As human life expectancy increases, the population aging crisis is spreading worldwide. Sexual health is integral to the overall health of older adults. The 50-60-year-old age group is in a transitional phase of physiological changes (e.g., women going through menopause) and social changes (e.g., changes in work status and social identity). Individuals aged 60 years and above still have sexual desires. However, there is relatively little research on sexual health in this age group. In this context, this paper delves into topics related to sexual health among those aged 50 years and above, aiming to understand the evolution and influencing factors of sexual health in this population during various stages of aging. This information can be used to formulate relevant policies and promote the overall health of this population.

Objective To understand the willingness to receive human papillomawrus (HPV) vaccination of men who have sex with men (MSM) and the male clients of sexually transmitted disease (STD) clinics and related factors in China.Methods MSM were enrolled from the community through snowball sampling and male clients of STD clinics were enrolled from a sexual health clinic through convenience sampling in Wuxi,China.A questionnaire survey on the subjects' socio-demographic characteristics and the awareness of HPV was conducted.Results A total of 186 MSM and 182 STD clients were recruited.The awareness rates of HPV were 18.4％ and 23.1％,respectively and the awareness rates of HPV vaccination were 10.2％ and 15.4％,respectively.STD clinic clients (70.9％) were more likely to receive HPV vaccination than MSM (34.9％) (x2=47.651,P＜0.01).Only 26.2％ of MSM and 20.2％ of STD clinic clients were willing to receive free HPV vaccination before the age of 20 years.Multivariate logistic regression analysis showed that MSM who had passive anal sex (OR=2.831,95％ CI:1.703-13.526),MSM who never used condom in anal sex in the past 6 months (OR=3.435,95％CI:1.416-20.108),MSM who had been diagnosed with STDs (OR=1.968,95％CI:1.201-8.312) and STD clinic clients who had commercial sex with females in the past 3 months (OR=1.748,95％ CI:1.207-8.539),STD clinic clients who never used condom in commercial sex in the past 3 months (OR=1.926,95％CI:1.343-5.819) and STD clinic clients who had been diagnosed with STDs in past 12 months (OR=2.017,95％CI:1.671-7.264) were more likely to receive free HPV vaccination.Conclusion Sexually active MSM and male clients in STD clinics in China had lower awareness of the HPV related knowledge.Their willing to receive HPV vaccination were influenced by their behavior related factors.It is necessary to strengthen the health education about HPV and improve people's awareness of HPV vaccination.

Objective:This study aimed to discover the HIV infection and associated factors among male sex workers (MSW) who provide sexual services for men. Data from this study thus can be used to provide evidence for designing related intervention programs.Methods:In this observational study, MSW were recruited from May to July, 2019 in KTV venues in Wuxi, China. A questionnaire was used to collect information with blood sample collected and tested for HIV and syphilis. EpiData 3.0 and SPSS 17.0 software were used to clean up data and statistical analysis.Results:A number of 500 MSW were involved including 243 (48.6 %) heterosexual and 257 (51.4 %) homosexual MSW. The overall HIV prevalence was 5.4 %(27/500) among all the MSW. there were significant differences between the HIV prevalence rates, the heterosexual MSW (3.3 %, 8/243) and the homosexual MSW (7.4 %, 19/257)( χ2=4.112, P=0.043). In the past 3 months, 28.0 % (72/257) of the homosexual MSW mainly engaged in receptive anal sex which was higher than 11.5 %(28/243) of the heterosexual MSW. Compared to 15.6 % (40/257) of the homosexual MSW who engaged in heterosexual behavior, a higher proportion of 98.4 % (239/243) was noticed among the heterosexual MSW. Higher percentage (44.9 %, 109/243) appeared among the heterosexual MSW who had not been tested for HIV than the homosexual MSW (20.6 %, 53/257). Results from logistic regression multivariate analysis showed that age ≥30 (a OR=7.54, 95 %CI: 2.53-37.11), having unprotected anal sexual practice (a OR=3.76, 95 %CI:1.15-12.23), having anal sex after drinking alcohol (a OR=10.91, 95 %CI: 2.29-51.87) and syphilis tested positive (a OR=8.23, 95 %CI:1.29-52.51) were risk factors associated with HIV infection among the heterosexual MSW. Having unprotected anal sexual behavior (a OR=2.94, 95 %CI: 1.17-7.37), having group anal sex (a OR=4.08, 95 %CI:1.05-15.81), without record on HIV testing (a OR=6.58, 95 %CI: 2.01-18.06) and syphilis tested positive (a OR=4.55, 95 %CI: 1.15-18.06) were risk factors associated with HIV among the homosexual MSW. Conclusions:High HIV prevalence was discovered among both heterosexual and homosexual MSW in Wuxi, China. Differences in sexual behaviors between these two groups should be considered when designing targeted HIV intervention programs for these populations.

