con hombres. Método: estudio transversal, analítico, nacional realizado de forma online en todas las regiones de Brasil, en 2020, a través de redes sociales y sitios de citas. El uso inconsistente del preservativo se definió como el uso ocasional o no usarlo nunca. Se realizaron análisis estadísticos descriptivos, pruebas de asociación y regresión logística binaria. Resultados: 1222 (85%) de los 1438 participantes informaron uso inconsistente del preservativo. Las variables "homosexuales" (ORA: 2,03; IC 95%: 1,14-3,59; p = 0,016), "tener pareja estable" (ORA: 2,19; IC 95%: 1,55-3,09; p<0,001), "sexo oral" (ORA: 2,41; IC 95%: 1,31-4,43; p = 0,005), "anal insertivo" (ORA: 1,98; IC 95%: 1,10-3,58; p = 0,023) y "diagnóstico de ITS" (ORA: 1,59; IC 95%: 1,13-2,24; p = 0,007) se asociaron de forma independiente con el uso inconsistente del preservativo masculino. Las variables "recibió consejo de un amigo sobre la prueba del VIH" (ORA: 0,71; IC 95%: 0,52-0,96; p = 0,028) y "trabajador sexual" (ORA: 0,26; IC 95%: 0,11-0,60; p = 0,002) fueron factores protectores. Conclusión: las variables estudiadas indicaron que hay una fuerte relación entre las parejas estables y el aumento de la confianza y la baja adherencia al uso del preservativo, lo que coincide con otros estudios.
Objective: to analyze the factors associated with inconsistent use of male condoms among HIV-negative men who have sex with other men. Method: a cross-sectional, analytical and nationwide study conducted online in all the Brazilian regions in 2020, via networks and in dating websites. Inconsistent condom use was defined as occasional use or as never using it. Descriptive statistical analyses were performed, as well as association and binary logistic regression tests. Results: inconsistent condom use was reported by 1,222 (85%) of all 1,438 participants. The "homosexuals" (ORAdj: 2.03; 95% CI: 1.14-3.59; p=0.016), "having a fixed partner" (ORAdj: 2.19; 95% CI: 1.55-3.09; p<0.001), "oral sex" (ORAdj: 2.41; 95% CI: 1.31-4.43; p=0.005), "insertive anal" (ORAdj: 1.98; 95% CI: 1.10-3.58; p=0.023) and "STI diagnosis" (ORAdj: 1.59; 95% CI: 1.13-2.24; p=0.007) variables were independently associated with inconsistent use of male condoms. The "receiving advice on HIV test from a friend" (ORAdj: 0.71; 95% CI: 0.52-0.96; p=0.028) and "sex worker" (ORAdj: 0.26; 95% CI: 0.11-0.60; p=0.002) variables were protective factors. Conclusion: the variables under study pointed to a strong relationship between steady partners and increased trust and low adherence to condom use, corroborating other studies.
Objetivo: analisar os fatores associados ao uso inconsistente do preservativo masculino entre homens HIV negativos que fazem sexo com homens. Método: estudo transversal, analítico, de abrangência nacional realizado on-line em todas as regiões do Brasil, em 2020, por meio de redes sociais e em sites de relacionamento. O uso inconsistente do preservativo foi definido como uso ocasional ou nunca ter usado. Foram realizadas análises estatísticas descritivas, testes de associação e regressão logística binária. Resultados: o uso inconsistente do preservativo foi relatado por 1222 (85%) dos 1438 participantes. As variáveis "homossexuais" (ORA: 2,03; IC 95%: 1,14- 3,59; p = 0,016), "ter parceiro fixo" (ORA: 2,19; IC 95%: 1,55-3,09; p<0,001), "sexo oral" (ORA: 2,41; IC 95%: 1,31-4,43; p = 0,005), "anal insertivo" (ORA: 1,98; IC 95%: 1,10-3,58; p = 0,023) e "diagnóstico de IST" (ORA: 1,59; IC 95%: 1,13-2,24; p = 0,007) foram independentemente associadas ao uso inconsistente do preservativo masculino. As variáveis "recebeu aconselhamento de amigo sobre teste de HIV" (ORA: 0,71; IC 95%: 0,52-0,96; p = 0,028) e "profissional do sexo" (ORA: 0,26; IC 95%: 0,11-0,60; p = 0,002) foram fatores de proteção. Conclusão: as variáveis estudadas apontaram uma forte relação das parcerias fixas com o aumento da confiança e uma baixa adesão ao uso do preservativo, o que corrobora com outros estudos.
