[Relationship between dietary nutrition and chronic disease of Jinuo Minority residents aged 20-80 in Jinghong District in 2020].

OBJECTIVE: To analyze the relationship between food intake and chronic diseases of Jinuo Minority residents living in Yunnan Province. METHODS: A total of 392 Jinuo Minority residents 20-80-year-old among 304 families(male 135, female 257; aged 20-49 years old 140, aged 50-59 years old 136, aged 60-80 years old 116)in Jinghong District in Yunnan Province were selected with stratified multistage cluster sampling method. To apply the method of food frequency questionnaire and questionnaire survey obtain the condition of dietary structure and overweight or obesity, diabetes and dyslipidemia among Jinuo Minority in the past 12 months. Non-conditional Logistic regression analysis was utilized to analyze the correlation between food intake and chronic diseases. RESULTS: In 2020, the prevalence of overweight/obesity, hypertension, diabetes and dyslipidemias among Jinuo adults in Jinghong District were 38.8%(n=152), 19.1%(n=75), 3.6%(n=14)and 26.3%(n=103). Jinuo residents aged 20 and above who have consumed noodle and instant noodle(OR=1.677, 95%CI 1.028-2.736), fermented soybean curd(OR=3.056, 95%CI 1.853-5.038), grass carp(OR=2.245, 95%CI 1.270-3.971), ethnic food/peanut(OR=1.975, 95%CI 1.162-3.355) were more likely to experience overweight/obesity compared to those who did not consume them. On the other hand, individuals who consumed snacks/bread(OR=0.322, 95%CI 0.190-0.545) were less likely to develop overweight/obesity compared to those who did not consume them. Jinuo residents aged 20 and above who have consumed other cereals and cereals products, such as buckwheat(OR=7.029, 95%CI 1.494-33.070), were more likely to develop diabetes than those who did not consume them. And those who have eaten cabbage vegetables(such as cauliflower/cabbage)(OR=0.155, 95%CI 0.034-0.708), and kernel fruits(such as apple/pear)(OR=0.227, 95% CI 0.069-0.743) were less likely to develop diabetes than those who did not consume them. Adults who consumed cooked meat and other livestock and poultry, such as donkey/horse meat(OR=9.676, 95% CI 1.418-66.027), were more likely to cause dyslipidemias compared to did not consume them. Conversely, individuals who consumed root vegetables(such as radish/lotus root)(OR=0.405, 95%CI 0.204-0.803), cooked pork from animal foods(OR=0.482, 95%CI 0.263-0.885), snacks/snack bread(OR=0.590, 95%CI 0.357-0.974) and plum blossom(OR=0.173, 95%CI 0.038-0.793) were less likely to develop dyslipidemia than those who did not consume them. CONCLUSION: In Jinghong District, the overweight/obesity of Jinuo adults aged 20-80 was positively correlated to the consumption of noodles and instant noodles, fermented bean curd, grass carp, and ethnic food/peanut. And there was a negative correlation with the consumption of snacks/bread. Regarding diabetes, a positive correlation was observed with the consumption of other grains and products, while negative correlations were found with the consumption of cabbage vegetables and kernel fruits. For dyslipidemias, there was a positive correlation with the consumption of cooked meat and other livestock and poultry, and negative correlations were identified with the consumption of root vegetables, cooked pork from animal foods, snacks/snack bread, and prunes.

[Status and related factors of overweight and obesity among children and adolescents aged 6-17 in Yunnan Province during 2016-2017].

