The situation and related factors of satisfaction of HIV-infected people towards the follow-up management of primary medical and health care institutions in rural areas of Jiangxi Province / 中华预防医学杂志

The HIV-infected people were investigated for their satisfactory situation towards the follow-up management of primary medical and health care institutions in Xinjian County, Yushan County and Guixi City of Jiangxi Province from January to July 2018 and related factors were also analyzed. The total score of the Infected Patients′ Follow-up Management Satisfaction Scale higher than 59 was defined as the satisfactory. 75.68% of 259 infected patients were satisfied with the follow-up management. Compared to farmers and other follow-up modes, non-farmers (OR=10.72, 95%CI: 2.07-55.63), and patients receiving follow-up service in responsible institutions (OR=6.44, 95%CI: 3.12-13.30) were more satisfied with follow-up management.

Follow-up of people living with HIV/AIDS by primary health care institutions in rural area of Jiangxi province / 中华流行病学杂志

Objective@#To understand the current status of follow up of people living with HIV/AIDS by health service at grass root in rural area of Jiangxi province and related factors, and provide references for the promotion of the follow up by grass root health service.@*Methods@#People living HIV/AIDS aged ≥18 years and diagnosed before 31 December 2017 in 6 townships of Xinjian, Yushan counties and Guixi city were included in the study in Jiangxi province. They had been followed up for more than one time after the first epidemiologic survey. The information about their demographic characteristics and HIV infection status were collected by using self-designed questionnaire. Univariate and multivariate logistic regression analyses were conducted to identify the factors that influencing the acceptance of follow up by grass root health service.@*Results@#Of the 373 surveyed HIV infected subjects aged (53.06±16.15) years, 261 were males (70.0%, 261/373). Among the surveyed subjects, the illiteracy and people who received only primary school education accounted for 54.7% (204/373). The rate of follow up of the HIV infected subjects by grass root health service was 55.8% (208/373), and those through heterosexual contact were 58.5% (190/325). The multivariate regression analysis showed that the acceptance of follow up by grass root health service was higher in those who were farmers (OR=7.36, 95%CI: 2.52-21.45), had family support (OR=16.01, 95%CI: 2.25-49.73), didn’t worry about discrimination (OR=12.97, 95%CI: 4.75-35.42), trusted health care provider (OR=5.07, 95%CI: 2.19-11.76) and showed AIDS symptoms (OR=10.58, 95%CI: 2.25- 49.73).@*Conclusions@#The performance of follow up of people living with HIV/AIDS by grass root health service was well, suggesting it is a feasible management model. Being famer or not, family member supporting or not, worry about discrimination or not, trusting health care provider or not and showing AIDS symptoms or not were the main factors influencing the acceptance of follow up by grass root health service.

Application of Bernoulli Process Model fitting the effect of intervention measures on sexual transmission among HIV sero-discordant couples / 中华流行病学杂志

Objectives To undersand the outcomes of major intervention measures on sexual transmission among HIV sero-discordant couples.Methods Bernoulli Process Model was applied to model the major influencing factors of HIV transmission among HIV sero-discordant couples.The major influencing factors appeared as consistent condom use,antiretroviral therapy,frequency of sexual behavior.These parameters were from the HIV sero-discordant couples in 30 counties in 4 provinces (Guangxi Zhuang Autonomous Region,Yunnan Province,Xinjiang Uygur Autonomous Region and Henan provinces) from January 1,2011 to December 31,2012.According to the main factors,modeling-intervention strategies and measures on reduction HIV transmission among sero-discordant couples were formed.Results Data from the present proportion of consistent condom use (85％) modeling and the coverage of antiretroviral treatment (60％) showed that,the proportion of cumulative seroconversion among the spouses was 1.76％.Results from the sensitivity analysis on modeling the consistent condom use and the antiretroviral treatment showed that,when the coverage of antiretroviral treatment was as 90％ and the proportion of consistent condom use increased from 50％ to 90％,with 80.7％ of the risk of spouse seroconversion could be reduced.Or,when the proportion of consistent condom use was as 90％ and the coverage of antiretroviral treatment increased from 50％ to 90％,with 64.5％ of the risk of spouse seroconversion could be reduced.Conclusions With measures as consistent condom use plus provision of timely antiretroviral therapy to HIV positive index spouses,the risk of sexual transmission among sero-discordant couples could be greatly reduced.

