艾滋病病毒感染者／艾滋病病人配偶／固定性伴HIV感染现状调查

[目的]了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人配偶/固定性伴HIV感染现状,探索艾滋病病毒感染者及艾滋病病人(PLWHA)配偶/固定性伴降低胜接触传播的有效预防措施.[方法]对已确认的PLWHA的配偶/固定性伴采血进行HIV抗体检测.[结果]对全县可随访到的PLWHA的配偶/固定性伴73例进行了艾滋病毒抗体(抗-HIV)筛查,检出阳性23例,占31.51%.[结论]对PLWHA及其配偶/固定性伴进行健康教育、行为干预,是今后澄江县艾滋病控制工作的重点和难点.定期随访,指导PLWHA做到每次性交时正确使用安全套是减少配偶、性伴间传播HIV的有效方法.     

Insurance status and access to health services among poor persons.

OBJECTIVE: We examine the relationship between health insurance status and access to care among low-income persons 65 years of age and under, taking into account their social demographic characteristics and health care needs. DATA SOURCES AND STUDY SETTING. Study groups consist of the subsamples of persons with incomes between 100 and 150 percent of the federal poverty level and those below the federal poverty level interviewed in the 1983, 1984, and 1986 Health Interview Surveys (HIS) of the National Center for Health Statistics. Sample sizes range from about 6,000 to 11,000 depending on the proportion of each study group administered the insurance supplement. STUDY DESIGN. Annual visits and whether hospitalized during a year are used as measures of access to medical care. The analysis consists of identifying predictors of use of services (i.e., health status and social characteristics) and, taking them into account, examining the relationship of insurance status to access to care. This was first undertaken on the 1983 survey; the models obtained then are replicated on the other two years of data. DATA COLLECTION/EXTRACTION METHODS. The HIS utilizes in-person interviews to gather health and medical history information from a stratified random sample of the U.S. population. Data were obtained through public use tapes distributed by the National Center for Health Statistics. PRINCIPAL FINDINGS. Results are consistent for all three years among persons in poverty. Being covered by Medicaid, in contrast to having private insurance or being without health insurance, is related to use of both ambulatory care and hospital care. The access differences for persons in poverty, regardless of their vulnerability or "risk" of requiring medical care, are marked and generally statistically significant. Among the near-poor the same findings occur, although the differences are less sharp and less often statistically significant. CONCLUSIONS. The most obvious explanation is that the poor, and to a considerable extent the near-poor, have limited access because of copayments and deductibles that are typically part of private insurance coverage. The findings raise policy questions regarding the utility of either "play or pay" employer-provided insurance or income tax deductions to increase access.     

Contraceptive method and self-reported HIV status among women in Malawi

ObjectivesWe aimed to describe contraceptive methods used by women in Malawi and determine whether contraceptive use differed by self-reported HIV status. Effective contraception is a primary method of preventing mother-to-child transmission of HIV.Study designAnalysis is based on 12,658 nonpregnant, sexually debuted women ages 15–49 years in the 2010 Malawi Demographic and Health Survey. Analysis was restricted to respondents with contraceptive need (i.e., fecund and did not want a child in the next 12 months) who reported their last HIV test result. We accounted for the two-stage cluster sampling design by applying cluster, stratum and sample weights. We assessed differences in contraceptive method use by HIV status with χ² tests and multivariable logistic regression.ResultsA total of 893 (7.0%) of respondents reported being HIV positive. Use of long-acting reversible contraception (LARC) was low and did not differ between HIV-positive (1.4%) and HIV-negative (1.9%) women [adjusted odds ratio (aOR)=0.7, 95% confidence interval (CI), 0.4–1.4]. HIV-positive women (15.6%) were less likely than HIV-negative women (30.4%) to use progestin-only injectable contraception (aOR, 0.7; 95% CI, 0.5–0.8). Prevalence of female sterilization was higher among HIV-positive women (17.9%) compared to HIV-negative women (9.2%; aOR=1.7; 95% CI, 1.2–2.3).ConclusionsLARC use was low among adult women with contraceptive need in Malawi. HIV-positive women were less likely to report progestin-only injectable use but more likely to report having undergone female sterilization compared to their HIV-negative counterparts. Noncoercive interventions that provide highly effective methods of contraception to HIV-positive women with contraceptive need are valuable methods of vertical transmission prevention in Malawi.ImplicationsContraceptive use differed by self-reported HIV status among adult women with contraceptive need in Malawi. Female sterilization was significantly higher, and use of progestin-only injectables was significantly lower, among HIV-positive women compared to their HIV-negative counterparts. Use of long-acting reversible contraception was low among both HIV-positive and HIV-negative women.     

