Epidemiology of hepatitis E virus in male blood donors in Jeddah, Saudi Arabia

To our knowledge, only a few epidemiological reports on the prevalence of hepatitis E antibodies in Saudi blood donors have been published. Men of several nationalities, donating blood at King Khalid National Guard Hospital (Jeddah, Saudi Arabia) were selected (n = 593) for this study examining the seroprevalence of hepatitis E virus (HEV) in the local male donor population and testing the relationship of the antibody to HEV (anti-HEV) to donor characteristics using Odds Ratio (OR) and Chi-square statistic. The prevalence of anti-HEV in the group examined was 16.9 per cent (100/593). The seroprevalence for Saudi donors was 14.8 per cent compared with 33.3 per cent for non-Saudis of Middle Eastern origin. Donors who were 40 yr and over had significantly higher seroprevalence than those donors who were 30 yr or younger (OR =2.5, p = 0.006). There was a significant association between anti-HEV and anti-HCV with donors who were positive to anti-HCV having about 5 times the risk of HEV than those who were anti-HCV negative (p = 0.02). These findings demonstrate the high seroprevalence rate of anti-HEV among male blood donors in Saudi Arabia.     

High risk health behaviours among adult Jamaicans

The purpose of this study was to assess the prevalence of high risk health behaviours among adult Jamaicans aged 15-49 years in 2000, and to compare the results with the 1993 survey. A nationally representative sample of 2013 persons aged 15-74 years was surveyed in 2000 using cluster sampling in the Jamaica Healthy Lifestyle Survey (Wilks et al, unpublished). Interviewer administered questionnaires and anthropometrical measurements were done. Data for a sub-sample of adults aged 15-49 years were analyzed The sub-sample included 1401 persons (473 men and 928 women). Significantly more men (18.6%) than women (4.3%) reported never having had a blood pressure check (p = 0.0001). Approximately one-third of the women reported that they had never had a Pap smear (36.0%) or a breast examination (31.2%). Current cigarette smoking was reported in 28.6% of men and 7.7% of women (OR 3.73 CI 2.71, 5.15), while 49.0% of men and 15.0% of women ever smoked marijuana (OR 3.28 CI 2.56, 4.20). Significantly more men (28.0%) than women (11.7%) reported ever having a sexually transmitted disease (OR 2.93 CI 2.16, 3.97); having more than one sexual partner in the past year (49.1% vs 11.4%, OR 4.31 CI 3.22, 5.76) and usually using a condom during sexual intercourse (55.3% vs 40.5%, OR 1.3 CI 1.11, 1.68). Between 1993 and 2000, significant trends include: more persons reported having a blood pressure check, a reduction in multiple sexual partners, increased condom use at last sex (women), reduced crack/cocaine use (males) and increased marijuana smoking. Although there were some significant positive lifestyle trends between 1993 and 2000, high risk behaviours remain common among Jamaican adults. Comprehensive health promotion programmes are needed to address these risk behaviours.     

Health-related attitudes and risk factors for sexually transmitted infections of Chinese women who have sex with women

Background  Previous studies have shown evidence of health-related risk behaviors among women who have sex with women (WSW), such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections (RTI)/sexually transmitted infections (STI).

Methods  Participants were recruited through outreach in venues and online for a cross-sectional study. Data was collected using interviews and laboratory tests.

Results  We recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% (206/224) of women reported sexual relations with women. The RTI rates were: gonorrhea (15.8%), Chlamydia (3.5%), syphilis (0.5%), bacterial vaginosis (BV) (14.4%), hepatitis B virus (HBV) (0.9%), hepatitis C virus (HCV) (0.5%), and candidiasis (6.9%). No HIV or herpes simplex virus (HSV) positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency [odds ratio (OR)=2.1, 95% confidence interval (CI): 1.2 to 3.8] and genital-genital contact (OR=3.1, 95% CI: 1.3 to 7.2); factors associated with curable STI (excluding BV, candidiasis, HBV and HCV) were non-Beijing local residency (OR=1.9; 95% CI: 1.2 to 3.0) and bleeding during or after sex (OR=18.1; 95% CI: 5.2 to 62.6); and the factor associated with RTI (including all the infections tested) was bleeding during or after sex (OR=37.8, 95% CI: 11.2 to 127.4).