OBJECTIVE: To understand the status and related factors of overweight and obesity in children and adolescents aged 6-17 in Yunnan Province. METHODS: From 2016 to 2017, 3463 children and adolescents aged 6-17 from 65 primary and secondary schools in 13 counties of Yunnan Province were selected by stratified cluster sampling method for face-to-face questionnaire survey, including 1716 boys and 1747 girls, 2098 elementary school students, 762 middle school students, 603 high school students, of which, 1368 students from urban area and 2095 students from rural area. The questionnaire included information including, weekly consumption of sugary drinks, sweets, puffed food, fruits, vegetables, breakfast, daily activities of moderate or high intensity, school sports, daily hours of playing video games and watching TV, daily sleep and outdoor activities. Height and weight were measured using standard method. SPSS20.0 was used for χ~(2 )test and multivariate Logistic regression analysis. RESULTS: The prevalence of overweight and obesity among children and adolescents aged 6-17 were 8.43%(292/3463) and 6.01%(208/3463) respectively. The overweight rates of male students and female students were 8.45%(145/1716) and 8.41%(147/1747) respectively, and the statistic was significant differently(χ~(2 )=0.001, P>0.05). The overweight rates of urban and rural children and adolescents were 11.99%(164/1368) and 6.11%(128/2095) respectively, and the statistic was significant differently(χ~2=37.04, P<0.01). The overweight rates of primary school, middle school and high school were 7.53%(158/2098), 9.32%(71/762) and 10.45%(63/603) respectively, and the statistic was significant differently(χ~2=6.15, P<0.05). The obesity rates of male and female students were 7.11%(122/1716) and 4.92%(86/1747) respectively, and the statistic was significant differently(χ~2=7.33, P<0.01). The obesity rates of urban and rural children and adolescents were 9.50%(130/1368) and 3.72%(78/2095) respectively, and the statistic was significant differently(χ~2=48.97, P<0.01). The obesity rates of primary school, middle school and high school were 7.67%(161/2098), 3.15%(24/762) and 3.81%(23/603), respectively, and the statistic was significant differently(χ~2=26.48, P<0.01). Multivariate Logistic regression analysis showed that cities(OR=2.025, 95%CI 1.646-2.492) and non-residential schools(OR=1.808, 95%CI 1.470-2.223) were associated with overweight and obesity in children and adolescents, both of which were statistically significant(P<0.05). CONCLUSION: The prevalence of overweight and obesity among children and adolescents aged 6-17 in Yunnan Province were high. Urban, non-residential school children and adolescents are more likely to be overweight and obesity.

[Relationship between dietary nutrition and chronic disease of residents in Gongshan County in Yunnan Province in 2016].

OBJECTIVE: To analyze the relationship between food intake and chronic diseases of Dulong minority residents living in Yunnan Province. METHODS: 460 Dulong minority residents 6-80-year-old among 304 families(male 191, female 269, children and adolescents aged 6-17 years old 56, aged 18-44 years old 229, aged 45-59 years old 123, aged 60-80 years old 52)in Gongshan County in Yunnan Province were selected with Stratified multistage cluster sampling method. To apply the method of food frequency questionnaire and questionnaire survey obtain the condition of dietary structure and overweight or obesity, diabetes and dyslipidemia among Dulong minority. Non-conditional Logistic regression analysis was utilized to analyze the correlation between food intake and chronic diseases. RESULTS: The prevalence of overweight or obesity, hypertension, diabetes and dyslipidemia were respectively 20.4%, 19.6%, 32.4% and 50.4% in 2016. Marital status and consumption of melons vegetables(OR=0.540, 95%CI 0.306-0.954), benevolence fruit kind fruit(OR=0.348, 95%CI 0.171-0.706) and low fat milk powder(OR=5.267, 95%CI 1.266-21.911) in the past 12 months were associated with hypertension among the Dulong minority population. For the Dulong minority residents, sex, eaten deep-fried dough stick(OR=0.403, 95%CI 0.182-0.894) in the past 12 months, solanaceous vegetables(OR=0.478, 95%CI 0.275-0.832) and whole milk powder(OR=2.090, 95%CI 1.372-3.184) have something to do with diabetes. Occupation, consumption of beancurd and bamboo vegetables(OR=4.753, 95%CI 1.079-20.937), solanaceous vegetables(OR=2.842, 95%CI 1.175-6.871) and edible fungi(OR=1.794, 95%CI 1.116-2.883) over the past 12 months were linked to the prevalence of overweight. Consumption of fresh legumes(OR=1.991, 95%CI 1.130-3.507), whole milk powder(OR=2.342, 95%CI 1.535-3.575), cooked poultry meat(OR=2.092, 95%CI 1.147-3.815), grass carp(OR=0.580, 95% CI 0.379-0.888)and fresh eggs(OR=0.432, 95%CI 0.196-0.950) and in the past 12 months were associated with dyslipidemia among the Dulong minority residents. CONCLUSION: The prevalence of overweight/obesity was mainly related to occupation, consumption of vegetables and products(solanaceous vegetables, edible fungi), and hypertension was mainly related to Marital status, and the intake of melons vegetables, benevolence fruit kind fruit, low fat milk powder), and diabetes was mainly related to sex, deep-fried dough stick, solanaceous vegetables and whole milk powder, and dyslipidemia was mainly related to Marital status, fresh legumes, whole milk powder, cooked poultry meat, grass carp, and fresh eggs for the Dulong nationality residents aged 6-80 years old in Gongshan County, Yunnan Province.

Perceived social support and diet quality among ethnic minority groups in Yunnan Province, Southwestern China: a cross-sectional study.

