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.

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.

OBJECTIVEThis study was aimed to investigate the ways of spousal notification and its associated factors among HIV discordant couples.

METHODSA face-to-face questionnaire survey was conducted in Henan, Yunnan, Sichuan provinces and Guangxi Zhuang Autonomous Region in China. Information including democratic characteristics, knowledge and behaviors correlated with HIV infections and ways of HIV infectious status notification was collected. 'Data information system' on AIDS prevention and control was used to collect information on the transmission route.

RESULTSA total of 770 pairs of HIV discordant couples were studied, among which 414 (53.77%) HIV positive respondents reported as self-notification, with another 44.68% were notified by medical staff. Factors associated with ways of notification included gender, nation, transmission route, and education level. HIV positive respondents who were female, under Han nationality, being paid blood donors, having had higher education level, were more likely to inform their HIV negative spouse by themselves.

CONCLUSIONNationality and HIV transmission route of the HIV positive individuals were found as significant factors associated with ways of spousal notification. Therefore, HIV discordant couples notification should be strengthened, especially in the Minority-living areas and areas where HIV transmission was predomint through sexual contact and/or via injected drug use.

China ; Female ; HIV Infections ; psychology ; transmission ; Humans ; Interpersonal Relations ; Male ; Minority Groups ; psychology ; statistics & numerical data ; Sexual Behavior ; Spouses ; psychology ; statistics & numerical data ; Substance Abuse, Intravenous ; Truth Disclosure

OBJECTIVETo understand the prevalence of informing doctors of the HIV infection status during medical care seeking and influential factors among people living with HIV/AIDS.

METHODSThe study was conducted among people living with HIV/AIDS in 7 provinces in China, including those receiving HIV test, HIV counsel and HIV infection treatment. The data were analyzed with software SAS 9.2. Chi-square test was used to compare the informing rates in patients with different characteristics. Univariate and multivariate logistic regression analyses were conducted to identify the influential factors.

RESULTSOf the 2 432 HIV/AIDS patients, 49.7% (716/1 442) didn't inform the doctors of their HIV infection status actively. The non-active informing rate was 51.9% (559/1 077) in males, 62.9% (212/337) in age group 18-30 years old, 58.1% (555/955) in those with a educational level >primary school, 65.7% (241/367) in those working in private/joint companies or the self employed and 62.5% (197/315) in those living in small cities. The non active informing rate was highest in those infected through sexual contact (66.3%, 275/415). Multivariate logical regression analysis indicated that those infected through illegal blood donation would like to inform of the HIV infection status actively (OR=0.083, 95% CI: 0.049-0.141) , but those working in private/joint companies or the self employed would like not to inform of the HIV infection status actively (OR=1.531, 95% CI: 1.017-2.304).

CONCLUSIONThe non active informing rate of HIV infection status was high in people living with HIV/AIDS. It is necessary to conduct the targeted health education to encourage people living with HIV/AIDS to inform of their HIV infection status actively.

Acquired Immunodeficiency Syndrome ; Adolescent ; Adult ; China ; Communicable Diseases ; Communication ; Female ; HIV Infections ; Health Behavior ; Health Education ; Humans ; Male ; Mass Screening ; Physician-Patient Relations ; Prevalence ; Sexual Behavior ; Young Adult