HIV, syphilis and behavioral risk factors among men who have sex with men in a drug-using area of southwestern China: Results of 3 cross-sectional surveys from 2013 to 2015.

To assess human immunodeficiency virus (HIV), syphilis, and behavioral risk factors among men who have sex with men (MSM) in southwestern China, where HIV started as a drug-driven epidemic, and shifted to mainly heterosexual transmission.These cross-sectional studies were conducted yearly in 2013, 2014, and 2015 in Guangxi, China. A total of 1,996, 1,965, and 1,697 participants were recruited in 2013, 2014, and 2015, respectively. The data included demographic and sexual behavioral variables. Other variables included individuals who used illegal drugs, and who received HIV counseling, testing, and free condoms, and peer education. Participants were tested for HIV, syphilis, and hepatitis C virus (HCV) with whole blood specimens. Questionnaires and laboratory testing data were double entered, and validated with EpiData software. The data were then transferred into SPSS software (SPSS Inc, Chicago, IL) and Chi-square test performed.The prevalence of HIV was 6.6% in 2013, 8.4% in 2014, and 11.2% in 2015. The prevalence of syphilis was 9.3% in 2013, 9.8% in 2014, and 6.1% in 2015. And HCV prevalence was 0.5% in 2013 and remained stable at 0.4% in 2014, and 2015. HIV infection, and associated factors among MSM in these 3 annual cross-sectional survey showed that HIV-infected MSM were significantly, more likely, to perform unprotected anal intercourse with any commercial male partners in the past 6 months (adjusted odds ratio [AOR] = 1.81, 95% CI: 1.50-2.20), had sex with any female partners in the past 6 months (AOR = 1.31, 95% CI: 1.01-1.71), used drugs in the past (AOR = 2.73, 95% CI: 1.30-5.71), and are syphilis infected (AOR = 3.53, 95% CI: 2.77-4.49).There is an urgent need for intervention strategies like condom distribution, HIV counseling, free testing, and education regarding safe sex, HIV, and other sex-related diseases in Guangxi to curb, and prevent HIV among MSM.

Acceptability of HIV testing using oral quick self-testing kit in men who have sex with men / 中华流行病学杂志

Objective To evaluate the acceptability of oral quick HIV self-testing in men who have sex with men (MSM).Methods From April 2013 to April 2014,MSM in Beijing and Nanning of China were recruited for an observational study including baseline survey and follow-up,including questionnaire survey,oral HIV self-testing and clinic-based HIV confirmation testing.The sensitivity and specificity of oral quick self-testing were evaluated through comparing the results of oral quick testing with blood testing.The acceptability and associated factors were evaluated by logistic model.Results A total of 510 MSM were recruited at baseline survey and 279 accepted follow-up.The sensitivity of the oral self-test was 86.00％ (43/50) and specificity was 98.23％ (445/453) at baseline survey.At baseline survey,78.63％ (401/510) of the MSM showed willingness to use oral quick HIV self-testing.The associated factors included unprotected anal intercourse with a regular male partner in the past 6 months (aOR=0.30,95％ CI:0.10-1.00) and preference of oral quick HIV self-testing (aOR=7.32,95％CI:1.61-33.31).At baseline survey,34.51％ (176/510) of the MSM reported that oral quick HIV self-testing was the preferred testing method rather than blood testing,which was associated with their birth places-urban area.Conclusion The acceptability of oral quick HIV self-testing in MSM in the two cities was high.

Effect of baseline CD4+ T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Changes in follicular helper T ( Tfh) cells and Tfh-related molecules during HIV-1 infection / 中华微生物学和免疫学杂志

