Skin cancer in Geraldton, Western Australia: a survey of incidence and prevalence

A survey of the incidence and prevalence of non-melanocytic skin cancer in Geraldton, Western Australia, was undertaken in November 1987. All residents aged 40 to 64 years whose names were on the electoral roll on August 1, 1987 were invited to undergo a whole-body skin examination by a dermatologist. When a skin cancer was suspected, participants were referred for treatment to their usual medical practitioner. Subjects were asked to recall incident skin cancers over the preceding two years, and medical records were searched for confirmatory evidence. Histological confirmation of all lesions, both prevalent and incident, was sought and sections were obtained for a standardized review. The prevalence of confirmed non-melanocytic skin cancer in those aged 40 to 64 years was 7.0% in men and 4.7% in women. The prevalence of basal-cell carcinoma (BCC) was 6.5% in men and 4.5% in women while the prevalence of squamous-cell carcinoma (SCC) was 1.2% in men and 0.3% in women. The estimated incidence rate of non-melanocytic skin cancer in this age group was 1560 per 100,000 person-years. The estimated incidence rate of BCC in men was 1335 per 100,000 person-years, and in women 817 per 100,000, while in men the estimated incidence rate of SCC was 890 per 100,000 person-years, and in women it was 289 per 100,000 person-years.     

Invasive Haemophilus influenzae infections in men with HIV infection.

OBJECTIVE--To determine the incidence of invasive Haemophilus influenzae disease in men with the acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection and the proportion of disease due to serotype b. DESIGN--Population-based, active surveillance. SETTING--San Francisco (Calif) Department of Health. PARTICIPANTS--All men 20 to 49 years of age with invasive H influenzae disease. RESULTS--The cumulative incidences of invasive H influenzae disease in men 20 to 49 years of age with AIDS and in HIV-infected men 20 to 49 years of age without AIDS were 79.2 and 14.6 per 100,000, respectively, but only 33% of cases were due to serotype b. The corresponding rates for invasive H influenzae b disease were 11.3 and 7.6 per 100,000. CONCLUSIONS--Men with AIDS or HIV infection are at increased risk of invasive H influenzae infections, including H influenzae b, but such infections are still infrequent in this population.     

异性性接触途径传播HIV的风险及相关因素研究

目的：了解经异性性接触途径感染人类免疫缺陷病毒(HIV)/获得性免疫缺乏综合征(AIDS)的患者作为艾滋病传染源传播HIV情况,为艾滋病防治决策提供依据。方法：对250名HIV阳性人员进行问卷调查,了解其社会人口学特征、异性性行为等有关情况,同时溯源调查与其性行为密切接触的易感人群,检测、了解其艾滋病感染情况,计算续发率和增长率。采用病例对照分析方法探讨传染源继续传播HIV的相关因素。结果：250名传染源的431名易感接触者有59人HIV阳性,续发率为13.7%(59/431),增长率为23.6%(59/250)。传染源继续传播HIV的相关因素为：艾滋病防治知识知晓情况、知晓感染后心理反映、与配偶/固定性伴安全套使用情况、与非固定性伴安全套使用情况。结论：HIV 异性性接触者的续发率和增长率较高;加强艾滋病防治知识宣传,对传染源及时提供心理和医学服务,促进安全套使用可以降低高危行为和控制HIV的进一步传播。     

Impact of the human immunodeficiency virus epidemic on mortality in women of reproductive age, United States