Initial follow-up and CD4+ T cell count test of newly reported students HIV cases in China, 2013-2017 / 中华预防医学杂志

Objective@#To analyze first follow-up and CD4+ T (CD4) cell count test of newly reported students HIV cases in China from 2013 to 2017.@*Methods@#Data were collected from both Case Reporting Cards and Follow-up Cards from China Information System for HIV/AIDS Control and Prevention between 1st January 2013 and 31st December 2017. The inclusion criteria are 15-24 years old students who were newly diagnosed with HIV infection. Logistic regression model was used to analyze relevant factors of the first CD4 test results less than 200 CD4 cells/μl.@*Results@#There were 12 037 newly diagnosed students HIV cases from 2013 to 2017. Most cases were male (97.7%), 19-22 years old (65.1%) and Han ethnicity (90.5%). At the time of diagnosis, the route of HIV infection was most frequently homosexual contact (82.2%). The majority of cases (46.9%) were diagnosed at HIV voluntary counseling and testing (VCT) location. About 2 465 (20.6%) students had unprotected intercourse in the past 3 months, of which 1 387 (56.8%) had 1 sexual partner, 610 (25.0%) with 2 sexual partners, 273 (11.2%) with 3 partners and 170 (7.0%) with more than 4 partners. 11.0% and 28.9% of cases had initial CD4 counts less than 200 cells/μl and 200-349 cells/μl. Compared to the male, younger than 18 years old and diagnosed at VCT location, female (OR=2.09, 95%CI: 1.51-2.89), aged 21 to 22 years (OR=1.25, 95%CI: 1.06-1.47), diagnosed in hospital settings (OR=2.20, 95%CI: 1.89-2.57) and preoperative testing (OR=1.36, 95%CI: 1.07-1.73) had greater proportion of the first CD4 test result less than 200 CD4 cells/μl.@*Conclusion@#The number of newly diagnosed students HIV cases significantly increased in past 5 years, and the proportion of late diagnosis was high. Female, aged 21 to 22 years, diagnosed in hospital settings and preoperative testing were related to the first CD4 test result less than 200 CD4 cells/μl.

Programs on mobility, status of follow-up and CD4+T cell testing among people living with HIV/AIDS, in China 2011-2015 / 中华流行病学杂志

Objective To analyze the mobility,status of follow-up and CD4+T cell testing (CD4 testing) programs among people living with HIV (PLHIV) between 2011 and 2015 and to improve the prevention program on HIV secondary transmission.Methods Data were collected from both Case Reporting Cards and Follow-up Cards through the National HIV/AIDS Comprehensive Control and Prevention data system.Changes of residence among the newly reported cases and survival cases between 2011 and 2015 were analyzed by SPSS 24.0 software.Results The number of newly reported inter-provincial mobile PLHIV had been increasing,with proportions of the total reported cases from 10.0％ (5 576/55 805) in 2011 to 13.3 ％ (15 348/115 231) in 2015.After adjusting for related confounders,percentages of follow-up and CD4 testing were lower in inter-provincial and inter-prefectural mobile cases than those without.Conclusion Service regarding the follow-up and CD4 testing programs was affected by mobility of people living with HIV/AIDS.Programs on communication and personal contact should be strengthened in the follow-up management services for PLHIV.Information on potential mobility of PLH1V should be gathered timely by health workers during the subsequent follow-up period to avoid the loss of follow-up and CD4 testing on patients.

Application of Bernoulli Process Model fitting the effect of intervention measures on sexual transmission among HIV sero-discordant couples / 中华流行病学杂志

Objectives: To undersand the outcomes of major intervention measures on sexual transmission among HIV sero-discordant couples. Methods: Bernoulli Process Model was applied to model the major influencing factors of HIV transmission among HIV sero-discordant couples. The major influencing factors appeared as consistent condom use, antiretroviral therapy, frequency of sexual behavior. These parameters were from the HIV sero-discordant couples in 30 counties in 4 provinces (Guangxi Zhuang Autonomous Region, Yunnan Province, Xinjiang Uygur Autonomous Region and Henan provinces) from January 1, 2011 to December 31, 2012. According to the main factors, modeling-intervention strategies and measures on reduction HIV transmission among serodiscordant couples were formed. Results: Data from the present proportion of consistent condom use (85%) modeling and the coverage of antiretroviral treatment (60%) showed that, the proportion of cumulative seroconversion among the spouses was 1.76%. Results from the sensitivity analysis on modeling the consistent condom use and the antiretroviral treatment showed that, when the coverage of antiretroviral treatment was as 90% and the proportion of consistent condom use increased from 50% to 90%, with 80.7% of the risk of spouse seroconversion could be reduced. Or, when the proportion of consistent condom use was as 90% and the coverage of antiretroviral treatment increased from 50% to 90%, with 64.5% of the risk of spouse seroconversion could be reduced. Conclusions: With measures as consistent condom use plus provision of timely antiretroviral therapy to HIV positive index spouses, the risk of sexual transmission among sero-discordant couples could be greatly reduced.

