Response rates for providing a blood specimen for HIV testing in a population-based survey of young adults in Zimbabwe

Background  

To determine differences among persons who provided blood specimens for HIV testing compared with those who did not among those interviewed for the population-based Zimbabwe Young Adult Survey (YAS).     

Decision-Making in HIV Prevention Community Planning: An Integrative Review

Since 1994, the Centers for Disease Control and Prevention has required that the 65 health department grantees that receive funding for HIV prevention interventions engage in a community planning process to involve affected communities in local prevention decision making; to increase the use of epidemiological data to target HIV prevention resources; and to ensure that the planning process takes into account scientific information on the effectiveness and efficiency of different HIV interventions. Local community planning groups are charged with identifying and prioritizing unmet HIV prevention needs in their communities, as well as prioritizing prevention interventions designed to address these needs. Their recommendations, in turn, form the basis for the local health department's request for HIV prevention funding from the Centers for Disease Control and Prevention.Given the community planning process's central role in the allocation of federal HIV prevention funds, it is critical that sound decision-making procedures inform this process. In this article, we review the basics of the community planning prioritization process and summarize the decision-making experiences of community planning groups across the US. We then describe several priority-setting tools and decision analytic models that have been developed to assist in HIV community planning prioritization and discuss their strengths and weaknesses. Finally, we offer suggestions for improving the decision-analytic basis for HIV prevention community planning.     

1989～2003年云南省艾滋病流行态势分析

目的　了解云南省不同地区和不同人群艾滋病流行特点和变化趋势。方法　 1989～2 0 0 3年对注射吸毒人群、女性性工作者、嫖客、性病患者、结核病患者、孕妇、献血员采用哨点监测、专题调查和常规资料收集等方法进行血清学流行病学调查。结果　 1989年首先在边境注射吸毒人群中发现较高水平的艾滋病流行 ,截止到 2 0 0 3年 12月 ,全省共发现人类免疫缺陷病毒 (HIV)感染者 14 90 5例 ,分布于全省 16个地州的 12 1个县 (市 ) ;注射吸毒人群HIV感染率为 2 1 2 %～ 2 7 8% ,6个地区注射吸毒人群HIV感染率超过 4 0 % ;女性性工作者、嫖客HIV感染率分别为 1 2 3%～ 6 6 7%和 0 3%～1 8% ;男性性病患者HIV感染率为 2 1%～ 2 7% ,个别地区达 10 8% ;孕妇HIV感染率 1993～ 2 0 0 2年为 0 14 %～ 0 2 5 % ,2 0 0 3年上升到 0 37% ;结核病患者的HIV感染率为 1 5 %～ 1 6 % ;1999～ 2 0 0 0年献血员的HIV感染率为 0 0 1% ,2 0 0 3年上升到 0 0 7%。结论　云南省艾滋病流行始于 2 0世纪 80年代后期 ,经注射吸毒人群从边境地区向内地传播 ,注射吸毒人群感染率维持在较高水平 ,性传播途径呈上升趋势 ,并在一般人群中呈现低水平流行 ,局部地区进入广泛流行阶段。     

Mortality rates and causes of death in a cohort of HIV-infected and uninfected women, 1993–1999

