杭州地区吸毒人群HIV感染状况及防治策略研究

目的　了解杭州地区吸毒人群的HIV感染状况。方法　对 1997年 1月～ 2 0 0 3年 6月的强制戒毒人员常规检测结果进行统计分析。结果　共检出HIV感染者 10 4例 ,并呈逐年上升趋势 ;感染者省籍已从 2个省份扩大到 8个省份 ;吸毒人群的HIV感染者以青壮年为主 ,2 0～ 3 9岁占 77.9% ,男女比例 8.5∶1,小学文化及以下占 64 .4% ,经静脉注射而感染HIV者占 94.2 %。结论　杭州地区吸毒人群的HIV感染快速增长趋势已经出现 ,应尽快开展高危人群行为干预     

临沧市21年HIV/AIDS流行病学分析

目的分析临沧市艾滋病病毒感染者(HIV)/艾滋病病人(AIDS)的流行特征和变化趋势。方法对该市1990～2011年上报的HIV/AIDS的流行病学调查资料进行分析。结果该市累计报告HIV/AIDS 7 903例,其中AIDS 1 799例,死亡1 076例。报告病例以医疗机构筛查发现为主。感染途径以性传播为主,占53.8%;血液传播(注射吸毒传播)占31.2%;母婴传播占1.4%。结论该市因静脉吸毒人群共用注射器造成HIV感染,从2004年大筛查开始,每年新报告的人数在800～1 000例之间,性传播比例呈逐年持续上升,至2006年性传播已成为主要的传播途径,存在HIV向一般人群蔓延的危险,艾滋病疫情仍然严峻。     

斯德哥尔摩地区人类免疫缺陷病毒和其他性传播疾病的流行病学

该调查目的是通过对斯德哥尔摩地区人类免疫缺陷病毒(HIV)和其他性传播疾病(STD)流行病学资料来分析这些疾病是否已在一般人群中传播,并评价一般人群和同性恋男性、静脉吸毒及来自非洲次撒哈拉移民三种人群接触HIV和其他STD的实际危险率。 调查结果,瑞典截止1995年1月共报告了3958例HIV感染者,其中2542例(65％)是在斯德哥尔摩地区。该地区估计有同性恋男性14000名,1991～1994年平均每年有1600名同性恋者接受HIV抗体检查,约有5％呈阳性。目     

乌干达农村人群中由于其它性传播疾病所致的HIV感染的比例:模拟模型估计

由于其它性传播疾病(STD)增加HIV传播的可能性,且高的STD流行率和发病率易导致HIV感染的传播。作者对乌干达农村人群中STD在传播HIV感染中所起的作用进行了研究。 根据HIV感染、溃疡性和非溃疡性STD的传播动力学的模拟模型,收集有关资料与模型进行拟合。在所有溃疡性STD,每例性接触者传播HIV设定为增加10倍,而在女性非溃疡性STD设定为增加2倍,这称为“低辅助情况”;而将STD传播HIV的效果分别设定为增     

贵阳市女性HIV/AIDS感染情况分析

目的探讨在艾滋病感染人群中女性的感染情况,为预防与控制艾滋病在女性人群中的传播提供科学依据。方法对1994年1月～2005年12月HIV/AIDS女性确诊报告和流行病学个案调查表进行统计分析。结果截止2005年12月,贵阳市共累计报告女性HIV/AIDS121例,占历年累计报告HIV感染者的31.68%;年龄以青壮年为主;传播途径以静脉吸毒占首位;目前尚无母婴传播报告。结论贵阳市女性HIV感染者人数逐年增加,艾滋病对妇女的危害日益严重,应采取有效措施预防艾滋病在女性人群中的传播。     

1985～1987年英国STD门诊就诊病人人类免疫缺陷病毒感染的血清流行情况

艾滋病(AIDS)是一种性传播性疾病(STD)。来STD 门诊就诊者多数有感染人类免疫缺陷病毒(HIV)的高危行为,所以,提出将这些门诊作为HIV 监测和监视异性恋间可能传播HIV 的场所。本文作者总结了1985～1987年间美国STD 门诊就诊者HIV 感染的情况,数据来源于1987年10月及11月     