Situation and reasons for missed follow-up services among newly reported HIV/AIDS cases transmitted by homosexual behavior in China, 2008-2015 / 中华流行病学杂志

Objective To determine the prevalence and relative factors on those who missed the follow-up service among newly reported HIV/AIDS cases that were infected by homosexual behavior.Methods Data were extracted from both HIV/AIDS case-reporting and follow-up cards on HIV/AIDS in the Comprehensive Response Information Management System,between December 2008 and December 2015.Data was analyzed,using the generalized estimating equations (GEE) to explore the relative factors of influence.Results Among the newly reported HIV infection among MSM,the proportion of those who missed the follow-up services was 5.06％ (6 037/119 358),and decreased dramatically,from 37.57％ (1 261/3 356) to 0.84％ (267/31 935) (trendx2=103.43,P＜0.01).In MSM population,the younger than 20-year olds (OR=1.30,95％CI:1.11-1.52),20-year olds (OR=1.52,95％CI:1.36-1.69),30-year olds (OR=1.22,95％CI:1.12-1.34),40-year olds (OR=1.10,95％CI:1.01-1.20) were receiving less follow-up services than those 50-year olds.Those who had received either junior (OR=1.52,95％CI:1.37-1.69) or senior high school education (OR=1.35,95％CI:1.23-1.49) were receiving less follow-up service than those who were more educated.MSM with the following characteristics as unspecified occupation (OR=2.06,95％ CI:1.49-2.87),unemployed (OR=1.54,95％ CI:1.30-1.83),working in commercial service (OR=1.31,95％ CI:1.15-1.49) or being student (OR=1.34,95％ CI:1.18-1.52) were more difficult to be traced or followed than the cadres.Cases being identified on site (OR=2.99,95％ CI:2.26-3.95) or under special investigation (OR=1.43,95％ CI:1.29-1.59) had received less follow-up service than those being identified through voluntary counsel testing service.Floating population (OR=1.46,95％ CI:1.28-1.66) were getting less follow-up service than local residents.Conclusions The prevalence of those who had missed the follow-up services in the newly discovered MSM HIV cases declined dramatically.Among the MSM HIV cases,those having the following characteristics as:younger than 50-year old,with less school education,with unspecified occupation or unemployment,working in commercial service,being student,having history of incarceration,recruited from special investigation,and floating population were prone to miss the follow-up program,suggesting that the follow-up service should be targeting on these patients.

Programs on mobility, status of follow-up and CD(4)(+)T cell testing among people living with HIV/AIDS, in China 2011-2015 / 中华流行病学杂志

Objective: To analyze the mobility, status of follow-up and CD(4)(+)T cell testing (CD(4) testing) programs among people living with HIV (PLHIV) between 2011 and 2015 and to improve the prevention program on HIV secondary transmission. Methods: Data were collected from both Case Reporting Cards and Follow-up Cards through the National HIV/AIDS Comprehensive Control and Prevention data system. Changes of residence among the newly reported cases and survival cases between 2011 and 2015 were analyzed by SPSS 24.0 software. Results: The number of newly reported inter-provincial mobile PLHIV had been increasing, with proportions of the total reported cases from 10.0% (5 576/55 805) in 2011 to 13.3% (15 348/115 231) in 2015. After adjusting for related confounders, percentages of follow-up and CD(4) testing were lower in inter-provincial and inter-prefectural mobile cases than those without. Conclusion: Service regarding the follow-up and CD(4) testing programs was affected by mobility of people living with HIV/AIDS. Programs on communication and personal contact should be strengthened in the follow-up management services for PLHIV. Information on potential mobility of PLHIV should be gathered timely by health workers during the subsequent follow-up period to avoid the loss of follow-up and CD(4) testing on patients.

Situation and reasons for missed follow-up services among newly reported HIV/AIDS cases transmitted by homosexual behavior in China, 2008-2015 / 中华流行病学杂志