Conclusions  Behaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when planning corresponding prevention and interventions.

     

Health-related attitudes and risk factors for sexually transmitted infections of Chinese women who have sex with women

Background  Previous studies have shown evidence of health-related risk behaviors among women who have sex with women (WSW), such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections (RTI)/sexually transmitted infections (STI).

Methods  Participants were recruited through outreach in venues and online for a cross-sectional study. Data were collected using interviews and laboratory tests.

Results  We recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% (206/224) of women reported sexual relations with women. The RTI rates were: gonorrhea (15.8%), chlamydia (3.5%), syphilis (0.5%), bacterial vaginosis (14.4%), hepatitis B virus (HBV) (0.9%), hepatitis C virus (HCV) (0.5%), and candidiasis (6.9%). No HIV or herpes simplex virus (HSV) positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency (odds ratio (OR)=2.1, 95% confidence interval (CI): 1.2–3.8) and genital-genital contact (OR=3.1, 95% CI: 1.3–7.2); factors associated with curable STI (excluding bacterial vaginosis, candidiasis, HBV and HCV) were non-Beijing local residency (OR=1.9; 95% CI: 1.2–3.0) and bleeding during or after sex (OR=18.1; 95% CI: 5.2–62.6); and the factor associated with RTI (including all the infections tested) was bleeding during or after sex (OR=37.8, 95% CI: 11.2–127.4).

Conclusions  Behaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when planning corresponding prevention and interventions.

     

The Internet as a newly emerging risk environment for sexually transmitted diseases

CONTEXT: Transmission of sexually transmitted diseases (STDs) such as human immunodeficiency virus (HIV) infection is associated with unprotected sex among multiple anonymous sex partners. The role of the Internet in risk of STDs is not known. OBJECTIVE: To compare risk of STD transmission for persons who seek sex partners on the Internet with risk for persons not seeking sex partners on the Internet. DESIGN: Cross-sectional survey conducted September 1999 through April 2000. SETTING AND PARTICIPANTS: A total of 856 clients of the Denver Public Health HIV Counseling and Testing Site in Colorado. MAIN OUTCOME MEASURES: Self-report of logging on to the Internet with the intention of finding sex partners; having sex with partners who were originally contacted via the Internet; number of such partners and use of condoms with them; and time since last sexual contact with Internet partners, linked to HIV risk assessment and test records. RESULTS: Of the 856 clients, most were white (77. 8%), men (69.2%), heterosexual (65.3%), and aged 20 to 50 years (84. 1%). Of those, 135 (15.8%) had sought sex partners on the Internet, and 88 (65.2%) of these reported having sex with a partner initially met via the Internet. Of those with Internet partners, 34 (38.7%) had 4 or more such partners, with 62 (71.2%) of contacts occurring within 6 months prior to the client's HIV test. Internet sex seekers were more likely to be men (P<.001) and homosexual (P<.001) than those not seeking sex via the Internet. Internet sex seekers reported more previous STDs (P =.02); more partners (P<.001); more anal sex (P<.001); and more sexual exposure to men (P<.001), men who have sex with men (P<.001), and partners known to be HIV positive (P<.001) than those not seeking sex via the Internet. CONCLUSIONS: Seeking sex partners via the Internet was a relatively common practice in this sample of persons seeking HIV testing and counseling (representative of neither Denver nor the overall US population). Clients who seek sex using the Internet appear to be at greater risk for STDs than clients who do not seek sex on the Internet. JAMA. 2000;284:443-446     