To assess the effect of the human immunodeficiency virus (HIV) on mortality in US women 15 to 44 years of age and to identify associated causes of death, we examined final (1980 through 1987) and provisional (1988) national mortality statistics. Between 1985 and 1988, the death rate for HIV/acquired immunodeficiency syndrome (AIDS) quadrupled (0.6 per 100,000 to 2.5 per 100,000), and by 1987, HIV/AIDS had become one of the 10 leading causes of death. In 1988, the death rate for black women (10.3 per 100,000) was nine times the rate for white women (1.2 per 100,000). The majority of deaths in both black and white women occurred in women 25 to 34 years of age, for whom HIV-related deaths accounted for 11% and 3% of all deaths in 1988, respectively. Among 1157 death certificates that included any mention of HIV/AIDS in 1987, other leading diagnoses included drug abuse (27%), Pneumocystis carinii pneumonia (20%), other pneumonias (14%), septicemia (10%), other infections not in the AIDS surveillance definition (7%), nephritis (6%), liver diseases (4%), and anemias (4%). If current mortality trends continue, HIV/AIDS can be expected to become one of the five leading causes of death by 1991 in women of reproductive age. Because women infected with HIV are the major source of infection for infants, these trends in AIDS mortality in women forecast the impact of HIV on mortality in children as well.     

HIV and AIDS in aboriginal and Torres Strait Islander Australians: 1992-1998. The National HIV Surveillance Committee

OBJECTIVE: To describe the epidemiological pattern of newly diagnosed HIV infection and AIDS among Indigenous Australians. DESIGN AND SETTING: National surveillance for newly diagnosed HIV infection and AIDS in Australia. Information on Indigenous status was sought at HIV/AIDS notification in all State/Territory health jurisdictions, except the Australian Capital Territory, and Victoria before June 1998. MAIN OUTCOME MEASURES: Number of people with newly diagnosed HIV per year and population rate of HIV diagnosis; demographic characteristics of people with HIV and AIDS diagnoses by Indigenous status. RESULTS: From 1992 to 1998, 127 Indigenous Australians were newly diagnosed with HIV infection and 55 were diagnosed with AIDS. The population rate of HIV diagnosis among Indigenous Australians (5.23/100,000 per year) was similar to that among non-Indigenous Australians (5.51/100,000 per year). The annual number of HIV diagnoses among Indigenous people was relatively stable, but among non-Indigenous people it declined steadily over time. A higher proportion of Indigenous people diagnosed with HIV were women (26.8% v 8.9%; P < 0.001). Although male homosexual contact was the predominant source of exposure for both Indigenous (46.7%) and non-Indigenous (75.0%) people with HIV infection, exposure by heterosexual contact (36.7% v 15.3%; P < 0.001) was reported more frequently among Indigenous people. CONCLUSION: Although HIV incidence was similar among Indigenous and non-Indigenous Australians, the lack of a recent decline in incidence and the higher proportion of Indigenous people exposed to HIV by heterosexual contact indicate the need to intensify interventions to prevent HIV transmission among Indigenous people.     

Increased risk of suicide in persons with AIDS

The rate of suicide has been reported to be higher in persons with chronic and life-threatening illnesses (eg, cancer, Huntington's disease, and renal failure). We studied the rate of suicide in 1985 in New York City residents diagnosed with the acquired immunodeficiency syndrome (AIDS). There were 668 suicides in New York City residents in 1985, yielding a rate of 9.29 per 100,000 person-years. In men aged 20 to 59 years without a known diagnosis of AIDS, the rate was 18.75 per 100,000 person-years. There were 3828 individuals who lived with the diagnosis of AIDS for some part, or all, of 1985. There were 12 suicides in men aged 20 to 59 years from this group who lived 1763.25 person-years with a diagnosis of AIDS. This yields a suicide rate of 680.56 per 100,000 person-years. Thus, the relative risk of suicide in men with AIDS aged 20 to 59 years was 36.30 times (95% confidence limits, 20.45 to 64.42) that of men aged 20 to 59 years without this diagnosis, and 66.15 times (95% confidence limits, 37.38 to 117.06) that of the general population. We conclude that AIDS represents a significant risk factor for suicide.     