Objective: To determine the prevalence and relative factors on those who missed the follow-up service among newly reported HIV/AIDS cases that were infected by homosexual behavior. Methods: Data were extracted from both HIV/AIDS case-reporting and follow-up cards on HIV/AIDS in the Comprehensive Response Information Management System, between December 2008 and December 2015. Data was analyzed, using the generalized estimating equations (GEE) to explore the relative factors of influence. Results: Among the newly reported HIV infection among MSM, the proportion of those who missed the follow-up services was 5.06% (6 037/119 358), and decreased dramatically, from 37.57% (1 261/3 356) to 0.84% (267/31 935) (trend χ(2)=103.43, P<0.01). In MSM population, the younger than 20-year olds (OR=1.30, 95%CI: 1.11-1.52), 20-year olds (OR=1.52, 95%CI: 1.36-1.69), 30-year olds (OR=1.22, 95%CI: 1.12-1.34), 40-year olds (OR=1.10, 95%CI: 1.01-1.20) were receiving less follow-up services than those 50-year olds. Those who had received either junior (OR=1.52, 95%CI: 1.37-1.69) or senior high school education (OR=1.35, 95%CI: 1.23-1.49) were receiving less follow-up service than those who were more educated. MSM with the following characteristics as unspecified occupation (OR=2.06, 95%CI: 1.49-2.87),unemployed (OR=1.54, 95%CI: 1.30-1.83), working in commercial service (OR=1.31, 95%CI: 1.15-1.49) or being student (OR=1.34, 95%CI: 1.18-1.52) were more difficult to be traced or followed than the cadres. Cases being identified on site (OR=2.99, 95%CI: 2.26-3.95) or under special investigation (OR=1.43, 95%CI: 1.29-1.59) had received less follow-up service than those being identified through voluntary counsel testing service. Floating population (OR=1.46, 95%CI: 1.28-1.66) were getting less follow-up service than local residents. Conclusions: The prevalence of those who had missed the follow-up services in the newly discovered MSM HIV cases declined dramatically. Among the MSM HIV cases, those having the following characteristics as: younger than 50-year old, with less school education, with unspecified occupation or unemployment, working in commercial service, being student, having history of incarceration, recruited from special investigation, and floating population were prone to miss the follow-up program, suggesting that the follow-up service should be targeting on these patients.

An analysis of factors associated with timeliness of antiretroviral therapy initiation among newly diagnosed HIV/AIDS from 2010 to 2014 in China / 中华预防医学杂志

Objective@#To analyze timeline of antiretroviral therapy (ART) initiation among newly diagnosed HIV/AIDS from 2010 to 2014, as well as influencing factors.@*Methods@#Data from the Chinese HIV/AIDS Comprehensive Response Information Management System was used to collect newly diagnosed HIV/AIDS cases from January 1, 2010 to December 31, 2014. Inclusion criteria of HIV/AIDS were confirmed cases and clinically diagnosed HIV positive, Chinese mainland cases, 14 years old and above, the first CD4+T lymphocyte ≤350 cells/μl in the follow up period. A total of 177 971 HIV/AIDS cases were included in this study. The general demographic characteristics (gender, age, ethnicity, education, occupation, etc.), infection routes, sample sources, CD4+T lymphocyte level and other information were collected from the database. Chi square test was used to analyze univariate factor of the timeliness of ART initiation. Multivariate logistic regressions were used to analyze potential factors associated with timeliness of ART initiation.@*Results@#Out of the 17 7971 cases, 130 679 (73.4%) were males. The proportion of the timeliness of ART initiation was 55% (97 915). The proportion of timeline of ART within 15 d increased from 26.4% (4 319/16 388) in 2010 to 39.7% (20 212/50 889) in 2014. The highest proportion was in the group of patients infected by illegal blood (plasma) donation, which was 38% (945). The proportion of timeline of ART within 30 d increased from 43.2% (7 077/16 388) in 2010 to 63% (32 070/50 889) in 2014.The highest proportion was in the group of patients infected by heterosexual transmission, which was 58.3% (73 098). Multivariate logistic regression analysis on timeliness of ART showed that the factors of timeliness of ART initiation of HIV/AIDS as follow. The possibility of timeliness of ART among patients who were female, education of junior high school and above, ethnic group of Han, farmers, married were higher, with OR values at 1.08, 1.09, 1.13, 1.05 and 1.12. The possibilities of timeliness of ART in group of patients aging 25-34, 35-44, 45-54 and ≥55 years old were higher than that of the group of patients aging 15-24 years old, with OR values at 1.13, 1.31, 1.46 and 1.51, respectively. The possibilities of timeliness of ART among the homosexuals, injection drug use and sexual contact plus injection drug use cases were lower than that of the heterosexuals, with OR values at 0.86, 0.59 and 0.72, respectively. The possibilities of timeliness of ART among patients whose HIV diagnosis from hospitals and detention centers were lower than that of patients whose HIV diagnosis from volunteer testing and counseling, with OR values at separately 0.90 and 0.29. The possibilities of timeliness of ART among patients whose CD4+T lymphocyte at 50-99, 100-199, 200-350 cells/μl were lower than that of the patients whose CD4+T lymphocyte count at 0-49 cells/μl, with OR values at 0.84, 0.64 and 0.40, respectively. All the P values above was<0.05.@*Conclusion@#The proportion of timeliness of ART increased annually from 2010 to 2014. Those who were men, unmarried or divorced, at younger age, injection drug use, diagnosis from hospitals and detention centers and high CD4+T lymphocyte levels were related to the timeliness of ART.

