广西各级综合医院艾滋病自愿咨询检测工作情况分析

目的了解广西壮族自治区各级综合医院艾滋病自愿咨询检测(VCT)工作情况,为制定艾滋病防治对策提供依据。方法从艾滋病综合防治信息系统检测咨询模块下载2011—2013年广西自愿咨询检测机构信息及个案信息,从中选取综合医院相关工作信息进行分析。机构信息包括机构类型、建立年度和使用状态;个案信息包括人口学特征、求询原因、既往HIV检测情况和本次检测结果等。结果至2013年底,广西累计在综合医院建立VCT门诊127家,综合医院VCT门诊检测发现的HIV筛查阳性人次数占全部VCT门诊阳性数的构成比从2011年的41.40%上升到2013年的47.69%。求询者平均年龄(39.91±15.70)岁,20~39岁占53.66%;男性占59.84%,男女比1.49:1;初中及以下文化占70.72%;已婚有配偶占68.72%。69.57%的求询者因性接触来院咨询,其中非商业非固定异性性行为史、商业异性性行为史、配偶/固定性伴阳性和男男性行为史所占比例分别为32.19%、28.41%、8.48%和0.49%。求询者HIV初筛阳性率为23.99%(9 799/40 838),男男性行为人群、注射吸毒人群、商业异性性行为、配偶/固定性伴阳性和非商业非固定异性性行为求询者有较高的阳性检出率,分别为46.53%(94/202)、45.39%(241/531)、40.84%(4 570/11 190)、32.53%(1 136/3 492)和20.65%(2 772/13 422)。结论广西各级综合医院VCT门诊体系建设逐步完善,求询者HIV初筛阳性率较高,VCT逐渐成为发现HIV感染者的重要途径之一。     

合山市1230名艾滋病自愿咨询检测求询者情况分析

目的分析合山市1 230名艾滋病自愿咨询检测(VCT)求询者的人口学特征和艾滋病病毒(HIV)感染情况,为有针对性的开展VCT工作提供科学依据。方法从艾滋病综合防治数据信息管理系统导出2011-2013年合山市疾病预防控制中心VCT求询者的数据资料,使用Excel整理资料,SPSS16.0进行统计分析。结果求询者中男女性别比为1.07:1;20~39岁的人群占49.51%;初中文化程度的人群占49.67%。非商业非固定异性性行为者占19.26%,商业异性性行为者占16.90%,配偶/固定性伴阳性者占9.10%,注射毒品者占4.31%。阳性率4.84%,其中配偶/固定性伴阳性者阳性率为20.54%,商业异性行为者阳性率7.69%,母亲阳性者阳性率8.33%,非商业异性行为者阳性率4.22%,注射毒品者阳性率3.85%。结论 VCT求询者阳性率较高,应加大宣传力度,提高服务质量和水平,阻断艾滋病从高危人群向普通人群传播扩散。     

2008～2013年上林县艾滋病自愿咨询检测结果分析

目的了解上林县艾滋病咨询检测者的社会人口学特征及艾滋病病毒感染情况,为今后更好地开展VCT服务,制定艾滋病防治对策提供科学依据。方法采用描述性流行病学方法,对2008~2013年到上林县各VCT门诊求询者的资料和HIV抗体检测结果进行统计分析。结果 2008~2013年上林县接受VCT服务的总人数为2 817人,其中男性1 818人,占64.54%;女性999人,占35.46%,男女之比为1.82∶1。20~49岁的青壮年占82.61%,已婚者占81.19%,初中文化占71.67%;求询者类型以有商业、非商业非固定异性性行为(即多性伴)史者为主,分别占58.64%、22.93%;2 817名求询者全部自愿接受HIV抗体检测,共检出HIV抗体阳性者101例,检出率为3.59%,其中有商业异性性行为史检出率最高占61.39%、有非商业非固定异性性行为史者占11.88%、配偶/固定性伴阳性占14.85%。结论通过艾滋病自愿咨询检测,能够及时发现艾滋病病毒感染者及病人,进而实施高危人群的艾滋病健康教育和行为干预、推广使用安全套,能有效降低艾滋病传播。     

