四川凉山州HIV感染者配偶阳转情况及影响因素分析

目的 了解凉山州艾滋病病毒感染者/艾滋病患者（HIV/AIDS）阴性配偶HIV血清阳转率及影响因素。方法 于 2009年1月1日—2019年12月31日,在HIV/AIDS的阴性配偶中进行回顾性队列研究,进行HIV检测及危险行为调查,采用Cox比例风险模型分析HIV感染配偶抗体阳转率的影响因素。结果 共纳入7 989名HIV感染配偶,总观察人时7 291.24人年,随访期间217名HIV感染配偶发生血清阳转,血清阳转率为2.98/100人年。多因素分析显示,文化程度小学以下（aHR = 1.86）、HIV/AIDS患者为女性（aHR = 2.13）、年龄≤35岁（aHR = 1.38）、确证感染时间＜1年(aHR = 3.74)、夫妻间性行为频率＞4次/月（aHR = 1.37）、病毒载量≥400拷贝/ml（aHR = 1.57）、近一次CD4细胞计数＜200个/μl（aHR = 1.81）是HIV感染配偶抗体阳转的危险因素,抗病毒治疗3年以上（aHR = 0.69）是HIV感染配偶抗体阳转的保护因素。结论 凉山州HIV感染配偶抗体阳转率处于较高水平,性行为频次高、文化程度低、年龄≤35岁、HIV/AIDS患者为女性、诊断感染时间＜1年、病毒载量400拷贝/ml以上、近一次CD4细胞计数＜200个/μl是HIV感染配偶抗体阳转的影响因素。     

HIV/AIDS患者合并机会性感染 与卫生服务利用现状分析

摘要:目的　分析HIV/AIDS患者合并机会感染与卫生服务利用的现状。方法　采用随机整群抽样对HIV/AIDS患者进行合并机会性感染及卫生服务利用问卷调查。结果　HIV/AIDS患者合并机会性感染率为57.78%;HIV/AIDS未合并机会性感染者和合并机会性感染者两周患病率分别为38.60%和73.08%,差异有统计学意义（P＜0.05）;HIV/AIDS未合并机会性感染者和合并机会性感染者两周就诊率分别为49.12%和76.92%,差异有统计学意义（P＜0.05）;HIV/AIDS患者家庭经济困难占64.71%,是他们未就诊的主要原因;HIV/AIDS患者选择医疗机构就诊差异有统计学意义（P＜0.05）;HIV/AIDS未合并机会性感染者和合并机会性感染者年住院率分别为15.79%和20.51%,差异无统计学意义（P＞0.05）;HIV/AIDS患者选择医疗机构住院差异无统计学意义（P＞0.05）。结论　HIV/AIDS合并机会感染者卫生服务利用量大于未合并机会感染者,HIV/AIDS患者卫生服务利用与医疗机构、病程、居住地、经济条件有关。     

The effects of HIV/AIDS intervention groups for high-risk women in urban clinics.

OBJECTIVE. This study reports the results of a behavior change intervention offered to women at high risk for human immunodeficiency virus (HIV) infection seen in an urban primary health care clinic. METHODS. Participants were 197 women randomly assigned to either an HIV/acquired immunodeficiency syndrome (AIDS) risk reduction group or a comparison group. Women in the HIV/AIDS intervention group attended five group sessions focusing on risk education; skills training in condom use, sexual assertiveness, problem solving, and risk trigger self-management; and peer support for change efforts. Women in the comparison group attended sessions on health topics unrelated to AIDS. RESULTS. At the 3-month follow-up, women in the HIV/AIDS intervention group had increased in sexual communication and negotiation skills. Unprotected sexual intercourse had declined significantly and condom use had increased from 26% to 56% of all intercourse occasions. Women in the comparison group showed no change. CONCLUSIONS. Socially disadvantaged women can be assisted in reducing their risk of contracting HIV infection. Risk reduction behavior change interventions should be offered routinely in primary health care clinics serving low-income and high-risk patients.     

