1.Evolution and perfection of the HIV/AIDS designated hospital system in China
Peng XU ; Wanying CHEN ; Lahong JU ; Liping MA ; Fan LU
Chinese Journal of Health Policy 2015;(5):67-72
Objective:To summarize the development of the HIV/AIDS designated hospital system, analyze the main issues and explore solutions for this system. Methods:184 leaders/experts of three levels of healthcare facilities ( provinces, cities and counties) from 30 provinces engaged in AIDS prevention and control for over five years, and 2,432 people living with HIV/AIDS(PLWHA) from seven provinces were investigated through two different question-naires. Results:According to the staff responses, the issues of surgery and hospitalization are difficult and outstand-ing for PLWHA due to the current designated hospital system with scores of 6. 49 in severity. Of the ten largest prob-lems, ranked third is the need for improved AIDS prevention and control. 2 367 (97. 3%) PLWHAs had an aware-ness of the designated hospitals, 1,376 received treatment in the designated hospitals, and 85. 5% believed that the illness was effectively treated, while 9. 0% thought that the medical technology of the designated hospital was limited;18 . 7% of hospitalized HIV/AIDS patients or those who received surgery experienced prevarication by the non-des-ignated hospitals. Policy analysis shows that China’s designated hospital system for PLWHA has developed gradually with the characteristics of periodic and temporary changes. Conclusion:The designated hospital system for PLWHA in China has played an important role, but there are still several problems. The government should improve the existing system by strengthening the comprehensive medical service capacity of designated hospitals, improving the mechanism of consultation and referrals, coordinating the non-designated hospitals to provide technical support, reducing dis-crimination and fear from medical staff against HIV/AIDS, decreasing the risk of occupational exposure, and enhan-cing the communication among hospitals, CDCs and patients.
2.Main issues, causes and strategies for AIDS prevention and control in health care systems
Peng XU ; Dapeng ZHANG ; Fuchang MA ; Liping MA ; Lahong JU ; Wanying CHEN ; Lin HAN ; Fan LV
Chinese Journal of Health Policy 2014;(10):68-72
Objective:To summarize the main issues, analyze the causes and offer a strategy for AIDS preven-tion and control for all types of healthcare facilities in the health care system. Methods:184 leaders and experts of tertiary-level healthcare facilities ( provinces, cities and counties) from 30 provinces who had been engaged in AIDS prevention and control for more than five years were studied through a questionnaire including the issues and causes in AIDS prevention and control. Results: According to the results of the respondents and experts’ demonstration, the main issues were identified, including a lack of human resources in the system of disease control facilities, a lack of relevant agencies involved in AIDS response, the difficulty for AIDS patients to receive surgery and follow-up, poor detection of HIV, shortcomings in medical insurance, and so on. Conclusion: Based on the analysis of issues and causes, the paper offers strategic solutions: Clearly define the responsibilities of various health institutions in AIDS prevention and control;promote the participation of primary health institutions in AIDS prevention and control; im-prove the medical service system for AIDS patients;improve AIDS medical security policies;reform the management system of antiretroviral therapy drugs;and strengthen technical support from disease control facilities.
