Association between response to repeated negative HIV testing and risk sexual behaviors in men who have sex with men in Chengdu / 中华流行病学杂志

Objective: To investigate the association between the response to repeated negative HIV testing and the risk sexual behaviors in men who have sex with men (MSM) in Chengdu. Methods: A total of 610 MSM were recruited by convenience sampling method through Chengdu Tongle Health Consultation Service Centre from March to May 2022. Data were collected from the MSM through questionnaire survey, including the demographic characteristics, sexual behaviors in the past 6 months, the response to rerpeated negative HIV testing. Univariate and multivariate logistic regression models were conducted to analyze the association between the response to repeated negative HIV testing and risk sexual behavior. Results: A total of 579 (94.9%) participants participated in the questionnaire survey and 354 (61.1%) subjects were included in the study.For the negative HIV testing, some MSM believed that they had taken effective protection measures (17.03±2.20), some believed that they were lucky (7.50±1.87) and some believed that they were at low risk (8.87±3.62). Multivariate logistic regression model showed that protected sexual behavior was negatively associated with group sex (aOR=0.80, 95%CI: 0.67-0.95), lucky was positively associated with casual sex (aOR=1.20, 95%CI: 1.06-1.35), inconsistent condom use (aOR=1.21, 95%CI: 1.06-1.37), group sex (aOR=1.26, 95%CI: 1.00-1.60), and multiple sexual partners (aOR=1.24, 95%CI: 1.09-1.42) and low risk perception was positively associated with multiple sexual partners only (aOR=1.08, 95%CI: 1.01-1.15). Conclusions: There were high levels of recognition of protected sexual behavior and lucky dimensions in response to repeated negative HIV testing and well risk perception in MSM in Chengdu. In HIV testing and counseling services, intervention and risk warning should be strengthened in MSM who believed that they are lucky to improve their awareness of safe sex and reduce the negative effects of fluke mind.

Tajectories of the self-efficacy of HIV testing among MSM based on latent class growth model / 中华预防医学杂志

Objective: To analyze the trajectories of HIV testing self-efficacy among men who have sex with men (MSM) based on latent class growth model. Methods: From August 2019 to May 2021, 404 MSM were recruited in Shandong Province and subjected to a 1-year follow-up study with individual intervention (pushing intervention pictures and videos in WeChat and follow-up questionnaires) and community intervention (forwarding to friends and sharing and discussing HIV testing-related information in WeChat groups). The level of HIV testing self-efficacy among MSM was measured. The long-term trend of HIV testing self-efficacy was analyzed using the latent class growth model (LCGM), and the influencing factors of the trend were analyzed. Results: A total of 404 MSM were (28.25±8.95) years old, with the oldest being 58 and the youngest being 18. The scores of HIV testing self-efficacy M(Q1, Q3) at baseline and 4 follow-ups were 18.00 (17.00, 21.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00) and 19.00 (18.00, 22.00). The results of the freely estimated two-category LCGM model showed that the trend of HIV testing self-efficacy among MSM could be divided into two classes, "intervention response group" [255(63.1%)] and "intervention non-response group" [149(36.9%)]. The former had a higher level of HIV testing self-efficacy which tended to increase at first and then decrease over time, while the latter had a lower and more stable level. The results of the multifactorial logistic regression analysis showed that the OR values of MSM in business or service and jobless or unemployed were 0.261 (95%CI: 0.108-0.633) and 0.186 (95%CI: 0.057-0.610), respectively, using the students as the reference group. Conclusion: There is a group heterogeneity in the trend of HIV testing self-efficacy in the intervention conditions among MSM, and occupation may be an influencing factor.

Progress in research of strategies of expanding HIV testing in men who have sex with men / 中华流行病学杂志

In recent years, HIV infection prevalence in MSM has been in increase in China. HIV testing is the only way to identify HIV-infection, effectively curb the spread of HIV and reduce AIDS-related death risks. At present, the situation of HIV testing in MSM is not satisfactory, and expanding HIV testing is the one of the key measures for AIDS prevention and control in this population. This paper summarizes the role and strategies of expanding HIV testing in MSM in order to provide a reference for the improvement of HIV testing in this population.

HIV self-testing and related factors in men who have sex with men in Shijiazhuang / 中华流行病学杂志

Objective: To understand HIV self-testing and related factors in men who have sex with men (MSM) in Shijiazhuang. Methods: From August to September 2020, convenient sampling was used to recruit MSM in Shijiazhuang. Online questionnaires were used to collect information about their demographic characteristics, sexual behaviors and HIV self-testing. logistic regression model was used to analyze the related factors associated with HIV self-testing. Results: In the 304 MSM respondents, 52.3% (159/304) had HIV self-testing in the past 6 months, and 95.0% (151/159) used fingertip blood HIV detection reagent. Self-purchase was the main way to obtain HIV testing reagents (45.9%, 73/159), followed by supply from MSM social organization (44.7%, 71/159). The reasons for having HIV self-testing were non-specific testing time (67.9%, 108/159) and privacy protection (62.9%,100/159), the reasons for having no HIV self-testing included inability of using (32.4%, 47/145), being unaware of HIV self-testing reagent (24.1%, 35/145), and worry about inaccurate self-testing results (19.3%, 28/145). Multivariate logistic regression analysis showed that being 18-29 years old (aOR=2.68, 95%CI: 1.20-5.94), obtaining free HIV self-testing kits in recent 6 months (aOR=8.61, 95%CI: 4.09-18.11) and making friends through Internet and social software (aOR=2.68, 95%CI: 1.48-4.88) were positive factors for having HIV self-testing. Conclusion: HIV self-testing is a more flexible and convenient way to detect HIV in MSM, and the promotion of HIV self-testing in MSM should be strengthened to further increase the HIV detection rate in this population.

