Study on the mortality and risk factors among HIV-infected individuals during 1989-2011 in Dehong prefecture, Yunnan province / 中华流行病学杂志

Objective To examine the mortality and risk factors among HIV-infected patients during 1989-2011 in Dehong prefecture,Yunnan province.Methods All HIV-infected patients reported during 1989-2011 in Dehong prefecture who held local residency were included in the study.Mortality rates and cumulative survival rates were calculated.Multiple regression analysis under Cox proportional hazard model was conducted to examine the risk factors for deaths.Results A total of 13 006 HIV-infected patients were included in this study including 73.2％ males,79.1％ peasants and 48.7％ married at the time of reporting.64.5％ of the patients were ethnic minorities,and 68.7％ were illiterate or having received only primary school education.All the patients were followed-up for a total of 55 962.30 person-years with 4648 patients died,with overall mortality rate as 8.31/100person-years.The mortality rate had been increasing from 1990 to 2004 but decreasing since 2005.The average survival time since the identification of HIV infection was 9.48 years overall,and was 16.65 years for those having received antiretroviral treatment (ART) and 7.67 years for those without ART.Data from multiple regression analysis indicated that ART and socio-demographic characteristics such as age,gender,ethnicity,occupation,marital status,education background etc.were significantly associated with death among HIV-infected patients.Conclusion The comprehensive AIDS campaigns including ART had significantly reduced the deaths among HIV-infected patients in Dehong prefecture.More efforts on the scaling up program of ART as well as the enhanced management and follow-up program tailored for HIV-infected patients with different sociodemographic characteristics were needed to further reduce the deaths in the area.

Survey on contact tracing of newly reported HIV infections in 2009 in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore a new method for finding more HIV/AIDS.</p><p><b>METHODS</b>In September 2009, newly reported HIV-infected individuals from May to August, 2009 in Dehong prefecture were asked to participate in a survey which requested demographic characteristics, history of high-risk behaviors and contact information of individuals with whom they had high risky contacts. People with risky contacts with HIV-infected cases (index cases) were also approached to participate in this survey and HIV testing was provided.</p><p><b>RESULTS</b>A total of 342 HIV-infected individuals were newly reported and served as index cases from May to August, 2009. Among them, 47.1% (161/342) were transmitted by regular sexual partners. Through three-round surveys, 218 contacts were traced and among them, 84.9% (185/218) were traced by regular heterosexual partners. HIV positive rate of the tested was 34.7% (60/173) in the first-round tracing and 12.5% (1/8) in the second one. Among the 560 individuals (index cases and their high-risk contacts), the proportions of having regular heterosexual partners, non-regular and non-commercial sexual partners, commercial sexual heterosexual partners and men having sex men were 87.9% (492/560), 18.9% (106/560), 22.3% (125/560) and 0.3% (1/318), respectively, while the proportion of having never used condoms when having sex with the above four types sexual partners were 73.8% (363/492), 72.6% (77/106), 63.2% (79/125) and 0.0% (0/1), respectively.</p><p><b>CONCLUSION</b>As an epidemiological method for HIV/AIDS finding, contact tracing identified a large number of HIV infectors who were traced by newly reported HIV-infected individuals.</p>

Incidence and risk factors of HIV infection among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the HIV incidence and risk factors among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province.</p><p><b>METHODS</b>A cohort of sero-negative spouses of the HIV patients had been developed and followed up since November, 2005. HIV new infections and related behaviors had been investigated every six months.</p><p><b>RESULTS</b>By the end of June, 2008, 790 sero-negative spouses of HIV patients had been recruited, of whom 702 were followed-up for at least one time. During the total 1202.35 person-years, 31 new HIV infections were identified, with an overall incidence of 2.58/100 person-years. The HIV incidence rates were 2.22/100 person-years in 2006, 2.95/100 person-years in 2007 and 2.74/100 person-years in 2008. Data from the Cox proportional hazard regression model indicated that those who resided in Yingjiang county [hazard ratio (HR) = 4.37, 95%CI: 1.48 - 12.90, P = 0.008], ever using drugs (HR = 3.49, 95%CI: 1.09 - 11.18, P = 0.035), or having an HIV-infected spouse who never exposed to antiretroviral treatment (HR = 3.60, 95%CI: 1.41 - 9.16, P = 0.007) were at higher risk for HIV infection.</p><p><b>CONCLUSION</b>Sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province had a relatively high incidence of HIV new infection during 2006-2008. More efforts should put on those people living in these areas, having a history of drug use or having an HIV-infected spouse who had never been exposed to antiretroviral treatment.</p>

Tracing the sources of newly reported HIV infections in Dehong prefecture of Yunnan province / 中华流行病学杂志