2010～2013年威海市艾滋病自愿咨询检测结果分析

目的了解2010~2013年威海市艾滋病自愿咨询检测门诊检测状况,为制定艾滋病防治策略提高科学依据。方法对威海市14家艾滋病自愿咨询检测门诊和各市疾控中心外展服务中自愿接受艾滋病咨询检测的所有求询者的登记、检测信息进行分析。结果 2010~2013年共检测13 572人;男性占45.18%,女性占54.82%;平均年龄31.03±9.75）岁;商业、非商业异性性行为者占78.99%,男男同性性行为者占3.48%;HIV抗体阳性率为0.29%,梅毒抗体阳性率为3.10%;男性同性性行为者HIV阳性检出率明显高于其他求询者（P〈0.01）。结论 VCT是早期发现艾滋病病毒感染者和病人的重要手段,男男同性性行为者是威海市VCT门诊工作的重点人群。     

2010-2012年扬州市艾滋病自愿咨询检测门诊求询者资料分析

目的了解扬州市疾控中心艾滋病（AIDS）自愿咨询检测门诊求询者社会人口学特征和艾滋病病毒（HIV）感染情况,为有针对性的制定健康教育和高危行为干预措施提供依据。方法对2010～2012年到扬州市疾控中心AIDS自愿咨询检测门诊求询者资料进行分析。结果655名求询者接受了VCT服务,其中男性占85．04％,女性占14．96％;20～29岁占54．81％。30～39岁占28．09％,40～49岁占9．92％;未婚者占53．13％,已婚者占45．04％;初中占14．20％,高中或中专占24．12％,大专及以上占56．64％;求询原因为有商业异性性行为史的占36．34％,有非商业非固定异性性行为史的占29．16％,有男男性行为史的占13．74％;检测655人,HIV抗体阳性45例,阳性率为6．87％。不同年龄、文化程度、求询原因人群HIV抗体阳性率差异有统计学意义（P〈0．01）;不同性别、婚姻状况人群HIV抗体阳性率差异无统计学意义（P〉O．05）。结论2010～2012年扬州市疾控中心AIDS自愿咨询检测门诊求询者主要是商业异性性行为者、非商业非固定异性性行为者及男男性行为者。     

2011年广西艾滋病自愿咨询检测结果分析

目的分析2011年广西艾滋病自愿咨询检测(VCT)工作现状,指导VCT工作开展,为制定艾滋病防治对策提供科学依据.方法将2011年广西各 VCT 门诊上报至国家艾滋病综合防治信息系统的《检测咨询个案登记表》等信息下载,进行统计分析.结果截止2011年底广西 VCT 门诊建点完成率87.99%、有效运行率89.09%.2011年咨询99755人次,其中检测96987人次.求询者以20~39岁青壮年为主,占70.12%;求询者类型以有商业、非商业非固定异性性行为(即多性伴)史者为主,分别占25.62%、23.85%.HIV阳性总检出率7.68%,其中配偶/固定性伴阳性者检出率最高为24.41%、有商业异性性行为史者为9.97%、母亲阳性者为9.59%、有非商业非固定异性性行为史者为7.66%、有男男性行为史者为6.33%.结论 VCT门诊求询者年龄以20~39岁的青壮年为主;求询者类型以有多性伴史者为主,HIV 阳性总检出率较高.应加强对咨询员的培训,继续做好 VCT 门诊工作,发挥VCT门诊优势和作用.     

