浦东新区新发现HIV感染者的高危行为特征

目的调查上海市浦东新区新发现的艾滋病病毒（HIV）感染人群的艾滋病相关高危行为的特征,为控制艾滋病在人群中的传播提供更好的防治措施和依据。方法采用横断面调查方法,对2011年1月1日至2012年6月30日期间,所有新发现并最终确认的HIV感染者进行面对面、一对一的流行病学问卷调查,收集社会人口学信息、性行为对象信息、高危行为史、既往性病史、配偶及性伴HIV检测情况等资料,进行相关的统计描述与分析。结果共完成合格的调查问卷249份,其中男性212人,女性37人,男女比例为5.7∶1。最近3个月有22.1%、22.1%、22.9%和7.6%的调查对象分别与配偶、固定性伴、临时性伴和商业性伴有过性行为,安全套使用率分别为12.7%、16.4%、5.3%和0;3个月前有41.4%、36.1%、59.4%和28.5%的调查对象与配偶、固定性伴、临时性伴和商业性伴有过性行为,每次使用安全套率分别为5.8%、6.7%、1.4%和4.2%。调查对象的配偶、固定性伴HIV感染率为32.1%（25/78）。调查对象中,既往有吸毒史、手术史和献血史的分别占4.4%、3.2%、5.6%。结论浦东新区的HIV感染者的性伴种类较多,且安全套使用率较低,配偶及固定性伴的感染率较高,应在该人群中加大艾滋病的防治力度。     

广东省HIV/AIDS患者性伴告知情况及影响因素分析

目的 了解广东省HIV/AIDS患者性伴告知情况,并分析其影响因素。方法 于2018年5月至2019年6月,采用方便抽样的方法在广东省6个城市招募新报告HIV/AIDS患者,通过国家艾滋病综合防治信息系统及电子问卷收集调查对象社会人口学信息、HIV感染相关信息、社会支持与HIV感染性伴告知情况。采用χ2检验和多因素非条件Logistic回归分析调查对象HIV感染性伴告知的影响因素。结果 纳入分析的705名HIV/AIDS患者年龄中位数45.50(33.79,56.01)岁,HIV感染性伴告知率为57.87%(408/705)。多因素Logistic回归分析显示,相比于已婚有配偶者,离异、丧偶或不详者（a OR=0.43,95%CI:0.26～0.70）性伴告知的可能性更小;相比于配偶/恋人/性伴已感染HIV者,配偶/恋人/性伴未感染HIV(a OR=0.18,95%CI:0.09～0.32)及未知配偶/恋人/性伴HIV感染状况者（a OR=0.04,95%CI:0.02～0.07）性伴告知的可能性更小;认为配偶/恋人/性伴态度会影响自己尽早治疗决定者（a OR=1.83,95CI:1....     

32例HIV感染者阳性告知的实践与思考

对劳教人员实行艾滋病病毒(HIV)感染者血清学检测阳性结果告知,是预防和控制艾滋病的传播,为HIV感染者提供关怀的重要环节。为探索劳教所HIV感染者阳性告知工作的健康有序开展,建立切实可行的心理咨询与行为矫治措施。对劳教所的32名HIV确认阳性感染者,按照告知时机、内容、技巧、注意事项等程序,在解教前1个月内实施阳性告知。掌握阳性告知的原则、相关知识和心理咨询技巧,是成功实施阳性告知的关键。提高干警知识和管理水平,消除恐惧和歧视,对劳教人员实施有效的行为矫治措施,对预防HIV在所内的传播流行,也为降低劳教人员解教出所后对社会的潜在威胁,具有十分重要的意义。     

云南省HIV/AIDS病人告知和随访工作模式初探

目的分析2006-2008年云南省艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（HIV/AIDS病人）告知、随访工作成效及主要措施,为其他地区开展相关工作提供参考。方法对新报告的HIV/AIDS病人进行结果告知、个案流调和转介,对现住址在云南的HIV/AIDS病人开展随访,用全国＂艾滋病综合防治信息系统＂和专报系统数据统计个案流调、随访、CD4检测、抗病毒治疗转介、治疗和配偶检测相关指标,分析采取的主要措施。结果 2008年云南省新报告的HIV/AIDS病人的个案流调率达到93.7%,累计HIV/AIDS病人的随访率达到61.4%,CD4检测率为32.7%,较2006年和2007年分别提高了69%和41%、30%和10.6%、26%和22%,配偶检测率为63.2%,较2007年提高了24%,抗病毒治疗转介及治疗工作逐年推进。结论落实首诊负责制,提高县疾病预防控制中心的信息化管理水平,把随访工作分解和下移到社区和艾滋病相关服务平台,优化社区卫生服务机构的资源配置,在经费使用中实行目标管理,是确保告知和随访工作长期有效运转的基础。     