泸州市艾滋病异性传播病例高危性行为史调查分析

目的 调查了解泸州市艾滋病病毒(HIV)感染者经异性传播的具体来源。 方法 招募经异性性行为传播的HIV感染者,采用深入访谈的方式调查其诊断HIV之前高危性行为信息和方式,分析其感染HIV最可能的时间和地点。 结果 对300名经异性性行为感染HIV的感染者的调查表明,男性和女性感染HIV的方式差异有统计学意义(χ²=164.834,P<0.001),男性以商业异性性行为为主(90.8%),另外固定性伴性行为占5.1%,临时异性性行为4.1%;而女性中以固定性伴性行为为主(71.9%),商业异性性行为占17.1%,临时异性性行为11.0%。自述经过商业异性性行为感染HIV的调查对象中,25.9%的人自述曾在2个以上地市发生过商业性行为,25.0%在2个及以上的省份发生过商业性行为;64.3%的调查对象自我判断在泸州市感染,而认为自己是在户籍地以外的其他省份感染HIV的调查对象占29.3%。 结论 泸州市艾滋病经异性性传播的情况较为复杂,亟需系统而全面地在全人群和重点人群中开展健康教育和行为干预工作。     

女性艾滋病病毒感染者和患者生存质量及影响因素调查

目的:了解女性艾滋病感染者和患者生存质量及影响因素。方法:应用WHOQOL-BREF中文版测量其生存质量。结果:女性HIV感染者及AIDS患者生存质量4个领域得分分别为:13.91±1.90(生理领域),12.33±1.97(心理领域),13.00±1.97(社会关系领域),12.00±1.87(环境领域)。单因素分析显示,职业、CD4细胞数、与配偶/固定性伴HIV检测前后性生活次数等因素与生存质量有关(P0.05)。多元线性回归分析结果表明,年龄、家庭收入、有非商业非固定性伴、艾滋病抗病毒治疗时间越长及由疾控人员告知HIV阳性结果并无其他人在场与艾滋病感染者生存质量呈正相关;年龄和家庭收入分别与社会关系及心理领域呈负相关。结论:艾滋病问题严重的威胁了女性艾滋病感染者和患者的生存质量,应提高其抵御艾滋病的能力。     

Risk behaviours and seroprevalence to HIV, HBV and HCV in patients of the AIDS information and prevention center in Valencia, Spain

OBJECTIVE: The purpose of this study was to describe the sociodemographic and serologic profiles in a first time consultant population at the Information and AIDS Prevention Center of Valencia (Spain). In addition, the HIV infection risk factors were analyzed. METHOD: A cross-sectional study was performed on 1,573 persons who consulted during the year 1995. Sociodemographic and infection risk practices data were recorded and serologic information about HIV, HBV and HCV infection were obtained. Exact binomial method with a 95% interval confidence was used to calculate infection prevalence and the chi square test to make comparisons between qualitative variables. RESULTS: Sex distribution was 66,1% males and 31,9% females; mean age was 29,01 (SD: 9.2) years. Sexual intercourse without condom (25.2%) and parenteral drug abusers (22.6%) were the more frequent risk groups seeking consultation about HIV infection. Global HIV infection prevalence was 12.7% (95% CI= 11,2-14,5%). Among HIV seropositive patients, sexual transmission accounted for 30.8% of cases, of which 69.4% were heterosexual relations. The HIV infection prevalence for different risk groups were the following: parenteral drug abusers 36.8% (95% CI= 31,7-42%), heterosexual intercourse with an HIV-infected partner 24.1% (95% CI= 17,1-32,2%) and homosexual intercourse between men 9,5% (95% CI= 5,8-14,5%). HCV antibody prevalence for parenteral drug abusers was 81.2% (95% CI= 76,7-85,1%). Risk practices with a statistically significant association with HIV infection were: being an injecting drug abuser, as well as having an HIV infected and/or a injecting drug abuser partner. CONCLUSIONS: Drug parenteral abusers are still the target population for prevention programs. Data suggest that prevention and sexual education programs must continue. The main effort should be focused on the young population and on sexual partners of injecting drug abusers and/or HIV seropositive partners.     

男男性行为人群HIV/AIDS及其性伴的分子传播关系分析

目的 了解浙江省MSM HIV/AIDS与性伴之间分子传播关系和相关危险因素。方法 采用横断面调查的方法,对浙江省2015-2017年新确证的MSM HIV/AIDS及参与性伴驱动检测的阳性性伴开展分子流行病学研究。收集血浆并提取RNA,运用RT-PCR和巢式PCR扩增并获得HIV-1的pol区基因序列,构建系统进化树,分析分子传播簇,判定性伴间的传播关系。结果 共937例MSM HIV/AIDS参与性伴驱动检测,检出173名阳性性伴。有61例性伴间（31对）形成传播簇,成簇比例为50.8%（61/120）,其中7对性伴结合新发感染结果初步判定传播方向。在性伴分子传播网络的相关因素分析中,性伴之间确证年份为相同年份（与不同年份相比,OR=12.190,95%CI：1.563~95.054）,现住址所在地为不同区（县）[与相同区（县）相比,OR=17.054,95%CI：1.742~166.982]更可能存在分子传播关系。结论 MSM HIV/AIDS的性伴驱动检测,结合分子传播网络分析技术,可以提高HIV/AIDS精准溯源,同时根据新发感染结果,初步判定传播方向。建议对MSM HIV/AIDS确证后,应尽早进行性伴驱动检测,包括跨区域的性伴追踪检测,有利于传染源追踪。     

