Objective: To investigate the detection of HIV/AIDS cases in medical institutions in Tianjin Municipality from 2005 to 2021, so as to provide insights into optimization of HIV antibody testing strategies in medical institutions. Methods: All data pertaining to individuals receiving HIV antibody tests in medical institutions in Tianjin Municipality from 2005 to 2021 were collected from the information systems in medical institutions and the HIV/AIDS Prevention and Control Information System of Chinese Disease Prevention and Control Information System. The positive rate of HIV antibody and epidemiological characteristics of HIV/AIDS cases in medical institutions were analyzed. Results: The number of HIV antibody tests increased from 86 102 person-times in 2005 to 1 369 345 person-times in 2021 in medical institutions in Tianjin Municipality, with annual increase by 18.88%. The positive rate of HIV antibody increased from 2.44/104 to 2.85/104 (P<0.05), with annual increase by 2.79/104. Both the proportion of the number of HIV antibody tests and the number of HIV/AIDS cases detected by medical institutions in the whole city appeared a tendency towards a rise (P<0.05). A high positive rate of HIV antibody was seen in sexually transmitted disease clinics (53.69/104) and other testing services (12.25/104), and the highest positive rate of HIV antibody was seen in individuals at ages of 20 to 39 years (5.40/104), while the positive rate of HIV antibody was higher in men (5.84/104) than in women (0.53/104) (P<0.05). A total of 3 610 HIV/AIDS cases were detected in medical institutions in Tianjin Municipality from 2005 to 2021, with a median age of 38 (interquartile range, 24) years. Of all HIV/AIDS patients, there were 3 277 men (90.78%), and men who have sex with men was the predominant transmission route (63.46%), while the proportion of late identification of HIV/AIDS cases was 65.60%. In addition, the proportion of timely detection for the first CD4+T lymphocyte count testing increased from 23.81% in 2005 to 71.54% in 2021 (P<0.05). Conclusions The number of HIV antibody tests and positive rate of HIV antibody appeared a tendency towards a rise in medical institutions in Tianjin Municipality from 2005 to 2021. The HIV/AIDS cases were predominantly identified in sexually transmitted disease clinics and other testing services, and were predominantly men.

Objective: To understand characteristics of men who have sex with men (MSM) who applied for HIV antibody self-testing reagents through "AIDS self-testing" column of a WeChat official account named "Dark Blue Public Health Center" in Tianjin City, so as to provide insights into exploring online modes of HIV antibody self-testing for MSM. Methods: Data of MSM who were 18 years old or above, currently lived in Tianjin City, had sex with men in the past six months and applied for HIV antibody self-testing reagents through "AIDS self-testing" column from May 2018 to December 2022 were collected. Demographic characteristics, results return and positive findings were descriptively analyzed. Results: Data of 2 064 MSM were collected, including 1 052 MSM aged 20 to 29 years (50.97%), 1 522 unmarried MSM (73.74%), 545 workers (26.41%), 1 385 MSM with college education or above (67.10%), and 315 MSM without testing for HIV antibody in the past (15.26%). A total of 6 470 self-testing reagents were applied, and 5 942 testing results were returned, with a return rate of 91.84%. There were 33.28% (687/2 064) of the applicants applying for 66.32% (4 291/6 470) reagents multiple times. There were 73 MSM with positive results, accounting for 1.23%. Conclusions The MSM applying for HIV antibody self-testing reagents through "AIDS self-testing" are mainly young and highly educated, including some who have never tested for HIV. However, attention should be paid to duplicate applications and the return rate should be increased.

Objective: To understand the HIV infection status and related factors in men who have sex with men (MSM) in Tianjin during 2016-2018. Methods: According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted to collect the information about the awareness of AIDS, related behaviors, HIV infection, syphilis prevalence and HCV infection in the MSM in Tianjin with the annual sample seize of 400 between April and June during 2016-2018. Results: From 2016 to 2018, a total of 1 200 MSM were surveyed. The condom use rate in anal sex was 45.4% (544/1 198) in the past 6 months. The HIV test rate in MSM recruited through network declined with year (trend χ²=42.742, P<0.001). The overall HIV infection rate was 3.3% (40/1 200). The HIV-1 infection rate was 2.6% (95%CI: 1.7%-3.5%). The overall prevalence rate of syphilis was 6.7% (80/1 200). The overall HCV infection rate was 0.8% (9/1 200). Results from multivariate logistic regression analysis showed that the risk factors associated with HIV infection in the MSM included divorced or widowed (compared with unmarried, aOR=7.137, 95%CI: 1.621-31.419) and syphilis positive group (compared with syphilis negative group, aOR=3.684, 95%CI: 1.520-8.932). The protective factors for HIV infection in the MSM included consistent use of condom in the past 6 months (compared with occasional use of condom, aOR=0.343, 95%CI: 0.126-0.932) and HIV test (compared with receiving no HIV test, aOR=0.314, 95%CI: 0.123-0.801). Conclusions The HIV infection rate in the MSM in Tianjin was high from 2016 to 2018. Syphilis prevalence status in MSM should not be neglected. The rate of consistent condom use in anal sex was low in the MSM. It is necessary to take effective measures to promote condom use and strengthen HIV test in MSM.