在强制戒毒所开展HIV阳性结果告知的实践和体会

艾滋病病毒（（Human immunodeficiency virus,HIV）检测阳性结果告知,可以在一定程度上有效防止HIV的二代传播[1]。2007年以来,HIV阳性结果告知得到了高度重视,社区HIV检测的阳性结果告知取得了突破,但强制戒毒所（简称＂强戒所＂）检测发现的HIV感染者的阳性结果告知,成了昆明市艾滋病防治工作的重点和难点。     

新余市新发现HIV感染者CD4＋T淋巴细胞检测结果分析

艾滋病病毒（Human immunodeficiency virus,HIV）侵入人体后不断复制,造成CD＋4T淋巴细胞（简称CD4细胞）数量持续减少,产生细胞免疫缺陷,从而增加各种机会性感染。新余市通过对CD4细胞计数统计分析,评价该地区新发现HIV感染者的机体免疫功能情况,判断疾病进程,以便及时开展治疗工作。     

12例急性期HIV感染者抗病毒治疗结果分析

目的初步探讨急性期艾滋病病毒(HIV)感染者进行抗病毒治疗(ART)对其预后的影响。方法对在佑安医院接受抗病毒治疗的12例急性期HIV感染者进行跟踪随访和分析。结果 12例HIV感染者均在感染6个月内开始ARV治疗,并坚持服药未中断治疗,随访治疗期6个月-3年。治疗后3个月内检测病毒载量均低于最低检测限,1年后CD4+T细胞数均>500/μL,无明显严重药物不良反应发生,HIV感染者生存状态良好。结论初步结果显示,急性期开始抗病毒治疗可能为艾滋病病人带来好的预后结果。     

北京市2016-2019年报告的男性高校学生HIV感染者性伴告知情况

目的 了解北京市2016-2019年男性高校学生HIV感染者性伴告知情况及影响因素.方法 对北京市2016年1月至2019年6月报告且在北京抗病毒治疗的18岁及以上的男性高校学生HIV感染者进行调查,采用自填式电子问卷调查方式,收集调查对象的社会人口学和行为学等特征,对该人群感染后的性伴告知情况进行分析.结果 共调查男...     

HIV抗体检测结果不确定时应用核酸诊断的可行性研究

目的探讨艾滋病病毒(HIV)核酸检测用于HIV感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)诊断的可行性,为制定新的检测策略提供依据。方法 2009年10月至2013年10月,对云南省德宏州疾病预防控制中心蛋白免疫印迹(WB)试验确证结果为不确定、背景资料齐全、初次血浆留样大于1000μL的样本进行核酸检测,并与抗体随访检测结果进行比较。结果 49例WB不确定的样本,有22例检出HIV核酸。其中成功随访18例,随访过程中17例HIV抗体阳转,1例带型有进展但不满足诊断标准。被访者WB条带在2周随访时均出现明显变化。核酸阴性的27例,7例成功随访,WB条带无进展或阴性。结论有条件开展HIV核酸检测的地区,对HIV抗体不确定者宜采用核酸检测尽早诊断;无核酸检测条件的地区,对HIV抗体不确定人群的随访间隔宜缩短至2周。     

艾滋病与结核病双重感染的研究

目的 调查HIV感染者和AIDS病人感染结核杆菌情况,了解HIV/AIDS与结核病的相关性。方法对202例健康者及40例经WB确证的HIV感染者和AIDS病人做结核菌素（PPD）试验,CD4、CD8淋巴细胞计数。结果 HIV感染者和 AIDS病人中PPD阳性率12.5％,而健康对照 PPD阳性率28.2％（P<0.05）。CD4细胞计数<200/mm3者PPD均为阴性。CD4/CD8比值<1者达90％。结论 HIV感染者和AIDS病人机体免疫力降低,PPD反应明显下降。对HIV/AIDS病人使用化学药物预防以控制和减少结核病发病及制定相关政策提供依据。     

Risk behavior score: a practical approach for assessing risk among men who have sex with men in Brazil