Progress in research on HIV self-testing and associated factors among men who have sex with men in China / 中华流行病学杂志

HIV testing is the first step in HIV prevention and control, the rate of HIV infection is high and the rate of HIV testing is low among men who have sex with men (MSM) in China. HIV self-testing provides MSM with a new choice and plays a vital role in expanding the coverage of HIV testing in this population. This paper reviews HIV self-testing and associated factors among MSM in China and provides a reference for promoting HIV self-testing in this population.

Adolescents infectés par le VIH au cours de la transition des soins pédiatriques aux soins pour adultes dans un hôpital de référence à Abidjan (Côte d'Ivoire). Etudes des caractéristiques cliniques / Hiv-infected adolescents during the transition from paediatric to adult care in a referral hospital in abidjan (cote d'ivoire). Clinical characteristics study

Les adolescents vivant avec le VIH ont de moins bons résultats que les adultes en matière de soins, en particulier lors de la transition entre les soins pédiatriques et les soins aux adultes. L' Objectif était de décrire les particularités socio familiales, cliniques, para cliniques et thérapeutiques des adolescents au cours de cette phase charnière de leur prise en charge. Méthodes. Il s'agissait d'une étude rétrospective à visée descriptive qui s'est déroulé du 1er au 31 mars 2020 (1 mois) sur la cohorte d'enfants vivant avec le VIH suivi au CHU de Cocody (Abidjan) de novembre 2005 à mars 2020 (15 ans). Résultats. Trente-huit adolescents en phase de transition ont été inclus. L'âge moyen était de 17 ans avec des extrêmes de 15 et 20 ans. Le sex ratio était de 1,37. La majorité des enfants étaient scolarisé (81,57%) avec un retard scolaire chez plus de la moitié (58%). Près de la moitié des cas était orphelin d'un ou des 2 parents (47,4%). Les conditions socioéconomiques étaient modestes ou défavorable (73,7%). Près de la moitié des adolescents était suivi depuis plus de 10 ans (42%). Un surpoids a été retrouvé dans 21% des cas. On notait un échec immunologique dans 10,5% des cas et un échec virologique dans un tiers des cas (31,6%). L'observance était moyenne ou mauvaise chez près de la moitié des adolescents (44,7%). La majorité des adolescents (94,7%) n'avait jamais eu de contact avec un médecin d'adulte. Conclusion. La transition des soins pédiatriques aux soins pour adulte est un processus au cours duquel l'adolescent est confronté à des diffi cultés socio familiale et scolaire, a l'inobservance avec échec thérapeutique qui doit être repéré de façon précoce. Le succès de cette étape nécessite également le rapprochement entre pédiatres et médecins d'adultes pour une prise en charge optimal des patients.

Uptake of HIV voluntary counseling and testing and associated factors among students in the Higher Institutions of Learning in Kigali, Rwanda: A cross-sectional study

Background HIV/AIDS remains a significant global public health challenge with youth bearing the brunt of the burden. One essential method for preventing and accessing AIDS care is through Voluntary Counselling and Testing (VCT). Regardless of this, youth population continues to have low utilization of VCT services. Objective To assess the uptake of HIV VCT services and associated factors among university students in Kigali. Methods A cross-sectional study among 374 students recruited using stratified sampling was conducted. A structured questionnaire was used to gather information. A multivariable logistic regression analysis was used to assess the independent factors associated with VCT uptake. Results The prevalence of VCT uptake was 59.9%. The logistic regression revealed that being Catholic (AOR = 11.99, 95%CI: 5.44-26.41) and Moslem (AOR = 37.34, 95%CI: 2.67-128.36) compared to Protestant, as well as availability of VCT services (AOR = 5.15, 95%CI: 3.11 - 8.541) favored the use VCT. On the other hand, being aged 20 to 24 years (AOR = 0.112, 95%CI: 0.04 - 0.29) had low likelihood of using VCT than those more than 24 years of age. Conclusion VCT uptake was significantly positively associated with religion and VCT services availability, and negatively associated with age 20-24 years in the campus. Therefore, targeted actions of disseminating information on benefits of VCT and enhancing accessibility of VCT services among students are necessary for the increased VCT uptake to be attained.

Facteurs associés à la non-observance des personnes vivant avec le VIH à la thérapie antirétrovirale / Factors associated with non-adherence to antiretroviral therapy among people living with HIV

Le VIH est un fléau le plus meurtrier de l'histoire et les antirétroviraux demeurent une panacée. Cette étude cherche à identifier les facteurs associés à l'inobservance des personnes vivant avec le VIH (PVVIH) à la thérapie antirétrovirale (TARV). Méthodes L'étude transversale analytique a été menée au sein de la structure ActionsCommunautaires SIDA/ Avenir Meilleur pour les Orphelins. Elle a ciblé les PVVIH éligibles. L'échantillonnage non probabiliste du type occasionnel a été utilisé par la technique d'interview. Les analyses bivariée et multivariée ont été utilisées ainsi que la régression logistique par le logiciel SPSS version 16.0. Résultats 72 PVVIH ont été interviewées dont l'âge moyen était de 44 ans, avec un sex ratio de 2 femmes pour 1 homme. L'observance thérapeutique était de 55,6 %. Les facteurs associés à l'inobservance sont l'anxiété (51,4%), le stress, la mauvaise relation avec le soignant (44,4%), l'oubli (37,5%), la démotivation sexuelle (20,8%), la conscience personnelle (19,4%) et le manque de confidentialité (13,9%). Conclusion L'inobservance à la thérapie antirétrovirale constitue une problématique dans le contexte de la RDC. Il est important d'insister sur l'éducation thérapeutique dans le succès de la thérapie antirétrovirale