杭州市男男性接触人群艾滋病病毒感染现状及感染者特征分析

目的了解杭州市男男性接触者（MSM）艾滋病病毒感染情况,并对感染者的社会行为特征进行分析,为艾滋病健康教育及高危行为干预计划的改进和完善提供依据。方法对2009-2011年杭州市614名MSM人群进行问卷调查,收集社会人口学和危险行为资料,采集外周静脉血进行HIV抗体检测。结果本组在614名MSM人群中共检出HIV感染者65例,HIV抗体阳性率为10.59%;HIV感染者以未婚、低龄化、高学历为主,艾滋病知识总知晓率为84.13%。65例HIV感染者均在最近半年与男性发生过肛交性行为,与男性最近一次性行为安全套使用率为62.17%;最近半年与异性发生性行为者20人,与异性发生性行为最近一次安全套使用率为33.25%。结论杭州市MSM人群HIV感染率较高,HIV感染者存在认知与行为分离、无保护男男性行为现象,应加强对MSM人群及其感染者的健康教育和行为干预。     

Preventing the high-risk sexual behavior of adolescents: focus on HIV/AIDS transmission, unintended pregnancy, or both?

Adolescents are at high risk for negative health outcomes associated with unprotected sexual intercourse including infection with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and unintended pregnancy. That unprotected sexual intercourse is the risk behavior common to both problems has not been fully capitalized on in prevention programs. Limited knowledge about the effects of type-of-outcome expectancy (i.e., disease vs. pregnancy) on the association between risk perceptions and precautionary or health-protective sexual behavior makes it difficult to determine what preventive approach would be most effective with adolescents. The literature suggests that pregnancy prevention is a greater concern for adolescents than disease prevention. This review focuses on the implications of these differential risk perceptions for HIV/AIDS prevention programs targeting adolescents.     

洛阳市中学生艾滋病性行为知识态度调查

目的了解河南省洛阳市中学生艾滋病性行为知识、态度现状，以便更好地开展中学生艾滋病及性行为健康教育活动。方法2004年9至12月采用分层整群随机抽样方法，对洛阳市6个区6所普通中学初中和高中的1980名学生进行了艾滋病性行为知、信、行结构式问卷调查。结果中学生没有接受过预防艾滋病的健康教育的比例为54．5％；艾滋病知识的掌握、传播途径不完全知道的比例为38．3％；不知道日常生活接触不传播艾滋病的比例为28．8％；没有与亲友谈论过艾滋病的比例为76．3％，而且91．2％的学生表示不愿意和AIDS／HIV感染者同班学习。中学生看过描写性行为的书刊、音像制品等的比例为21．7％；赞成婚前性行为的比例为13．4％；中学阶段学生曾发生性行为的比例为1．1％；80．5％的中学生认为艾滋病及性知识健康教育很有必要；18．9％的中学生希望从父母、教师或专家获得有关艾滋病及性的知识。结论中学生艾滋病及性知识缺乏，尽快在中学生中开展艾滋病及性行为健康教育。使之安然度过性困惑期已刻不容缓。     

Increased suppressor T cells in probable transmitters of human immunodeficiency virus infection.

To evaluate behavioral and immunologic factors related to transmission of human immunodeficiency virus (HIV) by homosexual intercourse, we studied a population of 329 homosexual/bisexual men (155 partner-pairs) seen in a community health center and medical outpatient clinic. Logistic regression analysis showed that behavioral risk factors for infection in the 130 HIV-infected men included: receptive anal intercourse (OR 4.6, 95% CI-1.8, 12.1); receptive fisting (OR 2.5, CI-1.1, 7.0); nitrite use (OR 2.3, CI-1.2, 4.6); history of gonorrhea or syphilis (OR 2.3, CI-1.4, 3.9); and history of sexual contact with men from areas with many AIDS cases (OR 1.9, CI-1.0, 3.5). Comparing seven men who were probable transmitters of HIV and 11 men who had not transmitted HIV to their uninfected partners despite unprotected insertive anal intercourse, we found no differences in HIV isolation from peripheral blood mononuclear cells, circulating HIV antigen detection, or presence of neutralizing antibody to HIV. Helper T-cell numbers were not significantly different between the two groups, but transmitters had more suppressor T-cells than did nontransmitters.     