Objective To analyze the changes in follicular helper T (Tfh) cells during HIV-1 in-fection, to investigate the influences of Tfh cells and Tfh-related molecules on HIV-1 progression and to pro-vide references for further research on using Tfh cells in highly active antiretroviral therapy ( HAART) and vaccines. Methods This study enrolled 33 patients with HIV-1 infection, including 11 long-term nonpro-gressors (LTNP), 10 rapid progressors (RP) and 12 typical progressors (TP), and 11 healthy subjects (normal controls, NC). Peripheral blood mononuclear cells were isolated from each subject. Multicolor flow cytometry was performed to detect CD4+CD45RA-CXCR5+Tfh and CD4+CD45RA-CXCR3-CXCR5+PD-1+Tfh subsets and the levels of inducible costimulatory molecule (ICOS), IFN-γ and IL-21. Moreover, the levels of IL-10 and the percentages of CD19+B cells in plasma samples of each group were also analyzed. Relationships among Tfh, CD4 and B cells were analyzed. Results The percentages of both Tfh subsets were higher in patients with HIV-1 infection than in NC. Compared with NC, LTNP had the highest percent-age of CD4+CD45RA-CXCR3-CXCR5+PD-1+Tfh cells (P<0. 05). Expression of Tfh-related molecules ICOS, IFN-γ and IL-21 were enhanced significantly upon Staphylococcus enterotoxin B ( SEB) stimulation, ICOS+Tfh cells were negatively related with HIV-1 progression, but had a positive correlation with CD19+B cells (r=-0. 49, P<0. 01; r=0. 60, P<0. 05). IL-10 level in plasma increased significantly in patients withHIV-1 infection , especially in TP and RP ( TP vs NC : P＜0. 01 ; RP vs NC : P<0. 05 ) . Conclusion HIV-1 patients and NC had significant differences in the expression of Tfh cells and Tfh-related molecules in peripheral blood. ICOS+Tfh cells were closely related to the progression of HIV-1 infection and the function of B cells.

Acceptability of HIV testing using oral quick self-testing kit in men who have sex with men / 中华流行病学杂志

Objective: To evaluate the acceptability of oral quick HIV self-testing in men who have sex with men (MSM). Methods: From April 2013 to April 2014, MSM in Beijing and Nanning of China were recruited for an observational study including baseline survey and follow-up, including questionnaire survey, oral HIV self-testing and clinic-based HIV confirmation testing. The sensitivity and specificity of oral quick self-testing were evaluated through comparing the results of oral quick testing with blood testing. The acceptability and associated factors were evaluated by logistic model. Results: A total of 510 MSM were recruited at baseline survey and 279 accepted follow-up. The sensitivity of the oral self-test was 86.00% (43/50) and specificity was 98.23% (445/453) at baseline survey. At baseline survey, 78.63% (401/510) of the MSM showed willingness to use oral quick HIV self-testing. The associated factors included unprotected anal intercourse with a regular male partner in the past 6 months (aOR=0.30, 95%CI: 0.10-1.00) and preference of oral quick HIV self-testing (aOR=7.32, 95%CI: 1.61- 33.31). At baseline survey, 34.51% (176/510) of the MSM reported that oral quick HIV self-testing was the preferred testing method rather than blood testing, which was associated with their birth places-urban area. Conclusion: The acceptability of oral quick HIV self- testing in MSM in the two cities was high.

Effect of baseline CD(4)(+) T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015 / 中华流行病学杂志