Acceso al diagnóstico rápido de VIH/sífilis en contextos de encierro: relato de experiencia en una unidad penal de la provincia de Buenos Aires en el año 2021 / Access to rapid diagnosis of HIV/syphilis in confinement contexts: an experience report in a penal unit in the province of Buenos Aires in the year 2021

En Argentina se estima que 140 mil personas viven con VIH y de ellas el 17% no conocen su diagnóstico (Ministerio de Salud, 2021). La Dirección de Sida y Enfermedades de Transmisión Sexual (DSyETS) del Ministerio de Salud de la Nación realizó un estudio que mostró una prevalencia global de VIH de 2,68% en unidades del servicio penitenciario federal (DSyETS; 2017). Por ello nuestro objetivo fue favorecer el acceso al testeo y a la prevención de estas enfermedades en personas privadas de su libertad en una unidad penal de la provincia de Buenos Aires en el marco de la pandemia. Relato de experiencia: en diciembre del 2021 se ofreció el testeo voluntario, gratuito y confidencial para VIH y sífilis y accedieron 38 personas. Participaron de la actividad docentes, estudiantes del Departamento de Ciencias de la Salud de la Universidad Nacional del Sur y referentes del programa de VIH-ITS y HV de la Región Sanitaria I del ministerio de salud de la provincia de Buenos Aires. Conclusiones: Esta experiencia mostró la importancia de construcción de redes para la articulación de prácticas que favorezcan el acceso a un diagnóstico temprano y tratamiento oportuno para VIH y sífilis a las personas viviendo en contexto de encierro (AU)

In Argentina, it is estimated that 140 thousand people live with HIV and 17% of them do not know their diagnosis (Ministry of Health, 2021). The Directorate of AIDS and Sexually Transmitted Diseases (DSyETS) of the Ministry of Health of the Nation carried out a study that showed a global prevalence of HIV of 2.68% in units of the federal prison service (DSyETS; 2017). For this reason, our objective was to promote access to testing and the prevention of these diseases in people deprived of their liberty in a penal unit in the province of Buenos Aires in the context of the pandemic. Experience report: in December 2021, voluntary, free and confidential testing for HIV and syphilis was offered and 38 people agreed. Teachers, students from the Department of Health Sciences of the National University of the South and referents of the HIV-STI and HV program of the Sanitary Region I of the Ministry of Health of the province of Buenos Aires participated in the activity. Conclusions: This experience showed the importance of building networks for the articulation of practices that favor access to early diagnosis and timely treatment for HIV and syphilis for people living in a confinement context (AU)

Impacto del aislamiento por la pandemia de COVID-19 en la realización de pruebas rápidas de VIH en un hospital general de agudos de CABA / Impact of isolation measures due to the COVID-19 pandemic on rapid HIV tests in an Acute General Hospital in Buenos Aires City

Introducción: La infección por VIH continúa siendo un problema de salud pública a nivel mundial. Las restricciones tomadas durante la pandemia por COVID-19 podrían afectar el alcance de las metas 95-95-95 propuestas por ONUSIDA. El objetivo de este trabajo fue determinar el impacto de la pandemia por COVID-19 en la realización de pruebas rápidas de VIH en un hospital general de agudos.Métodos: Análisis retrospectivo de los datos de pacientes mayores de 16 años, de ambos sexos, que se realizaron una prueba rápida de VIH durante la pandemia por COVID-19 vs. el período previo.Resultados: De 611 tests, 473 (77,4%) corresponden al período prepandémico y 138 (22,6%) al pandémico. La mediana de edad (rango intercuartílico) fue 32 años (24-40); sexo masculino 386 (63,2%), sin diferencias significativas. Durante el período prepandémico los motivos de testeo fueron control de salud 47,6% (n=225) y situaciones de riesgo/síntomas 52,4% (n=248), mientras que en el período pandémico fueron control de salud 27,5% (n=38) y situaciones de riesgo/síntomas 72,5% (n=100) respectivamente, p=0.0001. Tests positivos: 5,7% (n=27) vs. 8,7% (n=12), p=0.28. Las medianas de recuento de linfocitos T CD4+ y carga viral fueron: 327 cel/uL (135-718) y 66300 copias/mL (5260-192000), sin diferencias significativas.Conclusiones: La cantidad de testeos realizados durante la pandemia corresponde a un tercio de los realizados durante el período previo, con un descenso en aquellos motivados por controles de salud, evidenciando el impacto de la pandemia en el diagnóstico de VIH