HIV/AIDS epidemic is not well controlled, and multiple sexual behavior factors help explain high rates of HIV infection among men who have sex with men (MSM). This article proposes to exam the use of a potential risk behavior score for HIV infection, based on the type and number of sexual partners, and condom use, and their associated factors in a sample of MSM in Brazil. A cross sectional RDS (Respondent Driven Sampling) study was performed among 3738 MSM aged 18+ years old from ten Brazilian cities. The risk behavior score was composed by the number of male partners and anal condom use in the last year with steady, casual, and commercial partners. Most participants were 25+ years old (58.1%), non-white (83.1%), and single (84.9%). Final weighted ordinal logistic model showed that age ≤ 25 years old (p = 0.037), homosexual or bisexual identity (p < 0.001), sexual initiation before 15-year-old (p < 0.001), having sex with men only in the last 12 months (p < 0.001), frequent alcohol and illicit drug use (p < 0.001), and use of local sites to meet sexual partners in the last month were independently associated with higher scores of risky behavior. Specific strategies should be developed aimed at the MSM population. Additionally, pre-exposed prophylaxis (Prep) should be considered for those at higher score as a strategy for reducing risk for HIV infection in this population.     

2009年新发现HIV感染者/AIDS病人随访管理情况分析

目的了解2009年新发现艾滋病病毒感染者/艾滋病病人(HIV/AIDS)的随访情况,分析首次随访后的随访管理情况及其相关因素。方法分别使用2010年1月下载的艾滋病网络直报病例报告卡和2010年7月下载的艾滋病随访管理数据库,对相关数据进行统计分析。结果截至2009年12月31日,当年报告HIV/AIDS68 249人,新发现且存活的HIV/AIDS 56 018人,其中完成首次随访48 407人(86.4%),失访3 151人(5.6%),查无此人2 646人(4.7%),未随访1 814人(3.2%)。首次随访完成后,未婚、维吾尔族和彝族、初中及以下文化程度、感染途径为注射毒品、现住址为非报告地县区、样本来源于医疗机构和强制戒毒/劳教/羁押人员,检测的HIV/AIDS失访比例较高。医疗机构报告病例信息不全为病例流失的主要原因。讨论为减少病例的失访,应加强易失访人群的沟通与管理,提高医疗机构报告病例信息收集的准确性和完整性。     

嘉兴市292507例孕产妇HIV感染状况

目的为了解嘉兴市孕产妇艾滋病病毒（HIV）感染状况,探索适合当地的预防艾滋病母婴传播的运行模式和服务方式,最大程度地减少母婴传播。方法对孕产妇检测HIV抗体,初筛阳性标本进行确认试验;对感染HIV的孕产妇进行监测与管理。结果2006—2012年,孕产妇HIV抗体阳性率为0．19‰（57／292507）,其中本地户籍为0．02％（3／130 299）,流动人口为0．33％0（54／162208）,差异有统计学意义（P〈0．01）。分娩的22例活产婴儿中追踪到18个月的有12例,其中11例HIV抗体阴性,1例阳性。结论嘉兴市孕产妇HIV感染处于较低水平,流动人口是艾滋病防治的重点人群。妇幼保健机构和疾病预防控制中心要明确各自职责、加强合作,加强对感染HIV的孕产妇进行监测管理。     

运城市农村地区HIV感染者/AIDS病人健康状况分析

目的 为了摸清运城市农村地区艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人的健康状况,为今后的关怀、治疗、管理工作提供科学依据.方法 对477例HIV感染者/AIDS病人进行全面健康检查及相关化验检查,观察合并感染情况和治疗效果.结果 477例HIV感染者/AIDS病人中,有1/5的人发生常见机会性感染症状,AIDS病人治疗后白细胞计数、血红蛋白、血小板均高于治疗前(P＜0.05);男女性治疗后CD4 细胞明显高于治疗前(P＜0.01),平均增长37.08%;病人均有不同程度的肝功能损害.HIV合并乙型肝炎病毒(HBV)感染的占2.9%,合并丙型肝炎病毒(HCV)53.5%,同时合并HBV和HCV感染的占1.9%;有心电图改变者占20.3%;HIV/结核菌(TB)双重感染率为2.3%.结论 运城市农村地区HIV感染者/AIDS病人健康状况较好,抗病毒治疗效果良好,今后要积极开展机会性感染或合并感染的预防和治疗.     