Factors associated with marital status among spouse after diagnosed in newly reported HIV cases in China, 2014 / 中华流行病学杂志

Objective To analyze the factors associated with divorce or separation when one of the spouse diagnosed and newly reported as HIV positive,in China.Methods Data from the Chinese HIV/AIDS Comprehensive Response Information Management System,by December 31,2015 were used for collection on newly reported HIV cases regarding their baseline information in 2014 and follow-up within one year,among couples and above 18 year olds.HIV cases were divided into divorce/separation group and married group according to their marriage dynamics in one year after being diagnosed as HIV positive.Multivariate logistic regressions were used to analyze potential factors associated with divorce or separation after the diagnoses made.Results A total of 31 708 HIV cases were included in this study.22.5％ (7 134/31 708) of them got divorced or separated in one year after diagnose being made.81.6％ (25 864/31 708) of them had couples tested in one year after diagnose made and 10.0％ (2 599/25 864) of them got divorced or separated.Among 18.4％ (5 844/31 708) of the HIV cases who did not have their couples tested in one year after the diagnoses,77.6％ (4 535/ 5 844) got divorced or separated.For those who did not have their couples tested in one year after the diagnose.Data from the multivariate logistic regression analysis showed that factors as those who were older than 45 (46-60 yr.:OR=1.28,95％CI:1.03-1.58;≥61 yr.:OR=1.83,95％CI:1.41-2.37),with Han ethnicity (OR=1.56,95％CI:1.34-1.83),with high school education or above (OR=1.55,95％CI:1.27-1.90),non-farmers or non-rural laborers (OR=1.34,95％CI:1.17-1.54),infected through injecting drug use (OR=1.33,95％CI:1.03-1.71),men who had sex with men (OR=1.49,95％CI:1.20-1.86),or with childless (OR=2.35,95％CI:1.78-3.09) etc.were more likely to be divorced or separated after the diagnoses being made,among those who had their couples tested in one year after the diagnoses.Results from the multivariate logistic regression analysis showed that factors as those who were above 60 year olds (OR=1.32,95％CI:1.12-1.56),with Han ethnicity (OR=1.27,95％CI:1.13-1.44),with high school education or above (OR=1.26,95％ CI:1.11-1.43),non-farmers or non-rural labors (OR=1.37,95％CI:1.25-1.51),infected through having sex with men (OR=1.38,95％ CI:1.25-1.54),or without a child (OR=1.48,95％ CI:1.27-1.71),were more likely to be divorced or separated after the diagnoses.Conclusion A certain proportion of HIV cases got divorced or separated in one year after the diagnosis was made.The proportions of divorce or separation were different among populations.Interventions targeting reducing divorce or separation in certain populations should be integrated into routine care system to reduce the HIV transmission.

Survival time of newly diagnosed HIV/AIDS cases and related factors in China, 2010 / 中华流行病学杂志

Objective To analyze the survival time of newly diagnosed HIV/AIDS cases and related factors in China in 2010.Methods The reporting cards and follow-up cards of HIV/AIDS cases reported as of 31 December 2015 were collected from national AIDS information system.The newly diagnosed HIV/AIDS cases in 2010 were selected.The information of follow-up intervention,CD4+ T cells (CD4) testing,antiretroviral treatment and mortality of the cases from 2010 to 2015 were analyzed.Life table method was applied to calculate the survival probability.Kaplan-Meier was used to draw survival curve and Cox proportion hazard regression model were used to identify the factors related to survival time.Results Of the 40 335 HIV/AIDS cases,11 975(29.7％) died of AIDS related diseases.The median survival time was 63.1 months (95％CI:63.0-63.2),and the survival rates in 1 year and 5 years were 81.2％ and 69.9％.Multivariate Cox regression analysis showed that the risk factors for death in the HIV/AIDS cases were age (25-34 years old vs.15-24 years old:HR=1.41,95％CI:1.29-1.54;35-34 years old vs.15-24 years old:HR=1.90,95％CI:1.74-2.07;45-54 years old vs.15-24 years old:HR=2.24,95％CI:2.04-2.46;≥55 years old vs.15-24 years old:HR=2.81,95％CI:2.57-3.08).The protective factors for death in the HIV/AIDS cases were level of baseline CD4 counts (CD4 ≥ 500 cells/μ1 vs.CD4 ＜ 200 cells/μl:HR =0.12,95 ％ CI:0.11-0.13),receiving antiretroviral therapy (ART vs.no ART:HR=0.11,95％CI:0.10-0.12).Conclusion Survival time of HIV/AIDS cases might be influenced by age,baseline CD4 count and access to antiretroviral therapy.The early diagnosed and early antiretroviral therapy could extend the survival time of HIV/AIDS cases.

