18～45岁已婚HIV感染者生育安全认知现状调查

目的了解18～45岁已婚HIV感染者生育安全认知现状, 为艾滋病感染家庭生育安全干预提供依据。方法选择重庆市6个区和四川省自贡市2021年11月至2022年4月接受随访的18～45岁已婚HIV感染者进行问卷调查, 收集其一般人口学特征、性行为史、生育意愿、生育安全认知等, 采用非条件logistic回归分析和Poisson回归分析研究对象生育安全认知的相关因素。结果 266名研究对象中, 女性占58.3%(155/266), 有生育意愿的HIV感染者占48.9%(130/266)。研究对象的生育安全知识知晓率为59.4%(158/266), 生育安全知识知晓情况的多因素logistic回归分析结果显示, 女性生育安全知识知晓率是男性的2.14(95%CI:1.25～3.66)倍;高中及以上文化程度者生育安全知识知晓率是高中以下文化程度的1.88(95%CI:1.08～3.27)倍;有生育意愿者生育安全知识知晓率是无生育意愿的1.88(95%CI:1.10～3.22)倍, 接受过艾滋病知识宣传教育者生育安全知识知晓率是未接受过艾滋病知识宣传教育的9.06(95%CI:2.46～33.32...     

我国老年人群艾滋病防控现状与挑战

近年来我国老年人群艾滋病疫情呈现快速上升趋势,老年人群艾滋病防治面临新的挑战。老年人群对HIV感染风险认知较低,发生无保护的临时性行为或商业性行为比例较高,HIV感染风险较高。老年HIV感染者和感染风险较高的老年人群文化程度和社会经济水平普遍偏低,获取艾滋病相关知识和检测服务机会较为有限,老年HIV感染者由于检测发现晚、合并慢性疾病等因素,死亡风险显著上升。需从行为特征、社会经济、文化、心理等方面多维度深入开展老年人艾滋病防治研究,探索和采取适合老年人群特点的防治艾滋病健康服务的策略措施,强化对老年感染者全流程综合管理模式的研究。     

Chimeric multiple antigenic peptides for simultaneous detection of specific antibodies to HIV-1 groups M, N, O, and HIV-2

Synthetic peptides have frequently replaced the more costly recombinant proteins or viral lysates as the antigens of choice for detection of antibodies to human immunodeficiency viruses. However, development of an assay that is sensitive to all the types and groups of HIV, including the divergent strains of HIV-1 group O, group N, and HIV-2, would require many peptides derived from different types and groups of HIV. Combining multiple peptide antigens may reduce the analytical sensitivity of the individual peptide due to the competition for binding to the solid surface when used in an enzyme immunoassay format. In this study, we developed and evaluated two chimeric multiple antigenic peptides (CMAP) for simultaneous detection of specific antibodies to HIV-1 groups M, N, O, and HIV-2. Both CMAPs correctly identified 304 known HIV positive serum or plasma specimens (260 HIV-1 group M of varying subtypes, 3 group O, and 41 HIV-2) and one chimpanzee serum specimen (group N) and all 66 known HIV negative specimens. CMAP performance was superior to the corresponding individual linear peptides or a linear peptide mixture. The results indicate that CMAPs are useful for the development of highly sensitive and specific assays for the detection of infections caused by HIV-1, including group M, N, and O, and HIV-2.     

云南省文山州HIV感染者抗病毒治疗脱失影响因素的定性研究

目的 了解云南省文山州人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者抗病毒治疗（antiretroviral therapy,ART）脱失的影响因素。方法 根据"研究对象最大差异"原则,采用立意抽样的方法从文山州文山市和马关县的三个ART门诊选取ART脱失者、脱失者家属、ART工作人员进行深入定性访谈,从个人、家庭、门诊三个层面探讨ART脱失的影响因素,样本量根据信息饱和原则确定。结果 本次共访谈43名ART脱失者,平均年龄为（47.8±15.6）岁;还访谈了7名脱失者家属和11名ART工作人员。结果显示,药物副反应、对ART认知不正确、担心暴露、歧视、服药心理负担大、采用偏方替代治疗是个人层面影响治疗脱失的因素,家庭支持、ART可及性、门诊医疗服务水平是影响治疗脱失的外部因素。结论 影响文山州HIV感染者ART脱失的因素包括药物副反应、ART认知、心理因素、家庭支持、门诊服务水平和ART可及性,应从个人、家庭和门诊层面采取综合干预措施降低治疗脱失。     