Objective To trace and provide HIV-testing among those having contacts with HIV-infected individuals at various levels in Dehong prefecture, Yunnan province and to evaluate the effectiveness and feasibility of such investigation as a supplemental strategy for HIV testing and control. Methods Newly reported HIV infections from August throughout October in Dehong prefecture, in 2008 were asked to provide contact information of persons whom they had high risk contacts with. Persons having had risk contacts with HIV-infected cases were hereof interviewed and their blood tested on the sero-status of HIV. Results A total of 335 HIV cases were newly reported during this three-month period. A total of 309 cases of them and 148 HIV infections identified thereafter from their risk contacts were under informed consent, to participate in this study. A total number of 3395 risk contacts were reported, of whom only 20.7% (704/3395) had 'contact information' and 51.3% (361/704) were successfully located and interviewed, including 117 previously confirmed HIV infections and 244 people with unknown HIV status. The majority of them (203 or 83.2% of 244) were then tested for HIV and 56(27.6% of 203) were tested positive for HIV. The proportion of having detailed contact information and the proportion of being traced or followed among reported risk contacts of HIV infections were 68.8% and 68.2% for spouses of HIV patients, respectively, which were much higher than those among commercial sex partners (1.2% and 16.7%), casual sex partners (37.3% and 22.3% ) and peers who sharing needles (34.1% and 56.4% ). Conclusion Newly reported HIV infections reported a large number of risk contacts and new HIV infections were identified among them. It was extremely difficult to trace commercial sex partners or casual sex partners on their HIV infection status. Nevertheless, tracing the risk contacts of newly reported HIV infections seemed to be helpful in identifying new HIV infections and in understanding the nature of transmission towards controlling the HIV epidemics.

Incidence and risk factors of HIV infection among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province / 中华流行病学杂志

Objective To study the HIV incidence and risk factors among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province. Methods A cohort of sero-negative spouses of the HIV patients had been developed and followed up since November, 2005.HIV new infections and related behaviors had been investigated every six months. Results By the end of June, 2008, 790 sero-negative spouses of HIV patients had been recruited, of whom 702 were followed-up for at least one time. During the total 1202.35 person-years, 31 new HIV infections were identified, with an overall incidence of 2.58/100 preson-years. The HIV incidence rates were 2.22/100person-years in 2006, 2.95/100 person-years in 2007 and 2.74/100 person-years in 2008. Data from the Cox proportional hazard regression model indicated that those who resided in Yingjiang county [hazard ratio (HR) =4.37, 95% CI: 1.48-12.90, P=0.008] , ever using drugs (HR=3.49, 95% CI:1.09-11.18, P=0.035) , or having an HIV-infected spouse who never exposed to antiretroviraltreatment (HR=3.60, 95% CI: 1.41-9.16, P=0.007) were at higher risk for HIV infection.Conclusion Sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province had a relatively high incidence of HIV new infection during 2006-2008. More efforts should put on those people living in these areas, having a history of drug use or having an HIV-infected spouse who had never been exposed to antiretroviral treatment.

Incidence and risk factors of HIV infection among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province / 中华流行病学杂志

Objective To study the HIV incidence and risk factors among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province. Methods A cohort of sero-negative spouses of the HIV patients had been developed and followed up since November, 2005.HIV new infections and related behaviors had been investigated every six months. Results By the end of June, 2008, 790 sero-negative spouses of HIV patients had been recruited, of whom 702 were followed-up for at least one time. During the total 1202.35 person-years, 31 new HIV infections were identified, with an overall incidence of 2.58/100 preson-years. The HIV incidence rates were 2.22/100person-years in 2006, 2.95/100 person-years in 2007 and 2.74/100 person-years in 2008. Data from the Cox proportional hazard regression model indicated that those who resided in Yingjiang county [hazard ratio (HR) =4.37, 95% CI: 1.48-12.90, P=0.008] , ever using drugs (HR=3.49, 95% CI:1.09-11.18, P=0.035) , or having an HIV-infected spouse who never exposed to antiretroviraltreatment (HR=3.60, 95% CI: 1.41-9.16, P=0.007) were at higher risk for HIV infection.Conclusion Sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province had a relatively high incidence of HIV new infection during 2006-2008. More efforts should put on those people living in these areas, having a history of drug use or having an HIV-infected spouse who had never been exposed to antiretroviral treatment.

Incidence and risk factors on HIV infection among injection drug users in Dehong prefecture area of Yunnan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the incidence and risk factors on HIV infection among injection drug users (IDU) in Dehong prefecture area of Yunnan province.</p><p><b>METHODS</b>An epidemiological cohort of HIV-negative IDU had been developed and followed since October, 2004. HIV new infections and related behaviors had been investigated every six months.</p><p><b>RESULTS</b>By the end of 2008, 760 HIV-negative IDU had been recruited and followed for a total of 1153.6 person-years. 47 new HIV infections were identified, with an overall incidence of 4.07/100 person-years during the follow-up period. The HIV incidence was 4.45/100 person-years during 2004 - 2006, 4.50/100 person-years in 2007 and 2.54/100 person-years in 2008. Both the behavior of drug injection and the HIV incidence among the cohort had substantially decreased during the follow-up period. Multiple regression analysis using Cox proportional hazard model indicated that people with Jing-po ethnicity (Hazard ratio, HR = 2.56, 95%CI: 1.06 - 6.19) and other minorities except for Dai (HR = 3.26, 95%CI: 0.89 - 11.96) were at higher risk for HIV infection than the people with Han ethnicity. People injecting drugs with (HR = 2.27, 95%CI: 0.98 - 5.25) or without (HR = 5.27, 95%CI: 2.25 - 12.34) needle sharing were at higher risk for HIV infection than those reporting having no drug injection behavior during the follow-up period.</p><p><b>CONCLUSION</b>Both the behavior of drug injection and the HIV incidence among former IDU in Dehong prefecture area of Yunnan province had been decreasing during the four years. However, needle sharing remained the most important risk factor for HIV new infection among IDUs. IDUs with different ethnicities seemed to have different risks towards HIV infection.</p>