HIV感染者免疫状态与病毒载量的关系

目的了解HIV感染者体内CD3、CD4、CD8细胞计数与病毒载量间的关系。方法对无锡市2014—2015年199例HIV确证阳性者开展CD3、CD4、CD8淋巴细胞计数检测和病毒载量测定,细胞计数采用流式细胞仪的绝对计数法,病毒载量采用荧光定量PCR法。结果 199例HIV确证阳性者细胞计数范围,CD3为277~5 215/μL,CD4为12~1 183/μL,CD8为141~4 176/μL,196份(占98.49%)的标本CD4/CD8比值1。CD3、CD4细胞计数与HIV病毒载量(对数转换)均呈负相关,相关系数分别为-0.238(P=0.038)、-0.350(P0.01)。CD8细胞计数、CD4/CD8细胞比值与HIV病毒载量(对数转换)无统计学上的相关关系。结论 HIV病毒载量与CD3、CD4淋巴细胞含量有一定的相关性。     

Association between intimate partner violence and HIV status among Haitian Women

ABSTRACT

The prevalence of intimate partner violence (IPV) among women living in Haiti increased from 25% in 2006–29% in 2012, with escalating reports of crisis in the last several years. We examined the association between IPV and HIV status among these women in Haiti. Participants were drawn from a larger sample of women (n?=?513) with a history of IPV. Women living with HIV (n?=?55) were matched to uninfected women (n?=?110) to form a control group. Attitudes towards gender roles, mental and physical well-being, and partner violence were assessed and compared. Logistic regressions were utilised to calculate multivariable-adjusted odds ratios. Women living with HIV were more likely to report more severe forms of psychological violence (p?<?0.01), and severe physical violence (p?<?0.0001). Women who experienced severe forms of IPV were 3.5 times more likely to have an HIV positive status compared to those who did not experience severe IPV (p?<?0.0001). There were significant associations between severe forms of IPV, and HIV status among Haitian women. IPV severity should be integrated into eligibility screening for biomedical strategies of prevention such as pre-exposure prophylaxis (PrEP) among Haitian women.     

Influence of HIV positive status on sexual behavior among males.

OBJECTIVE: To compare HIV seronegative (HIV-) and HIV seropositive (HIV+) males in terms of sexual behavior with female and male partners of different types. METHOD: Cross-sectional study. From August 1994 to February 1995, a sample of 236 respondents (150 HIV- and 86 HIV+) recruited from public health centers in the State of S. Paulo (Brazil), answered a questionnaire, including questions on demographic aspects, HIV and AIDS related knowledge, sexual orientation, use of alcohol and other drugs, sexual behavior with regular and casual female and male partners, and perceived risk of HIV infection. Sexual behavior with regular and casual female and male partners within the previous three months, was investigated. RESULTS: A lower proportion of HIV+ engaged in sexual contact with regular female partners (p < .01) and in vaginal intercourse with this type of partner (p < .01). A lower proportion of HIV+ engaged in overall sexual activity (p < .001) and reported lower frequency of penetrative sexual practices (p < .05). A high level of condom use with female and male partners was identified with no significant differences being found between the two serostatus groups. Some risky sexual behavior was identified, however, especially with regular partners, suggesting that some men were continuing to practice unsafe sex. CONCLUSIONS: The high level of condom use identified suggests that safer sex advice has been taken up. Condom use was not universal, however, and some men continue to place themselves at risk, especially with regular partners. Prevention programs should strive not only to encourage HIV- to practice safer sex, but also to encourage HIV+ to do so in order to prevent further transmission of the virus.     

Dyadic HIV status and psychological distress among women on methadone.