Objective: To investigate the effect of baseline CD(4)(+) T cell count (CD(4)) on drop-out of antiretroviral therapy (ART) in HIV infected persons. Methods: Retrospective cohort was conducted in this study. HIV infected persons aged≥18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System, with follow-up conducted till May 30, 2016. Cause-specific Cox proportional hazard models were used to evaluate effect of different CD(4) on the drop-out of ART in the HIV infected persons. Results: A total of 58 502 eligible study participants were included in this retrospective cohort study. The average drop-out ratio was 4.8/100 person-years. After controlling the following baseline covariates: age, sex, marital status, route of HIV infection, WHO clinical stage before ART, initial/current ART regiment, ART regiment adjustment, and year of initiating ART for potential confounding, the adjusted HR of drop-out for HIV infected persons with 200- cells/μl, 351-cells/μl and ≥500 cells/μl were 1.110 (95%CI: 1.053-1.171, P<0.001), 1.391 (95%CI: 1.278-1.514, P<0.001) and 1.695 (95%CI: 1.497-1.918, P<0.001), respectively, in risk for drop-out compared with those with baseline CD(4)<200 cells/μl. Among the HIV infected persons, 56.0% (1 601/2 861) of drug withdrawal was due to poor compliance with medication. Conclusions: With the increase of baseline CD(4) when initiating ART, the risk for the drop-out in HIV infected persons increased significantly. To further reduce the drop-out of ART, it is important to take CD(4) into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Influential factors analysis on the survival time of patients infected with tuberculosis and HIV / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the predictors that reduced the survival time on HIV positive TB patients during their first year's anti-TB therapy.</p><p><b>METHODS</b>A retrospective study was conducted to review 519 TB/HIV co-infection patients from an Internet based TB surveillance system. We collected information of demography, HIV status, CD4+ lymphocytes count, antiretroviral therapy (ART), sputum smear results of diagnosis and around 2 months' initiation of anti-TB therapy, et al. Wilconxon rank sum test was used to compare the difference of age and CD4+ lymphocytes, count and Cox Uni-variable, and Multi-variable analysis were used to compare the different distribution of rest of risk elements between the groups of death and survival; survival function also has been used to evaluate the top 4 risk elements that have made negative impact on the survival time of HIV positive TB patients during their first year's anti-TB therapy.</p><p><b>RESULTS</b>Among 519 TB/HIV patients, 84 (16.18%) were dead, 435 (83.82%) survived. Median age (P50 (P25-P75)) in survival was 51.0 (41.0-65.0), while in death was 45.0 (35.0-60.0) (U=-2.68, P=0.007). There was significant difference between survival and death. Median CD4+ lymphocyte count in survival and death (P50 (P25-P75)) were 69.00 (26.00-131.20) and 114.50 (35.00-245.00), respectively, significant difference also has been observed. Based on the Cox analysis, patients with less than 2 months' intensive anti-TB therapy, poor treatment adherence, less than 4 months continue anti-TB therapy and sputum smear positive around 2 months initiation of anti-TB therapy had higher risk of death, the Relative Risk value (RR) were 1 100.40 (95% CI: 105.62-11,470.00), 52.91 (95% CI: 27.42-102.13), 49.43 (95% CI: 6.38-382.81), and 15.83 (95% CI: 2.55-98.40), respectively. Log-rank test results showed that there were significant difference between survival and death groups with anti-TB intensive therapy duration (Log-Rank value was 236.0, P<0.001), adherence (Log-Rank value was 302.9, P<0.001), and sputum smear results around 2 months' anti-TB initiation (Log-Rank value was 7.55, P=0.006).</p><p><b>CONCLUSION</b>Known HIV positive, less CD4+ lymphocyte count, not initiation of ART, sputum smear positive, around 2 months' initiation of anti-TB therapy, not enough anti-TB therapy duration of intensive and continue period and poor treatment adherence were the predictors of death of HIV positive TB patients in the first year's anti-TB therapy.</p>

Efficacy of antiviral therapy on prevention of HIV transmission among sero-discordant couples in Guangxi Zhuang autonomous region / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the efficacy of antiviral therapy on prevention of HIV transmission and to assess the feasibility of treatment-as-prevention strategy in public health practice, among sero-discordant couples in Guangxi Zhuang autonomous region (Guangxi).</p><p><b>METHODS</b>Data was gathered through the AIDS prevention and control information system in Guangxi from January 1, 2008 to December 31, 2014, on HIV sero-discordant couples. Time-dependent Cox Model was used to analyze the efficacy of antiviral treatment.</p><p><b>RESULTS</b>A total of 7 694 sero-discordant couples were followed and 394 appeared positive from those negative spouses. The overall HIV positive seroconversion rate was 2.5 (2.2-2.7) /100 person-year. The HIV positive sero-conversion rates were 4.3 (3.7-4.8) /100 person-year in the untreated cohort and 1.6 (1.4-1.9) per 100 person-year in the treated cohort. Rate of HIV transmission declined by 51% in the treated cohort (HR=0.49, 95%CI: 0.40-0.60) but appeared as 45% (AHR=0.55, 95%CI:0.43-0.69) after adjusting for factors as sex, age, education, marital status, occupation, transmission route and baseline CD4(+)T lymphocyte cell count. The rate of reduction in transmission was significant among couples in which the HIV-positive spouses showing the following features as: aged ≥25 years, married, farmers, with educational level of junior high school or below, baseline CD4(+)T lymphocyte cell count <500 cells/mm(3) and infection was through heterosexual intercourse.</p><p><b>CONCLUSION</b>Antiviral therapy as a prevention strategy among sero-discordant couples seemed feasible and effective in Guangxi. Expansion of the coverage on antiviral therapy would reduce the spread of HIV in married couples.</p>