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Humans , Male , Acquired Immunodeficiency Syndrome/prevention & control , Condoms , Unsafe Sex , Protective Factors , Sexual and Gender MinoritiesABSTRACT
Background: Men with sex with men (MSM) may face obstacles in accessing culturally competent and quality healthcare services since current medical practice does not often promote discussing sexual habits. The coronavirus disease-2019 (COVID-19) pandemic has further affected this group. This study assessed the impacts of COVID-19 and the general challenges of MSM in Benue State, Nigeria. Materials and Methods: This study was a quantitative cross-sectional survey conducted across three geopolitical zones of Benue State using a multistage cluster sampling method to collect data from MSM. The data collected were analyzed using IBM-Statistical Package for Social Sciences (IBM-SPSS) version 25.0 for Windows IBM Corp., Armonk, New York. Result: More than half (59.2%) of respondents said they were not denied healthcare services, and 78.4% were not afraid to seek them. Most (88%) were comfortable seeking medical help, and 61.6% did not experience stigmatization from healthcare providers. Many (68.0%) were not exposed to violence after sharing their status with healthcare providers. About half (50.4%) said COVID-19 did not affect their general quality of life. Over half (51.2%) said there was a decline in access to resources like food and money during the pandemic, 49.6% experienced difficulties accessing HIV testing, and 52.0% could not access PrEP. More than half (53.6%) reported challenges getting viral load or other laboratory tests, but 57.5% had no trouble getting HIV medication prescriptions. Conclusion: The Federal Government, and the Ministry of Health, Nigeria, should support intervention programs, peer educators, and outreach workers providing services to MSM
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@#Abstract: In recent years, the HIV prevention intervention strategy has had a positive effect on reducing the HIV infection prevalence in China. HIV non-occupational post-exposure prophylaxis (nPEP) has become an effective measure to prevent HIV for men who have sex with men (MSM) exposed to possible risks. From the perspective of the "knowledge, attitude, and practice" theory, domestic and overseas scholars used outpatient data and questionnaires to investigate the awareness, attitude, usage, medication, follow-up, and drug prescription of HIV nPEP among MSM in China. This article reviewed the above-mentioned and found that the overall awareness rate of HIV nPEP among MSM in China is high with a positive attitude, but the actual utilization rate is very low. On a regional level, their follow-up after the medication is not ideal despite good medication. Drug prescription varies between different regions domestically. The prescription rate of tenofovir + emtricitabine + raltegravir is the highest, followed by the prescription rate of tenofovir + emtricitabine + dolutegravir, and tenofovir + lamivudine + dolutegravir. In the future, researchers should expand the number of study objects and the scope of the research sites in China, analyze the "knowledge, attitude, and practice" of HIV nPEP, medication follow-up, and medication prescription among MSM, and increase the research on HIV nPEP service areas to provide the reference for further formulating and refining the comprehensive HIV prevention intervention strategy among MSM in China.
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Objective@#To investigate the quality of life and its influencing factors among HIV-infected college students among men who have sex with men (MSM), so as to provide the evidence for improving the quality of life among HIV-infected MSM college students.@*Methods@#HIV-infected MSM college students were sampled from those with follow-up management by Shaanxi, Chongqing and Guangdong Centers for Disease Control and Prevention using a convenience sampling method, and participants' demographics, AIDS-related knowledge, attitude and practice were collected using questionnaire surveys. The scores for physical, psychological, social and environmental domains, and the overall quality of life were measured using the Chinese version of the World Health Organization Quality of Life-Brief (WHOQOL-BREF), and their influencing factors were identified using a multivariable linear regression model.
