BACKGROUNDPrevious studies have shown evidence of health-related risk behaviors among women who have sex with women (WSW), such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections (RTI)/sexually transmitted infections (STI).

METHODSParticipants were recruited through outreach in venues and online for a cross-sectional study. Data were collected using interviews and laboratory tests.

RESULTSWe recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% (206/224) of women reported sexual relations with women. The RTI rates were: gonorrhea (15.8%), chlamydia (3.5%), syphilis (0.5%), bacterial vaginosis (14.4%), hepatitis B virus (HBV) (0.9%), hepatitis C virus (HCV) (0.5%), and candidiasis (6.9%). No HIV or herpes simplex virus (HSV) positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency (odds ratio (OR) = 2.1, 95% confidence interval (CI): 1.2 - 3.8) and genital-genital contact (OR = 3.1, 95%CI: 1.3 - 7.2); factors associated with curable STI (excluding bacterial vaginosis, candidiasis, HBV and HCV) were non-Beijing local residency (OR = 1.9; 95%CI: 1.2 - 3.0) and bleeding during or after sex (OR = 18.1; 95%CI: 5.2 - 62.6); and the factor associated with RTI (including all the infections tested) was bleeding during or after sex (OR = 37.8, 95%CI: 11.2 - 127.4).

CONCLUSIONSBehaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when planning corresponding prevention and interventions.

Adult ; Candidiasis ; epidemiology ; China ; Female ; Gonorrhea ; epidemiology ; Hepatitis B ; epidemiology ; Hepatitis C ; epidemiology ; Homosexuality, Female ; statistics & numerical data ; Humans ; Risk Factors ; Sexually Transmitted Diseases ; epidemiology ; Syphilis ; epidemiology ; Vaginosis, Bacterial ; epidemiology ; Young Adult

OBJECTIVES: Previous research has found that greater income inequality is related to problematic alcohol use across a variety of geographical areas in the USA and New York City (NYC). Those studies used self-reported data to assess alcohol use. This study examined the relationship between within-neighborhood income inequality and alcohol-related emergency department (ED) visits. METHODS: The study outcome was the alcohol-related ED visit rate per 10,000 persons between 2010 and 2014, using data obtained from the New York Statewide Planning and Research Cooperative System. The main predictor of interest was income inequality, measured using the Gini coefficient from the American Community Survey (2010-2014) at the public use microdata area (PUMA) level (n=55) in NYC. Variables associated with alcohol-related ED visits in bivariate analyses were considered for inclusion in a multivariable model. RESULTS: There were 420,568 alcohol-related ED visits associated with a valid NYC address between 2010 and 2014. The overall annualized NYC alcohol-related ED visit rate was 100.7 visits per 10,000 persons. The median alcohol ED visit rate for NYC PUMAs was 88.0 visits per 10,000 persons (interquartile range [IQR], 64.5 to 133.5), and the median Gini coefficient was 0.48 (IQR, 0.45 to 0.51). In the multivariable model, a higher neighborhood Gini coefficient, a lower median age, and a lower percentage of male residents were independently associated with the alcohol-related ED visit rate. CONCLUSIONS This study found that higher neighborhood income inequality was associated with higher neighborhood alcohol-related ED visit rates. The precise mechanism of this relationship is not understood, and further investigation is warranted to determine temporality and to assess whether the results are generalizable to other locales.

OBJECTIVES: Previous research has found that greater income inequality is related to problematic alcohol use across a variety of geographical areas in the USA and New York City (NYC). Those studies used self-reported data to assess alcohol use. This study examined the relationship between within-neighborhood income inequality and alcohol-related emergency department (ED) visits.METHODS: The study outcome was the alcohol-related ED visit rate per 10,000 persons between 2010 and 2014, using data obtained from the New York Statewide Planning and Research Cooperative System. The main predictor of interest was income inequality, measured using the Gini coefficient from the American Community Survey (2010-2014) at the public use microdata area (PUMA) level (n=55) in NYC. Variables associated with alcohol-related ED visits in bivariate analyses were considered for inclusion in a multivariable model.RESULTS: There were 420,568 alcohol-related ED visits associated with a valid NYC address between 2010 and 2014. The overall annualized NYC alcohol-related ED visit rate was 100.7 visits per 10,000 persons. The median alcohol ED visit rate for NYC PUMAs was 88.0 visits per 10,000 persons (interquartile range [IQR], 64.5 to 133.5), and the median Gini coefficient was 0.48 (IQR, 0.45 to 0.51). In the multivariable model, a higher neighborhood Gini coefficient, a lower median age, and a lower percentage of male residents were independently associated with the alcohol-related ED visit rate.CONCLUSIONS: This study found that higher neighborhood income inequality was associated with higher neighborhood alcohol-related ED visit rates. The precise mechanism of this relationship is not understood, and further investigation is warranted to determine temporality and to assess whether the results are generalizable to other locales.
Alcohol Drinking ; Emergencies ; Emergency Service, Hospital ; Humans ; Male ; Puma ; Residence Characteristics ; Socioeconomic Factors ; Surveys and Questionnaires ; Urban Health

OBJECTIVEThis study is to estimate the population size and prevalence of HIV and herpes simplex virus type 2 (HSV-2) infections among female sex workers (FSWs) in Kaiyuan, Yunnan Province, China.