黄石市2011—2017年艾滋病疫情及流行特征分析

目的 分析2011—2017年湖北省黄石市艾滋病疫情及流行病学特征,为制定防控措施提供依据。方法 收集2011—2017年新报告的现住址为黄石市的艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS）资料,采用Graphpad Prism 5、SPSS19.0软件和描述流行病学方法进行统计分析。结果 2011—2017年共新报告HIV/AIDS 1 518例,死亡471例;病例主要集中在大冶市,868例,占57.18%;男性1 156例占76.15%,女性362例占23.85%,男女性别比为3.2:1.0;50岁以上938例占61.79%;农民为主体,726例占47.83%,其次为无业人员,352例占23.19%。哨点监测显示MSM人群HIV感染率为3.89%,孕妇HIV感染率为0.00%。异性传播1 158例,占76.28%,同性性传播350例,占23.06%,且男男同性传播方式病例呈逐年上升趋势。结论 黄石市艾滋病疫情呈全市低流行和特定人群集中流行并存,性传播成为主要传播途径,大冶市和MSM人群流行形势严峻,须进一步加大防控力度。     

长沙市男男性行为者人群性行为特征分析

目的了解长沙市男男性行为者(men who have sex with men,MSM)的行为状态及艾滋病病毒感染状况。方法在男男性行为者社区中进行匿名问卷调查。结果被调查者年龄为25.9±6.8,绝大部分(89.9%)年龄为20～40岁;55.2%的人只有同性性行为,异性恋的占4.4%;第一次与男性发生性行为的年龄为24.1±6.8岁,最近6个月与男性发生肛交行为时每次都使用安全套的仅为39.4%;同时与女性发生过性行为的占19.8%,HIV确证感染率3.1%,梅毒确证阳性率15.6%。结论男男性行为者中无保护性肛交行为普遍存在,HIV感染率高,是长沙市艾滋病防治的重点人群之一,应加强对这类人群的行为干预,降低其危险行为发生,从而降低HIV感染率。     

Population-based monitoring of an urban HIV/AIDS epidemic. Magnitude and trends in the District of Columbia.

OBJECTIVE--To assess the extent of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic in the District of Columbia and demonstrate an approach to monitoring HIV infection and projecting AIDS incidence at a community level. DESIGN--Backcalculation methods to reconstruct HIV incidence from AIDS incidence in subgroups. Results were compared with directly measured HIV seroprevalence in selected sentinel populations: childbearing women, civilian applicants for military service, and hospital patients admitted for conditions unrelated to HIV infection. RESULTS--Between the start of the epidemic in 1980 and January 1, 1991, one in 57 District of Columbia men aged 20 to 64 years was diagnosed with AIDS. Unlike the plateau projected for the nation, AIDS incidence for the District of Columbia was projected to increase by 34% between 1990 and 1994. Models of HIV infection incidence suggested two broad epidemic waves of approximately equal size. The first occurred in men who have sex with men and peaked during the period from 1982 through 1983. The second began in the mid-1980s in injecting drug users and heterosexuals. We estimated that among District of Columbia residents aged 20 to 64 years, 0.3% of white women, 2.9% of white men, 1.6% of black women, and 4.9% of black men were living with HIV infection as of January 1, 1991. These estimates are broadly consistent with survey data: among black childbearing women in their 20s, HIV prevalence doubled to 2% between the fall of 1989 and the spring of 1991; from military applicant data, we estimated that over 5% of black men born from 1951 through 1967 were HIV-positive; in the sentinel hospital, HIV prevalence rates among male patients aged 25 to 34 years were 11.3% in white men and 16.9% in black men. CONCLUSION--Backcalculation and surveys yielded quantitatively consistent estimates of HIV prevalence. Many injecting drug users and heterosexuals in the District of Columbia were infected after January 1, 1986. Similar monitoring of the epidemic in other localities is needed to focus efforts to reduce the incidence of HIV transmission.     

The acquired immunodeficiency syndrome: a tuberculosis threat?