BACKGROUND: Social support is an important health determinant and may affect dietary behaviors. The purpose of this study was to examine the relations between perceived social support and the Chinese Diet Balance Index-16 (DBI-16) among ethnic minority groups in Southwest China. METHODS: This cross-sectional study was conducted between May 2019 and August 2020 among six ethnic minority groups native to Yunnan Province (n = 3564). Perceived social support from family, friends and significant others were measured with the Multi-dimensional Scale of Perceived Social Support (MSPSS). Dietary data were obtained using a 100-item Food Frequency Questionnaire (FFQ) and a lifestyle questionnaire. Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD) which represent inadequate, excessive and unbalanced food intake respectively were calculated to measure the compliance with the recommendations of the Dietary Guidelines for Chinese 2016. RESULTS: One thousand four hundred ninety-six men and two thousand sixty-eight women were included. 51.2% of the subjects had moderate or high levels of inadequate intake; 21.3% had moderate or high levels of excessive intake; and 74.0% had moderate or high levels of unbalanced dietary intake. With potential confounders adjusted, support from family was negatively associated with inadequate intake, while support from friends was positively associated with inadequate and excessive intake. No significant associations were found between perceived social support from significant others and diet quality indicators. CONCLUSIONS: An unbalanced diet is common among adults of the ethnic minority groups in Yunnan Province, Southwest China. Social support should be taken into account in designing nutrition interventions rather than focusing solely on individuals.

Social capital and dietary patterns in three ethnic minority groups native to Yunnan Province, Southwest China.

BACKGROUND: Few studies have focused on the influencing factors of dietary practices among ethnic minority groups in China, particularly from a social capital perspective. METHODS: Between May and September 2019, we conducted a cross-sectional survey among adults (n = 1,813) from three ethnic minority communities (A Chang, De Ang and Jing Po) in Yunnan Province, Southwest China. Dietary intakes during the past 12 months were measured with a 100-item Food Frequency Questionnaire (FFQ), and two forms of social capital (bonding and bridging) were measured using the validated Personal Social Capital Scale 16 (PSCS-16). Principal component factor analysis was used to derive dietary patterns from 20 food groups. Multivariate linear regressions were used to examine the associations between social capital and dietary patterns. RESULTS: Two distinct dietary patterns were identified: the traditional and the modern. The traditional pattern was characterized by high consumptions of tubers, poultry, rice, fruits, vegetables and low consumptions of oil and salt, whereas the modern pattern was highly correlated with egg, nut, beverage, snack and oil consumptions. After adjusted for potential confounders, the modern pattern was positively associated with bonding capital (ß = 0.066; 95%CI: 0.058, 0.075) and negatively associated with bridging capital (ß = -0.017; 95%CI: -0.024, -0.010). CONCLUSION: In conclusion, an unhealthy dietary pattern was identified among the ethnic minority groups in Southwest China. The influences of people's social connections on dietary behaviors should be considered in designing and implementing nutrition intervention programs for the population.

Plasma Phospholipid Transfer Protein Promotes Platelet Aggregation.

It remains unclear whether plasma phospholipid transfer protein (PLTP) is involved in hyper-coagulation or hypo-coagulation. This study investigated the direct effect of PLTP on platelet aggregation and the underlying mechanism. Washed platelets from humans or mice and mouse platelet-rich plasma and human recombinant PLTP were isolated. PLTP is present in human platelets. We assessed adenosine diphosphate (ADP)-, collagen- and thrombin-induced platelet aggregation, phosphatidylserine externalization and photothrombosis-induced cerebral infarction in mice. PLTP over-expression increased platelet aggregation, while PLTP deficiency had the opposing reaction. Human recombinant PLTP increased both mouse and human platelet aggregation in a dose-dependent manner. Phosphatidylserine externalization provides a water/lipid surface for the interaction of coagulation factors, which accelerates thrombosis. Compared with wild-type controls, platelets from PLTP transgenic mice had significantly more phosphatidylserine on the exterior surface of the plasma membrane, whereas platelets from PLTP-deficient mice had significantly less phosphatidylserine on the surface, thus PLTP influences fibrinogen binding on the plasma membrane. Moreover, recombinant PLTP together with ADP significantly increased phosphatidylserine exposure on the plasma membrane of PLTP-deficient platelets, thereby increasing fibrinogen binding. PLTP over-expression significantly accelerated the incidence of photothrombosis-induced infarction in mice, whereas PLTP deficiency significantly reduced the frequency of infarction. We concluded that PLTP promotes phosphatidylserine externalization at the plasma membrane of platelets and accelerates ADP- or collagen-induced platelet aggregation. This effect plays an important role in the initiation of thrombin generation and platelet aggregation under sheer stress conditions. Thus, PLTP is involved in hyper-coagulation. Therefore, PLTP inhibition could be a novel approach for countering thrombosis.

