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1.
BJPsych Open ; 7(6): e191, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34659795

RESUMO

Background: Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development. Aims: This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge. Method: Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted. Results: Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = -1.15, 95% CI = -1.70, -0.33) or death (adjusted B = -1.55, 95% CI = -2.62, -0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = -0.26, 95% CI = -0.31, -0.20), anxiety symptoms (adjusted B = -0.25, 95% CI = -0.33, -0.17), post-traumatic stress disorders (adjusted B = -0.16, 95% CI = -0.22, -0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10). Conclusions: COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.

2.
J Int AIDS Soc ; 24(9): e25781, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34473409

RESUMO

INTRODUCTION: The COVID-19 pandemic has affected antiretroviral therapy (ART) continuity among people living with HIV (PLHIV) worldwide. We conducted a qualitative study to explore barriers to ART maintenance and solutions to ART interruption when stringent COVID-19 control measures were implemented in China, from the perspective of PLHIV and relevant key stakeholders. METHODS: Between 11 February and 15 February 2020, we interviewed PLHIV, community-based organization (CBO) workers, staff from centres for disease control and prevention (CDC) at various levels whose work is relevant to HIV care (CDC staff), HIV doctors and nurses and drug vendors from various regions in China. Semi-structured interviews were conducted using a messaging and social media app. Challenges and responses relevant to ART continuity during the COVID-19 pandemic were discussed. Themes were identified by transcript coding and mindmaps. RESULTS: Sixty-four stakeholders were recruited, including 16 PLHIV, 17 CBO workers, 15 CDC staff, 14 HIV doctors and nurses and two drug vendors. Many CDC staff, HIV doctors and nurses responsible for ART delivery and HIV care were shifted to COVID-19 response efforts. Barriers to ART maintenance were (a) travel restrictions, (b) inadequate communication and bureaucratic obstacles, (c) shortage in personnel, (d) privacy concerns, and (e) insufficient ART reserve. CBO helped PLHIV maintain access to ART through five solutions identified from thematic analysis: (a) coordination to refill ART from local CDC clinics or hospitals, (b) delivery of ART by mail, (c) privacy protection measures, (d) mental health counselling, and (e) providing connections to alternative sources of ART. Drug vendors contributed to ART maintenance by selling out-of-pocket ART. CONCLUSIONS: Social and institutional disruption from COVID-19 contributed to increased risk of ART interruption among PLHIV in China. Collaboration among key stakeholders was needed to maintain access to ART, with CBO playing an important role. Other countries facing ART interruption during current or future public health emergencies may learn from the solutions employed in China.


Assuntos
Antirretrovirais/provisão & distribuição , Terapia Antirretroviral de Alta Atividade/métodos , COVID-19 , Continuidade da Assistência ao Paciente , Infecções por HIV/tratamento farmacológico , Acesso aos Serviços de Saúde , Adulto , Antirretrovirais/administração & dosagem , Antirretrovirais/uso terapêutico , COVID-19/epidemiologia , COVID-19/psicologia , China/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Participação dos Interessados
3.
Lancet HIV ; 8(9): e531-e543, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34339628