HIV/AIDS-associated and non-HIV/AIDS-associated death rates and causes of death between 1993 and 1999 were examined in 885 HIV-infected women and 425 uninfected women of the HIV Epidemiology Research Study cohort. Causes of death were determined by review of death certificates and the National Death Index. Adjusted bazard ratios were calculated for mortality risk factors. In the 885 HIV-infected women and 425 uninfected women, 234 deaths and 8 deaths, respectively, occurred by December 31, 1999. All-cause death rates in the HIV-infected women were unchanged between the pre-HAART (1993–1996) and HAART eras (1997–1999) —5.1 versus 5.4 deaths per 100 person-years (py). AIDS as a cause of death decreased from 58% of all deaths in 1996 to 19% in 1999, while HAART use increased to 42% by the end of 1999. In spite of the modest proportion ever using HAART, HIV-related mortality rates did decline, particularly in women with CD4+cell counts less than 200/mm³. Drug-related factors were prominent: for the 129 non-AIDS-defining deaths, hepatitis C positivity (relative bazard [RH] 2.6, P<0.001) and injection drug use (RH 1.7, P=0.02) were strong predictors of mortality, but were not significant in the Cox model for 105 AIDS-defining deaths (RH 0.9, P>30 and RH 0.7, P>.30, respectively. The regression analysis findings, along with the high percentage of non-AIDS deaths attributable to illicit drug use, suggest that high levels of drug use in this population offset improvements in mortality from declining numbers of deaths due to AIDS. Supported by cooperative agreements No. U64/CCU106795, U64/CCU206798, U64/CCU306802, and U64/CCU506831 with the Centers for Disease Control and Prevention including supplementary support from the National Institute on Drug Abuse. Centers for Disease Control and Prevention, Division of HIV     

同性交友方式对男男性行为人群高危性行为及感染HIV的相关影响

目的 了解同性交友方式对MSM的高危性行为及HIV感染的相关影响。方法 采用横断面调查方法,2018年4-11月在宁波市采用滚雪球的非概率抽样法招募MSM,收集其人口学特征、交友方式、同性社交软件使用、高危性行为发生情况等相关信息,研究对象均需进行HIV抗体检测。分类资料采用χ²检验,采用多因素logistic回归分析MSM的HIV感染相关因素。结果 共调查MSM 735人,同性社交软件交友者、QQ或微信交友者和场所交友者分别为447人（60.8%）、237人（32.3%）和51人（6.9%）。同性社交软件交友者最近6个月性行为次数≥ 1次/周和发生多性伴的分别有75人（16.8%）和187人（41.8%）;最近1次和最近6个月发生无保护肛交行为的分别有54人（12.1%）和234人（52.3%）;HIV感染率为12.1%（54/447）。感染时间<2年的HIV/AIDS中,同性社交软件使用时间<2年的比例为68.6%（24/35）。多因素logistic回归分析结果显示,与QQ或微信交友者比较,同性社交软件交友者更易感染HIV（OR=3.03,95% CI：1.30~7.07）。结论 宁波市MSM中,同性社交软件交友者比例较高,存在较高危险性行为和HIV感染风险。应针对同性社交软件交友者加强监测和干预。     

凉山彝族自治州HIV/AIDS抗病毒治疗前HIV-1耐药情况及其影响因素分析

目的 了解凉山彝族自治州（凉山州）HIV/AIDS抗病毒治疗前HIV-1耐药情况及其影响因素,为预防HIV-1耐药毒株的传播提供参考依据。方法 分别于2017年1月1日至6月30日、2018年1月1日至6月30日在凉山州开展HIV/AIDS抗病毒治疗前HIV-1耐药的横断面调查。提取获得HIV-1 pol基因区序列,根据2014年WHO耐药监测指南的推荐标准,应用HyPhy 2.2.4和Cytoscape 3.6.1软件进行HIV-1耐药毒株传播网络分析。结果 研究对象464例HIV/AIDS,HIV-1毒株为CRF07_BC亚型的占88.6%（411/464）,总的HIV-1耐药率为9.9%（46/464）,非核苷类反转录酶抑制剂（NNRTI）、核苷类反转录酶抑制剂（NRTI）和蛋白酶抑制剂（PI）耐药率分别为6.7%（31/464）、1.9%（9/464）和0.4%（2/464）;有1组HIV-1新型重组毒株URF_01BC亚型独立成簇并携带相关耐药突变位点;多因素logistic回归分析结果显示,与异性性传播人群相比,注射吸毒人群的HIV-1耐药风险较高（aOR=3.03,95% CI：1.40～6.54）。结论 凉山州HIV/AIDS抗病毒治疗前的HIV-1耐药率较高,且有新型重组毒株URF_01BC亚型携带相关耐药突变位点的成簇传播,建议加强HIV-1耐药毒株传播的预防工作。