桂林市13062例艾滋病自愿咨询检测情况分析

目的分析桂林市自愿咨询检测(VCT)门诊求询者的社会人口学特征、求询原因及阳性求询者分布,为制定艾滋病防治对策提供科学依据方法对2013年桂林市各VCT门诊上报至国家艾滋病综合防治信息系统的个案咨询信息,进行数据统计分析。结果截至2013年年底,全市设立艾滋病咨询检测点41家,其中市区9家,12县32家。2013年共完成自愿咨询13 062人次,其中检测13 032人次。HIV阳性总检出率为9.17%,其中男性求询者的HIV阳性检出率为12.48%,与女性求询者HIV阳性检出率5.48%比较,差异有较大统计学意义(P<0.01)。求询者类型以有商业、非商业非固定异性性行为(即多性伴)史者为主,分别占49.55%、21.92%。配偶/固定性伴阳性者检出率最高,为20.17%,有男男性行为史者为12.65%,有商业异性性行为史者为9.91%,母亲阳性者为9.35%,有非商业非固定异性性行为史者为7.98%。结论桂林市VCT门诊服务网络已经形成,并在艾滋病防治工作中显现重要作用,但仍存在一些薄弱环节,应加强对咨询员的培训,继续做好VCT门诊工作,发挥VCT门诊优势和作用。     

2012年南昌市青山湖区艾滋病自愿咨询检测情况分析

目的了解2012年南昌市青山湖区艾滋病自愿咨询检测人群的人群特征、求询原因及检测结果,为今后有针对性地制定健康教育干预计划,开展艾滋病的防治工作提供依据。方法采用描述流行病学方法,对2012年自愿咨询检测的求询者咨询情况和检测结果进行统计分析。结果 2012年有830名求询者接受咨询,男女比为1.1∶1;17~39岁青壮年占85.5%,高中及以上文化程度人群占61.8%。求询原因主要包括有商业异性性行为史(占32.5%)、非商业非固定异性性行为史(占16.8%)、注射毒品史(占12.3%)。检出HIV抗体阳性25人,阳性率3.0%,其中配偶/固定性伴HIV阳性人群阳性率最高(19.2%),其次为有男男性行为史、献血浆史人群(均为16.7%)。结论应针对青壮年人群进行广泛的艾滋病健康教育,重点加强对男男性行为人群和艾滋病感染者/病人的配偶/固定性伴的行为干预措施。     

2013～2014年济南市艾滋病自愿咨询人群检测分析

目的 分析济南市艾滋病自愿咨询检测（VCT）情况,为今后的艾滋病防治提供数据支持。方法 对济南市2013~2014年自愿咨询检测人群血清进行HIV抗体和梅毒抗体检测,并对结果进行统计分析。结果 2013~2014年共有2 000人自愿咨询检测,男性1 872人（占93.75%）,20~39岁的青壮年1 686人（占84.30%）,未婚者1 236人（占61.80%）,文化程度为大专及以上者1 409人（占70.45%）;求询者中MSM者1 222人（61.10%）,商业异性性行为史者356人（占17.80%）,非商业非固定异性性行为史者345人（占17.25%）;2 000名求询者中检出HIV抗体阳性者159例,阳性率为7.95%,通过MSM感染者达89.31%;梅毒阳性率为6.35%,HIV和梅毒合并感染20例,其中16例通过MSM感染。结论 济南市自愿咨询检测者中,梅毒抗体阳性、MSM人群HIV感染率更高。     

荆州市2012-2013年艾滋病自愿咨询检测

目的了解荆州市接受艾滋病自愿咨询检测（VCT）服务人群的现状,为探寻HIV感染重点人群、为制定艾滋病防治措施提供科学依据。方法对荆州市2012-2013年接受VCT服务的人员的人口学状况、求询原因、危险行为等进行统计学分析。结果 10 701名求询者中男性5 751人,女性4 950人,男女性别比为1.16∶1。年龄主要集中在20~49岁,占92.17%;已婚有配偶的7 678人（71.75%）;求询者中有非商业非固定异性性行为史的占45.41%;有商业异性性行为史的占35.49%;10 701名求询者接受了HIV抗体检测,检出阳性72例,HIV检出率为0.67%。配偶/固定性伴阳性史的咨询者HIV抗体检出率最高,为8.72%（13/149）,有男男性行为者次之。结论VCT是及时发现HIV感染者的有效手段,有非婚非固定异性性行为、商业性性行为及男男性行为者是感染HIV的重点人群。     

