OBJECTIVETo understand the high risk behaviors of female sex workers (FSWs) in Yunnan province in 2013.

METHODSA cross-sectional investigation was conducted during April to June, 2013 in Yunnan province, census was used to the investigation where the number of FSWs was close to 200, while probability sampling was used where the number of FSWs was obviously over 200. A total of 25 574 cases were investigated, and data on demography and risk behaviors were obtained by questionnaires one by one.

RESULTSA total of 25 574 cases were investigated, AIDS awareness among FSWs in high-level places, middle-level places and low-level place were 98.8% (92/7 401), 98.6% (150/10 995), and 96.0% (281/6 655). FSWs from low-level place had a lower rate than those from the other two types of places (P < 0.01). The rate of condom use each time when having sex with clients within the recent one month among FESs from high-level places, middle-level places and low-level place were 93.4% (6 307/6 755), 93.8% (10 109/10 782) and 90.4% (6 053/6 697), and the FSWs working in low-level place had a lower rate than those from the other two types of places(P < 0.01). Multi-factor logistic regression analysis showed that the following had a lower rate of condom use: the FSWs working in low-level place (OR = 1.56, 95% CI:1.36-1.79; OR = 1.36, 1.16-1.59), over 30 years old (OR = 0.77, 95%CI:0.69-0.85), Yunnan citizen (OR = 0.88, 95% CI:0.77-1.00), minority (OR = 1.32, 95% CI:1.16-1.50), under senior high school (OR = 0.61, 95%CI:0.49-0.75), married (OR = 0.81, 95% CI:0.71-0.92), living together (OR = 0.70, 95% CI:0.51-0.96), divorced or lost spouses (OR = 0.81, 95% CI:0.65-1.02), worked less than 6 months in local areas (OR = 1.74, 95% CI:1.34-2.27), drug users (OR = 1.65, 95% CI:1.11-2.46), had not accepted HIV interventions (OR = 2.91, 95% CI:2.36-3.58), had no knowledge about AIDS (OR = 4.50, 95% CI:3.48-5.82). The main reasons for not using condoms were the clients' unwilling to use, which accounted for 47.62% (270/567). The total rate of drug use was 1.0% (264/25 567) and the FSWs working in middle-level places had the highest rate of injecting drugs, which accounted for 0.6% (70/11 141). The FSWs working in low-level places had a higher rate than those who worked in high-level places and middle-level places in venereal diseases, which accounted for 1.2% (85/6 934) (P < 0.01). The rate of receiving effective interventions was 96.7% (24 717/25 574), the rate of accepting treatment and clean needles among drug users was 21.6% (57/264).

CONCLUSIONHigh risk behaviors were serious among the FSWs who worked in low-level places, especially among the olders, the minorities, people who had lower educational level, the new-comer and drug users, which indicated that more attention needs to be paid among these populations.

Age Factors ; China ; Condoms ; Cross-Sectional Studies ; Demography ; Drug Users ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Marital Status ; Risk-Taking ; Safe Sex ; Sex Workers ; Sexually Transmitted Diseases ; Socioeconomic Factors ; Surveys and Questionnaires

Objective To investigate the effects of thyroid hormone on extremely severe traumatic brain injury (TBI).Methods A retrospective case-control study was conducted to analyze the treatment of 105 patients with extremely severe TBI admitted from July 2010 to April 2014.There were 79 males and 26 females,with an average age of 32.9 years.The patients were divided into conventional treatment group (Group A,35 cases),conventional treatment ± thyroxine treatment group (Group B,35 cases) and thyroxine treatment group after the condition that thyroxine level was low (Group C,35 cases) according to the random number table method.The incidence of low T3 and T4,incidence of hypotension,the dosage of vasoactive drugs,function evaluation of liver and kidney damage,Glasgow outcome scale (GOS),and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) within 20 days after admission,and mortality rate within 30 days after admission were compared and analyzed.Results Within 20 days after admission,the rates of low thyroxine levels and hypotension of the Group B (22.9％,77.1％) were significantly lower than those in the other two groups (Group A:40％,100％;Group C:37％,100％) (all P ＜ 0.05).The doses of dopamine and norepinephrine in Group B was significantly lower than the other two groups and the combination rate of vasopressors in Group B was significantly lower than the other two groups (P ＜ 0.05),while there was no significant difference between Group A and Group C (P ＞ 0.05).The corresponding data in Group A and Group C had no statistically significant difference (P ＞ 0.05).The liver and renal dysfunction rates of Group B (29％,31％) were significantly lower than those of the other two groups (Group A:49％,51％;Group C:43％,51％) (all P ＜ 0.05).The corresponding data in Group A and Group C had no statistically significant difference (P ＞ 0.05).GOS in Group B [(4.8 ± 1.9) points] was significantly higher than that in Group A [(3.3 ± 0.2) points] (all P ＜ 0.05) within 30 days after admission and significantly higher than that of itself at the beginning [(3.6 ± 1.1) points] (P ＜ 0.05).The APACHE Ⅱ in Group A was significantly higher than those in other two groups as well as that in Group A at admission (P ＜ 0.05).Mortality rates in Group B (31％) and Group C (29％) were significantly lower than that in Group A (69％) within 30 days after admission (P ＜ 0.05).Conclusions Thyroxine can reduce the incidence of hypotension,liver and kidney injury rate in extremely severe TBI.Prevention is better than the supplementary treatment after severe TBI.Thyroxine can also reduce the mortality of extremely severe TBI within 30 days after admission.