A serosurvey of hepatitis B virus,hepatitis C virus,human T lymphotropic virus type-1 and syphilis in HIV-1-infected patients in Jamaica

The seroprevalences of hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotropic virus type-1 (HTLV-1) and syphyilis were determined in 129 HIV-1-infected patients using commercially prepared reagents. The seroprevalences were HCV, 0% (0/129); HBV, 37% (48/129); HTLV-1, 5% (6/129) and syphilis, 20% (26/129). Fifteen per cent (19/129) of the patients had active/chronic HBV infection. The seroprevalence of HBV was statistically significantly higher in HIV-1 infected men (24/49, 50% versus 17/80, 21%; p = 0.005), while the seroprevalence of syphilis was statistically significantly increased in HIV-1 infected patients in the over-40 age group (10/31, 32% versus 6/53, 11%; p = 0.05). These findings throw the spotlight on HBV infection and syphilis and suggest that these two sexually transmitted infections should be carefully surveyed in patients with HIV/AIDS in Jamaica. It is essential for management protocols in Jamaica to include screening for evidence of these co-infections.     

Risky behaviour in Jamaican adolescent patients attending a sexually transmitted disease clinic

The prevalence of sexually transmitted diseases (STD) and risky behaviour patterns were studied in 165 adolescents attending a STD clinic in Jamaica. A standardised structured questionnaire, clinical algorithms for STD and serological tests for HIV and syphilitic infection were applied. High prevalences of risky behaviour including young age at onset of sexual activity, especially in boys, (mean age 12.5 +/- 2.5 years); unprotected sexual intercourse (only 4% used condoms consistently); multiple sexual partners (mean 3.8 +/- 2.4 and 1.8 +/- 1.2 for boys and girls, respectively) were found. Marijuana, used by 60% of the boys, was an independent risk factor for dysuria (adjusted Odds Ratio (OR), 2.0; 95% CI, 1.6-3.4). Repeated episodes of STD (33%), coinfection with HIV (1.2%), syphilis (1.2%) and teenage pregnancy (13%) were prominent findings. Educational strategies which promote behaviour intervention at an early age, frequent and consistent use of condoms, abstinence or delayed onset of sexual activity are essential to reducing the HIV/AIDS and STD risk in adolescents in Jamaica.     

北京市男男性行为者无保护性同性性行为的调查研究

目的了解北京市男男性行为者无保护性同性性行为情况及其影响因素。方法2006年11月～2007年2月，在北京市朝阳区对男男性行为者进行问卷调查，内容包括社会人口学、近3个月行为学特征等。结果在所调查的541名男男性行为者中，分别有49．5％（268／541）和36．6％（198／541）的调查对象在过去的1个月与固定和临时男性发生过肛交。多因素Logistic回归分析结果显示，近3个月结婚／与女朋友同居（OR=3．00；95％CI1．40～6．40）更容易与固定男性近1个月发生无保护性肛交，近1个月感觉到孤独（OR=0．47；95％CI0．28～0．78）较少与固定男性性伴近1个月发生无保护性肛交；近3个月通过浴池／厕所／公园寻找男性性伴（OR=2．01；95％CI1．07～3．79）、近3个月未参加过艾滋病项目（OR=2．84；95％CI1．01～7．98）更容易与临时男性性伴近1个月发生无保护性肛交。结论男男性行为者中无保护性肛交行为普遍存在，应加强对这个人群的行为干预以降低其危险行为。     

Seroprevalence of Hepatitis B, Hepatitis C, HIV Infections in Blood Donors of Khulna, Bangladesh