Objective: To understand the current status of acquired immunodeficiency syndrome (AIDS) knowledge, attitudes, and practices of college students in Tianjin City and to further investigate the associated factors of high risk sexual behaviors, so as to provide a scientific and theoretical basis for accurate prevention and treatment of AIDS. Methods: A stratified cluster random sample of 64 697 students in 56 colleges and universities in Tianjin City in November to December 2022 was investigated about the current status of AIDS knowledge, attitudes and practices. Information was collected using online survey via Questionnaire Star. Descriptive analysis was used for the current status of AIDS knowledge, attitudes and practices among college students. Chi square test and multiple Logistic regression analysis were used to analyze the influencing factors of high risk sexual behavior among college students. Results: The AIDS awareness rate of college students in Tianjin City reached 87.33%. The sexual openness rate was 70.73 %. Among the 3 463 students who had sex during the past year, 42.13% of students reported high risk sexual behavior. Multivariate Logistic regression showed that female, having a romantic partner, having received sex education and prevention and treatment knowledge of AIDS were negatively associated with high risk sexual behavior ( OR =0.66, 0.59, 0.81, 0.59, P <0.05). Being in sophomore year, non heterosexuality (homosexuality, bisexuality, not knowing), prejudice against AIDS, and misunderstanding the testing methods for AIDS showed positive correlations with highrisk sexual behavior ( OR =1.22, 2.49, 2.30, 3.17, 1.43, 1.22 , P <0.05). Conclusions The awareness rate of AIDS in college students in Tianjin is high, but high risk sexual behaviors are still at a high level. Further targeted knowledge education and behavioral interventions are needed to scientifically prevent the spread of AIDS.

Objective: To study the survival time and influencing factors of HIV/AIDS cases who began receiving antiretroviral therapy (ART) from 2005 to 2015 in Tianjin. Methods: Data related to HIV/AIDS cases that receiving ART between 2005 and 2015 in Tianjin, were collected from the Chinese HIV/AIDS Basic Information Management System. A retrospective cohort study was conducted to analyze data of collection. Life table was used to calculate the survival proportion and Cox proportion hazard regression model was used to analyze the factors associated to the time of survival. Results: A total of 2 057 HIV/AIDS cases were involved, including 51 died from AIDS related disease, ending up with the survival rates of 1, 3, 5 and 10 years as 98.4%, 97.8%, 97.4% and 95.8%, respectively. Results from the multivariate Cox proportion hazard regression model showed that when comparing with the cases aged<30 years, aHR (95%CI) of the cases aged 30-39 years, 40-49 years, 50 years or above appeared as 4.506 (1.226-9.059), 5.944 (1.479-13.892) and 15.958 (5.309-27.206) respectively. When comparing with the cases having no loss of follow-up during ART process, the aHR of the cases having lost of follow-up during ART was 5.645 (95%CI: 3.124-10.200). When comparing with the cases diagnosed by other institutions, the aHR of the cases diagnosed by hospitals was 3.823 (95%CI: 1.423-10.274). When compared with the cases had no hepatitis B or hepatitis C before ART, aHR of the cases with hepatitis B or C prior to ART was 2.580 (95%CI:1.210-5.502). Compared with the cases receiving ART at Ⅰ/Ⅱ clinical stages, the aHR of the cases at Ⅲ/Ⅳ clinical stages was 3.947 (95%CI: 2.167-7.188). Compared with the cases with junior high school education or below, the aHR of the cases with high school education or above was 0.440 (95%CI: 0.238-0.810). Compared with the cases diagnosed before operation, aHR of the cases from special investigation and from counseling and testing (VCT) were 0.111 (0.027-0.456) and 0.182 (0.049-0.674) respectively. Conclusions The survival rate of HIV/AIDS cases that received ART was high in Tianjin. Risk factors related to the survival of cases would include: old age when started receiving ART, loss of follow-up during ART, diagnosed by hospitals, co-infected with hepatitis B or hepatitis C and receiving ART at Ⅲ/Ⅳ clinical stages. Meanwhile, protective factors related to the survival of cases would include: having high school or above education, diagnosis was made through other special programs or from VCT services.