INTRODUCTION: HIV infection remains as a public health worldwide problem. The restrictions taken during the COVID-19 pandemic could have affected the scope of the 95-95-95 goals proposed by UNAIDS. The aim of this work is to determine the impact of the COVID-19 pandemic on the performance of rapid HIV tests in an Acute General Hospital.METHODS: Retrospective analysis of data from patients over 16 years old, of both sexes, who underwent a rapid HIV test during the COVID-19 pandemic vs. the previous period.RESULTS: Of 611 tests, 473 (77.4%) correspond to the pre-pandemic period and 138 (22.6%) to the pandemic. The median age (interquartile range) was 32 years old (24-40); male sex 386 (63.2%), without significant differences. During the pre-pandemic vs pandemic period, the reasons for testing were: health control 47.6% (n=225) and risk situations/symptoms 52.4% (n=248), vs 27.5% (n= 38) and 72.5% (n=100) respectively, p=0.0001. Positive tests: 5.7% (n=27) vs 8.7% (n=12), p=0.28. The median CD4+ T lymphocyte count and viral load were: 327 cells/uL (135-718) and 66,300 copies/mL (5,260-192,000), with no significant differences.CONCLUSIONS: The number of tests carried out during the pandemic equals to a third of those performed during the previous period, with a decrease in those motivated by health controls; evidencing the impact of the pandemic on the diagnosis of HIV

Enfermedad de Castleman multicéntrica en pacientes HIV positivos. Reporte de dos casos y revisión de la literatura / Multicentric Astleman disease in HIV positive patients. Two cases. Report and literature review

La enfermedad de Castleman (EC) es un proceso linfoproliferativo poco frecuente que se caracteriza por hiperplasia de los ganglios linfáticos. Existen dos variedades histológicas bien diferenciadas la hialino-vascular y la plasmocelular, que a su vez pueden ser localizadas o multicéntricas. La forma hialino-vascular suele ser asintomática y localizada en mediastino mientras que la plasmocelular se presenta frecuentemente con signo-sintomatología sistémica y suele ser difusa o multicéntrica. En el contexto de la enfermedad debida al virus de la inmunodeficiencia humana (VIH), la EC se asocia en su patogenia a la infección por el herpes virus humano tipo-8 (HHV-8). La mayoría de los casos corresponden a la variante hialino-vascular (80/90%) en tanto un pequeño porcentaje (10/20%) son de la variante plasmocelular. En algunos pacientes, el patrón histopatológico puede ser mixto. Se describen dos casos de enfermedad de Castleman multicéntrica HHV8- positiva en pacientes con enfermedad HIV/SIDA.

Castleman's disease (CD), is a rare hematological condition of uncertain etiology, involves a massive proliferation of lymphoid tissues and typically presents as mediastinal masses. This is considered as a distinct type of lymphoproliferative disorder associated with inflammatory symptoms. In the context of human immunodeficiency virus (HIV) infection, CD is associated with human herpesvirus-8 (HHV8) infection. Most cases of CD represent either the hyaline vascular variant (80­90% of cases) or the plasma cell variant (10­20%); a small percentage present with a mixed histologic appearance. Two cases of Castleman's disease associated with HHV-8 and HIV/AIDS infection are described

Conductas sexuales por sexo en población universitaria chilena que demanda test rápido de VIH / Sex-disaggregated sexual behaviors among Chilean university students taking a rapid HIV test

OBJETIVO: Caracterizar por sexo una población universitaria que accedió voluntariamente a una prueba de detección rápida del virus de la inmunodeficiencia humana (VIH). MÉTODO: Estudio analítico de 3864 universitarios/as. Variables: sociodemográficas y académicas, comportamiento sexual, prevalencia de infecciones de transmisión sexual (autorreporte) y motivos para realizarse el test rápido. RESULTADOS: El 61,4% son mujeres, edad media 21,64 años, edad de inicio de la actividad sexual 17,01 años. Actividad sexual casual: 36,8%, destacando los hombres (p < 0,001). Sexo anal: 44,5%. Prevalencia de infecciones de transmisión sexual: 7,5%, destacando los hombres en gonorrea (p < 0,001) y sífilis (p = 0,032). Test rápido VIH (+): 0,2%. Consumo de sustancias durante la actividad sexual: 50%. El 41,1% nunca pregunta a su contacto sexual el estado serológico de VIH, destacando los hombres (p < 0,001), y el 64,4% no sabe si ha tenido una pareja sexual VIH (+), destacando los hombres (p < 0,001). El 16,5% siempre ha usado preservativo, destacando las mujeres (p = < 0,001). El 26,21% usa redes sociales para encuentros sexuales, con diferencias por sexo. CONCLUSIONES: Las mujeres demandan más el test rápido de VIH que los hombres. Existen conductas de riesgo y diferencias por sexo: poco uso del preservativo, relaciones sexuales casuales y bajo la influencia de sustancias, prácticas sexuales anales y orales sin protección, desconocer el estado serológico de su contacto sexual y uso de redes sociales para encuentros sexuales.

OBJECTIVE: To characterize a university population that willingly took a rapid HIV test by sex. METHOD: An analytical study with 3,864 university students. Variables: socio-demographic and academic variables, sexual behavior, (self-reported) STI prevalence, and reasons to take the rapid test. RESULTS: 61.4% are women; average age: 21.64 years; age of first sexual intercourse: 17.01 years; casual sexual activity: 36.8%, mostly men (p < 0,001), anal sex: 44.5%; STI prevalence: 7.5%, with gonorrhea and syphilis being more common among men (p < 0.001 and p < 0.032, respectively; positive rapid HIV test: 0.2%; substance use during sex: 50%. 41.1% of the participants, most of them men (p < 0.001), have never asked their partner about their serologic HIV status, and 64.4% does not know if they have had a HIV+ partner, an attitude that is more prevalent among men (p < 0.001). 16.5% has always used prophylactics, mostly women (p < 0.001). 26.21% uses social networks to arrange sexual encounters. CONCLUSIONS: Women ask more for the rapid HIV test than men. There are several risky behaviors and gender differences: low use of prophylactics, casual sexual relationships under the influence of substances, unprotected anal and oral sex practices, ignorance of their sexual partners serologic status, and the use of social networks for sexual encounters.