[Relationship between dietary nutrition and chronic disease of Nu nationality residents in Gongshan County in Yunnan Province in 2016].

OBJECTIVE: To analyze the relationship between food intake and chronic disease of Nu nationality residents living in Gongshan County in Yunnan Province. METHODS: A total of 368 Nu nationality residents aged above 6 years old among 342 families( male 172, female 196) in Gongshan County in Yunnan Province were selected with stratified multistage random cluster sampling method. The condition of dietary structure and anemia, overweight or obesity, diabetes and dyslipidemia among Nu nationality were obtained with food frequency questionnaire and questionnaire survey. Non-conditional Logistic regression analysis was utilized to analyze the correlation between food intake and chronic diseases. RESULTS: The prevalence of anemia, overweight or obesity, hypertension, diabetes and dyslipidemia were 16. 0%, 18. 5%, 18. 5%, 41. 3%and 53. 8% in 2016, respectively. Marital status and consumption of sugar( biscuits) in the past 12 months were related to the anemia in the Nu residents. Sex, occupation, marital status, education level and consumption of dried beans and products( soybeans)in the past 12 months were associated with hypertension among the Nu nationality population. For the Nu nationality residents, marital status, eaten cereals and products( cereals and other products) in the past 12 months, meat and meat products( fresh or frozen poultry) and sugar( bread, biscuits) food had something to do with diabetes. Sex, occupation and consumption of vegetables and products( solanaceous vegetables) over the past 12 months were linked to the prevalence of overweight or obesity. Marital status, consumption of livestock meat and products( fresh or frozen poultry) and fish( grass carp) in the past 12 months were associated with dyslipidemia among the Nu nationality residents. CONCLUSION: The prevalence of chronic diseases residents can not be ignored. The main influencing factors of anemia in Nu nationality are marital status and eating sugar. Sex, occupation, marital status, education level, consumption of dried beans and products are the main influencing hypertension factors. Factors causing diabetes are marital status, cereals and products, animal meat and products and carbohydrates. The influence factors of overweight or obesity are gender, occupation, eating vegetables and products. Marital status, eating animal meat and products and fish are the factors leading to dyslipidemia.

Patterns of smoking initiation during adolescence and young adulthood in South-West China: findings of the National Nutrition and Health Survey (2010-2012).

OBJECTIVE: This study aims to understand the age patterns of smoking initiation during adolescence and young adulthood in South-West China, where the prevalence of tobacco use is reported as the highest in the country. DESIGN: A cross-sectional study. SETTING: The data were derived from the China National Nutrition and Health Survey in Yunnan Province, South-West China (2010-2012). PARTICIPANTS: A total of 4801 participants aged 15-65 years were included. PRIMARY OUTCOME MEASURES: A survival model was used to estimate the hazard of smoking initiation by age and log-rank test was used to compare the hazard curves across subgroups (men/women, urban/rural, Han Chinese/ethnic minority). RESULTS: The prevalence of current smoking among men and women were 60.4% (95% CI 58.2% to 62.6%) and 5.1% (95% CI 4.3% to 5.9%), respectively. Smoking was more prevalent among men and women of lower education and less income, as well as rural and ethnic minority women. Among the current smokers, cigarette (80.7%) was the most commonly used tobacco product, followed by waterpipe (10.8%) and pipe tobacco (8.5%). The hazards of smoking initiation were low for both men and women before the age of 15 years (1% for men and 0.05% for women); and the hazards increased quickly from age 15 years and peaked at 19years (21.5% for men and 1.0% for women). Rural and ethnic minority women were at higher risk of smoking initiation than their counterparts between 15 years and 19 years of age (χ2=44.8, p<0.01; χ2=165.2, p<0.01) and no such difference was found in men. CONCLUSIONS: Findings of this study underscore the importance to implement tobacco prevention interventions among older teens and young adults in South-West China, especially for rural and ethnic minority women.

Dietary Balance Index-07 and the Risk of Anemia in Middle Aged and Elderly People in Southwest China: A Cross Sectional Study.

