Repeat HIV Testing and Incident Rates among Individuals Attending Voluntary Counseling and Testing Clinics in Wuxi, China: A Retrospective Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>We aimed to elucidate the rates of repeat HIV testing and incident HIV diagnosis, and baseline CD4+ T cell count among individuals attending HIV voluntary counseling and testing (VCT) clinics in Wuxi, China.</p><p><b>METHODS</b>A repeat HIV testing within 12 months was recorded if individuals had their first test with negative results, during 2013-2014 and retested within 12 months. An incident HIV diagnosis was recorded if individuals had their first test with negative results, during 2013-2015 and had a subsequent positive result at any point by the end of 2015. Data on HIV testing and diagnosis among individuals attending 32 VCT clinics from 2013 to 2015 and HIV diagnosis from other clinical services in Wuxi, China, were retrieved. A multivariate logistic regression model was used to analyze factors associated with repeat HIV testing. Cox regression was used to evaluate factors associated with incident HIV diagnosis.</p><p><b>RESULTS</b>From 2013 to 2014, 11,504 individuals tested HIV negative at their first recorded test, with 655 (5.7%) retesting within 12 months. Higher repeat HIV testing within 12 months was associated with male gender [adjusted odds ratio (aOR) = 1.7, 95% confidence interval (CI): 1.4-2.2], risk behaviors [commercial heterosexual behaviors (aOR = 1.4, CI: 1.1-1.6), male-male sexual behaviors (aOR = 3.7, CI: 2.7-4.9)], injection drug use (aOR = 9.9, CI: 6.5-15.1), and having taken HIV tests previously (aOR = 2.0, CI: 1.6-2.4). From 2013 to 2015, 1,088 individuals tested negative on HIV test at their visit and at ⋝ 2 subsequent tests; of them 30 had incident HIV diagnosis. The overall rate of incident HIV diagnosis among all VCT individuals was 1.6 (95% CI: 1.1-2.1) per 100 person-years. Incident HIV diagnosis was associated with male gender [adjusted hazard ratio (aHR) = 8.5, 95% CI: 1.9-38.1], attending hospital-based VCT clinics (aHR = 7.8, 95% CI: 1.1-58.3), and male-male sexual behavior (aHR = 8.4, 95% CI: 1.5-46.7). Individuals diagnosed at VCT clinics had higher CD4+ T cell count compared with those diagnosed at other clinical services (median 407 vs. 326 copies/mm3, P = 0.003).</p><p><b>CONCLUSION</b>VCT individuals in Wuxi, China, had a low repeat HIV testing rate and high HIV incidence. VCT-clinic-based interventions aimed at increasing repeat HIV testing are needed to detect more cases at an earlier stage, especially among individuals at high risk for HIV infection such as men who have sex with men.</p>

[Study on risk assessing indicator system after schistosomiasis transmission interruption in Wuxi City].

OBJECTIVE: To establish a risk assessing indicator system after the transmission interruption of schistosomiasis in Wuxi City, so as to provide evidences for formulating strategies on schistosomiasis control and prevention. METHODS: A primary risk assessing indicator system was established based on the literature review. Alternative indicators were scored and screened to establish a final indicator system through two rounds of Delphy method and the related normalized weights and combined weights were also calculated. RESULTS: The risk assessing indicator system was established through two rounds of expert consultation including 3 first grade indicators and 15 second grade indicators. Among the first grade indicators, the normalized weights of natural environment, key populations and social environment were 0.370 6, 0.292 9 and 0.336 5, respectively. Among the second grade indicators, the migrant population accounted for the highest combined weight of 0.125 2 compared to domestic animal of 0.037 1. The authority degree among the first grade indicators was between 0.91 and 0.93, while the authority degree among the second grade indicators was between 0.79 and 0.92. CONCLUSIONS: The scientific and authoritative risk assessing indicator system after the transmission interruption of schistosomiasis is established, which provides the evidences for risk assessment on schistosomiasis transmission in Wuxi City.

[Evaluation on capability of parasitic disease control and prevention among professional and technical personnel in medical and health institutions in Wuxi City].

OBJECTIVE: To understand the capability of parasitic disease control and prevention among professional and technical personnel in medical and health institutions in Wuxi City, so as to provide the evidence for promoting relative capability building. METHODS: Forty-one professional and technical persons from 22 medical and health institutions received the evaluation through the theoretical knowledge exam and laboratory operation skill assessment. RESULTS: The average score of theoretical knowledge exam was (76.5±15.6) with the pass rate of 80.5% and excellent rate of 48.9%. The average score, pass rate and excellent rate for Plasmodium blood slide making were (7.3±1.5), 87.8% and 41.5% respectively, the average score, pass rate and excellent rate for Plasmodium blood slide reading were (14.0±7.2), 31.7% and 12.2% respectively; the average score, pass rate and excellent rate for helminthes microscope examination were (19.4±10.4), 24.4% and 0 respectively; the average score, pass rate and excellent rate for Oncomelania hupensis snail identification were (8.6±1.1), 95.1% and 73.2% respectively. The average scores of helminthes microscope examination and Oncomelania hupensis snail identification were higher in the participants with middle-level professional title or above than in the participants with primary level professional title (both P < 0.05). The average scores of theoretical knowledge exam, Plasmodium blood slide reading and helminthes microscope examination were higher in the participants from disease control and prevention institutions than in the staff who came from medical institutions (all P <0.05). CONCLUSIONS: The professional and technical personnel in medical and health institutions in Wuxi do better in theoretical knowledge, Plasmodium blood slide making and Oncomelania hupensis snail identification. However, the capability of parasite microscope examination is urgently needed to be improved in the future.