METHODSEight cross-sectional studies were conducted among FSWs in Kaiyuan from 2006 to 2009. Based on the data from two study time points each year, the total numbers of FSWs and HIV positive FSWs were estimated by using the capture-recapture technique (CR).

RESULTSEstimated sizes of FSWs in Kaiyuan were 1 629, 1 672, 1 186, and 1 014 in the respective years from 2006 to 2009. Although the crude prevalence rates of HIV and HSV-2 varied over time, the adjusted prevalence among this population was relatively stable at 10%-12% and the adjusted HSV-2 prevalence ranged from 67% to72%.

CONCLUSIONThe reason for the slight decrease of the size of the FSW population is unknown. The adjusted prevalence rates of HIV and HSV-2 among them were stable over the course of this study.

Adolescent ; Adult ; China ; epidemiology ; Cross-Sectional Studies ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Sex Workers ; statistics & numerical data ; Young Adult

OBJECTIVETo estimate the probability of unprotected heterosexual vaginal transmission of HIV-1 from clients to Female Sex Workers (FSWs) in Kaiyuan County, Yunnan province, China, and analyze factors which impact the transmission probability.

METHODSAn open cohort research of FSWs in Kaiyuan was created from surveys conducted in April 2008, October 2008, and April 2009. Two cross-sectional surveys of local clients were also carried out in May 2008 and November 2008. A model was developed to estimate the probability of unprotected heterosexual vaginal transmission of HIV-1 from clients to FSWs.

RESULTSThe transmission probability from clients to FSWs was estimated as 0.0023 [95%CI 0.0014-0.0032] per unprotected heterosexual act.

CONCLUSIONSThe transmission probability among this group engaging in commercial sex in Yunnan province differs from that found in studies from other countries, and future studies should estimate the influence factors of HIV-1 transmission probability, such as stage of HIV infection, co-morbid sexually transmitted infections (STIs).

Adolescent ; Adult ; Aged ; China ; epidemiology ; Cohort Studies ; Cross-Sectional Studies ; Female ; HIV Infections ; epidemiology ; transmission ; HIV-1 ; isolation & purification ; Heterosexuality ; Humans ; Male ; Middle Aged ; Models, Statistical ; Probability ; Sex Work ; statistics & numerical data ; Sexually Transmitted Diseases, Viral ; epidemiology ; virology ; Social Class ; Unsafe Sex ; statistics & numerical data ; Young Adult

OBJECTIVE: To evaluate the efficacy of deep vein thrombosis (DVT) prevention among real-world surgical inpatients who received panax notoginseng saponins (PNS) combined with low-molecular-weight heparin (LMWH). METHODS: A prospective cohort study was conducted among surgical patients between January 2016 and November 2018 in Xuanwu Hospital, Capital Medical University, Beijing, China. Participants received LMWH alone or PNS combined with LMWH for preventing DVT. The primary outcome was incidence of lower extremity DVT, which was screened once a week. Participants in the LMWH group were given LMWH (enoxaparin) via hypodermic injection, 4000-8000 AxalU once daily. Participants in the exposure group received PNS (Xuesaitong oral tablets, 100 mg, 3 times daily) combined with LMWH given the same as LMWH group. RESULTS: Of the 325 patients screened for the study, 281 participants were included in the final analysis. The cohort was divided into PNS + LMWH group and LMWH group with 134 and 147 participants, respectively. There was a significant difference of DVT incidence between two groups (P=0.01), with 21 (15.7%) incident DVT in the PNS + LMWH group, and 41 (27.9%) incident DVT in the LMWH group. Compared with participants without DVT, the participants diagnosed with DVT were older and had higher D-dimer level. The multivariate logistic regression model showed a significant lower risk of incident DVT among participants in the PNS + LMWH group compared with the LMWH group (odds ratio 0.46, 95% confidence interval, 0.25-0.86). There were no significant differences in thromboelaslography values (including R, K, Angle, and MA) and differences in severe bleeding between two groups. No symptomatic pulmonary embolism occurred during the study. CONCLUSION Combined application of PNS and LMWH can effectively reduce the incidence of DVT among surgical inpatients compared with LMWH monotherapy, without increased risk of bleeding.
Anticoagulants/therapeutic use* ; Hemorrhage ; Heparin, Low-Molecular-Weight/therapeutic use* ; Humans ; Panax notoginseng ; Prospective Studies ; Saponins/therapeutic use* ; Venous Thrombosis/prevention & control*