3.Prevalence and influencing factors on food allergy among children aged 0-5 years in China
Lahong JU ; Liyun ZHAO ; Xiaoqi WEI ; Hongyun FANG ; Jiaxi LI ; Xingxing WU ; Xiaoli XU ; Shuya CAI ; Weiyi GONG ; Dongmei YU
Chinese Journal of Epidemiology 2024;45(6):817-823
Objective:To describe the prevalence of food allergy among children aged 0-5 years in China and to explore related influencing factors.Methods:Multistage stratified random sampling method was used to collect data from 275 surveillance sites of the China National Nutrition and Health Survey of Chinese children and lactating mothers programs in 31 provinces (autonomous regions and municipalities) of China in 2016-2017. A total of 70 107 participants aged 0-5 years were included in this study. The study collected information of participants' demographic characteristics and food allergies by face-to-face questionnaire. The prevalence of food allergy was analyzed, using the complex data weighting method. The logistic regression models were used to analyze the influencing factors related to food allergy.Results:The overall prevalence of self-reported food allergy among children aged 0-5 years was 4.81%. Prevalence rates in infants aged 0-5 months, and 6-23 months and preschool children aged 2-5 years were 0.81%, 4.68% and 5.26%, respectively. The results of logistic analysis showed that there was a significantly positive correlation between factors including children from 6 months to 5 years old, urban area, southwest area, first-born, mothers with college education or above, and the prevalence of food allergy in children. Shrimp, poultry eggs, crab shellfish, fruit, milk and fish appeared the common allergic foods in children aged 0-5 years, with prevalence rates of self-reported food allergy as 1.55%, 1.25%, 0.99%, 0.97%, 0.87% and 0.86%, respectively. The proportion of single food allergy in children with allergies was 69.85%.Conclusions:Among children aged 0-5 years, the prevalence of self-reported food allergy increases with age, in China. Foods that is prone to allergies include fish, shrimp, crab, shellfish, poultry eggs, milk and fruits, etc. Most allergies were only caused by single food in children, under observation.
4.Features and influencing factors of self-discrimination among HIV/AIDS patients according to sex
Lahong JU ; Fan LYU ; Peng XU ; Wanying CHEN ; Huijing HE ; Liping MA
Chinese Journal of Preventive Medicine 2016;50(10):863-868
Objective To investigate the features and influencing factors of self-discrimination among patients with HIV/AIDS according to sex. Methods A total of 2 432 HIV/AIDS patients were recruited in Yunnan, Henan, Hubei, Jiangsu, Shanxi, Jilin, and Inner Mongolia provinces by a multistage stratified cluster sampling method, based on HIV epidemic and transmission modes, from May 2013 to October 2013. All participants were ≥18 years old, and we excluded those with mental disorders, hearing loss or other factors that prevented them from properly answering questions, and those who were unwilling to participate. A self-designed questionnaire was conducted to collect information about self-discrimination features and social behavior changes among HIV/AIDS patients. Differences in performance and self-discrimination features between participants of different sexes were compared using the chi-squared test. Factors influencing self-discrimination were analyzed by sex, using unconditional logistic regression. Results Of the 2 432 cases, 78.9%(1 918 cases) were male and 21.1%(514 cases) female. The proportion of self-discrimination overall was 76.1%(1 850 cases);this proportion among female HIV/AIDS patients was 80.5%(414 cases), which was higher than that among men (74.9%, 1 436 cases) (χ2=7.17, P=0.007). Of the 11 forms of self-discrimination performance, proportions of feeling guilt, shame, and self-abasement among participants were greater than 50%. Proportions of feeling shame, inferiority, and blaming others among females were 61.3%, 59.5%, and 45.3%, respectively, which were higher than these among males (49.8%, 50.0%, 28.4%, respectively) (P<0.01). Multivariate unconditional logistic regression analysis showed that the risk of self-discrimination among those with HIV confirmatory testing time≥1 year was higher than those with HIV confirmatory testing time<1 year (females:OR=35.67, 95%CI:17.28-73.64;males:OR=8.74, 95%CI:6.79-11.25). Compared with other occupations, the risk of self-discrimination among male farm workers was higher (OR=1.62, 95%CI:1.03-2.54). The risks of self-discrimination in males who had been infected with HIV by transmission routes of blood transfusion or blood collection (OR=2.38, 95%CI:1.31-4.30), injection drug use (OR=1.78, 95%CI:1.09-2.91), and male-to-male sexual behavior (OR=1.48, 95%CI:1.08-2.03) were higher than in males infected via heterosexual behavior. Conclusion Female HIV/AIDS patients are more likely to engage in self-discrimination than male patients. Self-discrimination mainly takes the form of feeling remorse, shame, and inferiority. Confirmatory testing time≥1 year, occupation as a farm work, and routes of transmission via blood transfusion or collection, injection drug use, and male-to-male sexual behavior are influencing factors of self-discrimination among male HIV/AIDS patients. Confirmatory testing time ≥1 year is the influencing factor of self-discrimination among female HIV/AIDS patients.