上海市青少年危险行为现状研究(一)--艾滋病及性行为的知识态度行为

目的：了解上海市中学生艾滋病及性行为的知识态度行为现状。方法：2002年4月至6月选取105所普通中学和中等职业学校的初一、高一9246名学生，采取KAP(知、信、行)问卷调查。结果：中学生在学校里没有接受过预防艾滋病的健康教育的比例为49．3％。艾滋病知识的掌握，3条传播途径不完全知道的比例为27．8％，不知道日常生活接触不传播艾涝病的比例为24．7％，没有与亲友谈论过艾滋病的比例为66．7％，而且86．0％学生都表示不愿意和AIDS／HIV感染者同班学习。中学生看过描写性行为的书刊、音像制品等的比例为23．8％，赞成婚前性行为的比例为18．5％，高中阶段学生曾发生性行为的比例2．3％。结论：用多种形式，包括同伴教育在内健康教育方法，在中学生中尽快开展艾送病预防和生殖健康教育。     

An emerging opportunistic infection in HIV patients: A retrospective analysis of 11 cases of pulmonary aspergillosis

Invasive pulmonary aspergillosis usually occurs in patients with severe granulocytopenia or defects of cell-mediated immunity secondary to cytotoxic chemotherapy or high-dose corticosteroids, but it is an unusual opportunistic infection in patients with AIDS. Eleven cases of Aspergillus pulmonary disease were diagnosed in HIV-infected patients from January 1985 to December 1992, in the Department of Infectious Diseases of the Catholic University. Four patients had invasive pulmonary aspergillosis, six probable pulmonary invasive aspergillosis and one allergic broncopulmonary aspergillosis. Fiberoptic broncoscopy with bronco-alveolar lavage was confirmed to be an useful tool for the diagnosis of pulmonary aspergillosis in AIDS patients. The response of aspergillosis to therapy, either amphotericin B or itraconazole, has usually been poor. It is possible to speculate that the longer survival of AIDS patients and the latter development of other functional immunological abnormalities related to HIV infection may allow the appearance of opportunistic infection, such as pulmonary aspergillosis, different from those more often observed.Corresponding author.     

外展服务对性服务小姐艾滋病行为干预效果评价

[目的]评价外展服务对城乡结合部的性服务小姐的艾滋病认知水平和行为改变的效果。[方法]通过外展服务，工作人员主动深入现场，与目标人群建立信任关系，开展健康咨询和健康教育，提供性病诊疗建议。实施发放宣传资材、发放安全套、增加安全套的可获得性、一对一访谈、观看录像等干预措施。[结果]提高了性服务小姐的艾滋病知识的正确知晓率，坚持每次使用安全套的率和最近一次性生活中安全套使用率分别从干预前的20.00%、27.34%提高到于预后的51.28%和60.02%。[结论]外展服务干预是预防艾滋病的有效措施，可以提升性服务小姐对艾滋病的正确知晓率，纠正错误观念，改变高危行为，提高安全套的使用率。     

沈阳市性病患者艾滋病／性病的知信行调查

目的了解沈阳市性病患者艾滋病／性病知识、态度和行为等情况，为在本市性病患者中采取有针对性的预防艾滋病干预措施提供参考。方法对沈阳一所医院性病门诊就诊患者进行自愿匿名的问卷调查，由专业人员进行现场督导，并现场收回问卷。结果性病患者对艾滋病知识有一定的了解，有91．4％的被调查者对艾滋病存有恐惧心理，与妻子／丈夫或女／男朋友以外的人发生性关系时，每次都能用安全套的占17．2％，与妻子／丈夫和女／男朋友发生性关系时使用安全套的仅占8．6％。结论性病患者是感染艾滋病病毒的高危人群，多渠道提高该人群的艾滋病相关知识水平，并开展行为干预工作十分必要。     