人免疫缺陷病毒合并丙型肝炎病毒的调查及相关因素分析

目的对人类免疫缺陷病毒(human immunodificiency virus,HIV)感染者中合并丙型肝炎病毒(hepatitis C virus,HCV)感染的情况进行流行病学调查和统计学分析,评估合并感染的患病率和相关影响因素。方法对各医院在2006—2008年收治的门诊和住院HIV感染病例,用统一的流行病学调查表进行登记;并进行HCV抗体、肝功能和CD4细胞检测;多元回归法分析HIV合并HCV感染风险因素。结果 HIV感染者978例,合并HCV的感染率为33.9%,静脉吸毒途径感染HIV占合并感染者的81.3%,30~45岁年龄组HIV合并感染率为42.6%,无业人员HIV合并感染率为61.9%,均明显高于其他组。结论年龄30~45岁和无正当职业的人群HIV合并HCV感染率较高,静脉吸毒是HIV合并HCV感染的主要传播途径。     

南京市浦口区高危人群性病艾滋病干预效果评估

娱乐场所女性工作者在STD/AIDS传播中既是高危人群,又是从高危人群向一般人群传播的桥梁,在STD/AIDS的传播和流行中具有重要的意义.同时,我市STD/AIDS已由静脉吸毒传播向性传播途径转变,且经性传播感染者逐年增加,有专家预言,性途径传播将成为我国今后STD/AIDS传播的主要途径.为探讨如何提高娱乐场所女性性工作者安全套使用率,控制HIV从性服务人群向一般人群传播,我们结合中盖项目从2008年开始以全区娱乐、洗浴场所作为研究对象,开展了一系列干预活动,现将结果报道如下.     

2007～2009年性病门诊HIV感染者情况分析

目的:了解性病门诊HIV感染人群的分布情况。方法:采用ELISA(酶联免疫)法,对2007年1月～2009年12月性病门诊做HIV检测的6895例患者进行了检测,并对经确诊试验阳性的47例患者情况进行了分析。结果:6895例做HIV检测的患者中47例HIV阳性(0.70%)。47例HIV阳性患者中男性同性恋41例(87.23%)、双性恋14例(29.79%)、多性伴22例(46.81%)、异性恋6例(12.77%),37例梅毒血清阳性(78.72%)。结论:男性同性恋存在传播HIV的高危行为,是HIV传播的桥梁人群。对这一人群的STD/AIDS监测、检测及干预工作已刻不容缓。同时,有效控制性病特别是梅毒的发病率,对于控制艾滋病的流行有着重要意义。     

梅毒患者合并HIV、HCV和HSV病毒感染状况分析

目的：通过对梅毒患者HIV、HCV和HSV-2抗体的检测,了解梅毒患者合并上述病毒感染状况,为制订防控措施提供依据。方法：选取吸毒人群梅毒患者187例,性病门诊梅毒患者150例和健康正常人群91例,进行HIV、HCV和HSV-2病毒抗体血清学检测。结果：梅毒患者HIV感染率3．56％,HCV感染率49．55％,HSV-2感染率63．50％;健康对照者HIV、HCV和HSV-2感染率分别为0．00％、2．18％和26．37％。结论：梅毒患者HIV、HCV和HSV-2感染率明显高于正常人群,对梅毒患者应加强干预,以进一步控制HIV、HCV和HSV-2的传播。     

HIV seropositivity among patients with sexually transmitted diseases

2013 patients with various sexually transmitted diseases were screened for HIV antibodies in voluntary counseling and testing centre (VCTC) attached to Microbiology Lab of Govt. Medical College, Amritsar from Jan. 1998 to Dec. 2001. Sixty-one (3.03%) were found to be positive for HIV. 44 were males and 17 were females. There was a constant rise in the percentage positivity in females from 14.3% in 1998 to 38.09% in 2002. There was also rise in the prevalence of HIV among the STD attenders (1.65% in 1998 to 5.13% in 2001).     

Screening for sexually transmitted diseases in an HIV testing clinic; uptake and prevalence.