Construção e validação de simulação clínica sobre testagem e aconselhamento para o hiv em gestantes / Construction and validation of a clinical simulation on hiv testing and counseling in pregnant women / Construcción y validación de un simulacro clínico sobre pruebas y asesoramiento del vih en mujeres embarazadas

RESUMO Objetivo: construir e validar um cenário de simulação clínica sobre a testagem rápida e aconselhamento para o HIV em gestantes. Método: estudo metodológico, de validação de aparência e conteúdo, desenvolvido no período de junho a outubro de 2020 por meio da técnica Delphi. Para a validação, foram incluídos os juízes que obtiveram cinco ou mais pontos segundo os critérios de Fehring adaptados. Os dados foram analisados mediante o cálculo do Índice de Validade de Conteúdo (IVC). Resultados: depois da primeira rodada Delphi, dois itens (5,7%) não atingiram o I-CVI necessário para validação em todos os critérios avaliados, que foram: comportamental, objetividade, simplicidade, clareza, relevância, precisão, variedade, modalidade, tipicidade e credibilidade. Ao final da segunda rodada Delphi, todos os itens (100%) atingiram o I-CVI necessário para validação. Conclusão: o roteiro se mostrou válido, contribuindo para subsidiar o ensino da testagem e do aconselhamento de gestante sobre o HIV.

ABSTRACT Objective: to construct and validate a clinical simulation scenario on rapid HIV testing and counseling in pregnant women. Method: methodological study, of appearance and content validation, developed between June and October 2020 through the Delphi technique. For validation, the judges who obtained five or more points according to the adapted Fehring criteria were included. The data were analyzed by calculating the Content Validity Index (CVI). Results: After the first Delphi round, two items (5.7%) did not reach the I-CVI required for validation in all the criteria evaluated, which were: behavioral, objectivity, simplicity, clarity, relevance, accuracy, variety, modality, typicality, and credibility. At the end of the second Delphi round, all items (100%) reached the I-CVI required for validation. Conclusion: the script proved to be valid, contributing to subsidize the teaching of HIV testing and counseling of pregnant women.

RESUMEN Objetivo: construir y validar un escenario de simulación clínica sobre pruebas rápidas y asesoramiento para el VIH en mujeres embarazadas. Método: estudio metodológico, de valoración de la apariencia y el contenido, desarrollado en el período de junio a octubre de 2020 mediante la técnica Delphi. Para la validación, se incluyeron los jueces que obtuvieron cinco o más puntos según los criterios adaptados de Fehring. Los datos se analizaron calculando el Índice de Validez del Contenido (IVC). Resultados: Tras la primera ronda Delphi, dos ítems (5,7%) no alcanzaron el I-CVI requerido para la validación en todos los criterios evaluados, que fueron: comportamiento, objetividad, simplicidad, claridad, relevancia, precisión, variedad, modalidad, tipicidad y credibilidad. Al final de la segunda ronda Delphi, todos los ítems (100%) alcanzaron el I-CVI requerido para la validación. Conclusión: el rodillo se mostró válido, contribuyendo a subvencionar la enseñanza de la prueba y el asesoramiento de gestores sobre el VIH.

HIV infection status and related factors in men who have sex with men in sentinel surveillance in Shanxi province, 2010, 2015 and 2020 / 中华流行病学杂志

Objective: To understand the infection status of HIV and related factors in men who have sex with men (MSM) in Shanxi province in 2010, 2015 and 2020. Methods: According to the sentinel surveillance protocol, continuous cross-sectional survey were conducted to collect the information about basic characteristics, general demographic characteristics, AIDS knowledge awareness, high-risk sexual behavior, sexually transmitted diseases, intervention services and HIV infection rate of the MSM in Shanxi in 2010, 2015 and 2020. Results: In 2010, 2015 and 2020, a total of 2 708 MSM were included in this study. There were significant differences in HIV infection rate among three years (χ2=23.76, P<0.001) with an increasing trend with year (trend χ2 =17.34, P<0.001). The rates of anal sex, commercial sex and heterosexual behavior in the past 6 months were 77.62% (2 102/2 708), 5.91% (160/2 708) and 28.14% (762/2 708) respectively, and the rates of consistent use of condom were 52.52% (1 104/2 102), 63.13% (101/160) and 23.49%(179/762) respectively, and the rate of consistent condom use was low. Results from multivariate logistic regression analysis showed that different cities, having educational level of junior high school or below, being recruited through internet, voluntary counseling and testing, suffering from sexually transmitted diseases, occasional condom use in anal sex in the past 6 months were the correlative factors of HIV infection of MSM. Conclusions: The HIV infection rate of MSM in Shanxi increased year by year from 2010, 2015 to 2020. The HIV/AIDS-related risk behavior persisted, and the proportion of condomuse adherence was low, and the HIV detection rate was low in the MSM, so targeted and effective measures should be taken to promote the condom use adherence and regular HIV testing in MSM.