Objective:To observe the differences in biochemical indexes and AIDS-related complications at baseline in HIV-infected patients with different levels of immune reconstitution to antiretroviral therapy (ART).Methods:The subjects were treat-na?ve adult HIV-infected patients who were followed up for more than 24 months in the Guangzhou Eighth People's Hospital affiliated infection clinic at Guangzhou Medical University from January 2010 to December 2017. CD4 + T lymphocyte count at baseline at <200, 200-350, and >350 cells/μl levels were divided into poor, partial, and good immune reconstitution groups. The Kruskal-Wallis H and chi-square tests were used to analyze the differences in baseline sociodemographic characteristics, biochemical indexes, and AIDS-related complications among different groups. The SPSS 20.0 software was used for statistical analysis. Results:Among the 3 900 HIV-infected individuals, 385 cases (9.9%), 1 206 cases (30.9%), and 2 309 cases (59.2%) were grouped into poor, partial and good immune reconstitution groups, respectively. The baseline biochemical indexes of leukocyte, platelet, hemoglobin, TG, TC, FPG, AST, ALT and total bilirubin in the poor immune reconstitution group were significantly different from those in the good immune reconstitution group (all P<0.05). The proportion of AIDS-related complications at baseline in the poor immune reconstitution group, such as tuberculosis, pneumocystis yeli pneumonia, disseminated mycosis, esophageal candidiasis, extrapulmonary tuberculosis, dermatitis, oral candidiasis, oral mucous leukoplakia, continuous diarrhea for more than 1 month and continuous or intermittent fever for more than 1 month, was significantly higher than that in the good immune reconstitution group (all P<0.05). Conclusions:The biochemical indexes and AIDS-related complications in HIV-infected patients with different levels of immune reconstitution were significantly different at baseline. Attention should be paid to monitoring abnormal biomedical indicators and AIDS-related complications at baseline.

Objective To understand the willingness on acceptance of a short-message-service (SMS) program provided for HIV/STD testing and the related factors,among male clients at the STD clinics in China.Methods Convenience sampling method was used to select study subjectsat a STD clinic in Wuxi,Jiangsu province.A questionnaire survey was conducted among the subjects to collect the information on socio-demographic characteristics and willingness of acceptance to the SMS.Results A total of 368 SMS subjects were surveyed,in which 75.5％ expressed the willingness of acceptance,while 57.2％ and 38.1％ of them wanted to receive the short message every 3 months or 6 months,respectively.53.8％ of the respondents showed their willingness to share the news with their sexual partners about SMS and 44.8％ of them would do the same to their friends.Data from the Multivariate logistic regression analysis showed that those who had received senior high school or above education (aOR =3.632,95％CI:1.939-6.715),having homosexual behavior (aOR =1.973,95％ CI:1.234-8.358) or those having received AIDS related intervention service in the past year (aOR=9.416,95％CI:4.822-18.309) were more likely to accept the SMS.Conclusion SMS seemed to be acceptable among the male STD clinic clients in Wuxi,suggesting that it is feasible to conduct the SMS as a strategy to improve the HIV/STDs testing program at the STD clinics in the future.Promotion of SMS should be strengthened and the provision of general AIDS intervention service at the STD clinics should be established in order to make more STD clinic clients understand this SMS.

Objective To understand the current status of synthetic drug use and associated factors among men who have sex with men (MSM) at high risk of HIV infection.Methods A crosssectional study was conducted in Guangzhou,Wuxi and Shenzhen through January to August 2017.MSM at high risk of HIV infection were recruited from attendants at the health clinics,through internet advertisement and snowball sampling method.Eligible MSM were the ones who had met the following criteria:≥ 18 years old,having either 2 male sex partners,or condomless anal sex with a casual male sex partner,or a STD historg during the past 6 months.Data regarding demographic,sexual behavior,HIV/STD testing history and previous drug use were collected by sely-administered questionnaires.Blood was also drawn for HIV testing.Results Of the 603 MSM at high risk of HIV,25.5％ (154/603,95％CI:22.0％-29.0％) of them had used drugs in the past 6 months,including 29.1％ (88/302,95％CI:24.0％-34.3％) in Guangzhou,26.3％ (40/152,95％CI:19.2％-33.4％)in Shenzhen,and 17.4％ (26/149,95％CI:11.3％-23.6％) in Wuxi.'Rush'(85.1％,131/154) was the most commonly used drug.Results from the multivariable logistic regression revealed that drug use was associated with the following factors:having multiple casual sexual partners (aOR=3.24,95％CI:1.29-7.43) and alcohol use (aOR=1.78,95％CI:1.12-2.80) in the past 6 months after adjusting for age,education and monthly income.Conclusions Drug use seemed common among MSM population at high risk of HIV infection and was associated with higher risk behavior that leading to HIV infection.Synthetic drug use among MSM deserved more attention.

Objective:To investigate public health-related professions' recruit requirements and understand the training scheme for preventive medicine-majored undergraduates in colleges and universities in China.Methods:An online questionnaire was adopted to collect data on the recruit requirements of public health-related professions. Information on the core courses, internship, and practical training for preventive medicine-majored undergraduates was collected through universities' official websites.Results:The employers had a high requirement for education and specific majors. Also, administration professions attached importance to comprehensive quality, while professional positions to professional skills. 47.2% (67/142) employers made Talent Introduction Programs for the next three years. 20.0% (3/15) universities offered all the core courses required by national standards. For internship and practical training, both clinical practice and professional practice's median durations were 16 and 11 weeks, respectively.Conclusion:Employers showed significant demand for public health graduates and having a high requirement for personal ability and comprehensive quality. The universities should improve the setting of core courses and strengthen students' practical ability and overall quality.