To determine changes (Trends) in infection rates of Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV) and Human immunodeficiency virus (HIV) in blood donors of Khulna Population. Specimens of 34953 voluntary blood donors & party or relative donors in Transfusion Medicine Department of Khulna Medical College Hospital from 2007 to 2009 were screened for HBsAg, anti-HCV, anti-HIV 1 & 2 reactivity in a cross-sectional survey by rapid test method. Reactive samples were verified using a recognized confirmatory test which consisted of a second generation enzyme immune assay (HBsAg), anti-HCV antibodies by anti-HCV EIA & for HIV by western Blot, respectively. The seroprevalence of HBsAg, Anti-HCV, HIV antibody 1 & 2 was 1.4%, 0.09% & 0.03% respectively in all blood donors. Prevalence of confirmed positivity was 0.62% for HBsAg, 0.04 % for Anti-HCV, 0.02% for HIV Western Blot. Between 2007 to 2009 a decreasing trend was observed in HBsAg frequency, HCV frequency decreased in 2009 compared to 2007. One HIV positivity found in 2009. Although the frequency of transfusion transmitted infections is low, party or relative donors have some risk factors than voluntary blood donors. Through more scrutiny in donor selection, improved serological test & reevaluation of infections routes in donor, infection reduction can be achieved.     

Factors Associated with Sexually Transmitted Infections Among Young Ghanaian Women

Objective

To identify factors associated with a history of sexually transmitted infections in Ghanaian women 15 – 24 years.

Design

The study was a cross-sectional data analysis of 1280 sexually experienced females from the 2003 Ghana Demographic Health Survey. Using chi square and t-test, those with a history or symptoms of STI were compared with those denying such a history on demographic, individual and partner level variables. Significant variables were entered into logistic regression to identify variables associated with STI.

Results

The STI group comprised 12% of the study population. Compared to those denying a history of STI, the STI group was less likely to know where to get condoms (37% vs 23%, p=.001) but more likely to use a condom at their last sexual encounter (27% vs 17%, p=.003). Women in the STI group were significantly less likely to discuss family planning with their partners but more likely to have 2 or more partners in the preceding 12 months. Logistic regression showed that factors associated with STI among sexually active Ghanaian female youth included not knowing where to get condoms and not discussing family planning with partner.

Conclusion

Majority of sexually experienced Ghanaian female youth do not know where to get condoms. Lack of knowledge of source of condoms was identified as a risk factor for STI for these women.     

扬州市MSM人群艾滋病高危行为特征?感染状况及影响因素分析

目的:了解江苏省扬州市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征?感染情况及其影响因素?方法:采用横断面调查设计,采取分类滚雪球抽样的方法于2008年5月起,对扬州市范围内的MSM人群就艾滋病知识态度?高危行为特征的面对面问卷调查结果,以及血样的人类免疫缺陷病毒(human immunodeficiency virus,HIV)及其他性传播疾病(sexually transmitted disease,STD)感染的实验室检测数据进行统计分析?结果:所调查300例MSM中,82.7%最近6个月发生过同性性行为,其中79.4%有多个同性性伴;48.7%曾与异性发生过性行为,其中21.2%有多个异性性伴;最近6个月与同性发生肛交性行为时坚持使用安全套的比例为52.0%,与异性发生性行为时该比例为21.2%?均采集血样进行了血清学检测,确证HIV阳性22例,阳性率为7.3%;确证梅毒抗体阳性66例,阳性率为22.0%;未发现丙型肝炎病毒抗体阳性?在多因素Logistic回归模型中,常通过互联网寻找性伴(OR=1.93,95%CI:1.01~3.67)和最近6个月曾与固定性伴发生性行为(OR=0.45,95%CI:0.25~0.79)与最近6个月同性性行为时安全套坚持使用率的关系有统计学意义;梅毒感染(OR=3.17,95%CI:1.25~7.99)与HIV感染的关系具有统计学意义?结论:扬州市MSM人群无保护性性行为及多性伴现象较为普遍,HIV和梅毒感染率较高,需要进一步加强对该人群的行为干预以防止艾滋病在该人群中的蔓延以及传播至一般人群?     