Status of marriage and HIV transmission between couples in newly reported HIV cases before diagnosis was made, among men who have sex with men in China, 2014 / 中华流行病学杂志

Objective To analyze the status of marriage and HIV transmission between couples in newly reported HIV cases before diagnoses were made,among men who have sex with men (MSM) in China.Methods Baseline and follow-up information related to newly reported cases in 2014 were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System.Infected MSM who were older than 22 years of age were included in this study.HIV cases were divided into sero-concordant or sero-discordant group,according to the HIV status of the couple who were tested 180 days post-diagnosis.Multivariate logistic regression method was used to analyze the potential factors associated with HIV transmission between couples before diagnosis was made.Results A total of 5 081 (22.7％) of the HIV infected MSM who had couples,were included in this study.A total of 3 715 cases had their couples tested 180 days after the diagnosis was made.7.6％ (282) had positive couples.Results from the multivariate logistic regression analysis showed that factors as:older than 60 (OR=2.64,95％CI:1.50-4.65) years of age,being minorities (OR=1.93,95％CI:1.13-3.29),having CD4+T cells less than 500 cells/μl (＜200:OR=2.91,95％CI:1.82-4.65;200-349:OR=1.98,95％CI:1.22-3.23;350-500:OR=1.69,95％CI:1.00-2.86),with self-reported unsafe behaviors (OR=1.92,95％CI:1.44-2.58) etc.,were more likely to transmit HIV to their couples before the diagnosis was made.Conclusion Behavior interventions and early HIV testing should be promoted,especially among those MSM who had couples,to avoid inter-spousal transmission.

Factors associated with marital status among spouse after diagnosed in newly reported HIV cases in China, 2014 / 中华流行病学杂志

Objective To analyze the factors associated with divorce or separation when one of the spouse diagnosed and newly reported as HIV positive,in China.Methods Data from the Chinese HIV/AIDS Comprehensive Response Information Management System,by December 31,2015 were used for collection on newly reported HIV cases regarding their baseline information in 2014 and follow-up within one year,among couples and above 18 year olds.HIV cases were divided into divorce/separation group and married group according to their marriage dynamics in one year after being diagnosed as HIV positive.Multivariate logistic regressions were used to analyze potential factors associated with divorce or separation after the diagnoses made.Results A total of 31 708 HIV cases were included in this study.22.5％ (7 134/31 708) of them got divorced or separated in one year after diagnose being made.81.6％ (25 864/31 708) of them had couples tested in one year after diagnose made and 10.0％ (2 599/25 864) of them got divorced or separated.Among 18.4％ (5 844/31 708) of the HIV cases who did not have their couples tested in one year after the diagnoses,77.6％ (4 535/ 5 844) got divorced or separated.For those who did not have their couples tested in one year after the diagnose.Data from the multivariate logistic regression analysis showed that factors as those who were older than 45 (46-60 yr.:OR=1.28,95％CI:1.03-1.58;≥61 yr.:OR=1.83,95％CI:1.41-2.37),with Han ethnicity (OR=1.56,95％CI:1.34-1.83),with high school education or above (OR=1.55,95％CI:1.27-1.90),non-farmers or non-rural laborers (OR=1.34,95％CI:1.17-1.54),infected through injecting drug use (OR=1.33,95％CI:1.03-1.71),men who had sex with men (OR=1.49,95％CI:1.20-1.86),or with childless (OR=2.35,95％CI:1.78-3.09) etc.were more likely to be divorced or separated after the diagnoses being made,among those who had their couples tested in one year after the diagnoses.Results from the multivariate logistic regression analysis showed that factors as those who were above 60 year olds (OR=1.32,95％CI:1.12-1.56),with Han ethnicity (OR=1.27,95％CI:1.13-1.44),with high school education or above (OR=1.26,95％ CI:1.11-1.43),non-farmers or non-rural labors (OR=1.37,95％CI:1.25-1.51),infected through having sex with men (OR=1.38,95％ CI:1.25-1.54),or without a child (OR=1.48,95％ CI:1.27-1.71),were more likely to be divorced or separated after the diagnoses.Conclusion A certain proportion of HIV cases got divorced or separated in one year after the diagnosis was made.The proportions of divorce or separation were different among populations.Interventions targeting reducing divorce or separation in certain populations should be integrated into routine care system to reduce the HIV transmission.

