Objective To examine the prevalence of and risk factors for syphilis among men who have sex with men (MSM) in 16 cities/districts, 6 provinces in China. Methods Based on a previous survey on the entertainment place and population size of MSM, a cross-sectional study was conducted in 2007 using non-probability sampling method among MSM in 16 cities/districts in China.Information about the demography,risk behavior and syphilis infection was collected through questionnaires from MSM. Univariate and multivariate stepwise logistic regression model was constructed to evaluate independent factors associated with syphilis. Results A total of 4211 participants were recruited. The mean age of these participants was 28 years. Among them, 66.7% were self identified as homosexual, 72.5% were unmarried, and 76.4% had an education beyond senior middle school; in the past 6 months, 8.7% had sexual contact with more than 10 male sex partners, 5.6% had ever paid for male sex service, 11.3% had provided commercial sex service to males, and 18.9% had sexual contact with females, while condom was consistently used in only 36.3% of male-to-male anal sexual behavior. Syphilis was diagnosed in 10.6% of these participants. The risk factors independently associated with syphilis included being older than 25 years (adjusted OR = 1.7; 95% CI:1.3-2.0), local residency (adjusted OR = 1.3; 95% CI: 1.0-1.7), being recruited from a bar or a park (adjusted OR = 1.3; 95% CI: 1.1-1.7), having ever paid for a male sex service(adjusted OR = 1.5; 95% CI: 1.0-2.1),inconsistent condom use during male-to-male anal sexual behavior(adjusted OR = 1.2; 95% CI: 1.0-1.5 ), self reported sexually transmitted infection history (adjusted OR = 1.3; 95% CI: 1.0-1.7). Conclusions There is a high prevalence of syphilis in MSM in the 16 Chinese cities where male-to-male commercial sex service and unsafe sexual behavior are common. Further efforts are urgently needed to scale-up the prevention of and treatment program for syphilis among MSM, which should include syphilis and HIV screening as well as education on the use of condom.

Objective: To analyze first follow-up and CD₄⁺ T (CD₄) cell count test of newly reported students HIV cases in China from 2013 to 2017. Methods: Data were collected from both Case Reporting Cards and Follow-up Cards from China Information System for HIV/AIDS Control and Prevention between 1^st January 2013 and 31^st December 2017. The inclusion criteria are 15-24 years old students who were newly diagnosed with HIV infection. Logistic regression model was used to analyze relevant factors of the first CD₄ test results less than 200 CD₄ cells/μl. Results: There were 12 037 newly diagnosed students HIV cases from 2013 to 2017. Most cases were male (97.7%), 19-22 years old (65.1%) and Han ethnicity (90.5%). At the time of diagnosis, the route of HIV infection was most frequently homosexual contact (82.2%). The majority of cases (46.9%) were diagnosed at HIV voluntary counseling and testing (VCT) location. About 2 465 (20.6%) students had unprotected intercourse in the past 3 months, of which 1 387 (56.8%) had 1 sexual partner, 610 (25.0%) with 2 sexual partners, 273 (11.2%) with 3 partners and 170 (7.0%) with more than 4 partners. 11.0% and 28.9% of cases had initial CD₄ counts less than 200 cells/μl and 200-349 cells/μl. Compared to the male, younger than 18 years old and diagnosed at VCT location, female (OR=2.09, 95%CI: 1.51-2.89), aged 21 to 22 years (OR=1.25, 95%CI: 1.06-1.47), diagnosed in hospital settings (OR=2.20, 95%CI: 1.89-2.57) and preoperative testing (OR=1.36, 95%CI: 1.07-1.73) had greater proportion of the first CD₄ test result less than 200 CD₄ cells/μl. Conclusion The number of newly diagnosed students HIV cases significantly increased in past 5 years, and the proportion of late diagnosis was high. Female, aged 21 to 22 years, diagnosed in hospital settings and preoperative testing were related to the first CD₄ test result less than 200 CD₄ cells/μl.