德宏州HIV单阳夫妻双方丙型肝炎病毒感染状况及影响因素

目的 了解云南省德宏州人类免疫缺陷病毒（human immunodeficiency virus,HIV）单阳夫妻双方（HIV感染者及其阴性配偶）丙型肝炎病毒（viral hepatitis C,HCV）感染情况及其影响因素。方法 收集HIV单阳夫妻的人口学特征、行为学指标和血样,并进行HCV抗体检测,应用χ2检验和Logistic回归分析不同因素对HCV感染率的影响。结果 582对HIV单阳家庭中,夫妻双方均感染HCV有12对（2.1%）,仅一方感染HCV有138对（23.7%）。HIV阳性配偶HCV感染率为23.2%,HIV阴性配偶HCV感染率为4.6%,差异有统计学意义（χ2=83.641,P<0.001）。男性配偶中,HIV阳性者HCV感染率为32.6%,HIV阴性者HCV感染率为4.6%,差异有统计学意义（χ2=56.828,P<0.001）;女性配偶中,HIV阳性者HCV感染率为4.6%,HIV阴性者HCV感染率为4.7%,二者无统计学差异（χ2<0.001,P=0.958）。多因素Logistic回归分析显示,男性配偶中35~46岁、景颇族、HIV阳性、吸毒是HCV感染的危险因素。结论 德宏州HIV单阳夫妻特别是HIV阳性男性配偶中HCV感染率高,HCV存在性传播的潜在威胁,有必要加强对HIV单阳家庭的丙型肝炎防治,对男性和女性配偶采取针对性的预防干预措施。     

Protective behaviours among young African American women with non-monogamous sexual partners

In the USA, partner non-monogamy is reported to be more common among African American women than White women and may contribute to African American women’s increased risk for HIV and other sexually transmitted infections (STIs). Few studies have explicitly and comprehensively described the protective behaviours that African American women employ with non-monogamous partners to reduce their HIV risk. We conducted interviews to examine protective behaviours among 11 African American women aged 18–24 years who perceived that a partner in the preceding 12 months had another sex partner. Participants described three types of partnerships with 29 non-monogamous men; these partnerships clustered into three categories. Narrative analysis revealed an overall paucity of protective behaviours with non-monogamous partners. Protective behaviours (i.e. communication and condom use) were informed by partnership type, rather than perceptions of non-monogamy. There were few instances in which partner non-monogamy motivated women to terminate sex partnerships. Rather, these decisions were often motivated by changes in other relationship dynamics. To address HIV/STI risk related to partner non-monogamy, HIV prevention strategies for young African American women should emphasise the importance of condom use in all non-marital partnership types. Interventions where testing is available may be effective for women who frequently test for HIV/STIs but do not use condoms.     

Differences in Selected HIV Care Continuum Outcomes Among People Residing in Rural,Urban, and Metropolitan Areas—28 US Jurisdictions

Purpose

The HIV care continuum is used to monitor success in HIV diagnosis and treatment among persons living with HIV in the United States. Significant differences exist along the HIV care continuum between subpopulations of people living with HIV; however, differences that may exist between residents of rural and nonrural areas have not been reported.

Methods

We analyzed the Centers for Disease Control and Prevention's National HIV Surveillance System data on adults and adolescents (≥13 years) with HIV diagnosed in 28 jurisdictions with complete reporting of HIV‐related lab results. Lab data were used to assess linkage to care (≥1 CD4 or viral load test ≤3 months of diagnosis), retention in care (≥2 CD4 and/or viral load tests ≥3 months apart), and viral suppression (viral load <200 copies/mL) among persons living with HIV. Residence at diagnosis was grouped into rural (<50,000 population), urban (50,000‐499,999 population), and metropolitan (≥500,000 population) categories for statistical comparison. Prevalence ratios and 95% CI were calculated to assess significant differences in linkage, retention, and viral suppression.

Findings

Although greater linkage to care was found for rural residents (84.3%) compared to urban residents (83.3%) and metropolitan residents (81.9%), significantly lower levels of retention in care and viral suppression were found for residents of rural (46.2% and 50.0%, respectively) and urban (50.2% and 47.2%) areas compared to residents of metropolitan areas (54.5% and 50.8%).

Conclusions

Interventions are needed to increase retention in care and viral suppression among people with HIV in nonmetropolitan areas of the United States.     