HIV discrimination and the health of women living with HIV

Women living with HIV are especially vulnerable to discrimination because of the stigma associated with the disease, as well as their race, gender and class status. To investigate the association between self-reported HIV discrimination and health outcomes among African- American and white women living with HIV, 366 women living with HIV were recruited from HIV/AIDS clinics in Georgia and Alabama. In this cross-sectional study, participants completed an interview that assessed self-reported HIV discrimination and depressive symptomatology, suicidal ideation, self-esteem, stress, quality of life, sexual health and HIV/AIDS related health care seeking. Nearly a sixth of the sample reported experiencing HIV discrimination. Women reporting HIV discrimination had higher mean scores for stress, suicidal ideation, depressive symptoms, number of unprotected sexual episodes; they had lower mean scores for self-esteem, and quality of life, and were more likely to have not sought medical care for HIV/AIDS. In race-specific analyses, none of the relationships between HIV discrimination and health outcomes were significant for white women. African-American women who reported HIV discrimination had higher mean scores for stress, suicidal ideation, depressive symptoms, number of unprotected sexual episodes; they had lower mean scores for self-esteem, and quality of life, and were more likely not to have sought medical care for HIV/AIDS. The findings indicated that HIV discrimination adversely affects women's mental, sexual and physical health. However, separate race-specific analyses indicated that compared to white women, African-American women were markedly more likely to experience the adverse affects of HIV discrimination. Eradication of HIV discrimination remains an important public health priority.     

HIV Discrimination and the Health of Women Living with HIV

ABSTRACT

Women living with HIV are especially vulnerable to discrimination because of the stigma associated with the disease, as well as their race, gender and class status. To investigate the association between self-reported HIV discrimination and health outcomes among African-American and white women living with HIV, 366 women living with HIV were recruited from HIV/AIDS clinics in Georgia and Alabama. In this cross-sectional study, participants completed an interview that assessed self-reported HIV discrimination and depressive symptomatology, suicidal ideation, self-esteem, stress, quality of life, sexual health and HIV/AIDS related health care seeking. Nearly a sixth of the sample reported experiencing HIV discrimination. Women reporting HIV discrimination had higher mean scores for stress, suicidal ideation, depressive symptoms, number of unprotected sexual episodes; they had lower mean scores for self-esteem, and quality of life, and were more likely to have not sought medical care for HIV/AIDS. In race-specific analyses, none of the relationships between HIV discrimination and health outcomes were significant for white women. African-American women who reported HIV discrimination had higher mean scores for stress, suicidal ideation, depressive symptoms, number of unprotected sexual episodes; they had lower mean scores for self-esteem, and quality of life, and were more likely not to have sought medical care for HIV/AIDS. The findings indicated that HIV discrimination adversely affects women's mental, sexual and physical health. However, separate race-specific analyses indicated that compared to white women, African-American women were markedly more likely to experience the adverse affects of HIV discrimination. Eradication of HIV discrimination remains an important public health priority.     

Murders and HIV

Investigators have dismissed the previously reported HIV diagnosis links in two prominent homicide cases. Serial murderer Andrew Cunanan, who shot renowned fashion designer Gianni Versace and four other men, was thought to have killed out of rage because his own life was doomed by HIV. Tests conducted during Cunanan's autopsy revealed that he was not HIV-positive. Darnell McGee, who was HIV-positive, had unprotected sex with more than 100 women and girls and did not inform them of his HIV-status. McGee infected at least 30 women with HIV through unprotected sex. When McGee was found murdered in St. Louis, MO, police suspected that the motive was revenge for intentional HIV transmission. It was later determined that McGee was the victim of a street robbery.     