Objective: To analyze timeline of antiretroviral therapy (ART) initiation among newly diagnosed HIV/AIDS from 2010 to 2014, as well as influencing factors. Methods: Data from the Chinese HIV/AIDS Comprehensive Response Information Management System was used to collect newly diagnosed HIV/AIDS cases from January 1, 2010 to December 31, 2014. Inclusion criteria of HIV/AIDS were confirmed cases and clinically diagnosed HIV positive, Chinese mainland cases, 14 years old and above, the first CD4⁺T lymphocyte ≤350 cells/μl in the follow up period. A total of 177 971 HIV/AIDS cases were included in this study. The general demographic characteristics (gender, age, ethnicity, education, occupation, etc.), infection routes, sample sources, CD4⁺T lymphocyte level and other information were collected from the database. Chi square test was used to analyze univariate factor of the timeliness of ART initiation. Multivariate logistic regressions were used to analyze potential factors associated with timeliness of ART initiation. Results: Out of the 17 7971 cases, 130 679 (73.4%) were males. The proportion of the timeliness of ART initiation was 55% (97 915). The proportion of timeline of ART within 15 d increased from 26.4% (4 319/16 388) in 2010 to 39.7% (20 212/50 889) in 2014. The highest proportion was in the group of patients infected by illegal blood (plasma) donation, which was 38% (945). The proportion of timeline of ART within 30 d increased from 43.2% (7 077/16 388) in 2010 to 63% (32 070/50 889) in 2014.The highest proportion was in the group of patients infected by heterosexual transmission, which was 58.3% (73 098). Multivariate logistic regression analysis on timeliness of ART showed that the factors of timeliness of ART initiation of HIV/AIDS as follow. The possibility of timeliness of ART among patients who were female, education of junior high school and above, ethnic group of Han, farmers, married were higher, with OR values at 1.08, 1.09, 1.13, 1.05 and 1.12. The possibilities of timeliness of ART in group of patients aging 25-34, 35-44, 45-54 and ≥55 years old were higher than that of the group of patients aging 15-24 years old, with OR values at 1.13, 1.31, 1.46 and 1.51, respectively. The possibilities of timeliness of ART among the homosexuals, injection drug use and sexual contact plus injection drug use cases were lower than that of the heterosexuals, with OR values at 0.86, 0.59 and 0.72, respectively. The possibilities of timeliness of ART among patients whose HIV diagnosis from hospitals and detention centers were lower than that of patients whose HIV diagnosis from volunteer testing and counseling, with OR values at separately 0.90 and 0.29. The possibilities of timeliness of ART among patients whose CD4⁺T lymphocyte at 50-99, 100-199, 200-350 cells/μl were lower than that of the patients whose CD4⁺T lymphocyte count at 0-49 cells/μl, with OR values at 0.84, 0.64 and 0.40, respectively. All the P values above was<0.05. Conclusion The proportion of timeliness of ART increased annually from 2010 to 2014. Those who were men, unmarried or divorced, at younger age, injection drug use, diagnosis from hospitals and detention centers and high CD4⁺T lymphocyte levels were related to the timeliness of ART.

Objective To discuss the angiographic manifestations of hemorrhage after pancreaticoduo-denectomy (PD), and to evaluate the clinical curative effect of interventional therapy. Methods The angiographic findings and the therapeutic effect of interventional therapy for hemorrhage after PD in 19 PD patients, who were admitted to Fujian Provincial Hospital, China, during the period from January 2014 to February 2018 to receive DSA examination and interventional therapy, were retrospectively analyzed. Results Among the 19 PD patients, DSA examination showed that extravasation of contrast medium, pseudoaneurysm formation and irregular arterial lumen were observed in 16 patients, the rate of positive signs was 84.2％ (16/19) . All the 16 patients, who had positive DSA findings, received covered-stent implantation or embolization therapy for the responsible artery, except one patient who had hemorrhage from the branch of superior mesenteric artery and the super-selective catheterization for him failed. The technical success rate was 93.8％ (15/16) . Successful hemostasis was achieved in 13 patients (86.7％, 13/15) . Two patients developed recurrent bleeding and were transferred to surgical treatment. Two patients received twice angiography, the resultsshowed that pseudoaneurysm formation of gastroduodenal artery was detected in one patient, which was treated with embolization therapy, and in another patient angiography was normal and this patient was transferred to surgical treatment. Conclusion For postoperative hemorrhage of PD, DSA has diagnostic value, while interventional therapy has therapeutic value. The techniques are minimally-invasive and highlyeffective. Therefore, it is worthy of clinical popularization and application.

Objective To analyze the changes of marital status and high-risk sexual behaviors in newly reported HIV infected men who have sex with men (MSM) and provide evidence for the targeted behavior intervention in this population and the prevention of secondary HIV infection.Methods Data collected from HIV/AIDS case reporting cards and follow-up cards between December 31st,2012 and December 3st,2013 were used and newly reported HIV infected MSM were recruited,their demographic characteristics,marital status,and high-risk sexual behaviors were analyzed.Results Of 15 768 newly reported HIV infected MSM in 2012,10 426 (66.1％) were unmarried and 10 970 (69.6％) had educational level of ≥senior high school.Among the 15 049 HIV infected MSM receiving follow up in 2012,14 451 (96.0％) still received follow up in 2013.The number HIV infected MSM who had protected sexual behaviors increased from 9 779 (67.7％) in 2012 to 13 277 (91.1％) in 2013.Among the HIV infected MSM who had married,64.1％ remained their marital status in 2013.Among the HIV infected MSM,those who had educational level of ≥senior high school (OR=1.540,95％ CI:1.138-2.085),workers (OR=1.430,95％ CI:1.131-1.808),staff (OR=1.610,95％CI:1.236-2.098) or farmers (OR=1.661,95％C1:1.214-2.271) were more likely to have protected sexual behaviors than those who had educational level of primary school or were engaged in commercial services.Those who had never married,(OR=0.563,95％CI:0.439-0.722),divorced (OR=0.624,95％CI:0.448-0.870) or re-married (OR=0.444,95％CI:0.288-0.687) were more likely to have high-risk sexual behaviors.Conclusion Standardized follow-up seemed helpful for the newly diagnosed HIV infected MSM to have protected sexual behaviors.Highly effective intervention should be focused on MSM who have no spouses or regular sexual partners,with low educational level,or are engaged in commercial services to prevent secondary HIV transmission.