PURPOSE: Studies examining the association between psychological distress and HIV status among women belonging to populations at elevated risk for HIV have found mixed results. The goal of this study is to shed greater insight into possible explanations for the mixed findings of the earlier studies. Specifically, we examine psychological distress as a function of dyadic HIV status--that is, the combination of a participant and her partner's HIV statuses--among women attending methadone maintenance treatment programs (MMTPs). METHODS: A random sample of 349 female MMTP patients involved in intimate relationships provided self-reported data via structured, face-to-face interviews. Hypothesis testing involved multiple linear regression with 3 orthogonal contrast codes constructed from dyadic HIV status. RESULTS: Levels of psychological distress did not differ significantly between HIV-negative and HIV-positive women. HIV-negative women with HIV-positive partners reported significantly greater global levels, number of symptoms, and symptom severity of psychological distress compared to those with HIV-negative partners. HIV-positive participants with HIV-positive partners reported significantly lower global levels and symptom severity of psychological distress compared to those with HIV-negative partners. CONCLUSION: Findings support that psychological distress appears to differ as a function of the combination of a woman and her partner's HIV status rather than the woman's HIV status alone. Thus, dyadic HIV status represents an important factor with respect to the mental health needs of women in drug treatment.     

天津市结核病患者中HIV感染现状调查

摘要:目的　了解天津市结核病患者中人类免疫缺陷病毒感染的流行特征及临床特点,为制定有针对性的TB/HIV双重感染防治策略提供科学依据。方法　调查分析2010-2013年在某院登记报告的结核病人的HIV抗体检测情况及疾病相关信息,HIV初筛试验用ELISA法,初筛阳性者进一步做免疫印迹（WB）试验确证。结果　5 974例结核病患者中实际检测HIV抗体5 027人,筛查率84.15%,其中HIV阳性20例,HIV感染率为0.40%,各年度HIV感染率差异无统计学意义（P＞0.05）。在筛查的结核病患者中以男性、本地户籍、涂阴及无痰结核病、其他类型结核的HIV感染率较高。20例双感患者全部为男性,传播途径以性传播为主。结论　目前天津市的结核病患者中HIV感染率虽低于全国平均水平,但是TB/HIV双重感染不容忽视。应加强结核病人HIV抗体的检测,对控制TB/HIV双重感染有重要意义。     

南京市在婚男男性行为人群HIV感染状况及其相关行为特征调查

目的了解南京市在婚MSM(男男性行为)人群HIV感染状况及性行为特征。方法 2014年在南京通过"滚雪球"方法共招募220名在婚MSM人群,进行问卷调查和HIV抗体检测。结果在婚MSM人群HIV阳性检测率为12.7%;有77.7%的调查对象最近6个月与同性发生过肛交性行为,肛交性行为时坚持使用安全套的比例是43.9%,最近一次肛交安全套的使用比例为60.8%;有53.2%的调查对象最近6个月与女性发生过性行为,异性性行为时坚持使用安全套的比例为29.1%,55.6%在最近1次异性性行为时未使用安全套。调查对象中,HIV感染者最近1年做过HIV抗体检测的比例是42.9%,17.9%最近1年曾诊断罹患性病。感染者最近6个月中:78.6%与同性发生肛交性行为;22.7%坚持使用安全套;42.9%与异性发生性行为,性行为时坚持使用安全套的比例是33.3%。结论南京在婚MSM人群的HIV感染率较高,且无保护性的同性和异性性行为同时存在,将加剧HIV在MSM人群和在婚女性之间的传播。     

Abuse,HIV status and health-related quality of life among a sample of HIV positive and HIV negative low income women

The assessment of a persons quality of life as it relates to health, HIV status and intimate partner violence (IPV) among women has been limited in its scope of investigation. Consequently, little is known about the adjusted and combined effects of IPV and HIV on womens health status and QOL. 445 women (188 HIV + 257 HIV –) residing in an urban low income area were interviewed regarding current IPV experiences (no IPV, IPV more than 1 year ago, IPV in last year), HIV status (positive and negative), use of illicit drugs, and presence of instrumental social support. Health-related QOL (HRQOL) was measured using the MOS-HIV. Stratified bivariate analyses demonstrate that living with HIV or having experienced IPV in the past year was significantly associated with poorer levels of HRQOL. Multiple logistic regression models indicate a robust negative relationship between the experience of IPV in the past year, living with HIV, use of illicit drugs and a protective effect of social support on womens reported HRQOL. The results of the bivariate and multivariate analyses provide evidence that there are independent and adjusted detrimental associations of the experience of IPV and living with HIV with womens HRQOL. As HRQOL is a good indicator of physical and mental health, these findings should alert health care and other service providers to their responsibility to screen and treat women experiencing intimate partner violence and living with HIV.     