5.Features and influencing factors of self-discrimination among HIV/AIDS patients according to sex
Lahong JU ; Fan LYU ; Peng XU ; Wanying CHEN ; Huijing HE ; Liping MA
Chinese Journal of Preventive Medicine 2016;50(10):863-868
Objective To investigate the features and influencing factors of self-discrimination among patients with HIV/AIDS according to sex. Methods A total of 2 432 HIV/AIDS patients were recruited in Yunnan, Henan, Hubei, Jiangsu, Shanxi, Jilin, and Inner Mongolia provinces by a multistage stratified cluster sampling method, based on HIV epidemic and transmission modes, from May 2013 to October 2013. All participants were ≥18 years old, and we excluded those with mental disorders, hearing loss or other factors that prevented them from properly answering questions, and those who were unwilling to participate. A self-designed questionnaire was conducted to collect information about self-discrimination features and social behavior changes among HIV/AIDS patients. Differences in performance and self-discrimination features between participants of different sexes were compared using the chi-squared test. Factors influencing self-discrimination were analyzed by sex, using unconditional logistic regression. Results Of the 2 432 cases, 78.9%(1 918 cases) were male and 21.1%(514 cases) female. The proportion of self-discrimination overall was 76.1%(1 850 cases);this proportion among female HIV/AIDS patients was 80.5%(414 cases), which was higher than that among men (74.9%, 1 436 cases) (χ2=7.17, P=0.007). Of the 11 forms of self-discrimination performance, proportions of feeling guilt, shame, and self-abasement among participants were greater than 50%. Proportions of feeling shame, inferiority, and blaming others among females were 61.3%, 59.5%, and 45.3%, respectively, which were higher than these among males (49.8%, 50.0%, 28.4%, respectively) (P<0.01). Multivariate unconditional logistic regression analysis showed that the risk of self-discrimination among those with HIV confirmatory testing time≥1 year was higher than those with HIV confirmatory testing time<1 year (females:OR=35.67, 95%CI:17.28-73.64;males:OR=8.74, 95%CI:6.79-11.25). Compared with other occupations, the risk of self-discrimination among male farm workers was higher (OR=1.62, 95%CI:1.03-2.54). The risks of self-discrimination in males who had been infected with HIV by transmission routes of blood transfusion or blood collection (OR=2.38, 95%CI:1.31-4.30), injection drug use (OR=1.78, 95%CI:1.09-2.91), and male-to-male sexual behavior (OR=1.48, 95%CI:1.08-2.03) were higher than in males infected via heterosexual behavior. Conclusion Female HIV/AIDS patients are more likely to engage in self-discrimination than male patients. Self-discrimination mainly takes the form of feeling remorse, shame, and inferiority. Confirmatory testing time≥1 year, occupation as a farm work, and routes of transmission via blood transfusion or collection, injection drug use, and male-to-male sexual behavior are influencing factors of self-discrimination among male HIV/AIDS patients. Confirmatory testing time ≥1 year is the influencing factor of self-discrimination among female HIV/AIDS patients.