Effects of unsafe sexual behavior and sexual orientation on previous HIV testing and HIV testing willingness among college students in Harbin / 中华流行病学杂志

Objective: To analyze the effects of unsafe sexual behavior and sexual orientation on previous HIV testing and HIV testing willingness among college students in Harbin, to provide a theoretical basis for promoting and promoting HIV testing among them. Methods: A cross-sectional survey design was used to place the automatic vending machine of HIV urine test kit in 9 universities in Harbin from December 2017 to January 2018. The questionnaire star was used to design and recruit college students to carry out an anonymous online survey. The estimated sample size was 6 659. A multivariate logistic regression model was used to analyze the effects of unsafe sexual behavior and sexual orientation on previous HIV testing and HIV testing willingness among college students. WPS 2016 was used to sort out the database, and SPSS 21.0 software was used for statistical analysis. Results: A total of 60 849 valid questionnaires were collected. 19.1% (11 189/58 605) of college students reported having sex. College students who used condoms correctly every time, occasionally or never during sex in the past six months 58.5% (6 206/10 603), 25.2%(2 669/10 603)and 16.3% (1 728/10 603), respectively. Heterosexuality, homosexuality and bisexuality accounted for 94.1% (54 393/57 823), 2.4% (1 369/57 823) and 3.5% (2 061/57 823), respectively. The HIV testing willingness of college students was 73.3% (44 572/60 849). The proportion of previous HIV testing was 10.3% (951/9 241). Results of the multivariate logistic analysis showed that compared with the college students who used condoms correctly whenever they had sex in the past six months, there was no significant difference in the proportion of previous HIV testing among college students who sometimes/occasionally used or never used condoms (OR=0.94,95%CI:0.69-1.29; OR=1.11,95%CI:0.73-1.67), but their willingness to HIV testing was lower (OR=0.79, 95%CI:0.71-0.89; OR=0.48, 95%CI:0.42-0.55); Compared with heterosexual college students, homosexual or bisexual college students have a higher proportion of previous HIV testing (OR=2.62, 95%CI:1.62-4.24; OR=2.04, 95%CI:1.25-3.32), but have lower HIV testing willingness (OR=0.76, 95%CI: 0.62-0.93; OR=0.64, 95%CI: 0.53-0.77). Conclusions: Unsafe sexual behavior existed among college students in Harbin, and college students with weak awareness of HIV prevention also have weak awareness of testing. Behavioral intervention should be strengthened and HIV testing promoted. Compared with heterosexuals, homosexual or bisexual college students had a higher proportion of previous HIV testing, but their willingness to test was lower. The HIV detection mode with better concealment, accuracy, and convenience should be promoted on the college's campus.

Factors influencing HIV testing and counselling services among men who have sex with men in Western China: a cross-sectional study based on Andersen's Behavioral Model

BACKGROUND@#Men who have sex with men (MSM), as a marginal population, has been largely ignored by health service projects. We assessed the utilization of HIV testing and counselling services and its influencing factors based on Andersen's Behavioral Model, so as to provide a theoretical basis for future infectious disease prevention and control strategies and health services policy formulation for these population.@*METHOD@#This was a cross-sectional study. A sample survey was conducted in Western China, and an anonymous self-administered questionnaire survey was conducted among MSM. Based on Andersen's Behavioral Model, the questionnaire divided the influencing factors into predisposing factor, enabling factor and need factor. Multivariate logistic regression analysis was used to explore the factors influencing the utilization of HIV testing and counselling.@*RESULTS@#There were 3184 valid questionnaires. In the survey of HIV health services, 82.85% MSM had HIV testing and 64.98% MSM had HIV counselling, respectively. Among the predisposing factor, age 25 years old and over was a facilitator of HIV testing and counselling, and ethnicity was a factor associated with HIV testing. Among the enabling factor, MSM living in urban were more likely to have access to testing and counselling services, and income was also linked to HIV testing. Among the need factor, a high level of HIV knowledge could promote testing and counselling, and a history of sexually transmitted diseases (STD) was a facilitator of testing.@*CONCLUSIONS@#HIV testing is widespread in Western China and higher than counselling service. MSM with high-risk characteristics should be identified as a priority in the future public health services.

Potencialidades da atenção primária à saúde na consolidação do teste rápido anti-HIV: análise do discurso / The potential of primary health care in the consolidation of the of the anti-HIV rapid test: discourse analysis / Potencialidades de la atención primaria en la consolidación de la prueba rápida del VIH: análisis del discurso

Objetivo: analisar o discurso dos gerentes de saúde a respeito das potencialidades para realização do Teste Rápido anti-HIV na Atenção Primária à Saúde. Método: estudo exploratório, qualitativo, realizado em um dos cinco Distritos Sanitários da capital paraibana. A coleta de dados foi realizada em setembro de 2017. Utilizou-se o dispositivo teórico-metodológico da Análise do Discurso, de matriz francesa, por meio do conceito-análise potencialização da APS na consolidação do TR anti-HIV, divididos em dois blocos discursivos: a acessibilidade geográfica e a acessibilidade sócio-organizacional. Resultados: os discursos apontam elementos potencializadores da APS para a realização TR anti-HIV: proximidade do serviço de saúde, arranjos organizacionais, diagnóstico precoce do HIV, agilidade no resultado do teste rápido anti-HIV e tratamento imediato. Conclusão: verificou-se potencialidades na consolidação do teste rápido anti-HIV, evidenciando a Atenção Primária à Saúde como um espaço facilitador na ampliação da integralidade e o acesso aos serviços de saúde.

