傈僳族地区预防保健工作者应对艾滋病能力的调查和干预

目的探讨傈僳族地区预防保健工作者的艾滋病(AIDS)预防知识、态度,并对之进行AIDS的培训,传授健康教育技能。方法对42名预防保健工作者先进行问卷调查,根据需求确定培训内容,用参与式方法进行培训,结束后进行效果评价。结果培训前问卷平均得分为56.71分,培训后问卷平均得分为83.93分,培训前后差异有显著的统计学意义(P<0.01)。结论应重视低流行区AIDS预防,参与式培训方式在少数民族地区AIDS宣传教育中效果显著。     

北京市石景山区某大学学生AIDS知识问卷分析

目的了解北京市石景山区某大学学生艾滋病(HIV/AIDS)相关知识、对艾滋病病人的态度、其知识来源、变化情况。方法分别于2005年12月和2010年12月,对北京市石景山区某大学学生进行问卷调查,问卷包括流动人员人口学现状、HIV/AIDS相关知识知晓情况、对待感染者的态度和主要知识来源等方面。结果两次分别发出问卷300份,2005年收回有效问卷204份,2010年收回有效问卷201份。2010年较2005年受访者艾滋病相关知识水平有明显提高,2010年大学生对艾滋病性、血液和母婴三种传播方式知晓率分别达到92.5%、97.0%和100%,对艾滋病病人态度改善显著。结论经过不间断的艾滋病相关知识教育,北京市石景山区某大学学生艾滋病知识水平有提高,对艾滋病态度改善,但艾滋病相关教育仍应加强。     

Disparities in HIV knowledge and attitudes toward biomedical interventions among the non-medical HIV workforce in the United States

Non-medical, community-based workers play a critical role in supporting people living with (or at risk of acquiring) HIV along the care continuum. The biomedical nature of promising advances in HIV prevention, such as pre-exposure prophylaxis and treatment-as-prevention, requires frontline workers to be knowledgeable about HIV science and treatment. This study was developed to: measure knowledge of HIV science and treatment within the HIV non-medical workforce, evaluate workers’ familiarity with and attitudes toward recent biomedical interventions, and identify factors that may affect HIV knowledge and attitudes. A 62-question, web-based survey was completed in English or Spanish between 2012 and 2014 by 3663 US-based employees, contractors, and volunteers working in AIDS service organizations, state/local health departments, and other community-based organizations in a non-medical capacity. Survey items captured the following: respondent demographics, HIV science and treatment knowledge, and familiarity with and attitudes toward biomedical interventions. An average of 61% of HIV knowledge questions were answered correctly. Higher knowledge scores were associated with higher education levels, work at organizations that serve people living with HIV/AIDS or who are at a high risk of acquiring HIV, and longer tenure in the field. Lower knowledge scores were associated with non-Hispanic Black or Black race/ethnicity and taking the survey in Spanish. Similarly, subgroup analyses showed that respondents who were non-Hispanic Black or Hispanic (versus non-Hispanic white), as well as those located in the South (versus other regions) scored significantly lower. These subpopulations were also less familiar with and had less positive attitudes toward newer biomedical prevention interventions. Respondents who took the survey in Spanish (versus English) had lower knowledge scores and higher familiarity with, but generally less positive attitudes toward, biomedical interventions. In summary, low knowledge scores suggest the need for additional capacity-building efforts and training for non-medical HIV workers, particularly those who provide services in the communities most affected by HIV.     

乡镇中学生开展艾滋病性病知识同伴教育效果评估

目的探讨针对乡镇中学生采取同伴教育措施预防艾滋病的策略。方法在广东省珠江三角洲某市,随机选择2所乡镇中学,共征募并培训20名同伴教育员在校开展同伴教育工作,组织开展多种形式的艾滋病知识宣传活动。在干预前后用相同的调查表对学生进行问卷调查。结果干预前后(相隔6个月)分别调查192名和191名在校中学生,艾滋病知识总知晓率从干预前的22.92%提高到干预后的66.49%(P<0.05);最近半年有性行为的比例从干预前的18.23%下降到干预后的9.95%(P<0.05);最近一次性生活中采取安全措施的比例从干预前的52.71%增加到干预后的94.74%(P<0.05)。结论在乡镇中学生中开展同伴教育活动能显著提高中学生对艾滋病知识的知晓率,减少对艾滋病的歧视,减少危险性行为,对发挥中学生在控制艾滋病蔓延的作用具有重要作用。     