男男性接触者社交软件的使用和性行为特征及性传播疾病关系的系统综述

背景　近年来,随着智能手机的蓬勃发展,一些搭载在智能手机上,具有地理定位功能的,专门服务于男男性接触者（MSM）的同志社交软件（App）也逐渐发展并在MSM中受到了很大的欢迎。频繁使用这些App可能更方便MSM寻找性伴,从而导致更多性行为。目的　本研究就MSM人群App的使用和性行为特征、性传播疾病（STI）的关系做一系统综述。方法　计算机检索PubMed、万方数据知识服务平台和中国知网中关于MSM人群在智能手机上App的使用和性健康或性行为的关系,或MSM人群App用户和非App用户性行为特征、STI比较的研究,检索时间为2005—2017年。提取男性伴数量、群交性行为、无保护性行为及STI检测及确诊的相关数据。结果　共纳入23篇文献,21项研究。App用户过去12个月拥有5个以上男性伴的比例大于非App用户。过去6个月App用户有群交性行为者占10.9%~13.2%,高于非App用户（8.5%）。但也有研究显示App用户（8.8%）过去12个月有群交性行为的比例低于非App用户（10.3%）。过去6个月,App用户参与无保护性行为的比例占31.9%~50.5%,而非App用户为26.3%~35.6%。App用户既往STI检测率为29.9%~88.6%,非App用户为32.6%。App用户STI感染率为11.9%~51.1%,非App用户为23.2%。结论　较多地使用App可能对MSM人群的性健康产生不良影响。     

Prevalence, donation practices, and risk assessment of blood donors with hemochromatosis

CONTEXT: Despite changes in eligibility policies, practical barriers limit blood donations from individuals with hemochromatosis. Increased knowledge of hemochromatosis donor characteristics may help foster further changes that will promote more donations. OBJECTIVES: To estimate the prevalence of donors diagnosed as having hemochromatosis and to compare rates of unreported deferrable risks for transfusion-transmissible viral infections (TTVIs), positive screening test results for TTVIs, and donation patterns between hemochromatosis patient donors and donors reporting no medical conditions necessitating phlebotomy (non-health-related donors). DESIGN: An anonymous mail survey conducted in 1998 as part of the ongoing Retrovirus Epidemiology Donor Study. SETTING AND PARTICIPANTS: Among a stratified probability sample of 92 581 blood donors from 8 geographically diverse US blood centers, 52 650 (57%) responded. MAIN OUTCOME MEASURES: Prevalence of hemochromatosis among blood donors; prevalence of unreported deferrable risks and positive screening test results for TTVIs among hemochromatosis patient donors vs non-health-related donors. RESULTS: One hundred ninety-seven respondents (0.4%) identified themselves as hemochromatosis patients and 50 079 (95.1%) as non-health-related donors. An estimated 0.8% of all donations were from hemochromatosis patients, 45.8% of whom reported that they had donated blood to treat their illness. The proportion of repeat donors was higher in hemochromatosis patients than in non-health-related donors (83.5% vs 76.5%; P =.03). Among repeat donors, 68.7% of hemochromatosis patients reported donating at least 3 times in the past year compared with 49.1% of non-health-related donors (P<.001). The prevalence of unreported deferrable risks for TTVIs was similar in hemochromatosis patients (2.0%) and non-health-related donors(3.1%) as was the overall prevalence of positive screening test results (1.3% of hemochromatosis patients vs 1.6% of non-health-related donors). CONCLUSIONS: Although significant numbers of hemochromatosis patients reported donating blood for therapeutic reasons, our findings suggest that this population does not present a greater risk to blood safety than other donors.     