A balanced diet is essential to achieve and maintain good health. In this study, we assessed diet quality of middle aged and elderly people based on Chinese Diet Balance Index-07 (DBI-07) and explored the associations between DBI-07 and anemia. Data analyzed for this study was from the 2010-2012 National Nutrition and Health Survey in Yunnan province, southwest China (n = 738, aged 50-77 years). Dietary recalls over there consecutive days were done in a face-to-face interview. The scores of DBI-07 for each component and three DBI-07 indicators ((Lower Bound Score (LBS), Higher Bound Score (HBS), Diet Quality Distance (DQD)) were calculated according to compliance with the Dietary Guidelines for Chinese residents. Hemoglobin (Hb) concentration was determined using the cyanmethemoglobin method. Univariate and multivariate linear regression models were used to explore the associations between DBI-07 indicators and anemia, as well as scores of DBI-07 components and Hb level. The sample included 336 men and 402 women. Inadequate intakes of vegetables, fruits, dairy, soybean, eggs, fish and excessive intakes of cereals, meat, cooking oil, salt were both common. 91.3% of the participants had moderate or high levels of inadequate food intake, while 37.7% had moderate or high levels of excessive food intake. The mean Hb was 14.2 ± 1.7 g/dL, with a prevalence of anemia of 13.0%. Subjects with high LBS and DQD were more likely to be anemic (all p < 0.05). After adjustment for potential confounders, there were positive correlations between Hb level and the intakes of vegetables and soybean (ßvegetables = 1.04, p < 0.01; ßsoybean = 0.82, p = 0.04). In conclusion, dietary imbalance and anemia are common in middle aged and elderly population in southwest China and inadequate intakes of vegetables and soybean may increase the risk of anemia.

[Breast milk composition and influencing factors of the Han, Bai and Dai nationalities in Yunnan Province in 2011-2012].

OBJECTIVE: Analysis of breast milk composition and influencing factors of the Han, Bai and Dai nationalities in Yunnan Province from 2010 to 2012. METHODS: To choose two typical ethnic minorities-Bai and Dai in Yunnan province with high density of minorities population by using cross-sectional survey and multi-stage cluster sampling. 1053 aged 0-9 month babies and their healthy mothers with the first delivery of Dai, Bai and Han were selected as samples from Heqing county of Dali and Xishuangbanna city where most population were Bai and Dai people. The mothers were surveyed with the questionnaire and their breast milk was collected for the determination of the content of protein, fat and carbohydrate of breast milk; to evaluate the nutrition status of babies by using Z-scoremethod and to analyze the result by using multiple factors analysis of stepwise regression method. RESULTS: The contents of protein, fat and carbohydrate from the three nationalities breast milk are as follows. First, the protein, fat and carbohydrate from Han woman were( 1. 509 ± 0. 700), ( 3. 613 ± 1. 491) and( 6. 168 ± 0. 599) g/100 mL, respectively. Secondly, those of Dai nationality the lastrias breast milk were( 1. 464 ±0. 980), ( 2. 843 ± 1. 434) and( 6. 386 ± 0. 652) g/100 mL. Finally, those from Bai people were( 1. 567 ± 0. 724), ( 3. 791 ± 1. 643) and( 6. 190 ± 0. 669) g/100 mL. Morbidities of the babies sample including Han, Bai and Dai nationalities underweight, growth retardation and emaciation were 3. 80%( 40/1053), 5. 14%( 54/1051), 2. 39%( 25/1045). With other variables excluded, within one month after postpartum, breading mothers' milk was lower in fat due to their more outdoor activities and intake of olive and sesame oil compared with those who took peanut and soybean oil. More than 60 days after delivery, the more iodated salt and the more eating yellow fruits the mothers took in within one month by eating yellow fruits, the higher of fat content their breast milk was. More than 60 days after delivery, the more iodated salt the mothers take in within one month, the lower of carbohydrate content their breast milk was. Meanwhile the more number of pregnancy and more intake of olive and sesame oil comparing with peanut and soybean oil, the higher of carbohydrate content. The less of protein content of female babies compared with male babies their breast milk was. The lastrias who took in olive and sesame oil had less protein content of the breast milk compared with those taking in peanut and soybean oil. The lastrias who took in milk or milk products within 60 days after delivery had higher protein content of the breast milk. CONCLUSION: Nutrition problems of babies under 1 year old in Yunnan Province still exist. Breast milk contents of breast-feed mothers of Han, Dai and Bai can be influenced by a lot of factors, such as baby sex, pregnant times, outdoor activities in daytime and dietary intake of breast-feed mother.

[Impacts of antiretroviral treatment on drug use and high risk sexual behaviors among HIV-positive MMT clients].