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ObjectiveThis study aimed to investigate the HIV genotypic subtypes and molecular transmission clusters among men who have sex with men （MSM） with newly reported HIV infections in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunnan Province， China， between 2010 and 2019. The study aimed to identify potential high-risk transmitters and provide reference data for screening， management， and intervention of infection sources. MethodsPlasma samples from newly reported HIV-positive MSM individuals in Dehong Prefecture between 2010 and 2019 were collected. The viral pol gene fragments were amplified， sequenced， and genotyped. Genetic distances （GD） between pairwise sequences were analyzed and calculated. MEGA 7.0 and Gephi were used for phylogenetic and molecular transmission network analysis. ResultsA total of 159 newly reported HIV infections among MSM were included in the study， with successful genotyping of 100 cases. Nine HIV-1 subtypes were identified， with the most prevalent being CRF01_AE subtype （52%）， followed by CRF07_BC subtype （31%）， CRF55_01B subtype （10%）， and others （7%）. Cluster analysis revealed a total network access rate of 67%， forming three transmission clusters. CRF01_AE subtype formed two transmission clusters with 38 and 3 infected individuals， while CRF07_BC subtypes formed one transmission cluster with 26 infected individuals. The transmission network within the CRF01_AE clusters exhibited a more complex relationship. Significant differences in educational level were observed between the two main transmission clusters. ConclusionThe predominant HIV subtypes among newly reported MSM cases in Dehong Prefecture between 2010 and 2019 were CRF01_AE and CRF07_BC. Significant cultural differences are observed between the main transmission clusters. Continued monitoring of genotypic subtypes and targeted interventions within transmission clusters are warranted.
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ObjectiveTo analyze the changes in HIV， syphilis and hepatitis C prevalence among men who have sex with men （MSM） in Taizhou City， Zhejiang Province from 2017 to 2022， and the utilization of HIV intervention services and its influencing factors. MethodsMSM participants were recruited from HIV sentinel surveillance in Taizhou through snowball sampling method. Participants’ socio-demographic characteristics， sexual behavior characteristics， knowledge of HIV and utilization of HIV intervention services were collected and statistically described by questionnaire survey. Blood samples from MSM sentinel population were also collected for HIV， syphilis， and HCV antibody testing. Multivariate logistic regression analysis was used to analyze the influencing factors for utilizing HIV intervention services among MSM. ResultsA total of 2 499 MSM were included in the analysis from 2017 to 2022， with HIV prevalence of 5.8%， syphilis prevalence of 4.0%， and HCV prevalence of 0.6%. The infection rate， proportion of homosexual anal sex and heterosexual sex showed a decreasing trend， while the proportion of condom use during homosexual anal sex， condom publicity and distribution， AIDS consultation and testing， acceptance of peer education， and online temporary homosexual sex showed an increasing trend. All these differences were statistically significant. Multivariate logistic regression analysis showed that COVID-19 epidemic （aOR=1.66， 95%CI：1.04‒2.64） and HIV knowledge awareness （aOR=2.57， 95%CI：1.22‒5.40） were positively correlated with increased acceptance of condom publicity and distribution， and utilization of AIDS counseling and testing. Those who sought male sexual partners through offline route （aOR=3.44， 95%CI： 1.16‒10.21）， and had a history of sexually transmitted diseases within one year （aOR=5.47， 95%CI： 1.04‒28.76） were positively correlated with community-based methadone maintenance therapy， clean needle provision and exchange services， while COVID-19 epidemic （aOR=0.35， 95%CI： 0.14‒0.88） was negatively correlated with the utilization of these services. COVID-19 epidemic （aOR=2.11， 95%CI： 1.54‒2.89）， HIV knowledge awareness （aOR=2.09， 95%CI： 1.08‒4.02）， offline search for male sexual partners （aOR=1.47， 95%CI： 1.03‒2.11）， and awareness of HIV infection of sexual partners （aOR=2.09， 95%CI： 1.62‒2.69） were positively correlated with the increased use of peer education service， while married or cohabited （aOR=0.73， 95%CI： 0.55‒0.98） and VCT （aOR=0.61， 95%CI： 0.46‒0.82） were negatively correlated with utilization of peer education service. ConclusionHIV infection rate of sentinel MSM population in Taizhou decreases， while the utilization of HIV intervention services increases in general. Targeted measures should be developed according to the changes in sexual behavior and HIV intervention services among MSM populations in Taizhou to improve the HIV intervention services for the MSM population.