Investigation of a family clustering of human infection with avian influenza A (H7N9) virus in Nanning, Guangxi / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the transmission mode of human infection with avian influenza A (H7N9) virus.</p><p><b>METHODS</b>Field epidemiological investigation was conducted for a family clustering of human infection with H7N9 virus in Hengxian county, Guangxi Zhuang Autonomous Region in February 2014. Two patients and their 82 close contacts were surveyed. The samples collected from the patients, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction (rRT-PCR), and the samples from patients were used for virus isolation. The samples from 5 close contacts were tested with RT-PCR. The clinical data, exposure histories of the patients and the detection results of the isolates and their homology were analyzed.</p><p><b>RESULTS</b>Patient A became ill 4 days after her last exposure to poultry in Zhongshan, Guangdong province, and returned to her hometown in Hengxian 2 days after onset. Patient B was patient A's 5 years old son, who had no known exposure to poultry but slept with patient A for 4 days. He developed symptoms 4 days after last contact with his mother. Two strains of H7N9 virus were isolated from the two patients. The 2 isolates were highly homogenous (almost 100%) indicated by gene sequencing and phylogenetic tree. None of the other 81 close contacts developed symptoms of H7N9 virus infection.</p><p><b>CONCLUSION</b>Patients B was infected through close contact with patient A, indicating that avian H7N9 virus can spread from person to person, but the transmissibility is limited and non-sustainable.</p>

Feature analysis on patients died from co-infection of Mycobacterium tuberculosis and human immunodeficiency virus in Guangxi,from 2007 to 2012 / 中华流行病学杂志

Objective To understand the general feature of patients with Mycobacterium tuberculosis(MTB)and human immunodeficiency virus(HIV)co-infectious(TB/HIV)in Guangxi, from 2007 to 2012. Methods Information regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System,together with bacterium smear or culture results,onset of TB,time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death,age,occupation,the underlying cause of death among TB patients, bacterium distribution,average age of death,interval from onset to death,percentage of TB/HIV co-infection patients among all the patients etc,were all analysed. Results 203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24%(ranging from 3.94%in 2007 to 13.27%in 2012)among all the deaths of HIV infection while it accounted for 9.90%(ranging from 2.56%to in 2007 to 26.88%in 2012)among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66%(ranging from 8.83% to 13.27%) and 22.17%(ranging from 20.60% to 26.88%) among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1,with the average age of death as 44.65 (44.65 ± 15.52)years;median time from TB symptoms onset to diagnosis as 37(mean 94.31,standard deviation 206.07)days,record as(94.31 ± 206.07);median time from diagnosis to death as 46(165.22 ± 282.19)days,54.68%TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 (257.68 ± 340.79) days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases. Conclusion Compare to those TB patients without HIV,less bacterium evidence was found in TB/HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years,suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.

Feature analysis on patients died from co-infection of Mycobacterium tuberculosis and human immunodeficiency virus in Guangxi,from 2007 to 2012 / 中华流行病学杂志

Objective To understand the general feature of patients with Mycobacterium tuberculosis(MTB)and human immunodeficiency virus(HIV)co-infectious(TB/HIV)in Guangxi, from 2007 to 2012. Methods Information regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System,together with bacterium smear or culture results,onset of TB,time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death,age,occupation,the underlying cause of death among TB patients, bacterium distribution,average age of death,interval from onset to death,percentage of TB/HIV co-infection patients among all the patients etc,were all analysed. Results 203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24%(ranging from 3.94%in 2007 to 13.27%in 2012)among all the deaths of HIV infection while it accounted for 9.90%(ranging from 2.56%to in 2007 to 26.88%in 2012)among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66%(ranging from 8.83% to 13.27%) and 22.17%(ranging from 20.60% to 26.88%) among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1,with the average age of death as 44.65 (44.65 ± 15.52)years;median time from TB symptoms onset to diagnosis as 37(mean 94.31,standard deviation 206.07)days,record as(94.31 ± 206.07);median time from diagnosis to death as 46(165.22 ± 282.19)days,54.68%TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 (257.68 ± 340.79) days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases. Conclusion Compare to those TB patients without HIV,less bacterium evidence was found in TB/HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years,suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.