Objective To analyze the effects of a follow-up program among newly diagnosed HIV/AIDS cases in 2010 in China.Methods Database was downloaded on January,2016 from both HIV/AIDS Case Reporting and Follow-up Cards.Information related to newly diagnosed HIV/AIDS cases in 2010 was extracted from the database.Information on follow-up intervention programs,CD4 testing,antiretroviral treatment,sexual behavior and mortality from 2010 to 2015 were analyzed.Results Of the newly diagnosed HIV/AIDS cases in 2010,70.4％ were men and 72.0％ with Han ethnicity.Heterosexual transmission accounted for 65.8％.The proportion of having received standardized follow-up increased significantly,with an annually upward trend (trend x2=3 749.77,P＜0.01).The proportions of sexual risk behaviors decreased significantly,with safe sexual behaviors over 90％,and having yearly upward trend (trend x2=16 971.98,P＜0.01).Among those eligible for antiretroviral therapy,the proportion of initiation the therapy increased from 56.5％ in 2010 to 83.2％ in 2015,with significant upward trend,annually (trend x2=2 504.86,P＜0.01).Over the same period,the proportion of deaths decreased from 12.4％ in 2010 to 2.4％ in 2015,with significant annual downward trend (trend x2=4 935.89,P＜0.01).Conclusion The standardized follow-up intervention program included the contents of:CD4 testing;counseling and timely referrals to receive antiretroviral therapy etc.,which were correlated to the reduction on both high risk sexual behaviors and deaths.

Objective To analyze the factors associated with divorce or separation when one of the spouse diagnosed and newly reported as HIV positive,in China.Methods Data from the Chinese HIV/AIDS Comprehensive Response Information Management System,by December 31,2015 were used for collection on newly reported HIV cases regarding their baseline information in 2014 and follow-up within one year,among couples and above 18 year olds.HIV cases were divided into divorce/separation group and married group according to their marriage dynamics in one year after being diagnosed as HIV positive.Multivariate logistic regressions were used to analyze potential factors associated with divorce or separation after the diagnoses made.Results A total of 31 708 HIV cases were included in this study.22.5％ (7 134/31 708) of them got divorced or separated in one year after diagnose being made.81.6％ (25 864/31 708) of them had couples tested in one year after diagnose made and 10.0％ (2 599/25 864) of them got divorced or separated.Among 18.4％ (5 844/31 708) of the HIV cases who did not have their couples tested in one year after the diagnoses,77.6％ (4 535/ 5 844) got divorced or separated.For those who did not have their couples tested in one year after the diagnose.Data from the multivariate logistic regression analysis showed that factors as those who were older than 45 (46-60 yr.:OR=1.28,95％CI:1.03-1.58;≥61 yr.:OR=1.83,95％CI:1.41-2.37),with Han ethnicity (OR=1.56,95％CI:1.34-1.83),with high school education or above (OR=1.55,95％CI:1.27-1.90),non-farmers or non-rural laborers (OR=1.34,95％CI:1.17-1.54),infected through injecting drug use (OR=1.33,95％CI:1.03-1.71),men who had sex with men (OR=1.49,95％CI:1.20-1.86),or with childless (OR=2.35,95％CI:1.78-3.09) etc.were more likely to be divorced or separated after the diagnoses being made,among those who had their couples tested in one year after the diagnoses.Results from the multivariate logistic regression analysis showed that factors as those who were above 60 year olds (OR=1.32,95％CI:1.12-1.56),with Han ethnicity (OR=1.27,95％CI:1.13-1.44),with high school education or above (OR=1.26,95％ CI:1.11-1.43),non-farmers or non-rural labors (OR=1.37,95％CI:1.25-1.51),infected through having sex with men (OR=1.38,95％ CI:1.25-1.54),or without a child (OR=1.48,95％ CI:1.27-1.71),were more likely to be divorced or separated after the diagnoses.Conclusion A certain proportion of HIV cases got divorced or separated in one year after the diagnosis was made.The proportions of divorce or separation were different among populations.Interventions targeting reducing divorce or separation in certain populations should be integrated into routine care system to reduce the HIV transmission.