Trends in incidence and prevalence of major transfusion-transmissible viral infections in US blood donors, 1991 to 1996. Retrovirus Epidemiology Donor Study (REDS)

CONTEXT: Evaluating trends in blood donor infectious disease rates is essential for monitoring blood supply safety and donor screening effectiveness. OBJECTIVE: To determine changes over time in blood donor population infection rates of human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV), hepatitis C virus (HCV), and hepatitis B virus (HBV). DESIGN: Cross-sectional survey data from the National Heart, Lung, and Blood Institute-sponsored Retrovirus Epidemiology Donor Study. SETTING: Five blood centers in different regions of the United States. PARTICIPANTS: A total of 1.9 million volunteer blood donors with 1 or more nonautologous donations from January 1991 to December 1996. MAIN OUTCOME MEASURES: Changes in rates of HIV, HTLV, HCV, and HBV infections were evaluated by comparing yearly prevalence estimates (per 100,000 donations) for first-time allogeneic donors and period-specific incidence rates (IRs) (per 100,000 person-years) for repeat allogeneic donors between 1991 and 1996 (for HCV, from about March 1992 to June 1996). RESULTS: Prevalence of HIV decreased in first-time donors from 0.030% to 0.015% (P=.006) and HCV prevalence decreased from 0.63% to 0.40% (P<.001). Trends were not statistically significant for the proportion of first-time donors with hepatitis B surface antigen (HBsAg) or HTLV. For repeat donors, IRs did not change significantly, indicating a stable but low level of seroconversion. The overall IRs (95% confidence intervals) per 100,000 person-years were 2.92 (2.26-3.70) for HIV, 1.59 (1.12-2.19) for HTLV, 3.25 (2.36-4.36) for HCV, and an estimated 10.43 (7.99-13. 37) for HBV (based on an HBsAg rate of 2.66 [2.04-3.41] with presumed false-positive results considered negative). The HBV IR estimate with presumed false-positive results considered positive (for comparability to previous analyses) was 17.83 (14.60-21.56). CONCLUSION: The decrease in HIV and HCV prevalence rates, combined with the previously documented lower rates of infection in first-time donors compared with the general population, suggests the continued benefit of behavioral risk factor screening. JAMA. 2000;284:229-235     

Computer-based interview for screening blood donors for risk of HIV transmission.

OBJECTIVE--To test the ability of a computer-based interview to detect factors related to the risk of the human immunodeficiency virus (HIV) among potential blood donors and to determine donor reactions to the use of the interview. DESIGN--A comparison of the rate of detection of HIV-related factors elicited by a computer interview with that obtained by standard American Red Cross procedures for assessment of donor suitability, including a randomized crossover trial in which the order of the two methods was reversed. Information obtained by the computer was not available to influence the use of blood components for transfusion. SETTING--The computer interview was administered to donors at an American Red Cross blood donor center and at a mobile blood drive at a hospital. SUBJECTS--Consecutive sample of 294 male and female blood donors 18 to 75 years of age. MAIN OUTCOME MEASURES--Subjects' responses to the computer-based interview as well as responses to the standard Red Cross written questionnaires and face-to-face interviews were used for donor assessment. RESULTS--The interview took an average of 8 minutes to complete. From among 272 donors who provided complete data, the computer identified 12 donors who reported either behaviors associated with a risk of HIV acquisition or symptoms compatible with the acquired immunodeficiency syndrome; none of these donors had been so identified either by routine written questionnaires or by face-to-face interviews used to screen potential blood donors. Only one of the 12 identified donors used the confidential unit exclusion procedure to prevent use of his donated unit. The rate of elicitation of HIV-related factors by the computer interview was 12 (4.4%) of 272 (95% confidence interval [CI], 2.3% to 7.6%), compared with two (0.13%) of 1536 (95% confidence upper bound, 0.28%) using the standard Red Cross procedure (P less than .0001). Tests for antibodies to HIV were negative in blood samples from all of the 272 subjects studied. The subjects enjoyed the computer interview and judged it to be more private than the standard donor assessment method. They also predicted that donors would be more honest with the computer interview than with a human interviewer. CONCLUSIONS--Computer-based screening elicits more HIV-related factors in the health histories of blood donors than do the standard questionnaire and interviewing methods currently in use. Computer-based screening is also acceptable to blood donors.     