The HIV transmission gradient: relationship patterns of protection

We describe a gradient of potential HIV transmission from HIV-infected persons to their partners and thence to uninfected populations. The effect of this newly discovered transmission gradient is to limit the spread of HIV. We roughly estimate a 2% long-term transmission probability for sex and 14% for drug injection for two-step transmission. Then we test theories to account for this pattern on a network sample of 267 inner city drug users and nonusers. Although HIV positive persons engaged in a high level of risk with one another, they engaged in less risk with HIV negative partners, and these partners engaged in even lower levels of risk with other HIV negative persons. Analyses suggest that the primary motivation for sexual risk reduction is partner protection, while emotional closeness is the major barrier. Hypotheses accounting for risk in terms of self protection, social norms, gender power, and drug use were weakly supported or unsupported.     

Differences in Tunisian adolescents' knowledge,misconceptions and attitudes towards HIV/AIDS from 1997 to 2002

Surveys were conducted to estimate the extent to which knowledge, misconceptions and attitudes of adolescents in Tunisia towards HIV/AIDS had changed after a period of five years. A population of school-going adolescents of both sexes, age 16 to 20, was sampled in 1997 and again in 2002. We found that HIV/AIDS and sexually transmitted diseases became better known, there was more tolerance expressed for people living with AIDS, and the use of condoms was more positively judged. Fewer misconceptions surrounding the condition were also noted. However, many results recorded during the 1997 survey remained unchanged (e.g., scepticism about awareness campaigns; TV as a primary source of information). We discuss the socio-economic and medical/social context in Tunisia during the period 1997–2002 that seemed to allow adolescents to improve their knowledge of HIV/AIDS and to acquire positive attitudes towards persons living with the condition.     

云南省孕产妇艾滋病病毒母婴阻断的知识调查分析

目的了解云南省孕产妇对艾滋病病毒(HIV)母婴传播及阻断措施的认识和接受程度。方法对2005年3-6月在云南省三所妇幼保健院中,接受产前保健服务的孕妇和接受分娩服务的产妇,在书面知情同意、自愿的基础上进行调查分析。结果155名孕妇和148名产妇中,艾滋病的基本知识回答正确率为70%,96%的孕产妇选择母乳喂养,81%的孕产妇认为不用母乳喂养的母亲不会让人觉得"不一样"。汉族和少数民族对不用母乳喂养的母亲态度的差异有统计学意义。孕产妇婚前检测率为51%,其中HIV自愿检测率为15%。结论孕产妇的艾滋病基本知识、人工喂养方式在孕产妇中总体接受程度良好。     

中国18省市城市高中生预防艾滋病知识和态度分析

目的了解中国城市高中生预防艾滋病知识、态度情况,为进一步制定高中生艾滋病预防教育提供依据。方法按照分层整群抽样方法,抽取全国18个省(自治区、直辖市,下同)的109 754名城市高中生进行《中国青少年健康危险行为》问卷调查,问卷采取无记名自填方式。结果 109 754名城市高中生中,55.3%的学生曾从学校接受过艾滋病教育,79.0%的学生"知道艾滋病病原体",68.6%的学生"不同意将感染艾滋病的同学隔离",66.0%的学生表示"会像以前那样和感染艾滋病的朋友继续来往"。各省之间艾滋病预防教育差异较大,职业高中学生在学校接受艾滋病教育和反歧视态度的报告率,均低于重点高中和普通高中的学生(P<0.01);社会经济水平好的地区反歧视态度较高(P<0.01)。结论我国学校预防艾滋病教育资源分布不均衡,北方地区学校开展预防艾滋病知识教育的覆盖率还不够,还应加强对职业高中学生艾滋病的宣传和健康教育力度。     