Objective To understand the high risk behaviors of female sex workers ( FSWs) in Yunnan province in 2013.Methods A cross-sectional investigation was conducted during April to June, 2013 in Yunnan province, census was used to the investigation where the number of FSWs was close to 200, while probability sampling was used where the number of FSWs was obviously over 200.A total of 25 574 cases were investigated, and data on demography and risk behaviors were obtained by questionnaires one by one.Results A total of 25 574 cases were investigated, AIDS awareness among FSWs in high-level places, middle-level places and low-level place were 98.8%( 92/7 401 ) , 98.6%( 150/10 995 ) , and 96.0%(281/6 655).FSWs from low-level place had a lower rate than those from the other two types of places(P<0.01).The rate of condom use each time when having sex with clients within the recent one month among FESs from high-level places, middle-level places and low-level place were 93.4%(6 307/6 755), 93.8%(10 109/10 782) and 90.4%(6 053/6 697), and the FSWs working in low-level place had a lower rate than those from the other two types of places(P<0.01).Multi-factor logistic regression analysis showed that the following had a lower rate of condom use: the FSWs working in low-level place(OR=1.56,95%CI:1.36-1.79;OR=1.36,1.16-1.59), over 30 years old(OR=0.77, 95%CI:0.69-0.85), Yunnan citizen (OR=0.88, 95%CI:0.77-1.00), minority(OR=1.32, 95%CI:1.16-1.50), under senior high school (OR=0.61, 95%CI:0.49-0.75),married(OR=0.81,95%CI:0.71-0.92), living together(OR=0.70, 95%CI:0.51-0.96), divorced or lost spouses(OR=0.81,95%CI:0.65-1.02), worked less than 6 months in local areas(OR=1.74, 95%CI:1.34-2.27), drug users(OR=1.65, 95%CI:1.11-2.46), had not accepted HIV interventions(OR=2.91,95%CI:2.36-3.58), had no knowledge about AIDS(OR=4.50, 95%CI:3.48-5.82 ) .The main reasons for not using condoms were the clients′unwilling to use, which accounted for 47.62%( 270/567 ) .The total rate of drug use was 1.0%( 264/25 567 ) and the FSWs working in middle-level places had the highest rate of injecting drugs, which accounted for 0.6%( 70/11 141).The FSWs working in low-level places had a higher rate than those who worked in high-level places and middle-level places in venereal diseases, which accounted for 1.2%(85/6 934)(P<0.01).The rate of receiving effective interventions was 96.7%(24 717/25 574), the rate of accepting treatment and clean needles among drug users was 21.6%(57/264).Conclusion High risk behaviors were serious among the FSWs who worked in low-level places, especially among the olders, the minorities, people who had lower educational level, the new-comer and drug users, which indicated that more attention needs to be paid among these populations.