6.Quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in ;Zhoukou of Henan province
Liping MA ; Peng XU ; Dingyong SUN ; Ning LI ; Wenjie YANG ; Lin ZHANG ; Yujie BAI ; Lahong JU ; Huijing HE ; Wanying CHEN ; Fan LYU
Chinese Journal of Preventive Medicine 2016;50(4):339-345
Objective To investigate the quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in Zhoukou city of Henan province.Methods During January to May in 2015, by the convenience sample, World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL?BREF) (Chinese version) and a self?edited questionnaire were used to investigate 1 251 HIV/AIDS patients who were confirmed with HIV positive by local CDC, registered in“HIV serodiscordant family”and agreed to participate in a face?to?face interview with above 18 year?old based on the local CDC , township hospitals and village clinics of 9 counties and 1 district of Zhoukou city, excluding the HIV/AIDS patients who were in divorce, death by one side, unknowing about his HIV status, with mental illness and disturbance of consciousness, incorrectly understanding the content of the questionnaire, and reluctant to participate in this study. The scores of quality of life of physical, psychological, social relations, and environmental domain were calculated. The related factors of the scores of different domains were analyzed by Multiple Two Classification Unconditioned Logistic Regression. Results The scores of investigation objects in the physical, psychological, social relations, and environmental domain were 12.00± 2.02, 12.07 ± 2.07, 11.87 ± 1.99, and 11.09 ± 1.84, respectively. The multiple Unconditioned Logistic Regression analysis indicated that age <40 years, on ART and no other sickness in last two weeks were beneficial factors associated with physical domain with OR (95%CI): 0.61 (0.35-1.06), 0.52 (0.30-0.90), and 1.66 (1.09-2.52), respectively. The possibility of no poverty and no other sickness in last two weeks increased to 0.15(0.09-0.26) and 1.57(1.06-2.33) times of those who was in poverty and with other sickness in last two weeks in physical domain. The possibility of participants who were below 40 years old and with children increased to 0.58 (0.34-0.98) and 0.37 (0.23-0.57) times of who were above 40 years old and without children in psychological domain. The factors of with AIDS related symptoms, no children and with other sickness in last two week were found to be significantly associated with environmental domain with OR (95%CI):0.65 (0.48-0.88), 0.66 (0.51-0.85), and 0.65 (0.51-0.84), respectively . Conclusion The scores of every domain of quality of life in HIV serodiscordant couples of Zhoukou city were good. Age, whether having AIDS related symptoms, whether to accept ART , children, status of poverty, and whether suffering from other diseases in last two weeks were the main factors associated with the quality of life .
7.Quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in ;Zhoukou of Henan province
Liping MA ; Peng XU ; Dingyong SUN ; Ning LI ; Wenjie YANG ; Lin ZHANG ; Yujie BAI ; Lahong JU ; Huijing HE ; Wanying CHEN ; Fan LYU
Chinese Journal of Preventive Medicine 2016;50(4):339-345
Objective To investigate the quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in Zhoukou city of Henan province.Methods During January to May in 2015, by the convenience sample, World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL?BREF) (Chinese version) and a self?edited questionnaire were used to investigate 1 251 HIV/AIDS patients who were confirmed with HIV positive by local CDC, registered in“HIV serodiscordant family”and agreed to participate in a face?to?face interview with above 18 year?old based on the local CDC , township hospitals and village clinics of 9 counties and 1 district of Zhoukou city, excluding the HIV/AIDS patients who were in divorce, death by one side, unknowing about his HIV status, with mental illness and disturbance of consciousness, incorrectly understanding the content of the questionnaire, and reluctant to participate in this study. The scores of quality of life of physical, psychological, social relations, and environmental domain were calculated. The related factors of the scores of different domains were analyzed by Multiple Two Classification Unconditioned Logistic Regression. Results The scores of investigation objects in the physical, psychological, social relations, and environmental domain were 12.00± 2.02, 12.07 ± 2.07, 11.87 ± 1.99, and 11.09 ± 1.84, respectively. The multiple Unconditioned Logistic Regression analysis indicated that age <40 years, on ART and no other sickness in last two weeks were beneficial factors associated with physical domain with OR (95%CI): 0.61 (0.35-1.06), 0.52 (0.30-0.90), and 1.66 (1.09-2.52), respectively. The possibility of no poverty and no other sickness in last two weeks increased to 0.15(0.09-0.26) and 1.57(1.06-2.33) times of those who was in poverty and with other sickness in last two weeks in physical domain. The possibility of participants who were below 40 years old and with children increased to 0.58 (0.34-0.98) and 0.37 (0.23-0.57) times of who were above 40 years old and without children in psychological domain. The factors of with AIDS related symptoms, no children and with other sickness in last two week were found to be significantly associated with environmental domain with OR (95%CI):0.65 (0.48-0.88), 0.66 (0.51-0.85), and 0.65 (0.51-0.84), respectively . Conclusion The scores of every domain of quality of life in HIV serodiscordant couples of Zhoukou city were good. Age, whether having AIDS related symptoms, whether to accept ART , children, status of poverty, and whether suffering from other diseases in last two weeks were the main factors associated with the quality of life .