OBJECTIVE: To estimate the prevalence of sexually transmitted diseases (STDs) and the acceptability of STD screening among people seeking an HIV antibody test in an established free standing HIV testing clinic. DESIGN: A 9 month period prevalence study conducted between August 1993 and April 1994. SETTING: The Same Day Testing Clinic (SDTC) for HIV antibodies at the Royal Free Hampstead NHS Trust Hospital, London. SUBJECTS: 242 males and 160 females attending the Same Day Testing Clinic. OUTCOME MEASURES: The prevalence of STDs including gonorrhoea, chlamydia, syphilis and hepatitis B and the percentage of clinic attenders accepting an STD screen. RESULTS: Of those invited to take part in the study 69% of the males (242/350) and 59% (160/269) of the females agreed to be screened although for a variety of reasons not everyone agreed to a full screen. Two cases of untreated syphilis, no cases of gonorrhoea and six cases of chlamydia were detected. Four people had active, previously undiagnosed herpes while three had genital warts. Evidence of previously unknown hepatitis B infection was found in 26 people. Despite a high level of previous contact with genitourinary medicine services, uptake of hepatitis B vaccination among those homosexual men eligible for immunisation was low (28%; 23/83). Nine (4%) of the males, but none of the females screened for STD were found to be HIV antibody positive. CONCLUSION: Among people seeking an HIV antibody test in an established free standing HIV testing clinic, the prevalence of acute STDs was low. However, evidence of previously undiagnosed hepatitis B infection was found in a number of subjects and uptake of vaccination among those most at risk had been low. While opportunistic screening for STD was acceptable to almost two thirds of HIV testing clinic attenders, a substantial minority nonetheless declined this offer. Selective STD screening could be offered to those people seeking an HIV test who report never having been screened before, as both cases of positive syphilis serology and all those of chlamydia were in people who had not previously been screened. All those at risk for hepatitis B infection should be encouraged to establish their infection status and be immunised where appropriate.     

Sexually transmitted diseases in South Africa.

AIM: To review the epidemiology of and data collection for sexually transmitted diseases (STDs) in South Africa. METHODS: Literature published since 1980 on STDs in South Africa were complied and evaluated. Historical reports and salient unpublished literature were also used in the literature review. Studies were critically reviewed in the light of sample populations and study methods, and a baseline picture of the patterns of STD burden was developed. RESULTS: The STD burden in apparently asymptomatic study populations is significant. Ulcerative infections, primarily caused by syphilis and chancroid, are present in 5-15% of asymptomatic clinic attenders; prevalence rates of gonorrhoea average 8%, with up to 13% of gonococcal isolates resistant to penicillin antibiotics. In addition, on average, chlamydia and vaginal infections are detected in 16% and 20-49%, respectively, of antenatal and family planning clinic attenders. HIV seroprevalence rates have reached 7.6% in antenatal clinic attenders. Most South African STD data are derived from ad hoc surveys which have traditionally focused only on several major infections and particular urban centres. Almost all STD studies have been facility-based, with many studies based at STD clinics, thus reporting only relative frequencies and not population-based prevalences of STDs. With the possible exception of HIV, systematic surveillance data for STDs are conspicuously lacking. CONCLUSION: The disease burden of classic sexually transmitted infections has historically been heavy, and continues to be a serious public health problem in South Africa. Morbidity from both ulcerative and non-ulcerative infections, particularly in women, is significant. The body of STD data, although mostly sound, remains incomplete, and with the rapid emergence of HIV in South Africa, surveillance of STDs and focused STD policies will be critical.     

Evaluating a designated family planning clinic within a genitourinary medicine clinic.

OBJECTIVE--To evaluate an integrated family planning clinic (FPC) established by genitourinary medicine (GUM) staff held within a GUM women-only clinic (WOC). DESIGN--A retrospective case note review of women attending the FPC during the first year January-December 1992. RESULTS--One hundred and thirteen women, aged 13-41 years, attended the FPC; 45 were new attenders, six had previously tested antibody positive for the human immunodeficiency virus (HIV), seven were intravenous drug users; 54% had a history of sexually transmitted disease (STD); 17.7% were using no contraception; 32.7% had previous termination of pregnancy (TOP) with 70 TOPs in total. Within three months of FPC attendance 89 (78.8%) women had genital STD screening performed; syphilis, HIV and hepatitis B serology, together with cervical cytology were performed in 77, 18, 13 and 62 women respectively. Infections identified were similar to those identified in the GUM clinic but the prevalence of Chlamydia trachomatis in diagnosed infections was commoner in FPC attenders and epidemiological treatment commoner in GUM attenders. No high grade cytology abnormalities were detected. No positive syphilis or new HIV positive results were identified; five women were found to be hepatitis B surface antibody positive. Contraception was changed in 60.8%. Most frequently supplied was the combined oral contraceptive pill (COCP). At the first FPC attendance six women required post coital contraception (PCC) and five were already pregnant, three suspected it, two were unaware. During the year three women conceived; two used COCP, but were non compliant; one used a diaphragm with unclear compliance. Seven of the eight pregnancies were terminated. Over the following year, 1992-93, contraception was supplied to 42 women; four required PCC; two intentional pregnancies occurred. Only one of the TOP women returned. CONCLUSION--An integrated FPC provides co-ordinated sexual health care. Pregnancy, TOP and FPC re-attendance rates together with improvement strategies are discussed. Avoiding unwanted pregnancy remains a universal challenge.     