Feature analysis on patients died from co-infection of Mycobacterium tuberculosis and human immunodeficiency virus in Guangxi, from 2007 to 2012 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the general feature of patients with Mycobacterium tuberculosis (MTB) and human immunodeficiency virus (HIV) co-infectious (TB/HIV) in Guangxi, from 2007 to 2012.</p><p><b>METHODS</b>Information regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System, together with bacterium smear or culture results, onset of TB, time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death, age, occupation, the underlying cause of death among TB patients, bacterium distribution, average age of death, interval from onset to death, percentage of TB/HIV co-infection patients among all the patients etc, were all analysed.</p><p><b>RESULTS</b>203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24% (ranging from 3.94% in 2007 to 13.27% in 2012) among all the deaths of HIV infection while it accounted for 9.90% (ranging from 2.56% to in 2007 to 26.88% in 2012) among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66% (ranging from 8.83% to 13.27%)and 22.17% (ranging from 20.60% to 26.88%)among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1, with the average age of death as 44.65 (44.65 ± 15.52) years;median time from TB symptoms onset to diagnosis as 37 (mean 94.31, standard deviation 206.07) days, record as (94.31 ± 206.07); median time from diagnosis to death as 46 (165.22 ± 282.19) days, 54.68% TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 (257.68 ± 340.79) days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases.</p><p><b>CONCLUSION</b>Compare to those TB patients without HIV, less bacterium evidence was found in TB/HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years, suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.</p>

Sildenafil use and relevant risk factors among middle-aged or elderly male clients of female commercial sex workers in the central areas of Guangxi, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the illegal sidenafil use among middle-aged and elderly male clients of female sex workers (FSWs) in central region of Guangxi as well as on related risk factors. Initial evaluation regarding the effect of illegal sidenafil use on HIV infection among the middle-aged and elderly men was also conducted.</p><p><b>METHODS</b>A survey was conducted among the over 50-year-olds male clients of low-grade prostitutions in central areas of Guangxi. Information on demographics, related behavior, and illegal sidenafil use was collected. 5 ml blood sample were taken to test antibodies of HIV and syphilis. PASW Statistics 18.0 was used for data analysis.</p><p><b>RESULTS</b>2 056 questionnaires were completed. 23.1% of the participants said they had ever used illegal sidenafil. The risk of sildenafil use was low among the male clients who were not over 60 years old (OR = 0.586, 95% CI:0.459-0.749). The risks of sildenafil use among the male clients with frequencies(in the past 30 days) of having commercial sex behavior were:only once (OR = 0.184, 95%CI:0.090- 0.378), twice (OR = 0.187, 95%CI:0.089-0.378) or three times (OR = 0.181, 95%CI: 0.085-0.384) lower than those with more than five times. Being single (OR = 0.608, 95% CI: 0.396-0.933), married/cohabiting (OR = 0.533, 95% CI:0.391-0.727), having unstable partners (OR = 0.558, 95%CI:0.393-0.792) seemed to be protective on those who used sildenafil, among the study population. Factors as 'never use the condom (OR = 1.642, 95%CI:1.125-2.397) or 'seldom use as condom (OR = 1.840, 95%CI:1.278-2.648) when having commercial sex, were under high risk among the sildenafil users. Forty-seven subjects were HIV positive, with the prevalence as 2.29% in this study population. Male clients of the FSWs who used sidenafil were under 60 years of age and with higher risk of HIV infection.</p><p><b>CONCLUSION</b>people who were ≥60 years old, divorced/widowed/ separated, with frequencies (in the past 30 days) of having commercial sex more than 5 times, never or occasionally using a condom when having commercial sex etc., appeared at high risk. Middle-aged and elderly male clients who used sildenafil or sildenafil-like drugs were under high risk of contracting HIV infection.</p>