Family Related Factors and Concurrent Heroin Use in Methadone Maintenance Treatment in China

Background: The use of heroin during Methadone Maintenance Treatment (MMT) is a challenging problem that contributes to poor treatment outcomes. Families may play an important role in addressing concurrent heroin use during MMT, especially in collectivist societies such as China. Objectives: In this study, we explored the relationship between family-related factors and concurrent heroin use during MMT in China. Methods: This study was conducted at 68 MMT clinics in five provinces of China. There were 2,446 MMT clients in the analysis. Demographic information, MMT dosage, family members' heroin use status, family support of MMT, family problem, and self-reported heroin use were collected in a cross-sectional survey. The most recent urinalysis of opiate use was obtained from clinical records. Results: Of the 2,446 participants, 533 (21.79%) self-reported heroin use in the previous seven days or had a positive urine morphine test result in the clinic record. Participants whose family member[s] used heroin were 1.59 times (95% CI: 1.17, 2.15) more likely to use concurrently during treatment. Those with family members who totally support them on the MMT were less likely to use (AOR: 0.75, 95% CI: 0.60, 0.94). Having more family problems was positively associated with concurrent heroin use (AOR: 2.01, 95% CI: 1.03, 3.93). Conclusions: The results highlight the importance of the family's role in concurrent heroin use during MMT programs. The study's findings may have implications for family-based interventions that address concurrent heroin use.     

Sexually Transmitted Diseases Among Pregnant Women: 5 States,United States, 2009–2011

Introduction Screening for specific sexually transmitted diseases (STDs) during pregnancy has been a longstanding public health recommendation. Prior studies have described associations between these infections and socioeconomic factors such as race/ethnicity and education. Objectives We evaluated the prevalence of STDs and the correlation socioeconomic factors have with the presence of these infections among pregnant women in the United States. Methods We conducted an analysis using self-reported data from 12,948 recently pregnant women from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 5 states during 2009–2011. Responses to questions about curable STDs (chlamydia, gonorrhea, syphilis, trichomoniasis) diagnosed during pregnancy were utilized to calculate weighted STD prevalence estimates and 95% confidence intervals (CI). A logistic regression was also conducted to identify maternal socioeconomic characteristics significantly associated with STDs; results are displayed as adjusted prevalence ratios (aPR). The PRAMS protocol was approved at PRAMS participating sites and by CDC’s Institutional Review Board. Results Overall, 3.3% (CI 2.9–3.7) reported?≥?1 curable STD during her most recent pregnancy. The adjusted STD prevalence was higher among women with younger age (aPR, 2.4; CI 1.8–3.4), non-Hispanic black race/ethnicity (aPR, 3.3; CI 2.4–4.1), unmarried status (aPR, 2.1; CI 1.4–3.0), no college education (aPR, 1.4; CI 1.0–1.9), annual income <?$25,000 (aPR, 2.0; CI 1.3–3.2), and no pre-pregnancy health insurance (aPR, 1.4; CI 1.1–1.8). Conclusions for Practice This is the largest study of prevalence of self-reported curable STDs among U.S. pregnant women. Differences in STD prevalence highlight the association between certain socioeconomic factors and the presence of STDs.     

Workshop report: Nucleic acid delivery devices for HIV vaccines: Workshop proceedings,National Institute of Allergy and Infectious Diseases,Bethesda, Maryland,USA, May 21, 2015

On May 21st, 2015, the U.S. National Institute of Allergy and Infectious Diseases (NIAID) convened a workshop on delivery devices for nucleic acid (NA) as vaccines in order to review the landscape of past and future technologies for administering NA (e.g., DNA, RNA, etc.) as antigen into target tissues of animal models and humans. Its focus was on current and future applications for preventing and treating human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) disease, among other infectious-disease priorities. Meeting participants presented the results and experience of representative clinical trials of NA vaccines using a variety of alternative delivery devices, as well as a broader group of methods studied in animal models and at bench top, to improve upon the performance and/or avoid the drawbacks of conventional needle-syringe (N–S) delivery. The subjects described and discussed included (1) delivery targeted into oral, cutaneous/intradermal, nasal, upper and lower respiratory, and intramuscular tissues; (2) devices and techniques for jet injection, solid, hollow, and dissolving microneedles, patches for topical passive diffusion or iontophoresis, electroporation, thermal microporation, nasal sprayers, aerosol upper-respiratory and pulmonary inhalation, stratum-corneum ablation by ultrasound, chemicals, and mechanical abrasion, and kinetic/ballistic delivery; (3) antigens, adjuvants, and carriers such as DNA, messenger RNA, synthesized plasmids, chemokines, wet and dry aerosols, and pollen-grain and microparticle vectors; and (4) the clinical experience and humoral, cellular, and cytokine immune responses observed for many of these target tissues, technologies, constructs, and carriers. This report summarizes the presentations and discussions from the workshop (https://web.archive.org/web/20160228112310/https://www.blsmeetings.net/NucleicAcidDeliveryDevices/), which was webcast live in its entirety and archived online (http://videocast.nih.gov/summary.asp?live=16059).