HIV prevalence in patients with sexually transmitted diseases in Yaounde, (Cameroon) in 1989 and 1990: necessity of an STD control programme.

OBJECTIVE--To monitor HIV seroprevalence among STD clinic attenders as part of a sentinel surveillance programme. DESIGN--Seroepidemiological survey on randomly selected patients. SETTING--"Elig Essono" STD clinic, Yaounde; from February 1989 to December 1990. PATIENTS--1161 randomly selected patients. MAIN OUTCOME MEASURES--HIV and syphilis seroprevalence. RESULTS--Twenty six of the 1161 patients (2.4%; CI: 95%; 1.5%-3.3%) tested were found to be HIV positive (mostly due to HIV1); 35.4% had antibodies to Treponema pallidum. There was no association between HIV seropositivity and sex, marital status, or educational level. Genital ulcer disease did not correlate with HIV seroprevalence. However, patients with a positive serological test for T pallidum were more likely to have HIV infection (rr = 2.4; 95% CI; from 1.1 to 3.0). Results from 1990 were double those of 1989 (3.3% versus 1.6%, p = 0.02). CONCLUSIONS--Compared with the findings among the same groups in metropolitan areas of various other African countries, the HIV seroprevalence is still low; this could be due to many reasons, such as the recent introduction of the virus in the country, a different spectrum of STDs, the high level of circumcision of males. HIV infection trends should continue to be monitored among risk groups such as STD patients and control programmes implemented to reduce the rapid spread of AIDS in the country.     

Safe sex and women.

OBJECTIVE--Sexual behaviour, condom use, HIV knowledge and anxiety for women were examined to understand the range of sexual behaviours, predictors of safer sex and the extent of relapse. DESIGN--A cross sectional sample of women STD clinic attenders completed interviews and questionnaires. SETTING--Central London STD Clinic. SUBJECTS--153 women drawn from consecutive attenders at a sexually transmitted disease (STD) clinic in inner London. RESULTS--A quarter of the sample had never responded to safe sex and a further 14% had been unable to maintain it over time. Anxiety and knowledge did not differ between safe and relapsed groups, but self efficacy and cognitive variables did. Those who maintained safe sex had significantly less sex. Ten percent of the sample had unprotected anal intercourse. Most women saw themselves in longer term relationships, yet a quarter had sex outside of the relationship and a fifth stated that their partners also did. HIV information gathering was passive and 74% felt they could not protect themselves against infection. High concern over HIV was monitored. Condom uptake was low and non-existent for anal intercourse. 25% had undergone HIV testing. These women did not differ significantly in terms of their behaviour from the untested women. CONCLUSIONS--HIV risks for women are a source of anxiety and tailored intervention is needed to reduce risk and promote dialogue and negotiation.     

Sentinel surveillance of human immunodeficiency virus infection in sexually transmitted disease clinics in the United States.

From April 1988 through December 1989, sera obtained for syphilis testing from consecutive patients attending 98 sexually transmitted disease (STD) clinics in 37 metropolitan areas were tested for antibodies to human immunodeficiency virus (HIV) in an unlinked (blinded) survey. HIV seroprevalence in STD clinics ranged from 0 to 38.5% (median, 2.3%), with the highest rates found in the Mid-Atlantic states, Florida, and Puerto Rico. The highest median rates were found in men who have sex with men (36.1%) and heterosexual intravenous (IV) drug users (4.1%). For heterosexual persons who do not report IV drug use, median rates were highest in the 35- to 39-year-old age group for men (6.4%) and the 30- to 34-year-old age group for women (0.9%). Among persons who do not report risk behaviors for HIV infection, men had substantially higher median rates of HIV infection than women (P less than 0.001, Wilcoxon Signed Rank test), and rates were positively correlated with HIV infection rates in IV drug users in the same clinic (Pearson correlation coefficient [r] = 0.8; P less than 0.001). Among heterosexual STD clinic patients who do not report IV drug use, the median HIV infection rate for blacks (1.8%) was at least 2 times higher than the median infection rates for hispanics (0.9%) and whites (0.7%). The results of this study show that HIV infection in STD clinic patients varies by geographic area, sex, race and ethnic group, and risk behavior.(ABSTRACT TRUNCATED AT 250 WORDS)     