The role of RNA pooling technique in the diagnosis of acute HIV infection and the estimation on HIV incidence among low-grade-venues female sex workers / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the feasibility of RNA pooling technique in the diagnosis on acute HIV infection among female sex workers (FSWs) working at the low-grade venues.</p><p><b>METHODS</b>Plasma samples from the low-grade-venue FSWs in Guangxi, in 2011 were tested for HIV antibody using the rapid testing method. All samples which were HIV antibody negative in the rapid testing were tested for HIV RNA with RNA pooling technique. FSWs who showed HIV RNA positive were tested for HIV antibody by Western blot method in 3 months. The HIV incidence in the low-grade venue FSWs was counted under the estimation formula.</p><p><b>RESULTS</b>There were 6 469 cases of FSWs who were recruited in this study. Through rapid testing, results showed that HIV antibody was positive in 139 cases, with the positive rate as 2.15%. 6 330 FSWs with HIV antibody negative were tested by HIV RNA pooling method, with 7 of them showing HIV RNA positive, in which 6 cases showed HIV-1 antibody seroconversion, thus were diagnosed as acute HIV infection. HIV incidence in low-grade FSWs appeared to be 1.45 per 100 person years (95%CI:1.17-1.76 per 100 person years) in Guangxi.</p><p><b>CONCLUSION</b>Other than regular routine HIV antibody testing, it seemed necessary to adopt the HIV RNA pooling strategy in high-risk groups such as FSWs, so as to early detect the HIV infection and to timely perform the intervention or treatment programs to prevent sexual transmission of HIV.</p>

Investigation of Household Lavatories in Countryside of Guangxi Province / 环境与健康杂志

Objective To know the current status of the household lavatories in the countryside of Guangxi Province, China and to present the scientific data for the government to make decision in the lavatory improvement in the countryside. Methods A stratified cluster sampling was used in the investigation and 2 414 peasant households in 241 villages were selected in 2006. Results The popularization rate of sanitary lavatory was 43.79% and 50.95% of the peasant households used the non-sanitary lavatory, 5.26% had no household lavatory. The main types of the sanitary lavatories used in the investigated area were firedamp tank-like and three-case-cesspool, accounted for 50.14% and 33.96% respectively. The rate of dejecta treatment for the non-sanitary lavatories was only 13.74%. As the money spent on the sanitary lavatory in each household was no less than 810 Yuan (RMB), maybe the popularization rate of the sanitary household lavatory could reach 50%. Conclusion Although the popularization rate of sanitary household lavatory in the countryside of Guangxi province significantly increased in recent years, it still does not fulfill the requirement for controlling the intestinal infectious diseases and parasitism in this area.

Survey on Environmental Lead Pollution in Rural Areas around Lead-zinc Mining Area in Guangxi,2008 / 环境与健康杂志

Objective To know the environmental lead pollution status of rural areas around the mining area in Guangxi,2008.Methods From August to December,2008,the survey was carried out in 28 villages of 4 counties,which were located in basin of three rivers and their tributaries.Six lead-zinc-tin mines were situated in the investigated area.The local samples were collected,including 101 rice samples,30 paddy samples,59 vegetable samples and 45 samples of meat,viscera of poultry,5 fish samples,and 27 surface water samples,12 ground water samples,13 drinking water samples,29 cropland soil samples.The lead content of them were determined,the dietary survey on lead intake was performed among the residents living near the mining area also.Results 53.68%(102/190) of the crop samples revealed higher lead contents,which were over the standard limit,especially for rice(47.52%) and leafy vegetables(100%).The lead contents for five eggs samples,two peanuts samples and thirteen fresh corns were qualified.36%(102/190)of the samples of meat and viscera of poultry revealed higher lead contents,which were over the standard limit,especially for liver and chicken intestine.The lead intake only through rice and vegetables reached 4.55 mg in one week,which was over the tolerance dose by 0.52 times.Conclusion The lead intake of the residents living near the lead-zinc mining area are mainly from crop and vegetables and poultry.Environmental lead pollution is serious in the investigated area and must be controlled as possible as early.