In the United States there has been an increase in mycobacterial infections that is attributable to the acquired immunodeficiency syndrome (AIDS). Since 1983, when the first case of AIDS was reported in Australia, there have been 523 patients (to June 30, 1987) notified with group-IV AIDS and, of these, 361 (69%) cases have been in New South Wales. Of these 361 notifications, 59 (16%) patients have had concurrent mycobacterial infection. Seven of these patients had Mycobacterium tuberculosis infection and five of these infections occurred in 1986. This means that, in 1986, patients with group-IV AIDS had a rate of infection with Myco. tuberculosis of 3000 per 100,000 population, compared with 5.2 cases per 100,000 population for New South Wales. We sought to determine whether or not there was any unexplained increase in notifications which might be attributable to AIDS. This paper reports cases that were notified to the AIDS and tuberculosis registers, finds that atypical mycobacterial infections are underreported by at least 19.5%, and examines trends in notifications for mycobacterial disease since the onset of the AIDS epidemic. It also raises the importance of appropriate measures to protect health workers from tuberculosis.     

The incidence rate of acquired immunodeficiency syndrome in selected populations

Population figures were obtained, and incidence rates of acquired immunodeficiency syndrome (AIDS) for the 12 months from June 1, 1983, to May 31, 1984, were estimated for single (never-married) men aged 15 years or older, intravenous (IV) drug users, Haitians living in the United States, persons with hemophilia A and B, female sexual contacts of male IV drug users, and blood transfusion recipients. Single men in San Francisco and Manhattan, IV drug users in New York City and New Jersey, hemophilia A patients, and recent Haitian entrants had the highest rates of disease (82.0 to 268.9 per 100,000). Male IV drug users and male Haitians were two to four times as likely to experience development of AIDS as were females in each group. Persons with hemophilia A had six times the incidence rate of AIDS as did those with hemophilia B. Persons with severe hemophilia A had three times the rate of those with moderate and seven times the rate of those with mild clotting factor deficiency. Although blood transfusion recipients and female sexual contacts of male IV drug users had much lower average yearly rates than did persons in the four other groups (0.4 to 9.4 per 100,000), they still had a higher incidence rate of AIDS than did persons not belonging to any of these groups (0.1 per 100,000).     

Risk of suicide among persons with AIDS. A national assessment.

OBJECTIVE--We sought to describe the rate, risk, trends, methods, and distribution of suicide among persons with the acquired immunodeficiency syndrome (AIDS) in the United States. DESIGN--We used National Center for Health Statistics multiple-cause mortality data from 1987 through 1989 to identify suicides among persons with AIDS (PWAs) and public-access AIDS surveillance data to determine person-years of observation of PWAs. PATIENTS--Residents of the United States with death certificates indicating suicide. MAIN OUTCOME MEASURE--Death certificates indicating both AIDS and suicide. RESULTS--In 1987 through 1989, a total of 165 suicides among PWAs occurred in 45 states and the District of Columbia. All but one case were male. Among males the rate was 165 per 100,000 person-years of observation, 7.4-fold higher than among demographically similar men in the general population. Self-poisoning with drugs was both the most common method (35%) and the method with the highest standardized mortality ratio (35). Suicide risk for PWAs decreased significantly (P < .05) from 1987 to 1989. CONCLUSION--Persons with AIDS have an increased risk of suicide, and assessment of such risk should be a standard practice in their care. These assessments should be carefully considered when potentially lethal medications are prescribed. The declining trend in suicide rates between 1987 and 1989 is encouraging; possible causes include emerging therapies for human immunodeficiency virus/AIDS, better psychiatric care for these patients, and lessened social stigma against PWAs.     