Factors associated with newly diagnosed HIV among persons with concomitant sexually transmitted diseases

OBJECTIVE: We evaluated Illinois and Chicago Departments of Public Health surveillance databases to determine risk factors associated with newly diagnosed HIV among persons with bacterial sexually transmitted diseases (STDs). METHODS: Test results for Chlamydia, gonorrhea, early syphilis (primary, secondary, and early latent), and HIV from public health clinics in Illinois in 2002 were merged with demographic and behavioral survey data collected during patient visits. STD was defined as any positive non-HIV result. RESULTS: Among 43,517 patient encounters, 5814 (13.4%) had positive STD test results. There were 308 (0.7%) positive new HIV test results, of which 71 (23.1%) had concomitant infection with an STD. Compared with STD-positive, HIV-negative cases, age >30 years (OR = 1.9, 95% CI, 1.0,4.4), men who have sex with men (MSM) (OR = 22.2, 95% CI 11.3-43.7), and bisexual male (OR = 22.4, 95% CI 7.8-64.8) were independently associated with STD and HIV coinfections. Among distinct STDs, syphilis (n = 438) was the least frequent (7.5%), but was reported in the highest proportion (10.1%) of all new HIV infections and conferred the greatest risk (OR = 11.0, 95% CI 7.7-15.8) for newly diagnosed HIV. CONCLUSIONS: MSM were at increased risk for newly diagnosed HIV with STD coinfection. Persons with a concomitant STD and HIV were older than US populations that generally constitute the greatest proportion of STD cases. These results highlight the role in particular of syphilis among populations at high risk for HIV transmission. Public health interventions targeting MSM and older adults for effective testing and prevention strategies are critically needed within high-risk networks for cotransmission of STDs and HIV.     

Trends in reported cases of donovanosis in Durban, South Africa.

OBJECTIVE--To investigate recent trends in reported cases of donovanosis (granuloma inguinale) in Durban, South Africa. DESIGN--The annual reports of the Medical Officer of Health for Durban 1958-1988 were reviewed to identify cases of donovanosis, genital ulcer disease (GUD) and new patients with sexually transmitted diseases (STD). A rapid staining technique for the detection of Donovan bodies was introduced in 1988. SETTING--City Health STD Clinic, King Edward VIII Hospital, Durban. RESULTS--An initial peak was identified in men 1969-1974. A second peak was recorded in 1988 when reported cases of donovanosis (313) were the highest since records commenced. Both peaks were unrelated to either increases in the numbers of new attenders with STD or patients with GUD. CONCLUSION--The recent increase in donovanosis in Durban may reflect either a new epidemic or under-reporting of a disease previously diagnosed on clinical grounds. Improved control of donovanosis, a condition sometimes causing extensive GUD, and which has been implicated in HIV-1 transmission in local men, should be targeted in HIV control programmes.     

HIV infection and STD in drug addicted prostitutes in Amsterdam: potential for heterosexual HIV transmission.

To assess the potential role of drug using prostitutes in the heterosexual transmission of human immunodeficiency virus (HIV), 117 prostitutes, recruited from December 1985 to November 1987 at a weekly evening sexually transmitted diseases (STD) clinic for drug using prostitutes only, were studied for the prevalence of HIV and STD. Intravenous drug use was reported by 96 (82%) of the women. Antibody to HIV was found in 35/117 (30%) women, all but one of whom had been using drugs intravenously. Most (73, 62%) of the prostitutes reported having had more than 2000 clients each in the preceding five years. In the six months preceding enrollment to the study they had practised mainly vaginal (106/117) and orogenital (82/117) intercourse; 90% (105/117) reported frequent use of condoms in vaginal intercourse and 65% (68/105) in orogenital intercourse. Despite frequent condom use, 81% (84/104) contracted one or more STD in this period. Considering the high incidence of HIV and STD and the finding by others that the presence of STD may facilitate transmission of HIV, we conclude that the potential for HIV transmission from these prostitutes to their clients (and vice versa) was clearly present.