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Objective:To analyze the clinical characteristics of monkeypox patients.Methods:The clinical data and laboratory findings of 4 patients with monkeypox patients diagnosed at Yiwu Central Hospital in July 2023 were analyzed. Herpes fluid and skin tissue samples were collected, the viruses were isolation and cultured in African green monkey kidney cells (Vero) and identified with whole gene sequencing.Results:All four patients were male, aged 24-35 years. All patients had male-to-male behavior within 21 days before onset of the disease. Among them, one patient has AIDS and one patient has syphilis. Four patients presented with perineal skin lesions with itching, and 3 patients were found to have enlarged lymph nodes upon admission. Laboratory testing: lymphocyte abnormality (4.57×10 9/L) in 1 case; increased procalcitonin (0.25 ng/mL) in 1 case; elevated IL-10 levels ( 7.11 ng/L and 9.42 ng/L) in 2 cases; increased IL-6 (66 ng/L) and IL-4 (3.24 ng/L) in 1 case, respectively. One case had abnormal myocardial zymogram with a elevated lactate dehydrogenase level of 313 U/L. The monkeypox virus was isolated from lesion tissue and herpes fluid, and the whole gene sequencing identified it as the B. 1.3 subtype of the IIb evolutionary branch, exhibiting typical pathological effects on Vero cells. Conclusion:The clinical manifestations of the 4 monkeypox patients confirmed in Zhejiang province are mild, patients had a definitive history of male-to-male sexual behavior and the virus strains belong to the B. 1.3 lineage of the IIb evolutionary branch.
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Objective:To investigate the molecular epidemiological characteristics of HIV-1 infection among men who have sex with men (MSM) in Jiaxing city, and provide methods and ideas for the prevention and control of HIV-1 infection.Methods:This study retrospectively collected the blood samples from all newly reported cases of HIV-1 infection among MSM without antiviral treatment from 2020 to 2022. HIV-1 pol genes in the blood samples were amplified and sequenced. MEGA v6.0 software was used to analyze nucleic acid sequences. A phylogenetic tree was constructed to analyze HIV-1 subtypes. The calibrated population resistance program (CPR) was used to detect drug-resistant mutations. After calculating the genetic distance between gene sequences, molecular transmission networks were constructed using Cytoscape v3.6.0 software. Results:A total of nine genetic subtypes were identified, with CRF07_BC (43.3%) and CRF01_AE (36.9%) accounting for the most. The recombinant forms that were not clustered with the reference subtype accounted for 5.0%. Drug-resistant mutations were identified in 21 cases (7.0%), and the mutation rates among strains of CRF07_BC and CRF01_AE subtypes were 8.2% and 7.8%, respectively. The detection rates of drug-resistant mutations to protease inhibitors, nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors were 1.7%, 0.7% and 4.7%, respectively. The optimal genetic distance threshold of the molecular network was 0.018. At this genetic distance, the molecular network access rate was 43.3%, and 38 molecular clusters (ranging from 2 to 26 nodes per cluster) were included. Cases with ≥6 homosexual partners and a degree value of ≥4 were more likely to access the active molecular cluster. The population of high-risk transmission cases with TNS>0.75 were mainly nonlocal residents and commercial service providers. The recombinant forms showed high similarity in sequences with the strains from other provinces.Conclusions:The distribution of HIV-1 subtypes in MSM in Jiaxing city was complex. Given the increasing detection rate of recombinant forms, the high transmission rate of drug-resistant mutations, and the active molecular clusters and high-risk transmission clusters mainly detected in nonlocal residents and commercial service providers, strengthened surveillance and intervention are needed.