[Establishment of a monitoring database of historical Oncomelania hupensis environments at grass - root level for schistosomiasis prevention based on Google Earth].

OBJECTIVE: To establish a monitoring database of historical Oncomelania hupensis environments at grass-root level for schistosomiasis prevention based on Google Earth (GE), so as to improve the management efficiency of historical O. hupensis environments. METHODS: GE was labeled with the information about the historical O. hupensis environments through adding landmark, path and polygon. Meanwhile, POCO web album was used to storage the practice situation pictures of the environments, which could be imported into GE so that the environments could be monitored dynamically. RESULTS: There were 553 historical O. hupensis snail environments in Yangjian Town, Xishan District, Wuxi City and the accumulative area was 506 000 m2. Among these environments, 224 (40.5%) were Class IV environments, accounting for 40.5% of accumulative area. CONCLUSIONS: The monitoring database of historical O. hupensis environments based on GE at country level is established successfully and it can be used to manage the historical snail environments visually and monitor the changes dynamically.

[Survey on Toxoplasma gondii infection among key populations in Wuxi City].

OBJECTIVE: To investigate the prevalence and risk factors of Toxoplasma gondii infection among key populations in Wuxi City, Jiangsu Province, so as to provide evidences for developing preventive and control interventions for T. gondii infection. METHODS: A questionnaire was designed to conduct face-to-face interviews to HIV/AIDS carriers/patients, tumor patients, pregnant women and pet breeders. The blood samples were collected to test anti-Toxoplasma IgM and IgG antibodies by using ELISA method. RESULTS: Totally 404 participants were investigated, and 38 were positive in testing T. gondii antibodies (9.4%), and among these, 37 (97.4%) were IgG positive and 1 (2.6%) was IgM positive. The multivariate logistic regression indicated that age, regularly contacting cats/dogs and being HIV positive were associated with the infection of T. gondii (OR=2.1, 2.6 and 2.3, all P < 0.05). Breeding pets, being HIV positive and being tumor patients were more likely to infect T. gondii than being pregnant (OR = 1.5, 8.1 and 2.8, all P < 0.05). CONCLUSIONS: The high infection rate of T. gondii is observed among key populations in Wuxi City, so that the effective measurements should be taken to enhance the intervention among key populations including immunocompromised people, pet breeders or people having bad dietary habits of eating raw food.

Study on the HIV infection status, characteristics of AIDS-related behaviors and risk factors among men attending the sexually transmitted disease clinics / 中华流行病学杂志

Objective To understand the status on AIDS awareness,AIDS-related behaviors,risk factors on HIV infection status among 15-90 years or older men at the sexually transmitted disease clinics.Methods Data from the 2009 and 2010 national sentinel surveillance system,regarding men attending sexually transmitted disease clinics was collected from Guangdong,Guangxi,Henan,Sichuan,Yunnan and Jiangxi provinces,where the AIDS epidemic among 15-90 years or older population was serious.Data was uploaded to National Center for AIDS/STD Control and Prevention (NCAIDS) through the comprehensive AIDS control and prevention information system.Data was then analyzed by SPSS 18.0.Results A total of 64 003 pieces of data were collected.Among them,8783 ( 13.7％ ) were related to men at ≥ 50 years or older,and to men 15-49 years older were 55 220.The rates on the awareness of AIDS knowledge were from 69.6％ vs.80.1％,on frequently having had commercial sexual contacts in the last three months were between 34.1％vs.36.6％,on having had casual sexual contact in the last three months were 18.7％ vs.28.4％,on having had homosexual anal intercourse as 0.7％ vs.1.4％.The rates of taking HIV antibody testing in the last year (14.3％ vs.17.1％ ) among this population were all significantly lower than the rate among the 15 to 49 years age group.However,the HlV-positive rate among the older age group (fifty years of age or older) was significantly higher than the rate among 15 to 49 year age group ( 1.1％ vs.0.7％ ).Regard the fifty years of age or older men.Data from the multivariate logistic regression analysis demonstrated that factors as:having regular partner (OR=0.588,P=0.034),having homosexual anal intercourse (OR=5.226,P=0.006) were associated with positivities of HIV antibody.Conclusion High-risk sexual behaviors,including homosexual anal intercourse were the major risk factors for men at ≥50 years or older age,related to the infection of HIV.