RESUMO

BACKGROUND: Robust age-specific estimates of anal human papillomavirus (HPV) and high-grade squamous intraepithelial lesions (HSIL) in men can inform anal cancer prevention efforts. We aimed to evaluate the age-specific prevalence of anal HPV, HSIL, and their combination, in men, stratified by HIV status and sexuality. METHODS: We did a systematic review for studies on anal HPV infection in men and a pooled analysis of individual-level data from eligible studies across four groups: HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive men who have sex with women (MSW), and HIV-negative MSW. Studies were required to inform on type-specific HPV infection (at least HPV16), detected by use of a PCR-based test from anal swabs, HIV status, sexuality (MSM, including those who have sex with men only or also with women, or MSW), and age. Authors of eligible studies with a sample size of 200 participants or more were invited to share deidentified individual-level data on the above four variables. Authors of studies including 40 or more HIV-positive MSW or 40 or more men from Africa (irrespective of HIV status and sexuality) were also invited to share these data. Pooled estimates of anal high-risk HPV (HR-HPV, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68), and HSIL or worse (HSIL+), were compared by use of adjusted prevalence ratios (aPRs) from generalised linear models. FINDINGS: The systematic review identified 93 eligible studies, of which 64 contributed data on 29 900 men to the pooled analysis. Among HIV-negative MSW anal HPV16 prevalence was 1·8% (91 of 5190) and HR-HPV prevalence was 6·9% (345 of 5003); among HIV-positive MSW the prevalences were 8·7% (59 of 682) and 26·9% (179 of 666); among HIV-negative MSM they were 13·7% (1455 of 10 617) and 41·2% (3798 of 9215), and among HIV-positive MSM 28·5% (3819 of 13 411) and 74·3% (8765 of 11 803). In HIV-positive MSM, HPV16 prevalence was 5·6% (two of 36) among those age 15-18 years and 28·8% (141 of 490) among those age 23-24 years (ptrend=0·0091); prevalence was 31·7% (1057 of 3337) among those age 25-34 years and 22·8% (451 of 1979) among those age 55 and older (ptrend<0·0001). HPV16 prevalence in HIV-negative MSM was 6·7% (15 of 223) among those age 15-18 and 13·9% (166 of 1192) among those age 23-24 years (ptrend=0·0076); the prevalence plateaued thereafter (ptrend=0·72). Similar age-specific patterns were observed for HR-HPV. No significant differences for HPV16 or HR-HPV were found by age for either HIV-positive or HIV-negative MSW. HSIL+ detection ranged from 7·5% (12 of 160) to 54·5% (61 of 112) in HIV-positive MSM; after adjustment for heterogeneity, HIV was a significant predictor of HSIL+ (aPR 1·54, 95% CI 1·36-1·73), HPV16-positive HSIL+ (1·66, 1·36-2·03), and HSIL+ in HPV16-positive MSM (1·19, 1·04-1·37). Among HPV16-positive MSM, HSIL+ prevalence increased with age. INTERPRETATION: High anal HPV prevalence among young HIV-positive and HIV-negative MSM highlights the benefits of gender-neutral HPV vaccination before sexual activity over catch-up vaccination. HIV-positive MSM are a priority for anal cancer screening research and initiatives targeting HPV16-positive HSIL+. FUNDING: International Agency for Research on Cancer.


Assuntos
Canal Anal/virologia , Infecções por Papillomavirus/epidemiologia , Lesões Intraepiteliais Escamosas/epidemiologia , Fatores Etários , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Masculino , Papillomaviridae/classificação , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Prevalência , Fatores de Risco , Sexualidade/estatística & dados numéricos , Lesões Intraepiteliais Escamosas/virologia
4.
Retrovirology ; 18(1): 22, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34399785

RESUMO

BACKGROUND: CRF55_01B is a newly identified HIV-1 circulating recombinant form originated from MSM in China. However, its impact on the disease progression and transmission risk has not been investigated. This study aimed to determine the impact of CRF55_01B infection on viral dynamics and immunological status so as to provide scientific evidence for further control and prevention effort on CRF55_01B. Linear mixed effect models were applied to evaluate CD4 cell count decline and viral load increase by subtype. RESULTS: Of the 3418 blood samples, 1446 (42.3%) were CRF07_BC, 1169 (34.2%) CRF01_AE, 467 (13.7%) CRF55_01B, 249 (7.3%) type B, and 87 (2.5%) other subtypes (CRF_08BC, CRF_01B, C). CRF55_01B had become the third predominant strain since 2012 in Shenzhen, China. CRF55_01B-infected MSM showed lower median of CD4 count than CRF07_BC-infected MSM (349.5 [IQR, 250.2-474.8] vs. 370.0 [IQR, 278.0-501.0], P < 0.05). CRF55_01B infection was associated with slower loss of CD4 count than CRF01_AE (13.6 vs. 23.3 [cells/µl]¹/²/year, P < 0.05)among MSM with initial CD4 count of 200-350 cells/µl. On the other hand, those infected with CRF55_01B showed higher median plasma HIV RNA load (5.4 [IQR, 5.0-5.9]) than both CRF01_AE (5.3 [IQR, 4.8-5.7], P < 0.05) and CRF07_BC (5.0 log10 [IQR, 4.5-5.5], P < 0.001) at the initiation of antiretroviral therapy. Furthermore, the annual increasing rate of viral load for CRF55_01B infection was significantly higher than that of CRF07_BC (2.0 vs. 0.7 log10 copies/ml/year, P < 0.01). CONCLUSIONS: The relatively lower CD4 count and faster increase of plasma HIV RNA load of CRF55_01B-infected MSM without antiretroviral therapy suggest that CRF55_01B may lead to longer asymptomatic phase and higher risk of HIV transmission. Strengthened surveillance, tailored prevention strategies and interventions, and in-depth research focusing on CRF55_01B are urgently needed to forestall potential epidemic.