微量营养素对艾滋病病毒感染者体内免疫细胞及微量元素水平影响的研究

目的 研究微量营养素对HIV感染者体内免疫细胞及微量元素水平的影响.方法 选择25～49岁的HIV感染者,试验组服用复合微量营养素片,对照组服用安慰剂.试验开始及结束时分别进行体格测量、免疫细胞及微量元素水平的测定.结果 试验前试验组与对照组的身高、体重和微量营养素摄入、免疫细胞及微量元素水平差异均无统计学意义(P>0.05).6个月后,试验组免疫细胞(CD4+、CD8+、CD3+T淋巴细胞)分别为(2078±108)个/mm3、(582±75)个/mm3、(1287±97)+/mm3,高于对照组的(1436±105)个/mm3、(472±61)个/mm3、(998±84)个/mm3,差异有统计学意义(P<0.05).试验组血清锌、钙、镁、铁分别为(144.89±9.78)μmol/L、(1.89±0.19)μmol/L、(1.68±0.12)μmol/L、(152.61±8.94)μmol/L,高于对照组(102.67±5.45)μmol/L、(1.13±0.07)μmol/L、(0.85±0.05)μmol/L、(89.24±3.91)μmol/L,差异有统计学意义(P<0.05).结论 补充微量营养素能提高HIV感染者体内锌、钙、镁、铁的水平,并能增进免疫功能.     

Family secrets: disclosure of HIV status among gay men with HIV/AIDS to the family of origin

A mail survey obtained a sample of 117 gay men with HIV/AIDS to examine levels of disclosure of HIV status to the family of origin and the association between disclosure and levels of support and barriers to support from the family. Among men with HIV there was a significant difference in knowledge of HIV status between family members such that mothers and siblings were more likely to be knowledgeable than fathers. For the total sample disclosure of HIV status was associated with higher levels of support from all family members and with a lower level of barrier to support from mothers and fathers. Implications for practice are discussed.     

武汉市男男性行为人群HIV/STD流行病学调查分析

目的研究武汉市男男性行为人群艾滋病病毒（HIV）/性病（STD）感染状况及行为学特点;探讨同伴推动抽样法（RDS）对男男性行为者（MSM）调查的可行性。方法使用RDS方法对武汉市MSM进行抽样调查和血清学检测。结果共招募MSM456人,抗-HIV阳性率为6.6%;梅毒阳性率为21.9%;抗-HCV阳性率为2.1%;分层分析提示高年龄组（30岁以上）、低文化程度、低月收入水平、双性恋取向、浴池桑拿型、近6个月存在无保护性肛交、多性伴、最近1次肛交未使用安全套者的HIV、梅毒及HCV阳性水平较高。结论 RDS可作为隐匿人群调查行之有效的方法;武汉市MSM人群HIV感染率处于较高水平。     

河南省艾滋病病毒感染者和艾滋病患者社会支持状况研究

目的了解艾滋病病毒感染者和艾滋病患者社会支持状况,探索改善该人群生存环境的途径。方法采用多阶段随机整群抽样方式抽取河南省艾滋病高发的8个县（区）1200人（HIV／AIDS组）进行问卷调查,内容包括社会交往、工作和婚姻受影响情况及受资助情况等。并抽取同生活区非感染者1200人（非HIV／AIDS组）进行对照分析。结果HIV／AIDS组中与亲戚很少来往的比例占47．6％,认为就业受影响很大的占66．1％,生活困难者得到过政府在生活上的帮助的占64．5％。在与亲戚的来往频度、与朋友来往频度、对就业的影响程度、本人或家庭其他人员婚姻受影响程度、受亲朋好友资助、受政府及社会救助、生活困难者是否得到过政府在生活上的帮助等方面,HIV／AIDS组和非HIV／AIDS组之间有统计学差异。结论艾滋病对艾滋病病毒感染者和艾滋病患者的社会交往、家庭和生活有较大影响,需要各个方面给予他们更多的支持。     