Prevalence of depressive symptoms and associated factors among adolescents living with HIV/AIDS in South Western Uganda

ABSTRACT

Adolescents living with HIV (ALHIV) are prone to depression, which can have detrimental effects including disease progression, poor treatment adherence and mortality. We aimed to determine the prevalence of depressive symptoms and their associated factors among ALHIV in Uganda. We conducted a cross-sectional survey among ALHIV (10–19 years) attending urban and rural clinics in Mbarara, Uganda between March and May 2017. Presence of depressive symptoms was assessed using the Centre for Epidemiological Studies’ Depression scale. We interviewed 336 adolescents with a median age of 13 years, 62% of whom were female. A third (37%) had disclosed their HIV/AIDS status and 13% were sexually active. Overall, 154 (～46%, [95% CI: 40.5–51.2]) had depressive symptoms. On bivariate analysis, the odds of having depressive symptoms were higher among adolescents who were?≥?15 years, had disclosed HIV status, traveled >30?min for routine care and had risky sexual practices. On multiple variable analysis, only travel time to the clinic of >30?min was independently associated with depressive symptoms (AOR?=?1.6 [95% CI: 1.02–2.7]). With the high prevalence of depressive symptoms among ALHIV in Uganda, screening and prompt treatment of depression should be incorporated within their routine care.     

黑龙江省1993～1999年艾滋病流行状况

目的总结黑龙江省1993～1999年艾滋病流行趋势和传播途径,为黑龙江省艾滋病防治策略提供科学依据.方法对1993～1999年黑龙江省艾滋病监测资料进行分析.结果从1993～1999年末黑龙江省共检出艾滋病病毒感染者47例,艾滋病病人2例(已死亡),47例中血液传播占85%,经性接触传播占13%.黑龙江省目前主要传播途径以血液传播为主.结论黑龙江省处在艾滋病流行的低感染阶段,当前防治重点是对高危人群监测和艾滋病预防知识宣传.同时应注意控制艾滋病性接触传播流行.     

社区卫生服务机构艾滋病防治工作人员的艾滋病知识和歧视态度及相关影响因素的研究

目的了解社区卫生服务机构艾滋病防治工作人员,对艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）的歧视情况及影响因素。方法采用自填式调查问卷,对8个城市40家社区卫生服务机构361名工作人员进行调查。调查内容包括工作人员的一般情况、对HIV/AIDS病人的态度和开展艾防工作意愿等。结果 292人（80.9%）表示能像对待其他患者一样对待HIV/AIDS病人,或者可以为他们提供医疗卫生服务,没有歧视。多因素Logistic回归分析显示,近一年接受培训的天数（3-6天、7-14天和15天以上）、支持社区开展艾滋病防治工作的工作人员对HIV/AIDS病人歧视有显著性差异,比值比（OR）[95%可信区间（CI）]分别为3.96（1.10,14.25）、4.93（1.27,19.19）、10.33（1.86,57.42）、0.25（0.12,0.52）。结论社区卫生服务机构工作人员对HIV/AIDS病人依然存在歧视,当地卫生行政部门和疾控机构需要加强对社区医生的艾滋病防治知识、技能和职业暴露预防的培训,同时要提高其工作待遇,稳定基层防艾队伍。     

Knowledge of HIV/AIDS and attitudes towards people living with HIV among the general staff of a public university in Malaysia

Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development. This cross-sectional study was designed to determine the level of knowledge about HIV and AIDS and assess attitudes towards PLHIV among the general staff of Universiti Putra Malaysia (UPM), as well as to identify factors that are associated with it. Self-administered questionnaires were posted to a total of 344 general staff from six randomly selected faculties, and they were a given a week to return the questionnaires. The response rate was 38%. Data were analysed using Pearson's correlation, independent t-test and multiple linear regression. The respondents showed a considerably high level of knowledge about HIV/AIDS (mean knowledge score of 15.57±1.93 out of 18 points) although there were some misconceptions (N=129). Likert scale responses to 20 attitude statements revealed that respondents generally had moderately positive attitudes toward PLHIV (average score of 69.65±10.08 out of 100 points). Attitudes were inconsistent when it involved direct contact and interaction with PLHIV. Factors significantly associated with level of knowledge and attitudes included age, education and income. There was no difference in mean score for knowledge and attitudes by gender. Further efforts are necessary to improve attitudes of the general staff towards PLHIV, particularly in areas of direct contact with PLHIV.     