Objective: to analyze the discourse of health managers regarding the potentialities for conducting the HIV Rapid Test in Primary Health Care. Method: exploratory, qualitative study, conducted in one of the five Health Districts of the capital of Paraíba. Data collection was carried out in September 2017. We used the theoretical and methodological device of Discourse Analysis, of French matrix, through the concept-analysis potentialization of PHC in the consolidation of anti-HIV TR, divided into two discursive blocks: geographical accessibility and socio-organizational accessibility. Results: the speeches point out potentializing elements of PHC for the realization of anti-HIV test: proximity of the health service, organizational arrangements, early diagnosis of HIV, agility in the result of the rapid anti-HIV test and immediate treatment. Conclusion: potentialities in the consolidation of the anti-HIV rapid test were verified, evidencing Primary Health Care as a facilitating space in the expansion of integrality and access to health services.

Objectivo: analizar el discurso de los gestores sanitarios sobre las potencialidades de la realización de la prueba rápida del VIH en la Atención Primaria de Salud. Método: estudio exploratorio, cualitativo, realizado en uno de los cinco Distritos de Salud de la capital de Paraíba. La recogida de datos se realizó en septiembre de 2017. Se utilizó el dispositivo teórico-metodológico de la Análise do Discurso, de matriz francesa, mediante el concepto de análisis de la potencialidad del APS en la consolidación del TR anti-VIH, dividido en dos bloques discursivos: la accesibilidad geográfica y la accesibilidad socio-organizacional. Resultados: los discursos muestran los elementos potenciales de la APS para la realización de TR contra el VIH: la proximidad del servicio de salud, los arreglos organizativos, el diagnóstico precoz del VIH, la agilidad en el resultado de la prueba rápida contra el VIH y el tratamiento inmediato. Conclusión: se verificaron las potencialidades en la consolidación de la prueba rápida contra el VIH, evidenciando a la Atención Primaria a la Salud como un espacio facilitador en la ampliación de la integralidad y el acceso a los servicios de salud.

Efetividade das intervenções escolares para promoção do teste anti-HIV entre pessoas jovens: uma revisão sistemática / Effectiveness of school interventions to promote HIV testing among young people: a systematic review

Introdução: Jovens são desproporcionalmente afetados pela epidemia de HIV. Essas dificuldades já foram descritas e analisadas quanto a seus determinantes. Contudo, embora as intervenções efetivas para promover o teste anti-HIV estejam concentradas em ambientes escolares, ainda persistem controvérsias no que se refere à efetividade dessas intervenções para aumentar a atitude e o comportamento de testagem entre a população jovem. Objetivo: Avaliar a efetividade de intervenções realizadas em instituições formais de ensino (escolas e universidades) no aumento da atitude e do comportamento relativos à testagem anti-HIV entre pessoas jovens. Portanto, a pergunta norteadora deste estudo foi: As intervenções realizadas em instituições formais de ensino são efetivas para promover o teste anti-HIV entre pessoas jovens? Métodos: Esta revisão sistemática (RS) da literatura seguiu as recomendações metodológicas do Cochrane Handbook para Revisões Sistemáticas de Intervenções, versão 6.0. A estratégia de busca foi elaborada a partir do acrônimo PICOS (P = adolescentes e jovens; I = intervenções implementadas em instituições formais de ensino (escolas e universidades); C = nenhuma intervenção; currículo padrão de prevenção sexual; qualquer intervenção realizada fora do ambiente formal de ensino; O = atitude e comportamento relativos à testagem anti-HIV; S = ensaios clínicos randomizados (ou quase randomizados); e ensaios clínicos randomizados por conglomerado). A busca sistemática foi realizada entre maio e junho de 2019 em 17 bases de dados. Não foi estabelecido nenhum tipo de restrição quanto ao idioma ou limite temporal dos estudos pesquisados. A seleção dos estudos elegíveis foi realizada por dois avaliadores independentes, que também avaliaram a qualidade metodológica dos estudos incluídos e extraíram seus dados. As discordâncias foram dirimidas através de consenso ou com o auxílio de um terceiro avaliador. Os dados foram apresentados de forma descritiva e com metanálise. Resultados: Seis documentos e quatro estudos foram incluídos nesta RS. Desses, dois estudos são Ensaios Clínicos (EC) randomizados por indivíduos e dois são (EC) randomizados por conglomerados. Um estudo avaliou o desfecho de atitude para testagem anti-HIV e três estudos avaliaram o desfecho comportamental de testagem. Apenas este desfecho pôde ser incluído na metanálise. Dois estudos foram agrupados em metanálise e os resultados foram apresentados com gráfico de floresta. Houve significante (p=0,02) efeito da intervenção nos testes de HIV. No que concerne à atitude em relação à testagem, a síntese descritiva também sugere benefício das intervenções. Conclusão: Os achados qualitativos e quantitativos da presente RS sugerem que as intervenções realizadas em instituições formais de ensino, quando comparadas a nenhuma intervenção, são efetivas em aumentar a atitude e o comportamento relacionados ao teste anti-HIV entre jovens. No entanto, evidenciou-se que essas intervenções têm se restringido a uma abordagem restritiva de prevenção combinada, notadamente pela implementação de estratégias de cunho comportamental e biomédico, negligenciando ações preventivas combinadas mais abrangentes. Dado ao reduzido número de artigos incluídos, não há evidências suficientes para concluir que aspectos relacionados às características das intervenções implementadas possam ter influenciado os resultados.