长沙市大学生艾滋病相关高危行为现状调查

目的 了解长沙市大学生艾滋病感染相关高危行为发生现状、既往接受艾滋病预防服务情况,分析有关影响因素,为制定高校艾滋病防控策略提供依据。 方法 在长沙市选取三所综合性高校,于2015年11月-2016年1月对校内在读大学生(含研究生)进行问卷调查(个人基本情况、性行为、毒品使用等),使用SPSS 21.0软件进行数据整理和统计学分析。 结果 962名调查对象中有5名男生使用过毒品,83.8%(806/962)最近一年接受过艾滋病预防服务,最近6个月性行为发生率为11.6%(112/962),其中异性性行为、商业性性行为、男男同性性行为发生率分别为10.3%(99/962)、2.1%(20/962)、4.7%(26/552)。除商业性性行为在性别上无差异外,男性、少数民族、大年龄组、非一本学校、高年级组、文科专业的学生性行为发生率均较高(P<0.05)。最近一次性行为使用安全套的比例为55.4%(62/112),非商业和商业性行为之间以及男女之间安全套使用率差异均无统计学意义(P>0.05)。高危性性行为的发生率为7.7%(74/962),与性别(男性高于女性,OR=4.163,95%CI:1.752~9.893,P=0.001)、民族(少数民族高于汉族,OR=4.203,95%CI:4.563~11.301,P=0.004)、学校(一本高于非一本,OR=11.187,95%CI:5.371~23.298,P<0.001)、年级(大学3~5年级高于大学1~2年级,OR=2.285,95%CI:1.109~4.708,P=0.025)、近一年接受艾滋病预防服务(接受过低于未接受过,OR=0.339,95%CI:0.158~0.729,P=0.006)有关。 结论 长沙市大学生中存在艾滋病感染风险较高的行为,接受艾滋病预防服务的比例还不高,应特别重视大学生高危行为状况,采取针对性宣传和行为干预措施。     

Psychological adaptation and distress among HIV+ Latina women: adaptation to HIV in a Mexican American cultural context

In order to examine the relative importance of general individual orientations (mastery and self-esteem) and specific coping styles with regard to psychological distress among women with HIV, data are examined from a pilot study involving in-depth face-to-face interviews with 32 HIV+ Latinas receiving care at 4 clinics serving the South Texas population. Interviews were conducted to provide preliminary psychometric information on coping and distress instruments in this predominantly Mexican American population as well as to examine psychosocial factors related to individual adjustment to HIV among Latina females. Refusal rates were low in this study (approximately 10%) and measurement instruments generally had acceptable internal consistency reliability. Results of exploratory multiple regression analyses suggest that self-esteem and mastery may be more salient predictors of depression and anxiety symptoms than are specific coping strategies.     

成都市大中学生2011-2015年艾滋病流行特征分析

了解成都市青年学生艾滋病流行状况,为有针对性地开展学校艾滋病防治工作提供科学依据.方法 对成都市2011-2015年艾滋病综合防治信息系统中报告职业为学生、年龄>15岁的HIV感染者/AIDS病人数据进行回顾性分析.结果 2011-2015年共报告学生HIV感染者/AIDS病人559例,平均年龄为(20.84±2.41)岁,男性占98.6%(551例),女性占1.4%(8例).2011-2015年各年报告的学生病例数呈上升趋势,占当年报告总数的比例无上升趋势(x2=3.50,P=0.478).性传播占98.9%,其中同性传播占78.2%,学生中同性传播的比例(78.2%)高于成都市同期总体疫情同性传播比例(27.1%) (x2 =658.31,P<0.01).559例病例通过自愿检测(VCT)发现的占48.1%,其他就诊者占23.8%,性病门诊占14.4%.结论 成都市2011-2015年青年学生感染艾滋病数增长较快,同性性行为是主要传播途径.