Mortality risk of people living with HIV under hypothetical intervention scenarios of PM2.5 and HIV severity: a prospective cohort study.

This study estimated and compared mortality risks among people living with HIV (PLWH) under the real-world and hypothetical scenarios of PM2.5 concentrations and HIV severity. An open cohort from all PLWH receiving antiretroviral therapy in Sichuan during 2010-2019 was constructed, resulting in 541,515 person-years. Annual mean concentrations of PM2.5 were estimated and linked to PLWH by their residential address. The parametric g-formula were used to assess 3- and 5-year mortality risks under the real-world and hypothetical scenarios of PM2.5 (10-35, 35-50, 50-75 µg/m3) and CD4 concentrations (0-200, 200-500, 500-800, 800-1100 counts/µl). The estimated 3- and 5-year mortality risks among the PLWH were 14.43 % and 19.38 %, respectively, which would decrease substantially when annual PM2.5 concentration were reduced to between 10 and 35 µg/m3 (risk difference [RD] = -3.23 % and - 4.06 %) and would increase when PM2.5 concentration were elevated to between 50 and 75 µg/m3 (RD = 3.59 % and 5.04 %). The mortality risk would increase when CD4 concentration were reduced to <200 counts/µl (RD = 15.90 % and 20.27 %) and would decrease when CD4 concentration were ≥ 200 counts/µl, especially to between 800 and 1100 counts/µl (RD = -9.01 % and - 11.75 %). The elevated concentration of PM2.5 may disproportionately affect individuals with immune deficiency, especially those with more severity. The findings would serve as justifications for future intervention design and policy making to alleviate air pollution and improve environmental justice and health equity.

Epidemiological and spatiotemporal analyses of HIV/AIDS prevalence among older adults in Sichuan, China between 2008 and 2019: A population-based study.

OBJECTIVES: To describe epidemiological trends and spatial distributions of HIV/AIDS among older adults (aged ≥50) in Sichuan Province, China during 2008-19, and provide scientific reference for HIV/AIDS prevention, intervention and treatment. METHODS: Data on HIV/AIDS cases reported in 2008-19 was extracted from the Case Report System. The Cochran-Armitage trend test was used to determine epidemic trends. Spatial autocorrelation and space-time analysis were conducted with ArcGIS10.6 and ArcGIS Pro2.4, respectively. RESULTS: A total of 77854 HIV/AIDS cases among older adults were included in the study. Newly reported cases increased from 320 in 2008 to 22189 in 2019, and the reported incidence rate (number of new reported cases/older adult population) rose from 0.001% to 0.077%. Infections through heterosexual transmission increased from 65.3% to 98.2% of total cases in older adults in this period. Spatial analysis at the county-level showed significant clustering throughout Sichuan, with the main hot spots concentrated in the southeast. Spatiotemporal analysis indicated that most of the southeastern counties/districts were Consecutive Hot Spots. CONCLUSIONS: Older adults have become a key population in the HIV/AIDS epidemic in Sichuan; comprehensive prevention and intervention measures targeted to older adults are urgently needed to control the spread of HIV/AIDS.

[Infection status of HIV and its influence factors among men who have sex with men in Sichuan province].

OBJECTIVE: To investigate HIV infection status and its influence factors in men who have sex with men (MSM) in Sichuan province. METHODS: A face to face investigation and Syphilis and HIV serological detection were conducted among 2 783 MSM who have the insertion of oral or anal sex with men over the past year recruited by snowball sampling and respondent driven sampling methods in nine cities' Gay venues of Sichuan province. χ(2) test and logistic regression analysis were used for statistical analysis. RESULTS: A total of 2 783 MSM were surveyed, of which HIV and Syphilis infection rates were 11.1% (147/2 783) , 5.3% (310/2 783) , respectively. The HIV infection rates of <20 year-old age group, 20-29 year-old age group, 30-39 year-old age group, 40-49 year-old age group, ≥ 50 year-old age group were 6.6% (15/227), 9.7% (143/1 471), 11.8% (80/679), 18.0% (53/294), 17.0% (19/112) (χ(2) = 25.91, P < 0.05). The risk of HIV infection in 30-39 year-old age group, 40-50 year-old age group,> 50 years age group were 2.05 (1.14-3.69) times, 3.24 (1.75-6.01) times, 2.60 (1.22-5.52) times respectively of the <20 years age group. The risk of HIV infection in middle school and below one was 16.5% (73/443) , higher than the high school/college education MSM (11.1% (99/891) ) and the college and higher education MSM (9.5% (138/1 446)) (χ(2) = 16.46, P < 0.05). The risk of HIV infection in High school/college education MSM were 0.64 (0.45-0.90) times of the middle school and below. The HIV infection rates of MSM who accepted a HIV test and knew the result within the last year was 8.2% (119/1 446) , lower than the group who did not accepted any HIV test (14.3% (191/1 336) ) (χ(2) = 25.81, P < 0.05). The HIV infection rates of MSM who received intervention services was 10.1% (256/2 539), lower than the group who did not receive any intervention services (22.1% (54/244) ) (χ(2) = 32.65, P < 0.05) . The HIV infection rates of Syphilis-positive MSM was 32.0% (47/147) , higher than the Syphilis-negative one (10.0% (263/2 636) ) (χ(2) = 68.06, P < 0.05). Received intervention services (OR (95%CI) was 0.52 (0.40-0.68) ) and accepted a HIV test and knew the result within the last year (OR (95%CI) was 0.52 (0.36-0.74) ) were the protective factors of HIV infection. At the same time, the syphilis infection (OR (95%CI) was 4.01 (2.73-5.88) ) were risk factors for HIV infection. CONCLUSION: The prevalence rates of HIV infections were considered to be high among MSM in Sichuan province. The MSM of low-literacy, 30 years or older, not received any intervention services, not received any intervention services.Syphilis-positive have a greater risk of HIV infection.