Objective To explore the positive rates on HIV among men who have sex with men (MSM) who took bathhouse as the major place for sexual practice in China,between 2010 and 2015.Methods Articles published between 2010 and 2015 from CNKI,Wanfang Data,CJFD and PubMed were collected and Stata 12.0 software was used for Meta-analysis.Results A total of 14 articles were selected.Random effects model was employed to calculate the pooled positive rate according to statistical tests for homogeneity with the result f=88.1％.The pooled positive rate appeared as 10.3％,with 95％CI as 7.7％-13.0％.Publication bias was assessed by Egger's test and funnel plot.After stratified analysis on factors as:sample size,year,region and methods on recruitment,the pooled positive rate of HIV appeared higher in people living in the coastal provinces than those in the inland provinces.Conclusion The pooled positive rate of HIV identified from the bathhouses appeared higher than that from other places through,the national HIV sentinel surveillance data,with coastal higher than that in the inland provinces.Bathhouse was recognized as the key place to be caried on intervention programs for the MSM population.

Objective To understand the rate of follow-up lost in men who have sex with men (MSM) in a gay bathhouse cohort study in Tianjin and the associated factors.Methods The open cohort study in gay bathhouse was launched in 2012 in Tianjin,and the MSM for baseline survey were recruited from January to June 2012,while the follow up was carried out every six months.A questionnaire survey and HIV test were conducted in the study.The MSM who were HIV negative in the baseline survey in 2012 were used for follow up lost analysis.Univariate and multivariate logistic regression analysis were conducted to identify the factors associated with the lost of follow-up.Results A total of 658 gay bathhouse patrons were recruited in the baseline survey,at the end of 42-month follow-up period,173 of them dropped out (26.3％).Multivariate analysis showed that the MSM who were local residents (OR=0.552,95％CI:0.377-0.808),in Han ethnic group (OR=0.197,95％CI:0.066-0.593),having received HIV test in the last year (OR=0.481,95％CI:0.326-0.710),were male sex workers (OR=0.127,95％CI:0.028-0.585),and believed to be at high risk for HIV infection (OR=0.285,95％ CI:0.125-0.647).They were more likely to receive follow-up but the MSM who were aged ≥35 years (OR=1.891,95％CI:1.022-3.500) were more likely to be lost in the follow-up.Conclusion The lost rate of follow-up in MSM in the gay bathhouse cohort was high in Tianjin.Age,household registration,history of HIV test,the awareness of the risk to be infected with HIV and commercial homosex were factors associated with the follow-up rate in the MSM.It is necessary to conduct similar cohort study in targeted population on the basis of findings of this study.

Objective To understand the survival and influencing factors of HIV/AIDS patients in Tianjin.Methods The data of HIV/AIDS cases reported in Tianjin during 2004-2014,which were collected from National AIDS Prevention and Control Information System,were analyzed by using life table and Kaplan Meier method to calculate survival time and the survival rate,and univariate and multivariate Cox regression analysis was conducted to identify the influencing factors for survival time.Results For the 2 775 HIV/AIDS patients,1 year,3 years,5 years,10 years and 11 years cumulative survival rates were 91％,88％,86％,79％ and 79％ respectively.The risk of death in AIDS patients was higher than that in people living with HIV (x2=107.622,P＜0.001);Factors affecting the survival of people living with HIV were the first time CD4 value and antiviral treatment,and the influencing factors for survival of AIDS patients were the infection route,detection ways,first time CD4 value and antiviral treatment.Conclusion Early detection and early treatment can obviously reduce the risk for death of people living with HIV/AIDS.To improve the survival of HIV/ AIDS patients,it is necessary to strengthen the early detection and early treatment of HIV infection.

