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.

Adolescents and young adults are getting to becoming full-fledged adults, along with the maturity of physical bodies, the mentality is going to be matured. Adolescents and young adults are prone to unsafe sexual conducts which may lead to higher risks of HIV. The number of HIV newly reported cases has been increasing in adolescents and young adults and has attracted attention by people from all walks of life. This paper reviews the current status of HIV infection, routes of transmission, ways of case-finding and risk factors related to the susceptibility of HIV etc.,aiming to provide evidence for reducing the risk of HIV infection in adolescents and young adults.

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.

Objective:To understand death's mortality and risk factors among HIV-positive injecting drug users (IDU) aged 15 or above in China and provide further reference to future prevention and treatment policies.Method:Retrospective cohort study was conducted to calculate the mortality rate of HIV-positive IDU based on HIV/AIDS Comprehensive Response Information Management System. Cox proportion hazards regression model was performed to assess the risk factors for deaths. The Excel 2019 and SPSS 22.0 software was used for data cleaning and statistical analysis.Results:Between 2001 and 2020, 119 209 HIV-positive IDU were reported with 59 094 deaths. The all-cause mortality rate was 6.96 per 100 person-years (py), and the AIDS-related mortality rate was 1.91 per 100 py, with a decreasing trend over the years. Multivariate Cox regression indicated for all-cause death risks of HIV-positive IDU, compared with those baseline T + lymphocyte cells (CD4) counts above 500 cells/μl, the HR (95% CI) of those CD4 counts untested, between 0-199, 200-349, 350-500 cells/μl was 2.85 (2.78-2.93), 2.47 (2.40-2.54), 1.58 (1.53-1.62) and 1.24 (1.21-1.28) respectively. The HR (95% CI) of antiretroviral treatment (ART) na?ve was 7.13 (6.99-7.27) compared with those under ART. The HR (95% CI) of methadone maintenance treatment (MMT) na?ve was 1.07 (1.04-1.10) compared to those receiving MMT. As for AIDS-related death risks, compared with baseline T+ lymphocyte cell CD4 counts >500 cells/μl, the HR (95% CI) of those CD4 counts untested, between 0-199, 200-349, 350-500 cells/μl was 3.26 (3.08-3.46), 5.54 (5.24-5.85), 2.35 (2.21-2.50) and 1.41 (1.32-1.50). HR (95% CI) of ART na?ve was 5.96(5.74-6.18) compared to those under ART. Conclusions:Further efforts should be made timely on diagnosis, treatment, and harm reduction programs such as MMT for improvement compliance to reduce mortality risks of HIV-positive IDU.

Objective:To analyze characteristics of mortality density and the influencing factors of HIV/AIDS after diagnosis in Jiamusi of Heilongjiang province.Methods:The data were retrieved from HIV/AIDS Comprehensive Response Information System and selected cases diagnosed with HIV/AIDS in Jiamusi of Heilongjiang province during 2010-2020 and aged 15 years or older as the study objects. The method of retrospective cohort study was used to collect baseline and follow-up information, and characteristics of mortality density after HIV diagnosis were described. Death after HIV diagnosis was divided into 1-6 months, 7-12 months, and ≥13 months after HIV diagnosis. The Cox proportional hazards model was used to analyze the associated factors of mortality density within six months after HIV diagnosis. Excel 2019 and SPSS 22.0 software were used for data processing and statistical analysis.Results:A total of 953 HIV/AIDS with 173 deaths were included during the study period. Most HIV/AIDS were men (89.19%, 850/953), single or divorced or widowed (76.50%, 729/953), educated in middle school and lower level (51.84%, 494/953), and men who have sex with men (77.02%, 734/953). There was a cumulative follow-up of 3 944.59 person-years, with an overall mortality density of 4.39 (95% CI: 3.79-5.07)/100 person- years. The mortality density was highest in 21.60 (95% CI: 18.04-25.86) 100 person-years within the first six months after diagnosis, then decreased to 2.02 (95% CI: 1.59-2.58)/100 person-years over 13 months or more after HIV diagnosis. HIV/AIDS who died within the first six months after diagnosis had a higher proportion of first CD4 +T lymphocytes (CD4) counts untested (51.61%, 48/93) and AIDS-related deaths (32.26%, 30/93). In the multivariate analysis of the Cox proportional hazards regression model, mortality density within the first six months after HIV diagnosis was greater among HIV/AIDS who were older at diagnosis, detected by medical institutions, with lower first CD4 counts or no testing, and never receiving antiretroviral therapy (ART). Conclusions:Mortality density was generally low in Jiamusi of Heilongjiang province during 2010-2020 and declined over the follow-up time. However, early diagnosis and immediate ART initiation should be strengthened. Attention should also be paid to follow-up care management and referral services for HIV/AIDS within the first six months after HIV diagnosis to reduce the risk of death after HIV diagnosis.