6.
Infect Dis Poverty ; 10(1): 94, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225791

RESUMO

BACKGROUND: Various modalities of vaccines against coronavirus disease 2019 (COVID-19), based on different platforms and immunization procedures, have been successively approved for marketing worldwide. A comprehensive review for clinical trials assessing the safety of COVID-19 vaccines is urgently needed to make an accurate judgment for mass vaccination. MAIN TEXT: A systematic review and meta-analysis was conducted to determine the safety of COVID-19 vaccine candidates in randomized controlled trials (RCTs). Data search was performed in PubMed, Embase, Cochrane library, Scopus, Web of Science, and MedRxiv. Included articles were limited to RCTs on COVID-19 vaccines. A total of 73,633 subjects from 14 articles were included to compare the risks of adverse events following immunization (AEFI) after vaccinating different COVID-19 vaccines. Pooled risk ratios (RR) of total AEFI for inactivated vaccine, viral-vectored vaccine, and mRNA vaccine were 1.34 [95% confidence interval (CI) 1.11-1.61, P < 0.001], 1.65 (95% CI 1.31-2.07, P < 0.001), and 2.01 (95% CI 1.78-2.26, P < 0.001), respectively. No significant differences on local and systemic AEFI were found between the first dose and second dose. In addition, people aged ≤ 55 years were at significantly higher risk of AEFI than people aged ≥ 56 years, with a pooled RR of 1.25 (95% CI 1.15-1.35, P < 0.001). CONCLUSIONS: The safety and tolerance of current COVID-19 vaccine candidates are acceptable for mass vaccination, with inactivated COVID-19 vaccines candidates having the lowest reported AEFI. Long-term surveillance of vaccine safety is required, especially among elderly people with underlying medical conditions.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Vacinas contra COVID-19/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
7.
Am J Gastroenterol ; 2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34313608

RESUMO

INTRODUCTION: The association between proton pump inhibitors' (PPIs) use and mortality remains unclear. METHODS: This was a prospective analysis of 440,840 UK residents and 13,154 deaths. We evaluated the associations with multivariate Cox regression. RESULTS: After adjusting for confounders, such as over health status and longstanding diseases, the regular use of PPIs was not associated with an increased risk of all-cause mortality and mortality due to neoplasms, circulatory system diseases, respiratory system diseases, digestive system diseases, external causes, and other causes. DISCUSSION: Regular use of PPIs was not associated with an increased risk of all-cause and cause-specific mortality.

8.
Artigo em Inglês | MEDLINE | ID: mdl-34300033

RESUMO

OBJECTIVE: Interpersonal theories of suicide suggest that the Interpersonal Needs Questionnaire (INQ) can be used to measure suicidal ideation, but few studies have focused on migrant people, a group with a high prevalence of suicidal ideation. The aim of this study was to validate the psychometric properties of the INQ-15 and its prediction of suicidal ideation among migrant industrial workers in China. METHOD: A stratified multi-stage sample of 2023 industrial workers was recruited from 16 factories in Shenzhen, China. There were 1805 nonlocal workers, which we defined as migrant workers with a mean age of 32.50 ± 8.43 years old who were 67.3% male. The structure of the Chinese version of the INQ-15 and its correlation and predictive utility for suicidal ideation were examined through factor analysis, the Item Response Theory, the M2 test, logistic regression, and receiver operating characteristic (ROC) analysis. RESULTS: Different from studies among various samples in which a two-factor solution is identified, results within this sample indicated three factors: perceived burdensomeness, thwarted belongingness, and social isolation. The model fit statistics of three-factor INQ were 0.075 for RMSEA, 0.945 for CFI, 0.932 for TLI, and 0.067 for SRMR. The model standard estimated factor loadings ranged from 0.366 to 0.869. The summed scores of INQ and perceived burdensomeness predicted suicidal ideation after controlling for sociodemographic characteristics such as age, gender, and income with AUC of 0.733 (95% CI: 0.712/0.754) and 0.786 (95% CI: 0.766/0.804). In the meantime, the comparison of the predictive ability between INQ total scores and PB scores was significant with p < 0.05. CONCLUSION: The INQ has good psychometric properties and can be used to assess how migrant workers living in the Shenzhen perceive meeting interpersonal psychological needs and shows good predictive ability of suicidal ideation. Perceived burdensomeness appears to play a role in suicide and may be a point of intervention, yet the notable deviation from previous findings and the relative weakness of two of the other factors warrant further study.