Introduction: Young people are disproportionately affected for the HIV epidemic. The determinants of these difficulties have already been described and assessed. However, although effective interventions to promote HIV testing are concentrated in school environments, there are still controversies regarding the effectiveness of these interventions to increase the attitude and testing behavior among this population. Objective: To assess the effectiveness of interventions carried out in formal educational institutions (schools and universities) in increasing attitude and behavior related to HIV testing among young people. Therefore, the main question of this study was: "Are the interventions performed in formal educational institutions effective to promote HIV testing among young people?" Methods: A systematic literature review (SR) was conducted following the Cochrane Collaboration and PRISMA methodological recommendations. We elaborated the search strategy based on the acronym PICOS (P = adolescents and young people; I = interventions implemented in formal educational institutions (schools and universities); C = no intervention; standard sexual prevention curriculum; any intervention carried out outside the formal teaching environment; O = attitude and behavior related to HIV testing; S = randomized (or almost randomized) clinical trials; randomized cluster trials). The systematic search was conducted between May and June 2019 in 17 databases. We did not establish any type of restriction regarding the language or temporal cut for the studies surveyed. The eligible studies selection was performed by two independent evaluators, who also evaluated the methodological quality of the included studies and extracted their data. Disagreements were resolved by consensus or by a third evaluator opinion. We presented the data descriptively and with meta-analysis. Results: Six documents and four studies were included in this SR. Of these, two studies are individually randomized clinical trials (RCT) and two are cluster randomized (cRCT). One study assessed the attitude as outcome for HIV testing and three studies evaluated the testing behavioral outcome. Only this outcome could be meta-analyzed. Two studies were grouped into meta-analysis and the results were presented through the forest graph. We found a significant (p=0.02) effect of the intervention on HIV tests. Regarding the attitude towards testing, descriptive synthesis also suggests benefit of interventions. Conclusion: The qualitative and quantitative findings of this RS suggest that interventions carried out in formal educational institutions, when compared to no intervention, are effective to increase the attitude and behavior related to HIV testing among young people. However, it was evidenced that these preventive measures have a restrictive combined prevention approach, notably by implementing prevention and biomedical strategies, neglecting the more comprehensive combined preventive measures. Data provided to the of articles included, there is no number of articles proven for the aspects presented to the results presented to the related results.

The global HIV response at 40

It is helpful to divide the global HIV response into three phases: The first, from about 1980 to 2000, represents "Calamity". The second, from roughly 2000 to 2015 represents "Hope." The third, from 2015, is unfolding and may be termed "Choices" ­ and these choices may be severely constrained by COVID, so "Constrained Choices in an era of COVID" may prove more apt. As we take stock of HIV at 40, there are positive lessons for the wider health response ­ and challenging reflections for the wider impact of the global HIV response. The positive lessons include: (1) the importance of activism; (2) the role of scientific progress and innovation; (3) the impact of evidence in concentrating resources on proven approaches; (4) the importance of surveillance to understanding transmission dynamics; (5) the use of epidemic intelligence to guide precision implementation; (6) the focus on implementation cascades (diagnosis, linkage, adherence, disease suppression); and finally (7) an overarching execution and results focus. Given this remarkable legacy, it seems churlish to ask whether the HIV response could have achieved more. yet, consider these approximate figures. Development assistance for HIV totals about 100 billion dollars, 70 billion from the USA matched by roughly 100 billion in domestic resources. For 200 billion dollars, should we not have achieved more than 23 million people initiating treatment (very crudely, 10 000 dollars per person on treatment)? Much of the hundred billion dollars of development assistance (roughly half) focused on about a dozen priority countries in eastern and southern African. The larger PEPFAR recipients, with populations of roughly 50 million, each received 5 billion dollars or more cumulatively. And there are further Global Fund contributions of an additional billion dollars in many of these countries. For 6 billion dollars per country, should we have expected more? The World Bank Human Capital Project posits that to maximize human capital formation, countries must ensure that their children survive, are well nourished and stimulated, learn skills and live long, productive lives. Using the Human Capital Index (a composite index based on these factors), South Africa ­ the largest HIV financing recipient ­ ranks 126th of 157 countries, below Haiti, Ghana, the Congo Republic, Senegal and Benin. Consider how many recipients of major HIV development finance fall into the bottom fifth: Namibia, Botswana, Eswatini (formerly Swaziland), Malawi, South Africa, Tanzania, Zambia, Uganda, Lesotho, Ethiopia, Mozambique, Cote D'Ivoire and Nigeria. Of course, causality is unresolved and there are several possible explanations: (1) low human capital formation may increase HIV transmission; (2) the HIV epidemic may have intergenerational impacts; (3) the all-consuming focus on HIV may have displaced other health, education and development priorities. yet, it remains hard to see these data and to argue that successful HIV responses among the largest HIV financing recipients strengthened their wider health sector and human development outcomes. A plausible principle emerges. Narrowly targeted disease-specific emergency responses may lead to disease-specific gains but do not improve governance or national systems capacity or wider disease or development outcomes. This is not to undermine the emergency origins of the HIV response; 2021 is not 2000 and it is unlikely that we would have 23 million people initiating treatment without an emergency response. yet, there are reasons (intensified by COVID), to suggest that we must pivot towards long-term, integrated, developmental, nationally owned and financed, systems-orientated responses ­ particularly when both development assistance and national budgets are likely to be constrained in an era of COVID.