Sexual practices and risk of infection by the human immunodeficiency virus. The San Francisco Men's Health Study

The San Francisco Men's Health Study is a prospective study of the epidemiology and natural history of the acquired immunodeficiency syndrome in a cohort of 1034 single men, 25 to 54 years of age, recruited by multistage probability sampling. At entry, June 1984 through January 1985, the seropositivity rate for human immunodeficiency virus (HIV) infection among homosexual/bisexual study participants was 48.5%. No heterosexual participants were HIV seropositive. Among homosexual/bisexual men reporting no male sexual partners in the two years before entry into the study, seropositivity was 17.6%. For those reporting more than 50 partners, seropositivity was 70.8%. Only receptive anal/genital contact had a significantly elevated risk of HIV infection. Douching was the only ancillary sexual practice that contributed significantly to risk of infection.     

江苏省经异性性行为感染HIV病例感染方式及经商业异性性途径感染HIV病例确证阳性前后性行为调查分析

摘要：目的 分析江苏省经异性性行为感染HIV病例性行为感染方式及经商业异性性行为感染病例确证阳性前后性行为特征。方法 选取2014年1-6月报告经异性性行为感染HIV病例,询问具体感染方式,调查商业异性性传播病例确证前后性行为信息。结果 调查对象以商业异性性传播为主,占57.21%,但女性主要为婚内传播。经商业异性行为感染病例同时存在固定和临时性行为,三种性行为的比例由确证前100.0%、14.35%和17.72%降至确证后7.59%、5.06%和2.95%,但未坚持使用安全套、性伴不告知和不知晓性伴感染状态等传播风险仍然存在。调查对象的感染及感染后的传播均主要发生在本省内。结论 除继续推行现有的干预措施外,还应进一步缩短发现到治疗的时间以及推进“配偶强制告知”政策的落实。     

Heterosexual transmission of human immunodeficiency virus

Although parts of Africa already have a heterosexual epidemic of acquired immunodeficiency syndrome (AIDS), the potential for a major epidemic in the US or Europe remains a subject for speculation. Future heterosexual spread of the human immunodeficiency virus (HIV) is likely to depend on 2 key factors: patterns of sexual and needle sharing behavior; and the probability of transmission of HIV from men to women and from women to men. There is some evidence that the risk of transmission from men to women increases both with the duration of the seuxal relationship and the frequency of sexual contact. Infectivity has been suggested to increase as people progress towards AIDS. The relative risk for transmission by different sexual practices requires further study. Studies of HIV transmission from women to men have been small so that it is difficult to assess the relative risks of transmission from women to men and from men to women. Infectivity of the index case cannot yet be measured. It appears that infectivity varies both between individuals and within individuals over time. Treatment to reduce infectivity may be important in controlling the epidemic.     

The acquired immunodeficiency syndrome in Singapore--epidemiological perspectives

The Acquired Immunodeficiency Syndrome (AIDS) is caused by a retrovirus, the Human Immunodeficiency Virus (HIV). As at 30 April 1988, there were 22 infected individuals in Singapore, of which 4 had AIDS. A comprehensive retrospective study was carried out to establish the clinico-epidemiological features of the disease and its transmission in Singapore. The infected patients have been related mainly to sexual transmission through sexual contact (homosexual, bisexual or heterosexual) with men and women from countries where HIV infection is more prevalent. The majority of the infected were homosexual males in the age range 20-39 years. There was one case of transfusion-associated AIDS and another was infected through heterosexual transmission. The local pattern is consistent with the Western pattern (Pattern 1), with the notable absence of intravenous drug abusers, paediatric cases or infected haemophiliacs.     