Objective To understand the high risk behaviors of female sex workers ( FSWs) in Yunnan province in 2013.Methods A cross-sectional investigation was conducted during April to June, 2013 in Yunnan province, census was used to the investigation where the number of FSWs was close to 200, while probability sampling was used where the number of FSWs was obviously over 200.A total of 25 574 cases were investigated, and data on demography and risk behaviors were obtained by questionnaires one by one.Results A total of 25 574 cases were investigated, AIDS awareness among FSWs in high-level places, middle-level places and low-level place were 98.8%( 92/7 401 ) , 98.6%( 150/10 995 ) , and 96.0%(281/6 655).FSWs from low-level place had a lower rate than those from the other two types of places(P<0.01).The rate of condom use each time when having sex with clients within the recent one month among FESs from high-level places, middle-level places and low-level place were 93.4%(6 307/6 755), 93.8%(10 109/10 782) and 90.4%(6 053/6 697), and the FSWs working in low-level place had a lower rate than those from the other two types of places(P<0.01).Multi-factor logistic regression analysis showed that the following had a lower rate of condom use: the FSWs working in low-level place(OR=1.56,95%CI:1.36-1.79;OR=1.36,1.16-1.59), over 30 years old(OR=0.77, 95%CI:0.69-0.85), Yunnan citizen (OR=0.88, 95%CI:0.77-1.00), minority(OR=1.32, 95%CI:1.16-1.50), under senior high school (OR=0.61, 95%CI:0.49-0.75),married(OR=0.81,95%CI:0.71-0.92), living together(OR=0.70, 95%CI:0.51-0.96), divorced or lost spouses(OR=0.81,95%CI:0.65-1.02), worked less than 6 months in local areas(OR=1.74, 95%CI:1.34-2.27), drug users(OR=1.65, 95%CI:1.11-2.46), had not accepted HIV interventions(OR=2.91,95%CI:2.36-3.58), had no knowledge about AIDS(OR=4.50, 95%CI:3.48-5.82 ) .The main reasons for not using condoms were the clients′unwilling to use, which accounted for 47.62%( 270/567 ) .The total rate of drug use was 1.0%( 264/25 567 ) and the FSWs working in middle-level places had the highest rate of injecting drugs, which accounted for 0.6%( 70/11 141).The FSWs working in low-level places had a higher rate than those who worked in high-level places and middle-level places in venereal diseases, which accounted for 1.2%(85/6 934)(P<0.01).The rate of receiving effective interventions was 96.7%(24 717/25 574), the rate of accepting treatment and clean needles among drug users was 21.6%(57/264).Conclusion High risk behaviors were serious among the FSWs who worked in low-level places, especially among the olders, the minorities, people who had lower educational level, the new-comer and drug users, which indicated that more attention needs to be paid among these populations.

OBJECTIVETo investigate the digit ratio of men who have sex with men (MSM), and the relationship between digit ratio and the partner types of MSM.

METHODSParticipants were required from Yunnan Rainbow Sky, a community organization that specialized in HIV testing, intervention and counseling services for MSM between December 2014 and April 2015. Inclusion criteria of MSM as the following: more than 18 years old; men who have had sex with men; HIV test was negative. Exclusion criteria were as this: those who couldn't attend the research due to disability. Eventually, there were 115 MSM participated in the research. According to the nationality, we adopted 1:1 matched case-control study, and we selected 115 men as control group. According to the partner number of MSM, the MSM were divided into two groups. One group was fixed partner and another was multi-partner. We used a questionnaire to collect the demographic characteristics, knowledge about HIV/AIDS, sexual behaviors during nearly 6 months, sexual orientation, the places where looked for sex partners, sex roles, drug use, preventive services etc. Then, the physical measurements were used to measure the length from second to the fifth finger in MSM group and control group. The results were expressed as nD. The chi-square test was used to compare the demographic differences between MSM group and the control group, and the T-test was used to compare the digit ratio between two groups.

RESULTSAmong 115 MSM, there were 26% (30/115) MSM who had a fixed partner, and there were 74% (85/115) MSM who had multi-partner. The mean values of digit ratio of MSM presented a trend as 2D:3D < 2D:4D < 3D:4D < 2D:5D < 4D:5D < 3D:5D. The right 2D:4D and 2D:5D of MSM were 0.957 7 ± 0.048 1 and 1.229 8 ± 0.083 4, and the mean value was significasntly higher than control group (0.941 4 ± 0.038 0 and 1.204 1 ± 0.069 5, t values were 2.84, 2.54 and P values were 0.005, 0.012). The right 2D:4D of the fixed partner group and multi-partner group among MSM were 0.962 2 ± 0.051 0 and 0.956 1 ± 0.047 3, respectively, and the mean values were significantly higher than control group (t values were 2.98, 2.83; P values were 0.027, 0.015).

CONCLUSIONThe proportion of multi-partner MSM was higher, so MSM at a high risk of being HIV infected. Right 2D:4D could be used as a biomarker of the MSM in Kunming, but couldn't reflect the features of MSM whether he has a fixed partner or has several partners.

Case-Control Studies ; China ; Fingers ; anatomy & histology ; HIV Infections ; Homosexuality, Male ; Humans ; Male ; Risk-Taking ; Sexual Partners ; Surveys and Questionnaires

HIV Antibodies ; chemistry ; HIV Infections ; diagnosis ; Humans ; Pharmacies ; Pilot Projects ; Reagent Kits, Diagnostic ; Saliva ; chemistry