Objective To analyze the survival time of newly diagnosed HIV/AIDS cases and related factors in China in 2010.Methods The reporting cards and follow-up cards of HIV/AIDS cases reported as of 31 December 2015 were collected from national AIDS information system.The newly diagnosed HIV/AIDS cases in 2010 were selected.The information of follow-up intervention,CD4+ T cells (CD4) testing,antiretroviral treatment and mortality of the cases from 2010 to 2015 were analyzed.Life table method was applied to calculate the survival probability.Kaplan-Meier was used to draw survival curve and Cox proportion hazard regression model were used to identify the factors related to survival time.Results Of the 40 335 HIV/AIDS cases,11 975(29.7％) died of AIDS related diseases.The median survival time was 63.1 months (95％CI:63.0-63.2),and the survival rates in 1 year and 5 years were 81.2％ and 69.9％.Multivariate Cox regression analysis showed that the risk factors for death in the HIV/AIDS cases were age (25-34 years old vs.15-24 years old:HR=1.41,95％CI:1.29-1.54;35-34 years old vs.15-24 years old:HR=1.90,95％CI:1.74-2.07;45-54 years old vs.15-24 years old:HR=2.24,95％CI:2.04-2.46;≥55 years old vs.15-24 years old:HR=2.81,95％CI:2.57-3.08).The protective factors for death in the HIV/AIDS cases were level of baseline CD4 counts (CD4 ≥ 500 cells/μ1 vs.CD4 ＜ 200 cells/μl:HR =0.12,95 ％ CI:0.11-0.13),receiving antiretroviral therapy (ART vs.no ART:HR=0.11,95％CI:0.10-0.12).Conclusion Survival time of HIV/AIDS cases might be influenced by age,baseline CD4 count and access to antiretroviral therapy.The early diagnosed and early antiretroviral therapy could extend the survival time of HIV/AIDS cases.

Objective To analyze the status of marriage and HIV transmission between couples in newly reported HIV cases before diagnoses were made,among men who have sex with men (MSM) in China.Methods Baseline and follow-up information related to newly reported cases in 2014 were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System.Infected MSM who were older than 22 years of age were included in this study.HIV cases were divided into sero-concordant or sero-discordant group,according to the HIV status of the couple who were tested 180 days post-diagnosis.Multivariate logistic regression method was used to analyze the potential factors associated with HIV transmission between couples before diagnosis was made.Results A total of 5 081 (22.7％) of the HIV infected MSM who had couples,were included in this study.A total of 3 715 cases had their couples tested 180 days after the diagnosis was made.7.6％ (282) had positive couples.Results from the multivariate logistic regression analysis showed that factors as:older than 60 (OR=2.64,95％CI:1.50-4.65) years of age,being minorities (OR=1.93,95％CI:1.13-3.29),having CD4+T cells less than 500 cells/μl (＜200:OR=2.91,95％CI:1.82-4.65;200-349:OR=1.98,95％CI:1.22-3.23;350-500:OR=1.69,95％CI:1.00-2.86),with self-reported unsafe behaviors (OR=1.92,95％CI:1.44-2.58) etc.,were more likely to transmit HIV to their couples before the diagnosis was made.Conclusion Behavior interventions and early HIV testing should be promoted,especially among those MSM who had couples,to avoid inter-spousal transmission.

Objective This article endeavors to describe the key indicators of follow-up services for people living with HIV/AIDS (PLWHA) in China from 2008 to 2014.Methods All data were extracted from the National Comprehensive HIV/AIDS database and cleaned,based on three key indicators (proportion of follow-up of PLWHA,CD4 testing of PLWHA and HIV antibody testing of PLWHA' s spouse or partner) defined and developed by the National Center for AIDS/STD Control and Prevention for case management.Both key indicators were analyzed and comparisons were performed annually from 2008 through 2014.Results The proportion of follow-up of PLWHA increased from 55.7％ to 94.7％ and the proportion ofPLWHA's CD4 testing increased from 48.4％ to 88.3％.The proportion of HIV antibody testing among PLWHA' s spouse or partner increased from 48.3％ to 91.1％,during this period.The three indicators showed an yearly significant increase (intervention:x2 =180 466.733,P＜ 0.01;CD4:x2 =35 982.374,P＜ 0.01;partner testing:x2 =43108.270,P＜0.01).PLWHA with a history of injecting drug use (IDU),incarceration,as well as unknown infection route appeared significant lower proportion through the follow-up services.Conclusion Both follow-up services and the chosen key indicators set for PLWHA showed dramatic improvement but called for further reinforcement.Information that had been collected from cases when initial diagnosis was made,appeared vital during the follow-up services.