Intravenous drug users who present to the Albion Street (AIDS) Centre for diagnosis and management of human immunodeficiency virus infection

Intravenous drug users who presented to the Albion Street (AIDS) Centre for human immunodeficiency virus (HIV) antibody screening during the period March 1, 1985 to January 31, 1989, were included in this study. Information on medical history and HIV risk-related behaviour was collected by means of a standardized, computer-coded medical record. Of the 1222 intravenous drug users in this study, 72.3% were men, 26.9% were women and 0.8% were transsexual, with 60.1% of the total claiming exclusive heterosexuality. Of the sample, 40.2% were current intravenous drug users, and 86.8% recorded having shared needles and syringes. Among this sample, the over-all prevalence of HIV seropositivity was 14.5%. Of subjects who were diagnosed as HIV seropositive, 43.8% were homosexual men, 13.1% were bisexual men and 5.3% were heterosexual men. Of all intravenous drug users, 49.9% had a history of at least one sexually-transmitted disease, with 21.8% reporting a history of more than one. Fifty-two per cent of the sample reported that they had been infected with hepatitis B previously. There was no over-all increase in the annual rate of HIV infection among this population of intravenous drug users. The sexual activity and prevalence of hepatitis and other sexually-transmitted diseases among this group are suggestive of widespread, continuing risk behaviour.     

Human immunodeficiency virus infection in Singapore--the first 50 cases

As at 31 May 1990, fifty Singaporeans with the Human Immunodeficiency Virus (HIV) infection had been detected. Of these, nineteen had the Acquired Immunodeficiency Syndrome (AIDS). The majority of infected persons had been infected through sexual contact (homosexual 52%; bisexual 24%; heterosexual 20%) with men and women from countries where HIV infection was prevalent. The majority of infected patients (88%) were in the age range 20-39 years. There was one case of blood transfusion-associated AIDS. There were no infected paediatric or haemophiliac cases or intravenous drug use in any of the patients. A spectrum of AIDS-related opportunistic infections and cancers was observed, and Pneumocystis carinii pneumonia was the most frequent presentation. Thirteen patients with AIDS had died and the median survival time was about seven months.     

Serologic and immunologic studies in patients with AIDS in North America and Africa. The potential role of infectious agents as cofactors in human immunodeficiency virus infection

Serologic and immunologic studies were performed in 38 African and 60 US patients with acquired immunodeficiency syndrome (AIDS), 100 African and 100 US heterosexual men and women, and 100 US homosexual men to examine the potential role of infectious agents in human immunodeficiency virus (HIV) infection. There were no significant differences in the prevalence of antibodies to cytomegalovirus, Epstein-Barr virus, hepatitis A and B viruses, herpes simplex virus, syphilis, and toxoplasmosis among the African and US patients with AIDS, African heterosexual controls, and US homosexual men. However, these four groups all demonstrated a significantly greater prevalence of antibodies to each of these infectious agents compared with US heterosexual men. Immunologic studies demonstrated a significant elevation of activated lymphocytes (HLA-DR and T3 positive) and immune complexes in both AIDS populations and African heterosexual and US homosexual populations, compared with the US heterosexual population. These data demonstrate that the immune systems of African heterosexuals, similar to those of US homosexual men, are in a chronically activated state associated with chronic viral and parasitic antigenic exposure, which may cause them to be particularly susceptible to HIV infection or disease progression.     

1995年至2011年开远市艾滋病病毒感染者流行病学特征分析

目的 了解云南省红河彝族哈尼族自治州开远市艾滋病流行状况和趋势.方法 利用1995年5月至2011年12月的监测数据,分析艾滋病感染者的流行病学特征.结果 开远市1995年发现首例艾滋病病毒感染者,截至2011年底累计报告现住址艾滋病病毒感染者/艾滋病患者(HIV/AIDS)3 465例,其中男性占74.3％;20～ 49岁占90.3％;民族以汉族为主,占62.7％,其次是回族和彝族;职业以无业、农民为主,占68％;文化程度初小为主,占58.9％;HIV传播途径1995年至2003年以注射吸毒共用针具传播为主,性接触传播构成比从2005年的10.4％上升到2011年的64.9％.异性性接触传播成为主要传播途径.结论 开远市艾滋病的传播已由注射吸毒为主转为以异性性接触传播为主.在云南省开远市艾滋病病毒流行处于高流行区域.