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@#Abstract: Objective To summarize the clinical characteristics of 35 patients with human monkeypox in Chengdu City, in order to provide theoretical basis for prevention and control of monkeypox epidemic in China. Methods A total of 35 patients diagnosed with monkeypox infection by Chengdu CDC from July 1 to July 23, 2023 were included in our study. The results of general clinical data, blood laboratory tests, lymph node ultrasound and chest CT results were collected in order to analyze the clinical features of human monkeypox patients in Chengdu City. Results All 35 monkeypox patients were young adult males, and there were no serious or fatal cases. Among them, 32 cases (91.4%) were men who have sex with men (MSM), and 30 cases had engaged in male-to-male sexual behavior within 21 days prior to the onset of the disease, of which 13 cases had taken protective measures. Fever symptoms were observed in 26 cases (74.3%) of the patients, with 19 cases experiencing fever within 1-6 days after the appearance of rash. The initial rash commonly occurred in the male external genitalia. Color ultrasound examinations indicated that all patients had swollen inguinal lymph nodes. C-reactive protein was elevated in 26 cases (74.3%) of patients, and 19 cases showed CD3+CD4+T/CD3+CD8+T< 1.0. 15 cases (42.8%) of the patients were infected with both monkeypox virus and HIV, 28.5% (10/35) of patients had concomitant skin infections and anorectal proctitis,respectively. The mean time from rash onset to the shedding of rash scabs was 14.8 days. Conclusions The MSM population in sexually active age group is the main infection object of human monkeypox virus. In monkeypox patients in Chengdu City, the rash starting at genital areas and rash occurring before systemic symptoms were common. Swollen inguinal lymph nodes are especially common in monkeypox patients. Skin infection and anorectal proctitis are the most common complications in monkeypox patients in Chengdu City. The abnormal cellular immune function in monkeypox patients is mainly reflected in the inverted ratio of CD3+CD4+T/CD3+CD8+T. Currently, there is no evidence to suggest that protective measures during male-to-male sexual behavior can reduce the risk of human monkeypox infection.
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Objective@#To identify the risk of HIV infection among men who have sex with men (MSM) with different sex roles, so as to provide insights into the prevention and control strategies for HIV infection among MSM.@*Methods@#Peer-driven sampling method was employed to recruit MSM in a city in Xinjiang Uygur Autonomous Region in 2022, a questionnaire survey was conducted to collect demographic information and sexual behaviors, and laboratory tests were conducted to detect HIV and syphilis antibodies. The characteristics of sexual behaviors among MSM with different sex roles and prevalence of HIV infection were analyzed, and factors affecting HIV infection among MSM were identified using a multivariable logistic regression model.@*Results@#A total of 666 MSM were investigated, with a mean age of (28.70±8.09) years and 577 local residents (86.64%). There were 166 insertive MSM (24.92%), 179 receptive MSM (26.88%) and 321 both receptive and insertive MSM (48.20%). The HIV infection rate was 8.26%, with 3.61% in insertive MSM, 13.41% in receptive MSM, and 7.79% in both receptive and insertive MSM. Significant differences were seen in age, recruitment route, sexual orientation, age of first homosexual sex, condom use with temporary partners and HIV infection rate among different sex roles (all P<0.05). Multivariable logistic regression analysis showed that insertive MSM had a lower risk of HIV infection than both receptive and insertive MSM (OR=0.513, 95%CI: 0.272-0.969), while there was no significant difference in the risk of HIV infection between receptive MSM and both receptive and insertive MSM (OR=2.088, 95%CI: 0.081-5.380).@*Conclusions@#The risk of HIV infection among receptive and both receptive and insertive MSM are higher than that among insertive MSM. Classified measures should be taken to reduce the transmission of HIV in this population.
ABSTRACT
This study offers a set of reflections on the relationship between risk and pleasure in the field of HIV prevention and care, as it mediates new biomedical prevention/care technologies, particularly pre-exposure prophylaxis (PrEP), among men who have sex with men (MSM). We begin by investigating some studies about condomless sex between men, more specifically barebacking and PrEP use among young MSM. We base our analysis on the assumption that PrEP, as one of these new actants, has reconfigured the field of HIV prevention/care, especially in relation to the dimensions of risk and pleasure, with the potential to considerably reduce the chances of HIV infection while enabling maximum pleasure and a sense of greater safety and freedom. Despite this progress, we also problematize some of the ambivalences, tensions, and moral conflicts that still exist in the field of prevention, especially the potential for condomless sex. Finally, taking a praxiographic perspective on health care and foregrounding the situated practices of human and non-human actors/actants in interaction, we consider HIV/AIDS prevention as a more fluid, non-linear, erratic phenomenon that involves multiple types of knowledge, feelings, and participations, and is open to different kinds of experimentation. Besides a "logic of choice", we hold that health care is a permeable, continuous process that is enacted in situated practices and may produce different effects in response to a heterogeneous network of interactions.