吸毒人群HIV知识和高危行为调查及预防知识健康教育探讨

目的 了解广东省吸毒者的吸毒行为以及他们对艾滋病的预防知识和态度,为广东省在该人群中开展强有力的预防干预措施提供依据。方法 面对面的问卷调查获取基础和干预后资料,采用讲课、发放艾滋病预防宣传折页和小组咨询讨论等方法进行干预。结果 干预前吸毒者对艾滋病有关知识的正确认识率最低为 52％,最高为98％,干预后有不同程度的增加;61％的人担心会感染上艾滋病病毒;55.1％为静脉吸毒,其中41.1％有用过别人的注射器;68.8％的人声称有多性伴,而且 63.3％的人在最近 3次婚外性生活中没用安全套。结论 该人群在健康教育前对艾滋病知识已有一定程度的了解,但仍有感染艾滋病病毒的高危行为,因此如何来改变他们的行为不仅仅是宣传教育的问题,它将涉及到我国目前的一些政策和法律法规,这也将是目前HIV/AIDS控制策略的最大挑战。     

Clinical importance of HIV and depressive symptoms among veterans with HIV infection

OBJECTIVE: To compare the clinical importance (association with illness severity and survival) of depressive and HIV symptoms among veterans with HIV infection. DESIGN: Cross-sectional study; survival analysis. SETTING: Infectious Disease Clinics at 3 VA Medical Centers. PARTICIPANTS: HIV-infected patients (N = 881) and their health care providers from June 1999 through July 2000. MEASUREMENTS AND MAIN RESULTS: Depressive symptoms were assessed using the 10-item Centers for Epidemiologic Studies Depression Scale (CES-D). Patient baseline survey included an HIV Symptom Index measuring the frequency and bother of 20 common symptoms. Providers were surveyed on patients' illness severity, and survival data were obtained from VA death records. Of 881 patients, 46% had significant depressive symptoms (CES-D >/=10). Increasing depression symptom severity was associated with increasing HIV symptom frequency (P <.001) and bother (P <.001). Multiple regression results revealed that having moderate or severe depressive symptoms was not associated with provider-reported illness severity or survival. However, HIV symptoms were significantly associated with provider-reported illness severity (P <.01) and survival (P =.05), after adjusting for moderate and severe depressive symptoms, CD4 cell count/mm3, viral load, age, race, and antiretroviral use. CONCLUSIONS: Depression, while common in this sample, was not associated with illness severity or mortality after adjusting for HIV symptoms. HIV symptoms are associated with severity of illness and survival regardless of patients' severity of depressive symptoms. This suggests that equal medical consideration should be given to HIV symptoms presented by HIV-infected patients regardless of their depression status, rather than automatically attributing medical complaints to depression.     

Relationship between expressed HIV/AIDS-related stigma and HIV-beliefs/knowledge and behaviour in families of HIV infected children in Kenya

OBJECTIVES: To quantify expressed stigma in clients of the Kangemi program for HIV+ children, and to characterize the association between stigma and other population characteristics. METHODS: By means of a household survey we created a stigma index and indices for other social and knowledge domains that influence HIV-related healthcare. We used chi2, anova, and correlation to identify associations between domains. RESULTS: The mean (+/-SD) expressed stigma on a six points scale (6 = least stigma) was 3.65 +/- 1.64. Composite scores on knowledge about AIDS were skewed toward more knowledge; and analysis of individual knowledge items indicates that most respondents reject erroneous traditional beliefs and myths about the causes and transmission routes of AIDS. Respondents who were younger, had never married, and had less education expressed greater stigma. Differences in stigma were associated with poor knowledge about AIDS and negative attitudes toward testing, but not with gender or tribal affiliation. Condom use at last intercourse, unrelated to stigma, was only 40% (n = 218). CONCLUSIONS: While this population has good knowledge about AIDS and appraises risks realistically, it fails to reduce these risks. Associations between stigma and other domains can inform interventions that improve HIV care and mitigate spread of HIV.     