Objective To analyze the survival and influencing factors of treatment-naive HIV／AIDS patients aged 15 years or above in Tianjin.Methods The data of 973 untreated HIV／AIDS patients aged 15 years or above who were diagnosed during June 28 1996 to May 28 2017 in Tianjin were retrospectively analyzed.The survival rate of patients was calculated by the life table method , and the factors affecting the survival time were analyzed by the Cox proportional hazard model.Results There were 726 HIV carriers (74.6%) and 247 AIDS patients (25.4%).Among them, there were more males (93.7%, 912／973) than females (6.3%, 61／973); Han nationality accounted for 92.5%(900／973); the education level of most patients was high school or below (71畅0%, 691／973); half of the patients were unmarried (50.4%, 490／973); 57.7%(561／973) of the patients were infected by men who have sex with men ( MSM);62畅9%(612／973) were local residents and 37.1%(361／973) were migrants; 36.6%(356／973) cases were detected by pre-transfusion tests, and 74.5%( 725／973) had initial CD4 +T count tests.In this series, the average survival time is 11.03 years after diagnosis (95%CI 10.01-12畅05 years).The 1, 3, 5, and 10-year survival rates after diagnosis were 96.8%, 88.7%, 80.2%and 40.5%.183 cases (18畅8%) died from AIDS.Cox proportional hazard model analysis showed that compared with patients aged 15 to 35 years, patients aged 35-50 years (HR＝3.077, 95%CI 1.868-5.070) and ＞50 years (HR＝2.626, 95%CI 1畅553-4.440) had higher risk of AIDS-related deaths; compared with high school education or below , patients with college education or above ( HR＝0.562, 95%CI 0.371-0.851) had a lower risk of AIDS death; injection drug user (IDU) (HR＝0.751, 95%CI 0.316-0.909) had lower risk of death than MSM. Patients detected by the consultation ( HR＝0.463, 95%CI 0.252-0.851), special investigation ( HR＝0畅263, 95%CI 0.116-0.593), detainee physical examination ( HR＝0.055, 95%CI 0.007-0畅441) and STD clinic visits (HR＝0.033, 95%CI 0.005-0.239) had a lower risk of death than those detected by pre-transfusion tests.The initial CD4 +T lymphocyte counts were negatively correlated with the risk of AIDS-related death (P＜0.01).Conclusions The average survival time after diagnosis of untreated HIV／AIDS patients aged 15 years or above was 11.03 years in Tianjin.The age, education level, route of infection, detection of HIV infection and the initial CD 4 +T lymphocyte counts are related to the survival time after diagnosis of untreated HIV／AIDS patients.

Objective: To explore the pre-exposure prophylaxis (PrEP) awareness, willingness, uptake patterns, barriers and needs among Chinese student men who have sex with men (MSM), so as to provide relevant evidence for targeted interventions with PrEP. Methods: A proportional sampling method was used to conduct a cross sectional survey of MSM aged 16 years and older residing in 21 provinces, municipalities, and autonomous regions in mainland China between October 20 and December 20, 2021, to collect information on demographic and sexual behavioral characteristics, and 923 students of them were selected as the subjects of this study. The chi-square test and Fisher s test were used for univariate analysis, followed by multivariate Logistic regression to analyze the influencing factors of PrEP awareness and uptake. Results: According to the cascade analysis method, the awareness, willingness, uptake and adherence rates of PrEP among the student MSM were obtained as 88.95%, 67.36%, 13.20% and 45.21 %, respectively. HIV testing more than once in the last 3 months, and all of them were aware of the HIV test results of their sexual partners, and those with high frequency of condom use had a higher rate of awareness ( OR =2.32, 1.79, 1.69, P <0.05). Willingness rates were higher for those from the pilot city, using substances, and HIV testing more than once in the last 3 months ( OR =2.13, 1.65, 1.69, P <0.05). Higher rates of uptake were found among those from high risk and pilot areas, presence of commercial sex, substance use, and high literacy ( OR =5.60, 3.54,2.81, 1.92, 4.54, P <0.05). Adherence rates were higher among those who used one pill per day or both ( OR =12.77, 13.26, P <0.05). The barriers and needs faced by student MSM were primarily personal concerns about medication side effects, preventative effects, and confidence in sexual behavioral styles, and the high cost of medication and related service costs. Conclusions The student MSM population in China is characterized by high awareness, low willingness, low uptake, and low adherence to PrEP. Targeted interventions should be considered and tailored by the departments to facilitate PrEP promotion among student MSM.