Objective To study the HIV-1 drug resistance transmission level in HIV infected persons receiving no antiviral therapy in Dehong prefecture of Yunnan province in 2015.Methods A total of 72 plasma samples were collected from recently reported HIV-infected persons aged 16-25 years in Dehong from January to July 2015 for drug resistance gene detection.Results Forty eight samples were successfully sequenced and analyzed.Among them,31.2％ (15/48) were from Chinese,and 68.8％ (33/48) were from Burmese.Based on pol sequences,HIV genotypes included URF (52.08％,25/48),CRF01_AE (16.67％,8/48),RF07_BC (10.42％,5/48),subtype B (6.25％,3/48),subtype C (6.25％,3/48),CRF57_BC (6.25％,3/48) and CRF08_BC (2.08％,1/48).One drug resistant mutation site to non-nucleoside analog reverse transcriptase inhibitor (NNRTI) and two drug resistant mutation site to nucleoside analog reverse transcriptase inhibitor (NRTI) were detected in four sequences.Based on the statistical method of HIV drug resistance threshold survey,the prevalence of HIV-1 drug resistant strain was 5％-15％.Conclusions The proportion of Burmese among newly reported HIV-infected individuals aged 16-25 years in Dehong in 2015 was higher.HIV-1 genetic diversity was found in Dehong.The prevalence of HIV-1 drug resistant strain had reached a moderate level in Dehong.

Objective: To understand the HIV and syphilis infection and related treatment status of low-fee female sex workers (FSWs) in 3 provinces of China. Methods: Four cross-sectional survey data of low-fee FSWs from six cities (counties) in Guangxi, Yunnan and Hunan Province between October 2012 and July 2015 were obtained from the national science and technology major special project intervention study for reducing sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) in low-fee FSWs' database, which included social demographic characteristics, sexual service characteristics and related medical care seeking behaviors, etc. A total of 2 050 subjects were included in the database. Results: The age of the subjects was (35.16±9.76) years old, with a minimum age of 15 and a maximum age of 67. Those who use condoms every time in commercial sex accounted for 58.9% (n=1 206). Among the reasons of not using condom, the proportion of client reluctant to use was the highest (81.0% (n=682)). Only 38.1% (n=782) was tested for HIV in the last six months. HIV confirmed positive rate was 6.8% (n=139), previous positive accounts for 76.3% (n=106). Rate of antiviral therapy was 55.4% (n=77). By the end of 2015, the loss rate of antivirus treatment was 18.2% (n=14). Those who self-reported symptoms of sexually transmitted diseases in the last 6 months accounted for 9.4% (n=191). 50.3% (n=96) of reporters chose to go to formal hospitals, 23.0% (n=44) chose to go to private clinics and 20.4% (n=39) chose their own medication. The syphilis infection rate was 13.5% (n=277), among them, 91.3% (n=253) were asymptomatic. Conclusion Among low-fee FSWs, the rates of HIV and syphilis infection are higher, the condom consistent use rate, HIV antibodies and syphilis test rate are lower. In this group, active seeking medical idea is poor, the rate of anti-virus treatment and the rate of seeking medical treatment in formal medical institutions is low.

OBJECTIVETo understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.

METHODSFace to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.

RESULTSAmong the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9% (28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32 (7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents (4.5%, 9/198), the difference was statistically significant (χ(2)=11.715, P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.

CONCLUSIONSRisk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.

China ; epidemiology ; Condoms ; utilization ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Risk-Taking ; Sex Work ; psychology ; statistics & numerical data ; Sexual Behavior ; psychology ; statistics & numerical data ; Surveys and Questionnaires

OBJECTIVETo understood the accuracy of oral fluid-based rapid HIV self-testing among men who have sex with men (MSM) and related factors.

METHODSSurvey was conducted among MSM selected through non-probability sampling to evaluate the quality of their rapid HIV self-testing, and related information was analyzed.

RESULTSThe most MSM were aged 21-30 years (57.0%). Among them, 45.7% had educational level of college or above, 78.5% were unmarried, 59.3% were casual laborers. The overall accuracy rate of oral fluid based self-testing was 95.0%, the handling of"inserting test paper into tube as indicated by arrow on it"had the highest accuracy rate (98.0%), and the handling of"gently upsetting tube for 3 times"had lowest accuracy rate (65.0%); Chi-square analysis showed that educational level, no touch with middle part of test paper, whether reading the instruction carefully, whether understanding the instruction and inserting test paper into tube as indicated by the arrow on it were associated with the accuracy of oral fluid-based rapid HIV self-testing, (P<0.05). Multivariate logistic regression analysis indicated that educational level, no touch with middle part of test paper and understanding instructions were associated with the accuracy of oral fluid-based rapid HIV self-testing.

CONCLUSIONSThe accuracy of oral fluid-based rapid HIV self-testing was high among MSM, the accuracy varied with the educational level of the MSM. Touch with the middle part of test paper or not and understanding the instructions or not might influence the accuracy of the self-testing.

Adult ; Demography ; HIV Infections ; diagnosis ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; methods ; Saliva ; Self Care ; Surveys and Questionnaires ; Young Adult