Assuntos
Ideação Suicida , Migrantes , Adulto , China , Feminino , Humanos , Relações Interpessoais , Masculino , Teoria Psicológica , Psicometria , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
9.
Sex Transm Dis ; 48(8): 550-556, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34110748

RESUMO

BACKGROUND: Young men who have sex with men (YMSM) are particularly at increased risk for human papillomavirus (HPV) infection and related malignancies. Rectal douching, commonly practiced among MSM, has been associated with HIV, chlamydia, gonorrhea, and viral hepatitis in cross-sectional studies. We conducted this study to understand the association between self-reported rectal douching and anal HPV among YMSM in China. METHODS: Between September 2018 and March 2019, MSM aged 15 to 24 years who ever engaged in receptive anal intercourse over the last 3 months were recruited via community-based organizations and centers for disease control located in 4 cities in China. Participants were asked to complete an online survey. We performed multivariate logistic regression adjusted for potential confounders to examine the association between self-reported rectal douching and anal HPV. RESULTS: Among 273 MSM with a median age of 20 years (interquartile range, 19-21 years) included in this study, 130 (47.6%) practiced rectal douching during the preceding 3 months and 96 (36.2%) were infected with anal HPV. Self-reported rectal douching was found to be associated with increased odds of anal HPV infection (odds ratio, 2.16; 95% confidence interval, 1.22-3.82) among YMSM, after adjusting for age, sexual debut, sex with alcohol or drugs, and HIV testing history. CONCLUSIONS: Self-reported rectal douching is associated with higher odds of anal HPV infection independent of sexual behaviors among YMSM. More prospective studies to ascertain this association are needed. Health education materials should inform men of the potential risk of rectal douching. Research on safer rectal douching procedures is warranted.


Assuntos
Alphapapillomavirus , Infecções por HIV , Infecções por Papillomavirus , Minorias Sexuais e de Gênero , China/epidemiologia , Estudos Transversais , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Lactente , Masculino , Papillomaviridae , Infecções por Papillomavirus/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Comportamento Sexual , Irrigação Terapêutica
10.
Tumour Virus Res ; 12: 200222, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34175495

RESUMO

BACKGROUND: Human papillomavirus (HPV) infection and related diseases are common among men who have sex with men (MSM). The most effective prevention is HPV vaccination. In China, however, men are not included in the HPV vaccination plan. We investigated the intention to initiate HPV vaccination and associated factors among MSM in China. Methods We surveyed 563 unvaccinated MSM aged 18 or older from six cities in China. Participants completed an electronic questionnaire about demographics, knowledge of and attitude towards HPV and HPV vaccine, intention to initiate HPV vaccination, willingness to recommend HPV vaccine to peers, feeling about government policy about HPV vaccination. We used the structural equation modeling (SEM) to analyze factors associated with HPV vaccine intention. Results The knowledge of HPV and HPV vaccine among participants was low. The mean score of knowledge about HPV and HPV vaccine was only 1.59 (range 0-11). The intention to initiate HPV vaccination within 6 months among participants was moderate (43.3% in total, 18.1% for 'very high' and 25.2% for 'above average').