50岁及以上男男性行为人群对性伴艾滋病病毒感染状态知晓及影响因素分析

目的 分析≥50岁男男性行为人群(MSM)对性伴艾滋病病毒(HIV)感染状态知晓比例及相关因素,为制定有效的干预策略和措施提供参考。方法 采用方便抽样,借助同性社交软件进行网络问卷调查,收集调查对象的社会人口学、行为学及对性伴HIV感染状态知晓等信息。对最近一个男性性伴感染状态知晓相关因素进行单因素组间比较和多因素Logistic回归分析。结果 1037例≥50岁MSM中,知晓其最近一个男性性伴感染状态的比例仅为38.4%(398/1037),对最近一个男性性伴感染状态知晓情况的多因素分析结果显示:初中及以下文化程度者是高中及以上文化程度者的0.660倍(95%CI=0.473~0.922,P=0.015);失业和在职者分别是退休者的0.537倍(95% CI=0.322~0.896,P=0.017)和0.663倍(95%CI=0.466~0.944,P=0.022);过去一年有≥2个男性性伴者是没有或仅有1个男性性伴者的0.433倍(95%CI=0.320~0.586,P<0.001);未进行过HIV检测者是进行过HIV检测者的0.544倍(95%CI=0.403~0.734, P<0.001);对HIV或艾滋病相关知识不知晓者是知晓者的0.636倍(95%CI=0.466~0.868, P=0.004);有性病感染史者是无性病感染史者的0.472倍(95%CI=0.349~0.637, P<0.001),同时,艾滋病污名化水平越高者其知晓性伴感染状态的可能性越低(OR=0.742,95%CI=0.604~0.912, P=0.005)。结论 ≥50岁MSM对性伴感染状态知晓比例较低。文化程度、职业状况、过去一年性伴数量、HIV检测、HIV或艾滋病相关知识、性病感染史及艾滋病污名化水平等均为性伴感染状态知晓的相关因素。     

Donor blood procurement and the risk of transfusion transmissible viral infections in a tertiary health facility in South-South Nigeria

Background:

Blood and blood products are scarce commodities. The demand often outweighs the supply. This study is directed at investigating the blood procurement sources and the risk of viral transfusion transmissible infection.

Materials and Methods:

The records of the blood transfusion unit of a tertiary health facility in south-south Nigeria were studied. The procurement and screening records from 1 January to 31 December 2009 were analyzed.

Results:

7,552 donor records were analyzed, 6,931 were commercial donor and 621 replacement donors. 891 commercial donors were infected, 500 (7.2%) were HIV positive, 323 (4.7%) HBV positive, 42 (0.6%) had HIV and HBV co-infection, while 28 (0.4%) were HCV positive. Twenty-three replacement donors were infected, 16 (2.6%) were HIV positive, 6 (1%) were HBV positive, while 1 (0.2%) were HCV positive. None of the replacement donors had co-infection. The risk of infection was significantly higher with commercial donor procurement (X2=45.07, P<0.001, OD=3.845).

Conclusion:

Commercial blood donors are still the major source of blood to the hospital and they also have the highest prevalence of transfusion transmissible viral infections in this region thus constitute a major risk transmitting infections to potential recipients.     

Infection with HTLV-III/LAV and transfusion-associated acquired immunodeficiency syndrome. Serologic evidence of an association

We studied patients with transfusion-associated acquired immunodeficiency syndrome (AIDS) and their blood donors for serologic evidence of infection with human T-cell lymphotropic virus type III/lymphadenopathy-associated virus with two enzyme-linked immunosorbent assays and a Western blot assay. All 19 patients with AIDS were seropositive by at least one test. In all 28 donor sets containing "high-risk" donors, at least one donor was seropositive by one or more tests. Of 255 donors not considered high risk, two (0.8%) were seropositive by all three tests. When 30 seropositive high-risk donors were evaluated a median of 29 months after donation, four (13%) had developed AIDS and eight (27%) had lymphadenopathy. Our findings support the hypothesis that human T-cell lymphotropic virus type III/lymphadenopathy-associated virus causes AIDS and indicate that seropositive high-risk donors may be at relatively high risk for developing AIDS or related conditions themselves.     