O artigo fornece um conjunto de reflexões sobre a relação entre risco e prazer no campo da prevenção e tratamento do HIV, além de colocar na agenda a mediação das novas tecnologias biomédicas de prevenção e tratamento, particularmente a profilaxia pré-exposição (PrEP) entre homens que fazem sexo com homens (HSH). Começamos por rever alguns estudos sobre o sexo sem preservativo entre homens, mais especificamente o barebacking e o uso de PrEP por HSH jovens. Baseamos a análise na pressuposição de que a PrEP, enquanto uma das novas tecnologias, reconfigurou o campo da prevenção e tratamento do HIV, especialmente em relação às dimensões de risco e prazer, com o potencial para reduzir consideravelmente o risco de infecção pelo HIV ao mesmo tempo em que permite o prazer máximo e uma sensação de maior segurança e liberdade. Não obstante esses avanços, também problematizamos algumas das ambivalências, tensões e conflitos morais que persistem no campo da prevenção, principalmente o potencial para sexo sem preservativo. Finalmente, a partir de uma perspectiva praxiográfica sobre os cuidados de saúde e destacando as práticas de atores/actantes humanos e não humanos na interação, consideramos a prevenção do HIV/aids como um fenômeno mais fluido, não linear e errático, que envolve múltiplos tipos de conhecimento, sentimentos e participações, e que está aberto a diferentes tipos de experimentação. Além de uma "lógica de escolha", propomos que os cuidados de saúde constituem um processo permeável e contínuo que é instituído em práticas situadas e que podem produzir efeitos diferentes em resposta a uma rede heterogênea de interações.
Este trabajo ofrece un conjunto de reflexiones sobre la relación entre riesgo y placer, en el ámbito de la prevención y tratamiento del VIH, ya que debate el impacto de las nuevas tecnologías de prevención/cuidado biomédicas, particularmente la profilaxis de preexposición (PrEP) entre los hombres que tienen sexo con hombres (HSH). Empezamos investigando algunos estudios sobre el sexo sin condón entre hombres, más específicamente a pelo, y el uso de PrEP por parte de jóvenes HSH. Basamos nuestro análisis en la asunción de que la PrEP, uno de estos nuevos actantes, ha reconfigurado el campo de la prevención y cuidados del VIH, especialmente, en relación con las dimensiones de riesgo y placer, con el potencial de reducir considerablemente las posibilidades de infección por VIH, mientras que permite un máximo placer y sensación de una mayor seguridad y libertad. A pesar de este progreso, también problematizamos algunas de las ambivalencias, tensiones, y conflictos morales que todavía existen en el ámbito de la prevención, especialmente el potencial del sexo sin condón. Finalmente, teniendo en consideración una perspectiva praxiográfica sobre la atención en salud, y destacando las prácticas mencionadas de actores/actantes humanos y no humanos en la interacción, consideramos la prevención de VIH/SIDA como un fenómeno errático más fluido, no lineal, que implica múltiples tipos de conocimiento, sentimientos, y participaciones, y está abierto a diferentes tipos de experimentación. Además de la "lógica de elección", sostenemos que la atención sanitaria constituye un proceso permeable, continuo que se concreta en las prácticas mencionadas y puede producir diferentes efectos como respuesta a una heterogénea red de interacciones.
ABSTRACT
Adolescent men who have sex with men (AMSM) are at a heightened vulnerability for human immunodeficiency virus (HIV). This study aimed to estimate the prevalence of HIV and associated individual, social, and programmatic factors among AMSM in Salvador, Bahia State, Brazil. This is a cross-sectional study which analyzed baseline data from the PrEP1519 cohort in Salvador. Descriptive, bivariate, and multivariate analyses were conducted using the dimensions of vulnerability to HIV as hierarchical levels of analysis. Logistic regression models were used to estimate the odds ratios (OR) of the association between predictor variables and HIV infection. The prevalence of HIV infection among the 288 AMSM recruited to the project was 5.9% (95%CI: 3.7-9.3). Adjusted analysis showed a statistically significant association between self-identifying as a sex worker (OR = 3.74, 95%CI: 1.03-13.60) and HIV infection. Other associations with borderline statistical significance were the use of application programs to find sexual partners (OR = 3.30, 95%CI: 0.98-11.04), low schooling level (OR = 3.59, 95%CI: 0.96-13.41), failing to be hired or being dismissed from a job because of sexual orientation (OR = 2.88, 95%CI: 0.89-9.28), and not using health services as a usual source of care (OR = 3.14, 95%CI: 0.97-10.17). We found a high HIV prevalence among AMSM in Salvador. Furthermore, our study found that individual, social, and programmatic factors were associated with HIV infection among these AMSM. We recommend intensifying HIV combined-prevention activities for AMSM.