11.
Vaccine ; 39(27): 3565-3581, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34034949

RESUMO

BACKGROUND: Due to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework. METHODS: In January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling. RESULTS: Seventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM). CONCLUSION: Despite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Minorias Sexuais e de Gênero , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Vacinação
12.
Lancet Glob Health ; 9(7): e932-e941, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33939956

RESUMO

BACKGROUND: Medical male circumcision (MMC) reduces HIV infection among heterosexual men. There are concerns MMC might prompt higher-risk sexual behaviours because of lower self-perceived risk of HIV infection. We reviewed the published literature to examine associations between MMC and both condom use and number of sex partners among heterosexual men. METHODS: In this systematic review and meta-analysis, we searched PubMed, Embase, and the Cochrane Library for studies published before Nov 15, 2020. Interventional and observational studies were included if they contained original quantitative data describing the association between MMC and condom use or number of sex partners among heterosexual men. We excluded data from men whose circumcisions were ritual or religious and data from men who have sex with men. We extracted odds ratios (ORs) and 95% CIs for the associations between MMC and condomless sex and MMC and multiple sex partners directly from the publications if available, selecting adjusted ORs when provided; when necessary, we calculated ORs and 95% CIs using original study data provided in the publication. We used the Mantel-Haenszel random effects model to calculate pooled ORs and 95% CIs. FINDINGS: Our search yielded 3035 results, of which 471 were duplicates and 2537 did not meet the inclusion criteria. From the remaining 27 eligible studies, we identified 99 292 men from 31 independent population samples. 24 studies were done in Africa. We found no statistically significant associations between MMC and condomless sex (OR 0·91, 95% CI 0·80-1·05; k=30; I2=88·7%) or multiple sex partners (1·02, 0·88-1·18; k=27; I2=90·1%). No associations between MMC and condomless sex or multiple sexual partners were found in any subgroup analyses by study design, income of country, age, recruitment setting, circumcision assessment, circumcision prevalence, and risk of publication bias. INTERPRETATION: The promotion of circumcision as an HIV preventive measure does not appear to increase higher-risk sexual behaviours in heterosexual men. Ongoing sexual health education should be maintained as a vital component of effective MMC programmes. FUNDING: National Science and Technology Major Project of China, the Fundamental Research Funds for the Central Universities, and the Shenzhen Science and Technology Innovation Commission Basic Research Program.


Assuntos
Circuncisão Masculina/estatística & dados numéricos , Infecções por HIV/epidemiologia , Comportamentos de Risco à Saúde , Heterossexualidade/psicologia , Comportamento Sexual/psicologia , Preservativos/estatística & dados numéricos , Heterossexualidade/estatística & dados numéricos , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais/psicologia
13.
Sci Rep ; 11(1): 8730, 2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888749

RESUMO

This paper develops a two-dimensional (2D) radiomics approach with computed tomography (CT) to differentiate between benign and malignant ovarian neoplasms. A retrospective study was conducted from July 2017 to June 2019 for 134 patients with surgically-verified benign or malignant ovarian tumors. The patients were randomly divided in a ratio of 7:3 into two sets, namely a training set (of n = 95) and a test set (of n = 39). The ITK-SNAP software was used to delineate the regions of interest (ROI) associated with lesions of the largest diameters in plain CT image slices. Texture features were extracted by the Analysis Kit (AK) software. The training set was used to select the best features according to the maximum-relevance minimum-redundancy (mRMR) criterion, in addition to the algorithm of the least absolute shrinkage and selection operator (LASSO). Then, we employed a radiomics model for classification via multivariate logistic regression. Finally, we evaluated the overall performance of our method using the receiver operating characteristics (ROC), the DeLong test. and tested in an external validation test sample of patients of ovarian neoplasm. We created a radiomics prediction model from 14 selected features. The radiomic signature was found to be highly discriminative according to the area under the ROC curve (AUC) for both the training set (AUC = 0.88), and the test set (AUC = 0.87). The radiomics nomogram also demonstrated good calibration and differentiation for both the training (AUC = 0.95) and test (AUC = 0.96) samples. External validation tests gave a good performance in radiomic signature (AUC = 0.83) and radiomics nomogram (AUC = 0.95). The decision curve explicitly indicated the clinical usefulness of our nomogram method in the sense that it can influence major clinical events such as the ordering or abortion of other tests, treatments or invasive procedures. Our radiomics model based on plain CT images has a high diagnostic efficiency, which is helpful for the identification and prediction of benign and malignant ovarian neoplasms.