Survival time of newly diagnosed HIV/AIDS cases and related factors in China, 2010 / 中华流行病学杂志

Objective To analyze the survival time of newly diagnosed HIV/AIDS cases and related factors in China in 2010.Methods The reporting cards and follow-up cards of HIV/AIDS cases reported as of 31 December 2015 were collected from national AIDS information system.The newly diagnosed HIV/AIDS cases in 2010 were selected.The information of follow-up intervention,CD4+ T cells (CD4) testing,antiretroviral treatment and mortality of the cases from 2010 to 2015 were analyzed.Life table method was applied to calculate the survival probability.Kaplan-Meier was used to draw survival curve and Cox proportion hazard regression model were used to identify the factors related to survival time.Results Of the 40 335 HIV/AIDS cases,11 975(29.7％) died of AIDS related diseases.The median survival time was 63.1 months (95％CI:63.0-63.2),and the survival rates in 1 year and 5 years were 81.2％ and 69.9％.Multivariate Cox regression analysis showed that the risk factors for death in the HIV/AIDS cases were age (25-34 years old vs.15-24 years old:HR=1.41,95％CI:1.29-1.54;35-34 years old vs.15-24 years old:HR=1.90,95％CI:1.74-2.07;45-54 years old vs.15-24 years old:HR=2.24,95％CI:2.04-2.46;≥55 years old vs.15-24 years old:HR=2.81,95％CI:2.57-3.08).The protective factors for death in the HIV/AIDS cases were level of baseline CD4 counts (CD4 ≥ 500 cells/μ1 vs.CD4 ＜ 200 cells/μl:HR =0.12,95 ％ CI:0.11-0.13),receiving antiretroviral therapy (ART vs.no ART:HR=0.11,95％CI:0.10-0.12).Conclusion Survival time of HIV/AIDS cases might be influenced by age,baseline CD4 count and access to antiretroviral therapy.The early diagnosed and early antiretroviral therapy could extend the survival time of HIV/AIDS cases.

Status of marriage and HIV transmission between couples in newly reported HIV cases before diagnosis was made, among men who have sex with men in China, 2014 / 中华流行病学杂志

Objective To analyze the status of marriage and HIV transmission between couples in newly reported HIV cases before diagnoses were made,among men who have sex with men (MSM) in China.Methods Baseline and follow-up information related to newly reported cases in 2014 were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System.Infected MSM who were older than 22 years of age were included in this study.HIV cases were divided into sero-concordant or sero-discordant group,according to the HIV status of the couple who were tested 180 days post-diagnosis.Multivariate logistic regression method was used to analyze the potential factors associated with HIV transmission between couples before diagnosis was made.Results A total of 5 081 (22.7％) of the HIV infected MSM who had couples,were included in this study.A total of 3 715 cases had their couples tested 180 days after the diagnosis was made.7.6％ (282) had positive couples.Results from the multivariate logistic regression analysis showed that factors as:older than 60 (OR=2.64,95％CI:1.50-4.65) years of age,being minorities (OR=1.93,95％CI:1.13-3.29),having CD4+T cells less than 500 cells/μl (＜200:OR=2.91,95％CI:1.82-4.65;200-349:OR=1.98,95％CI:1.22-3.23;350-500:OR=1.69,95％CI:1.00-2.86),with self-reported unsafe behaviors (OR=1.92,95％CI:1.44-2.58) etc.,were more likely to transmit HIV to their couples before the diagnosis was made.Conclusion Behavior interventions and early HIV testing should be promoted,especially among those MSM who had couples,to avoid inter-spousal transmission.

Velocity and target location influence the upper limb reaching movements:three-dimensional motion analysis combined with surface electromyograph / 中国组织工程研究

BACKGROUND:Three-dimensional (3D) motion analysis system combined with electromyograph cannot only objectively analyze movement function of the upper limb, but also exert an important role in exploring the exercise-related factors and the underlying mechanism. OBJECTIVE:To explore the influence of movement velocity and target location on kinematics and muscle activity in upper limb reaching. METHODS:Twelve healthy young adults reached for three different location targets (frontal, ipsilateral and contralateral) at self-selected and fast speeds to with the dominant right hand, respectively. Kinematic parameters and muscle activity were recorded by Vicon 3D motion analysis system and Noraxon wireless electromyograph, synchronously. RESULTS AND CONCLUSION:Reach path ratio became smal er when moving faster (P<0.001), while mean velocity, peak velocity and the time percentage of peak velocity increased (P<0.001). Posterior deltoid, biceps brachi and triceps brachi activation was higher during fast speed movement (P<0.001). Muscle activation of anterior deltoid was lower in ipsitralateral reaching than contralateral (P=0.001) and frontal reaching (P<0.001), and posterior deltoid was higher than contralateral reaching (P=0.019). Biceps brachi (P=0.039) and triceps brachi (P<0.001) activation was also higher in ipsitralateral reaching than frontal reaching. These results suggest that moving fast can contribute to more muscle activation, high velocity, smooth trajectory and increased movement quality. Posterior deltoid, elbow extension and flexion muscle activation are high in ipsitralateral reaching, while high anterior deltoid activation in contralateral reaching;therefore, target location result in muscle synergies.

