[Application of " Internet Plus" AIDS prevention services among men who have sex with men in Guangzhou, China: results from 2010 to 2015].

Objective: To introduce the development strategy of " Internet Plus" AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods: A gay men's health column was created for an active website aimed at men who have sex with men(MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools(including scenario-based applications and HIV risk self-assessment systems)and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the " Internet Plus" concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the " Internet Plus" AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared(χ2)test, to roughly reflect the effect of"Internet Plus" AIDS prevention services. Results: As of 31 December 2015, a total of 34 395 MSM had received " Internet Plus" services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3%(301), 70.8%(283), 83.3%(334), 85.0%(538), 69.1%(420), and 83.8%(503)each year, respectively(trend χ2=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361)each year, respectively(trend χ2=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3%(240), 62.0%(248), 56.6%(227), 57.0%(361), 48.4%(294), and 43.7%(262)each year, respectively(trend χ2=42.21, P<0.001). Conclusion: The"Internet Plus"AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.

[Distribution of HIV-1 subtypes among foreign patients, in Guangzhou, between 2008 and 2010, and in 2015].

Objective: To understand the characteristic of subtype distribution among foreigners who were living with HIV-1, in Guangzhou. Methods: HIV-1 RNAs were extracted from 114 serum specimens in foreigners diagnosed with HIV-1 infections between 2008 and 2010, and in 2015. Partial pol gene of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) with nucleotide sequenced. Subsequently, phylogenetic tree was reconstructed using the pol sequences of samples and references. Results: Among all the 114 samples, 57.9% were from males and 42.1% from females, with an average age as 35.21 years old and the standard deviation as 9.63 years. A total of 6.8% of the samples were from Africans. The top three subtypes were identified as CRF02_AG, subtype G and subtype C, accounted for 30.7%, 14.9% and 12.3% respectively. Compared with samples gathered from 2008 to 2010, the proportions of subtype A1 and CRF01_AE significantly increased, while the other subtypes significantly decreased in 2015 (χ(2)=37.570; P=0.013, 99% CI: 0.010-0.016). Proportions of CRF01_AE and subtype G among males outnumbered the females but the proportions of subtype A1, CRF02_AG and URF among females appeared the other way round (χ(2)=15.528; P=0.029, 99%CI: 0.024-0.033). Proportions of CRF02_AG and subtype G among HIV-1 positive Africans were larger than those from other Southeast Asian countries or areas, However, the proportion of CRF01_AE among HIV-1 positive patients from Southeast Asian countries was higher than those patients from other areas (χ(2)=39.399; P=0.009, 99% CI: 0.006-0.011). The rates of resistance to any drug of protease inhibitors (PIs), reverse transcriptase inhibitors (RTIs), as well as to PIs, NRTIs, and NNRTIs alone, were 21.9%, 12.3%, 6.1% and 7.0%, respectively. One of nine CRF01_AEs from the HIV-1 positive patients were found closely clustered in those phylogenetic tree (bootstrap=0.855) samples, collected from local patients in Guangzhou. Conclusions: Our findings showed that these foreign subtypes had been spread to the natives, more from the Africans than from the other areas, in Guangzhou. These types of viruses were different from the strains identified locally, suggesting that they might have been brought in by foreigners living with HIV-1, in Guangzhou. Programs related to care, support and behavioral intervention for HIV positive foreigners living in Guangzhou, should be strengthened.