14.
BMC Public Health ; 21(1): 802, 2021 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902499

RESUMO

BACKGROUND: The prevalence of HIV among men who have sex with men (MSM) in southwest China is still increasing. This study aimed to investigate the trend in HIV incidence and its associated risk factors among MSM in Chengdu, China. METHOD: Incidence data were collected from the largest local non-governmental organization (NGO) serving MSM in Chengdu between 2012 and 2018, while information on sexual behaviors was collected from 2014. All MSM who received voluntary counseling and testing services (VCT) in the collaborating NGO at least twice during the study period were included. We calculated the HIV incidence density among MSM every 2 years and the overall incidence rate. A Cox proportional hazards regression model was employed to identify risk factors for HIV infection. RESULT: A total of 4578 HIV-negative participants were included in the cohort. The total incidence density was 5.95 (95% CI: 5.37-6.56)/100 person-years (PYs) between 2012 and 2018. The segmented incidence density was 9.02 (95% CI: 7.46-10.78), 5.85 (95% CI: 4.86-6.97), 5.43 (95% CI: 4.53-6.46), and 3.09 (95% CI: 2.07-4.41)/100 PYs in 2012-2013, 2014-2015, 2016-2017, and 2018, respectively. After adjusting for sociodemographic characteristics, compared to participants without sexual partners within 6 months, MSM with one fixed partner (Adjusted Hazard Ratio, AHR = 1.18, 95% CI: 0.44-3.19) and more than five partners (AHR = 2.24, 95% CI: 0.81-6.20) had increased risk of HIV infection. MSM who used condom inconsistently had a higher risk of HIV infection (AHR = 1.87, 95% CI: 1.46-2.38) compared to consistent condom users. CONCLUSION: The decreased HIV incidence density among MSM was potentially related to the successful comprehensive HIV prevention strategies in Chengdu. Multiple male sexual partnerships and inconsistent condom use during anal intercourse were risk factors associated with HIV occurrence.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , China/epidemiologia , Estudos de Coortes , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Incidência , Masculino , Estudos Retrospectivos , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais
15.
AIDS Care ; : 1-8, 2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33908841

RESUMO

Recent evidence shows that circumcision is associated with lower HIV prevalence among MSM. We assessed the acceptability of circumcision for preventing HIV and that of Shang Ring circumcision (SRC) among men who have sex with men (MSM) in China. 538 adult MSM were recruited from six cities in China between January and March 2019. Participants were surveyed by an online, self-administered questionnaire. The acceptability of circumcision was assessed before and after the potential protective effect of circumcision against HIV was informed, and subsequently men's willingness to undergo SRC was assessed. The level of circumcision was 16.4%. Of 450 uncircumcised MSM, their willingness to be circumcised in the following six months increased significantly from 32.2% to 55.6% after the information session. Three quarters of men who were willing to undergo circumcision accepted SRC. MSM who perceived that circumcision could maintain genital hygiene were more likely to accept circumcision after the information session, whereas those who regarded circumcision as an embarrassing surgery were disinclined to be circumcised. The low circumcision rate, along with its high acceptability in Chinese MSM, suggests a great potential benefit of circumcision intervention if proved effective. SRC might be a popular circumcision procedure in this population.

16.
Biomed Res Int ; 2021: 6682932, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33869634

RESUMO

This study is aimed at investigating the awareness of and preferences for oral and long-acting injectable HIV preexposure prophylaxis (PrEP) and their associated factors among men who have sex with men (MSM) at high risk of HIV infection in southern China. A cross-sectional survey was conducted among 603 MSM who were recruited through a cohort study called the T2T Study at three sexual health clinics in Guangzhou, Shenzhen, and Wuxi, China, from 2017 to 2018. We collected information on HIV-negative participants' awareness of and willingness to use PrEP and its potential correlations. Univariate and multivariate logistic regressions were used for data analyses. A total of 550 HIV-negative MSM were enrolled in the study. Less than half of at-risk MSM (43.1%) had heard of PrEP before, and the rate of overall willingness to use PrEP was 65.8%, while MSM were more willing to use daily oral PrEP than long-acting injectable- (LAI-) PrEP (62.2% vs. 38.5%). MSM who had university degrees or above (aOR = 1.55, 95% CI: 1.01-2.37), used condoms during last anal sex (1.52, 1.01-2.29), and tested 3 times or more for HIV (2.45, 1.10-5.47) were more likely to be aware of PrEP. MSM who had use of gay dating apps (1.51, 1.02-2.23), ever participated in HIV- or sexually transmitted disease (STD-) related studies (1.91, 1.24-2.94), and had heard of PrEP (3.06, 2.06-4.54) were more willing to use any regimen of PrEP. MSM at high risk of HIV infection had low awareness of PrEP and moderate willingness to use PrEP. Further studies of the implementation and promotion of PrEP targeting at-risk MSM should be performed.