低收入高结核病负担国家的成人HIV/AIDS,特别是合并结核病者的处置

由于在低收入国家获得HIV抗逆转录病毒(antiretroviralARV)制剂可能性的提高,目前,许多临床医生需要ARV应用方面的培训。现在临床医生在治疗结核病(TB)时,还要进一步考虑到HIV/AIDS的情况。本文概要介绍医生处置HIV感染者时需要解决的关键问题,尤其是HIV/TB双重感染者。初级卫生保健医生要对所有提示HIV感染的症状、体征者和所有结核病患者进行HIV快速检测诊断。本文主要内容为:对HIV检测前和检测后的咨询问题进行探讨。对HIV感染者进行评估,确定临床分期;通过某些实验室检查判断免疫抑制的程度,以便确定应用ARV治疗和结核病预防性治疗的最佳时机。ARV治疗需要良好的依从性,建议劝导和加强依从性。介绍ARV治疗方案和患者随访要求。优先治疗结核病。不管是否合并HIV感染,治疗结核病的原则是相同的。对合并结核病的患者应用ARV提出了建议。必须建立标准化和不断充实的信息系统,以便监控HIV与结核病双重感染者的处置及结核病和HIV联合防治的执行情况。通过对结核病患者进行HIV感染的筛查,发现HIV感染病例,并对其进行诊断和处置,医生能为减少HIV负担做出贡献,同样也为减少结核病负担做出贡献。     

广州市吸毒人员中HIV／AIDS传播动力学特征探讨

目的了解广州地区吸毒人员的艾滋病病毒感染/艾滋病（HIV/AIDS）流行现状。方法于2007年8月,对广州市白云区戒毒所的433名入所者进行调查研究。采用数学模型的方法计算使用男性安全套后,广州市HIV/AIDS传播的基本复制系数（Rm）。结果 R0=5.41,使用男性避孕套后基本复制系数Rm=2.97。结论男性安全套使用后明显降低了基本复制系数,但是仍大于1,表明吸毒人员中艾滋病防治工作仍需结合其他措施进行控制。     

Violence,abuse and discrimination: key factors militating against control of HIV/AIDS among the LGBTI sector

The Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) South Africans continue to face considerable challenges, including societal stigma, homophobic violence (particularly corrective rape), and high rates of sexually transmitted diseases and infections (particularly Human Immunodeficiency Virus (HIV)/AIDS) even when discrimination based on sexual orientation was outlawed by South African’s post-apartheid constitution. This study was conducted to ascertain violence, abuse and discrimination against the LGBTI sector as key factors that hinder the smooth implementation of HIV/AIDS programme among sexually minority (LGBTI) group in Walter Sisulu University, South Africa. The self-structured questionnaire was used to collect data. The study involved 3048 purposively selected participants (1285 male and 1763 female) aged 17–38 years. About 70.5% of the participants witnessed physical attack as a form of violence against people in same-gender relationship; 47.7% disagreed that violent targeted at this sexually minority group is justified. The LGBTI face challenges which include verbal insults (937, 32.4%), bullying (532, 18.4%) and name-calling (1389, 48%). Discrimination against members of the LGBTI sector was witnessed in various forms: non-acceptance (981, 33.9%), disapproval of act of homosexuals (1308, 45.2) and denial of rights (327, 11.3). Violence, abuse and discrimination which constitute stigmatisation among the LGBTI sector are received with mix feeling. Some respondents justified the use of one or more of these key elements of stigmatisation against the LGBTI (6.6%, supports violence), others condemned these acts of stigmatisation (28.8%), against discrimination). Social stigma which resulted from violence, abuse and discrimination exist in this institution and is responsible for the unwillingness of disclosure of sexual orientation among the LGBTI members. An enabling environment should be created where the LGBTI members could come out freely to access programmes targeted at the prevention and control of HIV/AIDS.