Homens adolescentes que fazem sexo com homens (AHSH) apresentam vulnerabilidade aumentada ao HIV. O estudo teve como objetivo estimar a prevalência de HIV e fatores individuais, sociais e programáticos entre AHSH em Salvador, Bahia, Brasil. O estudo transversal foi baseado na análise dos dados da linha de base da coorte PrEP1519 em Salvador. Foram realizadas análises descritivas, bivariadas e multivariadas, usando as dimensões de vulnerabilidade ao HIV como níveis analíticos hierárquicos. Foram usados modelos de regressão logística para estimar as razões de chances (OR) da associação entre as variáveis preditoras e a infecção pelo HIV. A prevalência de infecção pelo HIV entre os 288 AHSH recrutados pelo projeto foi de 5,9% (IC95%: 3,7-9,3). A análise ajustada mostrou uma associação estatisticamente significativa entre a autoidentificação como profissional do sexo (OR = 3,74, IC95%: 1,03-13,60) e a infecção pelo HIV. Outras associações com significância estatística limítrofe foram: uso de aplicativos para achar parceiros sexuais (OR = 3,30, IC95%: 0,98-11,04), menor escolaridade (OR = 3,59, IC95%: 0,96-13,41), história de não ter sido contratado ou de ter sido demitido em função da orientação sexual (OR = 2,88, IC95%: 0,89-9,28) e falta de uso de serviços de saúde como fonte usual de cuidados (OR = 3,14, IC95%: 0,97-10,17). Foi encontrada uma alta prevalência de HIV entre AHSH em Salvador. Além disso, o estudo mostrou que fatores encontrados nas dimensões individual, social e programática estiveram associados à infecção pelo HIV entre esses AHSH. Recomendamos a intensificação das atividades de prevenção combinada entre AHSH.
Los hombres adolescentes que tienen sexo con hombres (AHSH) sufren más vulnerabilidad ante el VIH. El objetivo de este estudio fue estimar la prevalencia de VIH y los factores asociados individuales, sociales, y programáticos asociados entre AHSH en Salvador, Bahia, Brasil. Se trata de un estudio transversal, basado en el análisis de los datos de referencia de la cohorte PrEP1519 en Salvador. Se realizaron análisis descriptivos, bivariados, y multivariados usando las dimensiones de vulnerabilidad respecto al VIH, como los niveles jerárquicos de análisis. Los modelos de regresión logística se usaron para estimar las odds ratios (OR) de la asociación entre las variables predictoras y la infección por VIH. La prevalencia de infección por VIH entre los 288 AHSH reclutados para el proyecto fue 5,9% (IC95%: 3,7-9,3). El análisis ajustado reveló una asociación estadísticamente significativa entre autoidentificarse como un trabajador sexual (OR = 3,74, IC95%: 1,03-13,60) y la infección por VIH. Otras asociaciones con una significación estadística marginal fueron: uso de apps para encontrar pareja sexual (OR = 3,30, IC95%: 0,98-11,04), menos años de educación (OR = 3,59, IC95%: 0,96-13,41), no estar contratado o ser despedido de un trabajo debido a la orientación sexual (OR = 2,88, IC95%: 0,89-9,28), y no usar los servicios de salud como recurso habitual de atención sanitaria (OR = 3,14, IC95%: 0,97-10,17). Se identificó una alta prevalencia de VIH entre AHSH en Salvador. Asimismo, nuestro estudio halló que los factores desde una perspectiva individual, dimensión social, y dimensión programática estuvieron asociados con una infección por VIH entre AHSH. Recomendamos que se intensifiquen las actividades combinadas de prevención contra el VIH para AHSH.