Analysis on the ‘late diagnosis’ (LD) phenomena among newly identified HIV/AIDS cases in China, 2010-2014 / 中华流行病学杂志

Objective To analyze the ‘late diagnoses’ (LD) phenomena among newly identified HIV/AIDS cases in China from 2010 to 2014.Methods Newly identified HIV/AIDS cases from 2010 to 2014 were selected from the National HIV/AIDS comprehensive information system.Rates related to LD were stratified according to the demographic indicators.Results From 2010 to 2014,numbers of newly identified HIV/AIDS cases were reported as 64 338,74 517,82 434,90 119 and 103 501 in China.Among them,proportions of LD were 41.8％,42.1％,38.1％,36.8％ and 35.5％ respectively.LD proportions appeared high in medical settings,with the minimum proportion as 45％ (x2=5 174,P＜0.000 1).Proportion of LD among patients who were heterosexually transmitted appeared over 40％,which was significantly higher than that seen among men who have sex with men or injecting drug users (x2=3 066,P＜0.000 1).Proportion of LD showed more than 39％ in those newly identified cases,and was seen higher in permanent residents than in floating population (less than 30％) (x2=5 265,P＜0.000 1).Conclusion With the expansion testing coverage on HIV,newly identified HIV/AIDS increased year by year.Among the newly identified cases,late diagnosis was high,especially in medical institutions.More effective strategies and measures are needed to promote the early detection of HIV in high risk population.

Analysis on the ‘late diagnosis’ (LD) phenomena among newly identified HIV/AIDS cases in China, 2010-2014 / 中华流行病学杂志

Objective To analyze the ‘late diagnoses’ (LD) phenomena among newly identified HIV/AIDS cases in China from 2010 to 2014.Methods Newly identified HIV/AIDS cases from 2010 to 2014 were selected from the National HIV/AIDS comprehensive information system.Rates related to LD were stratified according to the demographic indicators.Results From 2010 to 2014,numbers of newly identified HIV/AIDS cases were reported as 64 338,74 517,82 434,90 119 and 103 501 in China.Among them,proportions of LD were 41.8％,42.1％,38.1％,36.8％ and 35.5％ respectively.LD proportions appeared high in medical settings,with the minimum proportion as 45％ (x2=5 174,P＜0.000 1).Proportion of LD among patients who were heterosexually transmitted appeared over 40％,which was significantly higher than that seen among men who have sex with men or injecting drug users (x2=3 066,P＜0.000 1).Proportion of LD showed more than 39％ in those newly identified cases,and was seen higher in permanent residents than in floating population (less than 30％) (x2=5 265,P＜0.000 1).Conclusion With the expansion testing coverage on HIV,newly identified HIV/AIDS increased year by year.Among the newly identified cases,late diagnosis was high,especially in medical institutions.More effective strategies and measures are needed to promote the early detection of HIV in high risk population.

Marital status and high-risk sexual behaviors among newly reported HIV infected men who have sex with men in China in 2012, one year follow up study / 中华流行病学杂志

Objective To analyze the changes of marital status and high-risk sexual behaviors in newly reported HIV infected men who have sex with men (MSM) and provide evidence for the targeted behavior intervention in this population and the prevention of secondary HIV infection.Methods Data collected from HIV/AIDS case reporting cards and follow-up cards between December 31st,2012 and December 3st,2013 were used and newly reported HIV infected MSM were recruited,their demographic characteristics,marital status,and high-risk sexual behaviors were analyzed.Results Of 15 768 newly reported HIV infected MSM in 2012,10 426 (66.1％) were unmarried and 10 970 (69.6％) had educational level of ≥senior high school.Among the 15 049 HIV infected MSM receiving follow up in 2012,14 451 (96.0％) still received follow up in 2013.The number HIV infected MSM who had protected sexual behaviors increased from 9 779 (67.7％) in 2012 to 13 277 (91.1％) in 2013.Among the HIV infected MSM who had married,64.1％ remained their marital status in 2013.Among the HIV infected MSM,those who had educational level of ≥senior high school (OR=1.540,95％ CI:1.138-2.085),workers (OR=1.430,95％ CI:1.131-1.808),staff (OR=1.610,95％CI:1.236-2.098) or farmers (OR=1.661,95％C1:1.214-2.271) were more likely to have protected sexual behaviors than those who had educational level of primary school or were engaged in commercial services.Those who had never married,(OR=0.563,95％CI:0.439-0.722),divorced (OR=0.624,95％CI:0.448-0.870) or re-married (OR=0.444,95％CI:0.288-0.687) were more likely to have high-risk sexual behaviors.Conclusion Standardized follow-up seemed helpful for the newly diagnosed HIV infected MSM to have protected sexual behaviors.Highly effective intervention should be focused on MSM who have no spouses or regular sexual partners,with low educational level,or are engaged in commercial services to prevent secondary HIV transmission.