The Effects of HIV Stigma on Health, Disclosure of HIV Status, and Risk Behavior of Homeless and Unstably Housed Persons Living with HIV

HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health of homeless/unstably housed PLWHA.     

Site factors may be more important than participant factors in explaining HIV test acceptance in the prevention of mother-to-child HIV transmission programme in Kenya, 2005

Objective  To determine the role of participant factors on the acceptance of a Prevention-of-Mother-to-Child (PMTCT) HIV test programme in a situation with an opt-out testing strategy.
Methods  We analysed antenatal clinic (ANC) HIV sentinel surveillance data. All 43 sites in the 2005 round of Kenya's ANC surveillance offered opt-out PMTCT services and recorded if women were offered PMTCT HIV testing and whether they accepted or refused. Logistic regression was used to determine the role of participant-level factors on PMTCT acceptance.
Results  During the period of sentinel surveillance, 13 026 women attended ANC and testing was offered to 12 030 women. Of those offered testing, 9690 (80.5%) accepted, with a large variation in the percent of acceptors by site. Age, residence and educational status were significant determinants of PMTCT acceptance. However, after adjusting for site none of the participant-level factors were significant determinants of PMTCT acceptance.
Conclusions  Participant level factors were not significant determinants of PMTCT HIV test acceptance after adjusting for sites. PMTCT programmes should collect and evaluate the role of site-level (provider and testing service) factors on PMTCT acceptance. Improvement of site-level factors could improve PMTCT uptake.     

Structural-level factors affecting implementation of the methadone maintenance therapy program in China

This study identifies structural-level factors influencing methadone maintenance therapy (MMT) program implementation in China. Twenty-eight service providers and 560 randomly selected clients from 28 MMT clinics in the study area underwent face-to-face interviews. Number of clients, retention rate, coverage, and structural-level factors were collected from a survey of service providers. Individual-level factors and self-reported illicit drug use information were obtained from clients. Urine specimens were collected from the client participants to test for heroin use. Clinics affiliated with the local Centers for Disease Control and Prevention (CDC) had more clients, higher retention rates, and broader coverage than those not affiliated with the CDC. Longer operating hours, incentive for compliant clients, and comprehensive services were positively associated with client recruitment and coverage. Comprehensive services and incentives for compliant clients were negatively associated with concurrent illicit drug use. Comprehensive services should be incorporated into the MMT program. Extended operating hours and incentives for compliant clients should be implemented.     

宫颈上皮内瘤变发生的相关危险因素分析

目的 调查分析宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）发生的相关危险因素.方法 对人组的148例富颈疾病患者（包括CIN组105例和宫颈炎组43例）通过问卷调查的形式采集相关资料分析CIN发生的相关危险因素.结果 经单因素非条件Logistic回归分析,首次性生活年龄、妊娠次数、性生活频率和性生活前清洗习惯这4项因素差异有统计学意义（P＜0.05）;多因素非条件Logistic回归分析结果显示,妊娠次数＞3次是CIN发生的危险因素（P＜0.05）,性生活前双方清洗阴部是CIN发生的保护因素（P＜0.05）.结论 加强女性的健康保健意识、性行为时积极采取安全保护措施可能会降低CIN的发生率.     

艾滋病病毒亚型及其影响

根据联合国艾滋病规划署(UNAIDS)2010年最新估计[1],2009年全球新近感染艾滋病病毒者约为260万人,有180万人死于艾滋病;目前存活的HIV感染者约有3 330万,已有3 000万人死于艾滋病,尽管全球艾滋病的发病率总体呈现下降趋势,但艾滋病目前仍然在全球范围内流行.     

南昌市西湖区2009--2010年性病报告的流行病学分析

目的了解南昌市两湖区性病监测点报告的性病的流行病学特征,为制定防治对策提供科学依据。方法对2009--2010年性病疫情报告资料进行描述性流行病学分析。结果2009年性病报告病例数为619例,以梅毒、淋病为主,男女性别比为1．42：1;2010年性病报告病例数为610例,以梅毒、尖锐湿疣、淋病为主,男女性别比为0．89：1;总体略呈下降趋势,报告发病数以20～34岁及60岁以上年龄段为主,职业分布以家务及待业和工人为主。结论今后性病防治重点人群为20～40岁及60岁以上者,职业以流动人口及工人为主。防治措施以加强宣传性病防治知识及推广100％使用安全套为主。     

中国三地区女性性工作者对杀微生物剂的可接受性及其影响因素研究

目的探索女性性工作者(female sex workers,FSWs)对阴道外用杀微生物剂的可接受性及其影响因素。方法采用横断面调查的方法,于2008年9月至2009年1月在云南德宏、四川乐山和辽宁沈阳3现场共抽取968名FSWs作为研究对象,以面对面访谈方式进行问卷调查。主要评价指标包括杀微生物剂可接受性得分、危险性行为、安全套使用率、性病史、艾滋病/性病感知风险等。结果被调查的FSWs对杀微生物剂的可接受性平均得分为(2.88±0.58)分。可接受性受FSWs的所在地区、性服务场所的档次与性质、年龄、文化程度、是否主动要求使用和被拒绝使用安全套、是否检测过HIV抗体、是否担心感染艾滋病/性病、妊娠史和阴道外用药史等因素影响。结论接受调查的FSWs对使用杀微生物剂的态度普遍较积极,提示杀微生物剂有可能作为安全套的补充措施,满足女性在艾滋病/性病预防中的特殊需要。     

云南省澜沧县艾滋病病毒感染者及病人生存质量现状及相关因素研究

目的了解艾滋病病毒感染者及病人生存质量的现状并分析其相关因素。方法应用世界卫生组织生活质量量表(WHOQOL-BREFF)中文版评价艾滋病病毒感染者及病人的生存质量,同时调查可能影响生活质量的人口学特征和HIV感染有关特征。采用t检验、方差分析进行单因素分析,多元线性回归模型分析生理、心理、社会关系及环境4大领域的影响因素。结果 300例艾滋病病毒感染者及病人生存质量4大领域平均得分分别为:生理领域(14.04±1.87)分、心理领域(12.48±1.88)分、社会关系领域(12.78±2.25)分、环境领域(11.87±2.00)分。配偶的文化程度越高其本人的心理、社会关系和环境领域得分越高;静脉注射途径在各领域中得分最低。结论应加强年轻患者、抗病毒治疗患者和静脉注射感染者的心理健康辅导,以提高生存质量。