ABSTRACT
At the end of 2017, Brazil adopted HIV pre-exposure prophylaxis (PrEP) as part of a combination prevention strategy for the most at-risk populations. However, Brazil does not have specific guidelines for PrEP use among adolescents aged < 18 years. Therefore, researchers from different health disciplines conducted PrEP1519, the first PrEP demonstration cohort study, ongoing in three Brazilian cities - Salvador, Belo Horizonte, and São Paulo - among adolescent men who have sex with men and transgender women, aged 15-19 years. This study aims to evaluate the effectiveness of PrEP in real-world settings. Quantitative and qualitative methods were integrated to obtain data on PrEP acceptability, uptake, use, and adherence. Moreover, comprehensive services and friendly environments were implemented in the PrEP1519 clinics. This study aims to describe the collaborative efforts of interdisciplinary practices in the development of the PrEP1519 study. The articulation of researchers from different institutions and areas is challenging; but it also allows for a broader outlook on questions regarding the direction of the research, while enriching the decisions needed to be taken during the interactions and negotiations among the different individuals, including the youth team and participants. Furthermore, it reflects on the communication process between cultures and languages considering the trans-epistemic arena of knowledge production about HIV, sexually transmitted infections, PrEP, and other combination prevention strategies for adolescents.
No final de 2017, Brasil adotou a profilaxia pré-exposição do HIV (PrEP) como parte de uma estratégia de prevenção combinada para as populações com maior risco de infecção. Entretanto, o país não dispõe de diretrizes específicas para o uso da PrEP entre adolescentes abaixo de 18 anos de idade. Assim, pesquisadores de diferentes disciplinas de saúde realizaram o PrEP1519, o primeiro estudo de coorte de demonstração da PrEP, atualmente em andamento em três cidades brasileiras - Salvador, Belo Horizonte e São Paulo - entre homens adolescentes que fazem sexo com homens e mulheres transgênero, entre 15 e 19 anos de idade. O estudo busca avaliar a efetividade da PrEP em contextos da vida real. Foram integrados métodos quantitativos e qualitativos para obter dados sobre a aceitabilidade, adoção, uso e adesão à PrEP. Além disso, foram implementados serviços integrados e ambientes acolhedores nas clínicas PrEP1519. O estudo busca descrever os esforços colaborativos das práticas interdisciplinares no desenvolvimento do estudo PrEP1519. A articulação de pesquisadores de diferentes instituições e áreas representa um desafio, mas permite um olhar mais abrangente sobre questões relativas à direção da pesquisa, ao mesmo tempo em que enriquece as decisões necessárias durante as interações e negociações entre diferentes indivíduos, inclusive a equipe de jovens e os participantes. Além disso, reflete o processo de comunicação entre culturas e linguagens, considerando a arena trans-epistêmica da produção de conhecimento sobre HIV, infecções sexualmente transmissíveis, PrEP e outras estratégias de prevenção combinada para adolescentes.
A finales de 2017, Brasil adoptó la profilaxis previa a la exposición al VIH (PrEP) como parte de una estrategia de prevención combinada para las poblaciones de mayor riesgo. Sin embargo, Brasil no tiene directrices específicas para el uso de la PrEP entre los adolescentes < 18 años. Por lo tanto, investigadores de diferentes disciplinas sanitarias llevaron a cabo el PrEP1519, el primer estudio de cohorte de demostración de la PrEP, en curso en tres ciudades brasileñas -Salvador, Belo Horizonte y São Paulo- entre hombres adolescentes que tienen relaciones con hombres y mujeres transexuales, de entre 15 y 19 años. El objetivo de este estudio es evaluar la eficacia de la PPrE en entornos reales. Se integraron métodos cuantitativos y cualitativos para obtener datos sobre la aceptabilidad, la aceptación, el uso y la adherencia de la PrEP. Además, se implementaron servicios integrales y entornos amigables en las clínicas de PrEP1519. Este estudio pretende describir los esfuerzos de colaboración de las prácticas interdisciplinarias en el desarrollo del estudio PrEP1519. La articulación de investigadores de diferentes instituciones y áreas supone un reto; pero también permite ampliar la visión de las cuestiones relativas a la dirección de la investigación, a la vez que enriquece las decisiones que debían tomarse durante las interacciones y negociaciones entre los diferentes individuos, incluyendo el equipo de jóvenes y los participantes. Además, reflexiona sobre el proceso de comunicación entre culturas y lenguas teniendo en cuenta el ámbito trans-epistémico de la producción de conocimiento sobre el VIH, las infecciones de transmisión sexual, la PrEP y otras estrategias de prevención combinada para adolescentes.