In 2012, the World Health Organization (WHO) released tenofovir/emtricitabine (TDF/FTC) as pre-exposure prophylaxis drug to help people at risk of HIV infection in specific populations, and various clinical trials and real-world data have confirmed the effectiveness of TDF/FTC in preventing HIV infection. In 2019, propofol tenofovir combined with emtricitabine (TAF/FTC) was approved in the United States as the second oral drug for pre-exposure prophylaxis(PrEP). However, for people who cannot take the drug or have poor adherence to the drug, second-generation PrEP, or long-acting antiretrovirals, provide more options. This artical reviewed the research progress of the first generation of oral PrEP and the new PrEP developed in recent years to provide reference for the promotion of HIV PrEP in China.

Objective:To understand the willingness of pre-exposure prophylaxis (PrEP) use to prevent HIV infection and related factors in men who have sex with men (MSM) in Yunnan Province.Methods:Cross-sectional study method and snowball sampling method was used to carry out the survey in 14 cities (autonomous prefectures) in Yunnan from April to June 2021. According to national sentinel surveillance program, the sample size was 400 at national sentinel sites and 100 at provincial sentinel sites. The related factors of PrEP use willingness were analyzed by multiple logistic regressions with software SPSS 22.0.Results:A total of 2 450 questionnaires were completed, the rate of having heard of PrEP was 68.5% (1 677/2 449), the willingness rate of PrEP use was 56.7% (1 343/2 368), the willing rate of PrEP use at their own expense was 30.6% (724/2 368), and the willingness rate of free PrEP use was 56.2% (1 330/2 367). The of multivariate logistic analysis results showed that related factors of low willingness to use PrEP included aged 40-49 years and 50 years or above (a OR=2.49 and a OR=4.48), Han ethnic group (a OR=1.47), residence in other provinces (a OR=1.64), education level of senior high school (a OR=1.96) and college or above (a OR=3.49), sample source of bath house (a OR=3.53), online recruiting (a OR=2.53) and voluntary counseling and testing (a OR=1.42), local living time for 3-6 months and 7-12 months (a OR=0.18 and a OR=0.25) ,class 2 and 3 of survey areas (a OR=3.63 and a OR=1.71), having no anal sex with men in the past week (a OR=2.60), having no commercial homosexual behavior in the past six months (a OR=13.32) and self-perceived higer risk for HIV infection (a OR=0.50). Conclusions:There was more than half of MSM with willingness to use PrEP. The health education to promote PrEP use should be strengthen in MSM who had low willingness to use PrEP from underdeveloped areas, in Han ethnic group, with older age, from other provinces, with shorter local living time and self-perceived low risk for HIV infection.

Objective:To understand the current status of monkeypox knowledge and related factors among men who have sex with men (MSM) in China.Methods:The survey was conducted in 30 provinces from September 5 to 10, 2022. With the assistance of social organizations of MSM, MSM respondents were recruited one-to-one by investigators through a convenient sampling method. Respondents log in to the questionnaire star to participate in the anonymous online survey. The sample size was estimated at 5 070 based on China's population infectious disease prevention literacy level of 25%. The self-administered online questionnaire collected information on sociodemographic, behavioral, HIV infection status, attention to monkeypox, and knowledge of monkeypox. The logistic regression model was used to analyze the factors associated with knowledge awareness of monkeypox.Results:Among 5 780 MSM subjects, the awareness rate of monkeypox knowledge was 31.8% (1 840/5 780). The results of multivariate logistic regression analysis showed that the related factors with higher awareness rate of monkeypox knowledge in MSM included the current address was in the eastern region ( OR=1.26, 95% CI: 1.01-1.56), college education level or above ( OR=1.50, 95% CI:1.14-1.97), the number of anal-sex partners in the last month was ≥3 ( OR=1.71, 95% CI: 1.28-2.28) or 2 ( OR=1.36, 95% CI:1.07-1.73), and there was no homosexual group sex in the last month ( OR=1.20, 95% CI:1.01-1.43), they had no heterosexual behavior ( OR=1.28, 95% CI:1.02-1.62), were HIV negative ( OR=1.85, 95% CI:1.44-2.36) or HIV positive ( OR=1.65, 95% CI:1.27-2.16), and paid frequent attention to monkeypox information ( OR=7.08, 95% CI: 5.28-9.48), occasional attention ( OR=4.52, 95% CI: 3.49-5.86) or minimal attention ( OR=2.55, 95% CI: 1.93-3.37). Conclusions:MSM has some attention and understanding of monkeypox in China, but the awareness rate of monkeypox knowledge is not high. It is necessary to strengthen the awareness of monkeypox knowledge among the MSM population with junior middle school education or below, who ignore the epidemic of monkeypox, have not been tested for HIV, and have had homosexual group sex or heterosexual sex to promote monkeypox prevention and self monitoring among MSM.