Drinking Water Quality Analysis of Provide for Oneself Water Supply in Rural Schools,Guangxi from 2007 to 2008 / 环境与健康杂志

Objective To know the current situation of drinking water quality and the influencing factors of provided for oneself water supply in rural schools in Guangxi.Methods According to the randomly proportionate stratification (economic,geography and topography etc.),43 and 50 counties were selected in 2007 and 2008 and the monitoring sites from 3 rural schools with provided for oneself water supply facility were taken out based on the proportion of water sources and technical patterns coverage in each county.The survey on water supply technical patterns,water sources and their coverage was conducted.One hundred and thirty,one hundred and fifty-three monitoring sites in rain season (July or August) and dry season (March or November) were monitored separately in 2007 and 2008.The monitoring results of drinking water were assessed according to Sanitary Standards for Drinking Water Quality (GB5749-2006).Results The groundwater was main drinking water source,which were 84.03% and 90.75% in 2007 and 2008.Most of water supply had not any water treatment,which was 75.86% in 2007 and 64.22% in 2008.The qualified rate in rain season (18.02%) was significant lower than dry season (31.80%) (P

Water Quality Analysis for Centralized Drinking Water Supply Projects in Rural Areas,Guangxi in 2008 / 环境与健康杂志

Objective To investigate the quality of drinking water produced by safe drinking water projects in rural areas of Guangxi.Methods A survey of water quality was conducted from January to October 2008,in the drinking water projects funded by treasure bonds in 89 counties (cities and districts) of Guangxi.The water samples were collected from waterworks and tap water in dry season (March) and rainy season (July to August),respectively,and evaluated for aesthetic,microbiologic and chemical indexes.Results A total of 1 327 drinking water projects were surveyed.58.25% had a daily output under 100 tons,and only 2.71% had an output over 1 000 tons (enough for 10 000 persons).Only 12.28% adopted comprehensive water treatment process (i.e.coagulation,sedimentation,filtration and disinfection),whereas 62.85% did not provide any treatment.Up to 79.80% had no disinfection equipment and 90% failed to provide effective disinfection.25.21% and 21.48% of finished water,and 25.78% and 20.59% of tap water samples tested up to the standard respectively in the dry season and rainy season.Over 88% of water samples met the aesthetic,chemical and toxicological standards (100% up to standard for chronic,arsenic and fluoride),while 73.16%-80.78% met the standard for bacterial count,30.86%-36.17% for fecal coliforms and 41.86%-47.73% for thermotolerant coliforms.Conclusion The study results indicate that the inadequate supply of safe water,absence of water treatment facilities and poor drinking water quality have represented a potential health risk in Guangxi rural areas.

The Study on the Relationship of MS with BMI and WC in Residents of Urban and Rural in Guangxi / 中国慢性病预防与控制

Objective To explore the relationship of metabolic syndrome(MS)with body mass index(BMI)and waist circumference(WC)in residents of urban and rural in Guangxi.Methods According to the method of multistage stratified randomized cluster sampling confirmed in ″The Nutrition and Health Status of the Chinese People,2002″,2 970 urban and rural people(aged ≥18 years)were selected from 4 cities and 4 countries in Guangxi and their body height,weight,waist circumference and laboratory tests were investigated.Results The prevalence rate of MS was 3.77%,and the urban rate(5.56%)was higher than that of the rural(2.05%),male's rate(4.99%)was higher than female's(2.68%).The prevalence rates of MS in groups with BMI

The Study on the Relationship between Nutrients Intake and Metabolic Syndrome in Urban and Rural Residents in Guangxi / 中国慢性病预防与控制

Objective To explore the relationship between nutrients intake and the prevalence of metabolic syndrome(MS) in urban and rural residents in Guangxi.Methods 3026 people aged 18 years and above were sampled at random from 4 cities and 4 countries in Guangxi with a multistage stratified sampling.All subjects took the diet investigation with 24-hours review method,medical examination and blood assay.Results 107 subjects(3.54%) suffered from MS,and the prevalence rate in city(5.21%) was significantly higher than that in countryside(1.90%,P