HIV care continuum among newly diagnosed student and non-student youths between 2012 and 2016 in Hangzhou, China / 中华医学杂志(英文版)

BACKGROUND@#Youths are disproportionally affected by the human immunodeficiency virus (HIV) infection. We aimed to assess anti-retroviral therapy (ART) initiation and viral suppression rates among student and non-student youths in Hangzhou, China.@*METHODS@#Data were taken from the Chinese HIV/acquired immune deficiency syndrome Comprehensive Response Information Management System. Youths aged 15 to 24 years who were newly diagnosed with HIV between 2012 and 2016 and were living in Hangzhou were included in the study. Comparisons between student and non-student youths were made for ART initiation within 30 days, 90 days, and 12 months of HIV diagnosis, and the viral suppression rate at 12 months of HIV diagnosis and at 12 months of ART initiation.@*RESULTS@#A total of 707 cases met inclusion criteria, 29.6% of which were students and 70.4% were non-student youths. The student group had a higher proportion of ART initiation compared with the non-student group within 30 days of diagnosis (45.5% vs. 37.0%, P = 0.044), and a slightly higher but not statistically significant proportion at 90 days (67.0% vs. 62.7%), and 12 months (83.7% vs. 78.5%) of HIV diagnosis. ART initiation within 30 days improved from 90% in 2016. A smaller proportion of students experienced viral suppression compared with the non-student group (9.6% vs. 17.1%, P = 0.011) at 12 months after HIV diagnosis, but the suppression rate was similar at 12 months of ART initiation (69.9% vs. 71.1%, P = 0.743).@*CONCLUSIONS@#ART initiation in both student and non-student youths has significantly improved between 2012 and 2016. However, the viral suppression rate remained unacceptably low at 12 months of HIV diagnosis in both student and non-student groups. Specific intervention strategies must be taken to address this challenge.

HIV care continuum among newly diagnosed student and non-student youths between 2012 and 2016 in Hangzhou, China / 中华医学杂志(英文版)

Background@#Youths are disproportionally affected by the human immunodeficiency virus (HIV) infection. We aimed to assess antiretroviral therapy (ART) initiation and viral suppression rates among student and non-student youths in Hangzhou, China.@*Methods@#Data were taken from the Chinese HIV/acquired immune deficiency syndrome Comprehensive Response Information Management System. Youths aged 15 to 24 years who were newly diagnosed with HIV between 2012 and 2016 and were living in Hangzhou were included in the study. Comparisons between student and non-student youths were made for ART initiation within 30 days, 90 days, and 12 months of HIV diagnosis, and the viral suppression rate at 12 months of HIV diagnosis and at 12 months of ART initiation.@*Results@#A total of 707 cases met inclusion criteria, 29.6% of which were students and 70.4% were non-student youths. The student group had a higher proportion of ART initiation compared with the non-student group within 30 days of diagnosis (45.5% vs. 37.0%, P = 0.044), and a slightly higher but not statistically significant proportion at 90 days (67.0% vs. 62.7%), and 12 months (83.7% vs. 78.5%) of HIV diagnosis. ART initiation within 30 days improved from <15% in 2012 to over 65% in 2016 in both groups, and ART initiation within 90 days improved from <30% in 2012 to >90% in 2016. A smaller proportion of students experienced viral suppression compared with the non-student group (9.6% vs. 17.1%, P = 0.011) at 12 months after HIV diagnosis, but the suppression rate was similar at 12 months of ART initiation (69.9% vs. 71.1%, P = 0.743).@*Conclusions@#ART initiation in both student and non-student youths has significantly improved between 2012 and 2016. However, the viral suppression rate remained unacceptably low at 12 months of HIV diagnosis in both student and non-student groups. Specific intervention strategies must be taken to address this challenge.

Prevalence of HIV, syphilis and HCV and their risk factors among drug users in Hangzhou / 预防医学

Objective To learn the prevalence of HIV, syphilis and HCV and to identify the potential risk factors among drug users in Hangzhou. Methods A consecutive cross-sectional survey was conducted from 2012 to 2016. The drug users from compulsory rehabilitation center, community and methadone clinic were interviewed face to face with questionnaires to collect the information about their demographic characteristics, drug use behaviors and sexual behaviors. Blood specimens were collected for HIV, syphilis and HCV testing. Results Totally 4067 drug users were included during this 5-year study. The infection rates of HIV, syphilis and HCV were 0.64％, 7.25％ and 22.69％, respectively. Multivariate logistic regression analysis indicated that the risk factors for syphilis infection were female (OR=4.411, 95％ CI: 3.273-5.945) , single (married/cohabited:OR=0.664, 95％ CI: 0.482-0.915; divorced/widowed: OR=0.534, 95％ CI: 0.353-0.810) , club drug user (OR=5.064, 95％CI: 3.287-7.803) and mixed drug user (OR=2.663, 95％CI: 1.191-5.954); the risk factors for HCV infection were age (OR: 2.168-2.878), place of domicile (OR=1.747, 95％CI: 1.398-2.184), injecting drug use (OR=3.120, 95％CI: 2.534-3.840) and conventional drug use (club drug user: OR=0.348, 95％CI: 0.277-0.438; mixed drug user: OR=0.611, 95％CI: 0.390-0.959) . Conclusion The infection rate of syphilis and HIV is high among drug users in Hangzhou. Female, single, club drug use and mixed drug use may increase the risk of syphilis infection. high age, drug injection and migrant population are risk factors for HCV infection.

Epidemiological characteristics of students with HIV/AIDS in Hangzhou / 预防医学

Objective To explore the epidemiological characteristics of young students with HIV/AIDS in Hangzhou and to provide scientific basis for AIDS prevention and control in school settings. Methods Data on HIV/AIDS patients was collected from HIV Comprehensive Prevention and Control Information System, and retrospective survey was conducted to those who were students and whose current residential address was Hangzhou. Results A total of 132 HIV/AIDS student cases were surveyed. The average age was (21.42±2.65) years, and 98.48％ were male. The proportion of homosexual transmission was 83.33％. Before positive confirmation, 55.45％ had homosexual partners both from students and non-students, 90.91％ had temporary sexual behavior, five cases had heterosexually fixed partners and two cases had heterosexually temporary partners.The proportions of condom use in all types of sexual partners ranged from 0.00％-50.00％. Seventy-two (54.55％) HIV/AIDS student cases thought they were impossible to be infected by HIV. Only 23.48％ of cases did HIV antibody test before positive confirmation. The proportion of HARRT was 80.30％. The proportion of co-infected with syphilis was 18.03％. Conclusion Homosexual behavior is the main route of transmission for HIV infection among young students in Hangzhou. Dangerous behaviors are prevalent, and the situation of AIDS prevention and control among students is severe.