Assuntos
Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina , Preferência do Paciente , Profilaxia Pré-Exposição , Administração Oral , Adulto , Fármacos Anti-HIV/uso terapêutico , China , Infecções por HIV/diagnóstico , Humanos , Masculino , Fatores de Risco , Adulto Jovem
17.
Eur J Clin Microbiol Infect Dis ; 40(7): 1357-1367, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33768442

RESUMO

Human papillomavirus (HPV) infection among men who have sex with men (MSM) in China is underreported. We performed a systematic review and meta-analysis to clarify site-specific HPV prevalence among MSM in China. We searched both English and Chinese databases for all studies published before April 1, 2020, that reported HPV prevalence among MSM in China. Random-effects meta-analysis was used to calculate summary estimates. Thirty-four articles were eligible, where 32, 5, and 2 articles reported HPV prevalence at the anus, penis, and oral cavity, respectively. The estimated prevalence of anal HPV among MSM in China was 85.1% (HIV-positive), 53.6% (HIV-negative), and 59.2% (unknown HIV status), with HPV genotypes being predominated by HPV 6, 11, 16, 18, 52, and 58. Any HPV and high-risk (HR) HPV was more common in northern China, while low-risk HPV was more common in southern China. HPV prevalence increased with age among HIV-negative MSM, from 40.5% (aged < 20 years) to 57.2% (aged ≥ 40 years). High prevalence of any HPV (HIV+: 95.1%; HIV-: 97.7%) and multiple infections (HIV+: 75.9%; HIV-: 41.7%) was found in anogenital warts among MSM. HPV is common among MSM in China. MSM living with HIV and/or anogenital warts were at disproportionate risk for HR HPV. Younger MSM were found to have a lower HPV prevalence. HPV vaccines would have prevented the majority of infections if given before sex debut. HPV at anatomical sites other than the anus, incident HPV infection, and the cost-effectiveness of HPV vaccination in this population are worth further investigation.


Assuntos
Homossexualidade Masculina , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , China/epidemiologia , Humanos , Masculino , Infecções por Papillomavirus/epidemiologia
18.
Hum Vaccin Immunother ; 17(7): 2279-2288, 2021 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-33522405

RESUMO

Background: A safe and effective vaccine against COVID-19 has become a public health priority. However, little is known about the public willingness to accept a future COVID-19 vaccine in China. This study aimed to understand the willingness and determinants for the acceptance of a COVID-19 vaccine among Chinese adults.Methods: A cross-sectional survey using an online questionnaire was conducted in an adult population in China. Chi-square tests were used to identify differences for various intentions regarding COVID-19 vaccination. The t test was used to identify differences among vaccine hesitancy scores. Multivariable logistic regression was used to analyze the predicated factors associated with the willingness to receive a COVID-19 vaccine.Results: Of the 3195 eligible participants, 83.8% were willing to receive a COVID-19 vaccine, and 76.6% believed the vaccine would be beneficial to their health; however, 74.9% expressed concerns or a neutral attitude regarding its potential adverse effects. Of the participants, 76.5% preferred domestically manufactured vaccines and were more willing to be vaccinated than those who preferred imported vaccines. Multivariable logistic regression indicated that lack of confidence, complacency in regard to health, risk of the vaccine, and attention frequency were the main factors affecting the intention to receive a COVID-19 vaccine.Conclusion: Our study indicated that the respondents in China had a high willingness to accept a COVID-19 vaccine, but some participants also worried about its adverse effects. Information regarding the efficacy and safety of an upcoming COVID-19 vaccine should be disseminated to ensure its acceptance and coverage.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , China , Estudos Transversais , Humanos , SARS-CoV-2 , Inquéritos e Questionários , Vacinação
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