OBJECTIVE: To explore the impacts of antiretroviral treatment on drug use and high risk sexual behaviors among HIV-positive MMT clients. METHODS: A cross-sectional study was conducted in patients undergoing ART (ART-experienced) and patients not undergoing ART (ART-naive) attending MMT in 5 clinics in Yunnan Honghe and Dehong prefectures in 2014. A questionnaire was designed to collect socio-demographic characteristics, ART and MMT information and sexual and drug use behaviors within 3 months before the investigation was conducted. Logistic regression analysis was conducted to identify the predictors for drug use and risky sexual behaviors. RESULTS: A total of 328 cases were included in the analysis, among which 202 were ART-experienced and 126 were ART-naÏve. Among 152 respondents who were sexually active, 61 (40.1%) reported having unprotected sex (UPS) with their regular partners in the prior 3 months. A total of 57.6% (189/328) of the respondents used drugs in the prior 3 months. Multiple logistic regression analysis revealed that younger than 35 years old (OR = 3.57, 95% CI: 1.23-10.37), fertility desire (OR = 4.47, 95% CI: 1.49-13.41), partner being HIV-positive (OR = 4.62, 95% CI: 1.80-11.86), length of MMT attendance less than 5 years (OR = 2.92, 95% CI: 1.14-7.53), agreed that it was necessary to use condom no matter the viral load is high or low (OR = 0.14, 95% CI: 0.04-0.51) were protective factors of UPS in the prior 3 months. Multiple logistic regression analysis revealed that being Han (OR = 0.46, 95% CI: 0.24-0.89), feeling having good health status (OR = 0.39, 95% CI: 0.18-0.85), being enrolled in ART (OR = 0.32, 95% CI: 0.17-0.60) were protective factors for drug use in the prior three months, having contact with drug using friends (OR = 4.41, 95% CI: 2.31-8.29), having experience of missing an MMT dose (OR = 3.47, 95% CI: 1.92-6.29), and not satisfied with current MMT dose (OR = 13.92, 95% CI: 3.24-59.93) were risk factors for drug use during the prior three months. CONCLUSION: ART was not associated with risky sexual behavior and drug use in the prior 3 months in this population. Future interventions should promote ART among this population, and provide education at the same time to prevent the emergence of cross infections and drug-resistant strains.

HIV incidence and risk factors in Chinese young men who have sex with men--a prospective cohort study.

OBJECTIVES: To assess HIV incidence and its associated risk factors among young men who have sex with men (YMSM) in urban areas, China. DESIGN: The study used a prospective cohort study design and standard diagnostic tests. METHODS: A twelve-month prospective cohort study was conducted among YMSM (18-25 years old) in 8 large cities in China. The participants were recruited via snowball sampling. A total of 1102 HIV-negative YMSM completed baseline assessment, 878 YMSM participants completed 6-month follow-up, and 902 completed 12-month follow-up. HIV was screened by an enzyme-linked immunosorbent assay and confirmed with Western Blot. Syphilis was screened via rapid plasma reagent and confirmed by treponema pallidum particle agglutination assay. RESULTS: 78 HIV seroconversions were identified within 1168.4 person-year observations yielding an incidence rate of 6.7 per 100 person-years. HIV seroconversion was associated with non-student status (RR = 2.61, 90% CI = 1.3-5.26), low HIV transmission knowledge (RR = 8.87, 90% CI = 2.16-36.43), and syphilis infection (RR = 5.04, 90% CI = 2.57-9.90). CONCLUSIONS: Incidence of HIV among YMSM is high in urban areas of China. Interventions measures are required to contain the HIV epidemic within this population.

[Syphilis incidence and its risk factors in a cohort of young men who have sex with men].

OBJECTIVES: To investigate the incidence of syphilis infection and to determine the risk factors related to syphilis infection among young men who had sex with men (YMSM), which were documented for developing effective intervention to prevent sexually transmitted diseases among YMSM. METHODS: A cohort study was conducted in 8 cities (Beijing, Shanghai, Kunming,Guiyang, Chongqing, Chengdu, Urumqi and Nanning) from May to December, 2009. A total of 1 037 syphilis-negative YMSM aged 18-25 were enrolled in the cohort and the two follow-up surveys were carried out every six months. The contents of study included sociodemographic characteristics, HIV-related knowledge, sexual behavior and condom use in the 6 months prior to survey. All participants were tested for syphilis with whole blood specimens. Chi-square test was used to compare demographic characteristics of participants in baseline with those of two follow-up, and Cox regression analysis was used to identify risk factors associated with syphilis infection. RESULTS: The rates of participants in 6, 12 months follow-up surveys was 79.85% (828/1 037) and 82.16% (852/1 037) respectively.39 syphilis seroconversions were found in the 12 months follow-up survey. Cumulative observed person-years during follow-up time was 1 106.67. The syphilis incidence rate was 3.5%. The Multivariate Cox regression analysis showed that the education of senior high school (senior high school vs some college or higher, RR = 2.19, 95% CI:1.21-3.98), bisexual orientation (bisexual orientation vs homosexual orientation, RR = 2.19, 95% CI:1.21-3.97), score of HIV/AIDS knowledge <8 (score of HIV/AIDS knowledge <8 vs knowledge = 8, RR = 2.39, 95%CI:1.35-4.21), had two and more sexual partners and inconsistent condom use in the past 6 months (inconsistent condom use vs consistent condom use, RR = 3.10, 95% CI:1.39-6.91) were significantly associated with syphilis seroconversion in the 12-month period. CONCLUSIONS: The syphilis incidence was high and risk behaviors were common among YMSM of China.