重庆市部分地区新报告异性性传播HIV/AIDS感染方式分析

目的 了解重庆市部分地区新报告异性性传播HIV/AIDS的感染方式,为有效开展艾滋病经异性性传播的防控提供依据。方法 对重庆市部分地区2019年7月1日至10月1日新报告的异性性传播HIV/AIDS展开面对面问卷调查,收集社会人口学特征、异性性行为情况等相关数据。结果 共完成312例异性性传播HIV/AIDS的问卷调查,主要以男性（207,66.3%）、≥50岁（210,67.3%）、初中及以下文化程度（252,80.8%）、已婚或同居者（200,64.1%）为主。经商业性行为感染占48.7%（152/312）,经配偶/固定性伴感染占40.4%（126/312）,经非商业临时性行为感染占10.9%（34/312）。不同性别、年龄、职业的HIV/AIDS,感染方式差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示,相比于经配偶/固定性伴感染,男性（OR=822.34,95% CI：103.99～6 503.10）、初中及以下文化程度者（OR=3.02,95% CI：1.05～8.66）的商业性行为感染HIV风险更大;而家务/待业者（OR=0.23,95% CI：0.07～0.76）的商业性行为感染HIV的风险更小;男性（OR=29.20,95% CI：9.40～90.75）、初中及以下文化程度者（OR=4.28,95% CI：1.24～14.81）的非商业临时性行为感染HIV的风险更大。除了在线下场所结识非婚异性性伴,有一定比例（6.2%）HIV/AIDS通过线上交友发展性伴关系,且性伴交往场所以低档为主。结论 重庆市部分地区新报告异性性传播HIV/AIDS的感染方式以线下低档场所结识性伴,并经商业性行为感染为主,应深入了解异性性传播HIV/AIDS的感染方式,制定有针对性的干预策略。     

Factors in the Delayed HIV Presentation of Immigrants in Northern California: Implications for Voluntary Counseling and Testing Programs

To describe the determinants of delayed HIV presentation in one Northern California County, the authors identify persons with an opportunistic infection (OI) at HIV diagnosis. From 2000–2002, a sample of HIV patients attending a public AIDS program (n=391) were identified. Immigrants composed 24% of our sample; 78.7% of immigrants were Hispanic. Immigrants, compared to U.S.-born patients, presented with lower initial CD4+ counts at diagnosis than U.S.-born patients (287 cells/mm³ vs. 333 cells/mm³, p=0.143), were more likely to have an OI at HIV diagnosis (29.8% vs. 17.2%, p=0.009), and were more likely to be hospitalized at HIV diagnosis (20.2% vs. 12.5%, p=0.064). We found only immigrant status was significantly and independently associated with delayed presentation. Interviews with 20 newly HIV diagnosed Hispanic patients suggest lack of knowledge regarding HIV risk, social stigma, secrecy and symptom driven health seeking behavior all contribute to delayed clinical presentation. The main precipitants of HIV testing for immigrants were HIV/AIDS related symptoms and sexually transmitted infection (STI)/HIV diagnosis in a sexual partner. These results support augmentation of STI/HIV voluntary clinical testing and partner notification services along the Mexico-California migrant corridor.     

Incidence of primary opportunistic infections in two human immunodeficiency virus-infected French clinical cohorts

BACKGROUND: Clinical guidelines for the prevention of opportunistic infections in human immunodeficiency virus (HIV)-infected individuals have been developed on the basis of natural history data collected in the USA. The objective of this study was to estimate the incidence of primary opportunistic infections in HIV-infected individuals in geographically distinct cohorts in France. METHODS: We conducted our study on 2664 HIV-infected patients from the Tourcoing AIDS Reference Centre and the hospital-based information system of the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine enrolled from January 1987 to September 1995 and followed through December 1995. We estimated: (1) CD4-adjusted incidence rates of seven primary opportunistic infections in the absence of prophylaxis for that specific infection or any antiretroviral drugs other than zidovudine; and (2) CD4 lymphocyte count decline. RESULTS: The highest incidence rates for all opportunistic infections studied occurred in patients with CD4 counts < 200/microl. With CD4 counts < 50/microl, the most common opportunistic infections were toxoplasmic encephalitis (12.6 per 100 person-years) and Pneumocystis carinii pneumonia (11.4 per 100 person-years). Mycobacterium tuberculosis was the least common opportunistic infection (< 5.0/100 person-years). Even with CD4 counts > 300/microl, cases of Pneumocystis carinii pneumonia and toxoplasmic encephalitis were reported. The mean CD4 lymphocyte decline per month was 4.6 cells/microl. There was a significant association between HIV risk behaviour and the incidence of cytomegalovirus infection, between calendar year and the incidence of Pneumocystis carinii pneumonia, toxoplasmic encephalitis and Candida esophagitis, and between geographical area and the incidence of Pneumocystis carinii pneumonia and cytomegalovirus infection. CONCLUSIONS: Geographical differences exist in the incidence of HIV-related opportunistic infections. These results can be used to define local priorities for prophylaxis of opportunistic infections.