四川绵阳地区MSM群交行为HIVI梅毒感染及影响因素

摘要：目的了解男男性行为者（MSM）群交行为及艾滋病病毒（nlv）／梅毒感染,分析影响因素。方法结合滚雪球抽样法招募调查对象,进行相关行为匿名调查和血清学检测。结果合格调查367例,3．5％近6月有群交行为。有群交／无群交者HIV感染率7．7％N．5％,梅毒累计感染率23．1％陀1．2％、现症感染率15．4％,9．O％（x1-0．286、0．027、0．083,P均〉0．05）。单因素分析,群交行为与年龄、职业、接受同伴教育、寻找性伴场所、首次性行为年龄、近6月男性肛交数、近6月性伴最小年龄、固定性伴侣期间多性伴、累计偶然性伴数、经常观看同志性文化影视、同志性文化影视对行为影响相关（x2分别-5．416、6．261、5．821、11．487、3．876、5．672、22．117、4．316、21．064、4．835、5．018、6．692,P均〈0．05）。多因素分析,MSM群交行为的独立影响因素：年龄（OR=11．129）、近6月商业性行为（0R=295．842）、近6月无保护性肛交（OR=9．091）、同志性文化影视对行为影响（0R=32．810）,年龄33～41岁、近6月有商业性行为、有无保护性肛交、同志性文化影视对行为有影响者群交行为的比例较高。结论MSM群交行为受人口学特征、性行为和同志性文化影视影响,高危行为普遍,HIV感染和传播的桥梁作用明显,应针性开展行为干预。     

Multiple false-positive serologic tests for HIV, HTLV-1, and hepatitis C following influenza vaccination, 1991.

OBJECTIVE--(1) To assess factors associated with the occurrence of multiple false-positive viral enzyme-linked immunosorbent assays (ELISAs) for human immunodeficiency virus (HIV), human T-cell lymphotrophic virus type 1 (HTLV-1), and hepatitis C virus (HCV) among individual blood donors and (2) to determine the frequency and time course of this phenomenon. DESIGN--Case-control study. SETTING--A regional blood center. PARTICIPANTS--Blood donors found to have multiple false-positive viral ELISAs (case donors) and randomly selected seronegative controls (control donors) who donated between October 31, 1991, and December 15, 1991. An additional random sample of 262 donation records was reviewed to calculate the proportion of donors who received influenza vaccine. MAIN OUTCOME MEASURES--Multiple false-positive viral ELISAs, receipt of influenza vaccination formulated for the 1991-1992 influenza season, and follow-up ELISA results on serum samples obtained from case donors. RESULTS--Among 17,941 donors, 10 case donors were identified. Nine of the 10 case donors received influenza vaccine, compared with three of 30 control donors (odds ratio [OR] = 81; 95% confidence interval [CI], 6 to 3670; P less than .001). Among nine case donors, the mean time between vaccination and blood donation was 26 days (range, 9 to 68 days). Follow-up ELISAs of serum samples from seven case donors obtained 52 to 130 days (mean, 75 days) after vaccination demonstrated reversion to HIV and HTLV-1 seronegativity in all but one specimen, with persistence of positive HCV ELISAs in four specimens. We estimate between 0.6% and 1.7% of blood donors who received influenza vaccine this season had multiple false-positive viral ELISAs. CONCLUSIONS--The occurrence of multiple false-positive viral ELISAs among blood donors was associated with influenza vaccination, but was infrequent among vaccinees. This phenomenon is of short duration for HIV and HTLV-1, but may persist longer for HCV. We recommend influenza vaccinees not be deferred from blood donation. Blood donors with multiple false-positive viral ELISAs should be considered for future reentry as blood donors.