Objective:To understand the basic qualities, practitioners will and related influences, of undergraduate, master, and doctoral students majoring in public health (hereinafter referred to as public health students), and explore the influencing factors of practitioners will.Methods:Through the online questionnaire survey, we collected information on the basic qualities of the public health students, their practitioners will and related influencing factors, and their opinions on the current state of public health in China. χ 2 test and multi-factor logistic regression were used to analyze the influencing factors of public health students' willingness to engage in public health related work, and word frequency analysis was used to conduct a descriptive analysis of public health students' views on public health in China. Results:A total of 2 081 pieces of valid information were collected, of which 86.54% (1 801/2 081) of the students in the school chose to engage in public health related work in the future. For public health students, the higher the target after-tax monthly income ( OR=0.345, 95% CI: 0.158-0.751), the lower the willingness to engage in public health related work in the future; Very satisfied with school employment guidance work ( OR=4.072, 95% CI: 1.234-13.436) compared with very dissatisfied, the willingness to engage in public health related work in the future is higher. Conclusion:The willingness of students in public health related majors to engage in public health related majors in China is mainly affected by three factors: payment levels, employment guidance and professional post recognition. It is recommended to appropriately raise the salaries of public health related positions. Strengthening school employment guidance training and professional identity training is conducive to enhancing the willingness of public health students to engage in relevant work in their profession.

Objective:To understand the basic qualities, practitioners will and related influences, of undergraduate, master, and doctoral students majoring in public health (hereinafter referred to as public health students), and explore the influencing factors of practitioners will.Methods:Through the online questionnaire survey, we collected information on the basic qualities of the public health students, their practitioners will and related influencing factors, and their opinions on the current state of public health in China. χ 2 test and multi-factor logistic regression were used to analyze the influencing factors of public health students' willingness to engage in public health related work, and word frequency analysis was used to conduct a descriptive analysis of public health students' views on public health in China. Results:A total of 2 081 pieces of valid information were collected, of which 86.54% (1 801/2 081) of the students in the school chose to engage in public health related work in the future. For public health students, the higher the target after-tax monthly income ( OR=0.345, 95% CI: 0.158-0.751), the lower the willingness to engage in public health related work in the future; Very satisfied with school employment guidance work ( OR=4.072, 95% CI: 1.234-13.436) compared with very dissatisfied, the willingness to engage in public health related work in the future is higher. Conclusion:The willingness of students in public health related majors to engage in public health related majors in China is mainly affected by three factors: payment levels, employment guidance and professional post recognition. It is recommended to appropriately raise the salaries of public health related positions. Strengthening school employment guidance training and professional identity training is conducive to enhancing the willingness of public health students to engage in relevant work in their profession.

Objective:To explore changes in high-risk sexual behaviors and associated factors in HIV-infected men who have sex with men (MSM) in industrial workers, and provide evidence for designing behavioral interventions for this population.Methods:In this observational study, HIV-infected MSM were recruited in industrial workers using convenient sampling during August to September 2021. The sample size was estimated to be 530. A questionnaire was used and combined with routine follow-up to collect socio-demographic characteristics, high-risk sexual behaviors, partner notification, viral load testing and history of sexually transmitted diseases before and after diagnosis of HIV infection. The χ2 test was used to analyze the changes in high-risk sexual behaviors before and after diagnosis and logistic regression was conducted to identify factors associated with high-risk sexual behaviors. Results:A total of 560 HIV-infected MSM in industrial workers were recruited in this study. Of whom, 32.1% (180/560) had unprotected anal intercourse (UAI) within 12 months after diagnosis . The proportions of those having UAI with casual, commercial and regular same-sex partners significantly decreased from 73.4% (381/519), 75.1% (187/249) and 69.5% (207/298) within 12 months before diagnosis to 36.2% (146/403), 40.2% (86/214) and 34.2% (67/196) within 12 months after diagnosis , respectively. Educational level of college or above (a OR=0.41, 95% CI:0.23-0.71), passive anal sex (a OR=0.40, 95% CI:0.19-0.85), both active and passive anal sex after diagnosis (a OR=0.40, 95% CI:0.20-0.83) and no unprotected oral sex (a OR=0.02, 95% CI:0.01-0.05) were negatively associated with UAI within 12 months after diagnosis. Whereas, not considering necessary to use condom consistently after having repeated undetectable viral load (a OR=3.02, 95% CI:1.37-6.69) was positively associated with UAI within 12 months after diagnosis. Conclusions:Compared with that before diagnosis of HIV infection, although the prevalence of UAI seemed to decrease in HIV-infected MSM in industrial workers after diagnosis, nearly one third of them had high-risk sexual behaviors. Therefore, relevant interventions should be strengthened to reduce high-risk sexual behaviors.