Factors influencing HIV infection in men who have sex with men in China.

To identify risk factors for HIV infection among men who have sex with men (MSM) and to provide a theoretical basis for prevention interventions. Between December 2011 and August 2012, a case-control study was conducted among MSM who underwent voluntary counselling and testing for HIV. Confirmed HIV-positive MSM were included in the case group, and HIV-negative MSM were included in the control group. Information on possible risk factors was collected by a survey questionnaire and a qualitative interview. The results of a conditional logistic regression showed that the following were influencing factors for HIV infection: average monthly income between 2001 and 3000 Yuan (odds ratio (OR)=6.341, 95% CI: 1.714-12.544), only sometimes using condoms when having anal sex with men in the last 6 months (OR=7.601, 95% CI: 1.359-23.083), having HIV-positive sex partners (OR=5.273, 95% CI: 1.572-17.691), rectal trauma with bleeding in the last 6 months (OR=2.947, 95% CI: 1.308-6.638), not using condoms at last sexual encounter (OR=1.278, 95% CI: 1.012-5.595), engaging in commercial sex (OR=5.925, 95% CI: 1.923-13.890) and having more than 16 sex partners in the last 6 months (OR=1.175, 95% CI: 1.021-1.353). These seven factors were the risk factors of HIV infection (OR>1). However, having anal sex less than 10 times in the previous 1 month (OR=0.002, 95% CI: 0.000-0.287) was a protective factor against HIV infection among MSM (OR<1), and insertive (OR=0.116, 95% CI: 0.000-0.236) (OR<1) anal intercourse influenced HIV infection. Interventions should be targeted at MSM whose average monthly income is between 2001 and 3000 Yuan, and who engage in commercial sex. In addition, the importance of using condoms at every sexual encounter should be emphasised in health education, as should the treatment of rectal trauma with bleeding. Finally, MSM should decrease the number of sex partners and frequency of anal sex to decrease the rate of HIV infection.

[Loss to follow-up and associated factors in a cohort study among men who have sex with men].

OBJECTIVE: To explore the associated factors on loss to follow-up among men who have sex with men (MSM) in a prospective cohort study. METHODS: We recruited eligible HIV-negative MSM at baseline in eight cities from June to October 2009. Interviewer-administrated questionnaire and blood testings for HIV, syphilis and human simplex virus type 2, were accomplished upon enrollment, 6-month and 12-month follow-up visits in the program. Loss to follow-up was recorded at each visit in this cohort. Univariate and multivariate statistical analysis were conducted to examine the associated factors on loss to follow-up. RESULTS: A total of 3196 eligible MSM were enrolled at the baseline study. During one year of follow-up, 894 (28.0%) of them dropped out thoroughly while 2302 (72.1%) showed up at least on one visit. Factors as MSM who were at age 25 or younger, resided locally less than 1 year, being unemployed, self-recognized as heterosexuality or bisexuality, never taking HIV testing in the past year, having had sex with women in the past 6 months etc., were more likely to withdraw from the follow-up visits. Conclusion Age, length of residency, sex orientation and history of HIV testing were associated with the loss of follow-up among MSM cohort in our study. These factors should be considered in this kind of study design in the future.

[Male circumcision is an effective "surgical vaccine" for HIV prevention and reproductive health].

Recent randomized controlled clinical trials in Africa have demonstrated that adult male circumcision (MC) efficiently decreases the rate of HIV, HPV and HSV-2 infections. Many studies have clearly shown that MC is a simple, safe, and cost-effective method for the prevention of sexually transmitted diseases and urinary tract infection, and for improving genital hygiene. While a 30% MC prevalence exists worldwide, only 5% or less of the Chinese males have undergone circumcision. In this review, we report recent trends in international MC and HIV prevention efforts, as well as the potential benefits and importance of promoting MC in China. We appeal to medical and public health authorities to pay close attention to the international experience in MC and HIV prevention.

[Promoting male circumcision in China for preventing HIV infection and improving reproductive health].