Tobacco and HIV

The risks to an HIV-infected person who smokes are dramatically amplified compared with the general population. Smoking has been shown to be an independent risk factor for non-AIDS-related mortality in patients who have HIV, even in patients who receive highly active antiretroviral therapy. It has been independently associated with lower scores for quality-of-life indices, such as general health perception, physical functioning, bodily pain, energy, and cognitive functioning. Over time, considering the significant pathology elicited by tobacco, it is hoped that smoking cessation will help reduce the risks of lung disease, heart disease, and neoplastic conditions in patients who have HIV and increase their general sense of well-being.     

HIV and employment

According to 2009 statistics, the human immunodeficiency virus (HIV) infected an estimated 86,500 individuals within the UK, although around one-quarter were unaware of their infection. In the majority of cases, it is now considered a long-term controllable but incurable infection. Indeed, most HIV-positive individuals are able to work. Employment is across most, if not all, workforce sectors and protection against workplace discrimination is provided by the Equality Act 2010. Issues including confidentiality, workplace adjustments, vaccinations and travel restrictions may be relevant to the occupational health of HIV-positive workers. There are special considerations concerning HIV-infected health care workers, including avoidance of performing exposure-prone procedures. Prevention of HIV acquisition in the workplace is relevant to a diverse range of occupational environments, and HIV post-exposure prophylaxis should be considered after potential HIV exposure incidents. If a worker contracts HIV by occupational means, financial help may be available.     

HIV and adolescents

Seroprevalence studies and documented sex and drug use risk behaviors indicate the importance of primary prevention programs for HIV among adolescents. Females and minority adolescents are at particular risk. Prevention workers must decide which strategies to advocate: abstinence, monogamy, HIV testing, screening partners, or explicit instruction of safer acts. Youths must be helped to personalize knowledge of HIV, acquire coping skills, and gain access to health care resources. Programs based on cognitive-behavioral models have been initially successfully in reducing risk behaviors, however, there is a need for more community-wide and media interventions. Adolescents' developmental features require that special attention be paid to implementation issues, including parent and peer involvement in the design of prevention programs.This work was supported by Grant 1P50 MH 43520 to the HIV Center for Clinical and Behavioral Studies from the National Institute of Mental Health and the National Institute on Drug Abuse, Anke A. Ehrhardt, Director, as well as by a grant from the W. T. Grant Faculty Scholars Award Program. We also wish to acknowledge the contributions of Elizabeth Grace, Clara Haignere, Joyce Hunter, Damien Martin, Alphonso Silverls, and J. St Hill.Mary Jane Rotheram-Borus and Cheryl Kooperman are affiliated with the Division of Psychiatry, Columbia University, the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, and Columbia-Presbyterian Medical Center.     

Women and HIV

HEALTH ISSUE: The epidemic of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in developed countries has changed from the early epidemic that affected primarily men who have sex with men, to one that increasingly affects other groups such as injecting drug users (IDU) and heterosexuals. As a result, the number and percentage of women with HIV and AIDS is increasing. KEY FINDINGS: The number of women in Canada living with HIV, including those with AIDS, has increased over time. An estimated 6,800 women were living with HIV at the end of 1999, an increase of 48.0 % from the 1996 estimate of 4,600. On an annual basis, women account for a growing proportion of positive HIV test reports among adults in Canada. This proportion increased from 10.7% in the period 1985-95 to 25% in 2001. Heterosexual contact is the main risk factor for HIV infection in women, accounting for 63% of newly diagnosed cases of HIV infection in adult Canadian women in 2001; the majority of the remainder is due to IDU. KEY DATA GAPS AND RECOMMENDATIONS: Research is needed to address specific information gaps regarding risk behaviours, testing patterns and HIV incidence and prevalence in women. This research needs to include the broader contextual factors that influence women's lives and their risk of HIV infection. Programmes and prevention efforts must be gender and age-specific and should target not only individual behaviours, but also the social and cultural context in which these behaviours occur.