Associations of types of substances with condomless sex in vulnerable people living with HIV/AIDS

For people living with HIV who are not readily retained in medical care, substance use can contribute to risky sexual behavior that may lead to HIV transmission. This cross-sectional study examined the relationship between stimulants versus opioids and condomless sex in a sample of 223 vulnerable people living with HIV/AIDS. We examined the associations of stimulant and opioid use in the past 30 days with condomless sex while controlling for sample characteristics. More than two thirds (69%) reported having condomless sex in the past six months. Results showed a positive association between condomless sex and any illicit substance use (AOR: 2.82; 95% CI: 1.29–6.17; P?=?0.009) or stimulant use (AOR: 2.54; 95% CI: 1.04–6.24; P?=?0.041) in the past 30 days. These findings suggest the importance of promoting behavioral interventions that increase consistent condom use and reduce stimulant use among people who have difficulties with HIV care retention.     

Adoption of safer infant feeding and postpartum sexual practices and their relationship to maternal HIV status and risk of acquiring HIV in Zimbabwe

OBJECTIVE: To examine the relationships between maternal knowledge and concern about HIV status, adoption of preventive practices and risk of acquiring HIV in Zimbabwe. METHODS: Knowledge and behavioural data were collected via interview from 2595 mothers enrolled in ZVITAMBO, a randomized trial of postpartum vitamin A supplementation that also offered education on safer infant feeding and sexual practices. Mothers were tested for HIV at delivery; those uninfected at baseline were retested during study follow-up. Logistic regression methods were used to identify variables associated with adoption of preventive behaviours and, for HIV-negative mothers, their relationship to risk of acquiring HIV post-delivery. RESULTS: A total of 518 mothers (20%) reported practicing safer sex and 289 mothers (11%) reported modifying their feeding behaviour because of HIV. Fear of transmitting HIV (50.4%) and protecting the baby's health (30.9%) were the most frequently cited reasons for behaviour change. Forty-nine HIV-negative mothers acquired HIV during the first postpartum year. After taking into account other significant covariates, mothers who were concerned about their own HIV status were 1.9 times more likely (95% CI: 1.05-3.52; P = 0.03), and those reporting safer sex practices were 58% less likely to become infected (adjusted odds ratio: 0.42; 95% CI: 0.17-1.04; P = 0.06). Married women who reported practicing abstinence to prevent HIV were 3.2 times more likely to become infected than non-abstaining mothers (P = 0.01), while there were no new HIV infections among abstaining single mothers. CONCLUSIONS: Greater emphasis should be given to safer sex practices among women who test negative in mother-to-child HIV prevention programmes.     

Combined effects of HIV and marijuana use on neurocognitive functioning and immune status

The current study examined the independent and combined effects of HIV and marijuana (MJ) use (no use, light use, and moderate-to-heavy use) on neurocognitive functioning among a convenience sample of HIV-positive (HIV+) and HIV-negative (HIV–) individuals recruited from HIV community care clinics and advertisements in the Greater Los Angeles area. MJ users consisted of individuals who reported regular use of MJ for at least 12 months, with last reported use within the past month. Participants included 89 HIV+ (n?=?55) and HIV– (n?=?34) individuals who were grouped into non-users, light users, and moderate-to-heavy users based on self-reported MJ use. Participants were administered a brief cognitive test battery and underwent laboratory testing for CD4 count and viral load. HIV+ individuals demonstrated lower performance on neurocognitive testing than controls, and moderate-to-heavy MJ users performed more poorly on neurocognitive testing than light users or non-users. Moderate-to-heavy HIV+ users performed significantly lower on learning/memory than HIV– moderate-to-heavy users (M_D?=??8.34; 95% CI: ?16.11 to ?0.56) as well as all other comparison groups. In the domain of verbal fluency, HIV+ light users outperformed HIV– light users (M_D?=?7.28; 95% CI: 1.62–12.39), but no HIV group differences were observed at other MJ use levels. HIV+ MJ users demonstrated lower viral load (M_D?=??0.58; 95% CI: ?1.30 to 0.14) and higher CD4 count than non-users (M_D?=?137.67; 95% CI: 9.48–265.85). The current study findings extend the literature by demonstrating the complex relationship between HIV status and MJ use on neurocognitive and clinical outcomes.     

基于互联网和移动电话的创新性匿名性伴告知平台—易告知TM

近年中国艾滋病(AIDS)/性病(STD)疫情逐渐蔓延,鼓励感染者进行性伴告知和检测,是控制疫情传播的重要策略之一。传统的面对面性伴告知方式已不能满足多性伴的感染者的告知需求,而互联网和移动电话已成为现代社会有效快捷的沟通媒介,因此研究人员开发了一个基于互联网和移动电话的AIDS/STD匿名性伴告知平台—易告知TM,作为传统性伴告知方式的创新性辅助措施。文章介绍了易告知TM的构建情况和使用情况,并分析了易告知TM的未来需求。