The incidence of heterosexually transmitted HIV infection is rapidly increasing in China, which reached 44.7% among the HIV-positive patients in 2007. With a view to the reduction of HIV transmission and improvement of reproductive health in the Chinese population, this paper introduces the latest evidence obtained from the international epidemiological studies and randomized controlled clinical trials on the preventive effect of male circumcision (MC) on HIV transmission, and elucidates the cellular and molecular mechanisms of HIV transmission through the foreskin. Four studies published during 1997-2007 demonstrated that the mean prevalences of redundant prepuce and phimosis in 15,109 Chinese males aged 3-23 years in 4 areas of China were 43.90 and 11.55% , respectively, while the rate of MC was only 2.66%. As MC is a simple, inexpensive and highly effective technique in HIV prevention, we appeal to the policy-makers in China to conduct a practical program for promoting MC and enhancing male productive health in combination with other approaches to the prevention of HIV infection. MC for neonates, children, adolescents and adults should be included in the health insurance program, and free and timely MC should be performed for the male adults with the high risk of HIV infection and the normal ones whose wives are HIV-positive. Further investigations should be carried out on the epidemiology of redundant prepuce and phimosis, the acceptance and socio-cultural context of MC and the development of simpler and safer methods for MC.

[The analysis of human immunodeficiency virus-1 subtypes in Yunnan province].

OBJECTIVE: To analyze the geographical distribution and risk factors of HIV-1 subtypes in Yunnan province. METHODS: Blood samples from 1319 HIV positives were collected in Yunnan Province from 2001 to 2006. The nested polymerase chain reaction was used to amplify the gag (p24)-protease fragments from RNA extracted from plasma or sera. The sequences were used for subtype determination by phylogenetic tree analysis. RESULTS: Among 1319 samples studied, the subtypes has been successfully obtained from 644 samples that were constituted of seven subtypes: CRF08_BC, CRF07_BC, CRF07/08_BC, CRF01_AE, C, B' and URFB/C. C/CRF07_BC/CRF08_BC were distributed in the whole province, but CRF01_AE were mainly distributed in the boarding areas with Myanmar such as Dehong, Baoshan, Xishuangbanna and Puer. Moreover, injecting drugs users accounted for 61.6% (270/438) among C/CRF07_BC/CRF08_BC infections, while only 8.5% (15/177) among CRF01_AE infections. CONCLUSION: Our data indicated that at least seven subtypes were identified in Yunnan province, the relationship between subtypes and transmission routes were analyzed, and the geographic difference of subtypes was also observed.

[Epidemiologic study on STD/HIV infections among tin mining workers in Gejiu, Yunnan province].

OBJECTIVE: To estimate human immunodeficiency virus (HIV)/sexually transmitted diseases (STDs) related knowledge, the prevalence and risk factors for HIV/STDs among tin miners in Gejiu, Yunnan Province. METHODS: A cross-sectional study was conducted in tin miners working at 5 mining regions from March to June 2006 in Gejiu City, Yunnan Province. A total of 1796 miners were enrolled in the study, and a standardized questionnaire was administered probing socio-demographic factors, knowledge of HIV/STDs and sexual behavior. 7 ml-volume venous blood and 15 ml urine specimens were collected for HIV/STDs testing. RESULTS: Twelve participants [0.7%] (12/1760) were identified HIV positive. While, the positive proportions for syphilis, herpes simplex virus type-2 (HSV-2), Neisseria gonorrhea and Chlamydia trachoma were 1.8% (31/1760), 9.6% (169/1760), 0.8% (14/1773), 4.8% (85/1773), respectively. The total prevalence of STDs was 14.9% (264/1776). Factors associated with HIV infection were illegal drug use (adjusted OR = 17.8; 95% CI: 4.0 - 78.8), frequencies of visiting female sex workers in the past twelve months (adjusted OR = 8.7; 95% CI: 1.9 - 39.0), tattoos (adjusted OR = 6.6; 95% CI: 1.8 - 24.0), surgical operation experiences (adjusted OR = 6.0; 95% CI: 1.6 - 22.5) and toothbrush sharing (adjusted OR = 5.6; 95% CI: 1.0 - 31.3). Factors associated with STDs infection were race (adjusted OR = 2.0; 95% CI: 1.5 - 2.7), age (adjusted OR = 1.7; 95% CI: 1.0 - 2.9), illegal drug use (adjusted OR = 2.3; 95% CI: 1.0 - 5.2), living with spouses (adjusted OR = 1.4; 95% CI: 1.1 - 1.9) and visiting female sex workers (adjusted OR = 1.9; 95% CI: 1.4 - 2.6). Only 4.1% (49/1201) of respondents aware the correct transmission routes of HIV. 21.6% (339/1569) of the miners who had previous sexual experience self-reported visiting female sex workers. CONCLUSION: HIV and other STDs are highly prevalent amongst miners in this region. In addition, the awareness of HIV/STDs is low and multiple routes of HIV transmission, such as heterosexual intercourse and IDU, were also observed in these study subject. HIV/STDs interventions should therefore be reinforced among the miners in this region.