Objective To understand the factors associated with high risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnoses in some areas in Henan province,and evaluate the risk of secondary transmission.Methods A face to face interview was conducted among people infected with HIV through heterosexual contact by using self-designed questionnaires during January-May in 2015.Results Among 361 HIV infected persons,the proportions of those with commercial heterosexual behaviors or sex with irregular sex partners decreased from 77.3％(279/361) and 28.5％(103/361) before diagnosis to 13.6％ (49/361) and 2.5％(9/361) after diagnosis,the difference was significant (x2=16.66,P＜0.001;x2=4.80,P=0.03).The subjects surveyed always had more commercial heterosexual behaviors in Henan,Guangdong and Zhejiang provinces before and after diagnosis.After HIV infection confirmation,the condom use rates were 51.0％(25/49) for commercial heterosexual behaviors,88.5％ (184/208) for sex with regular partners and 88.9％(8/9) for sex with irregular partners,respectively.Multivariate logistic regression analysis indicated that risk behaviors associated with HIV transmission included commercial sexual behaviors,previous HIV detection and age of 35 years or older.Conclusions Extra-marital heterosexual behavior has posed serious challenge to the prevention and control of HIV spread.It is necessary to inform the HIV test results,improve the intervention and promote condom use in people with history of commercial sex and people aged ≥35 years.

Objective:To analysis the characteristics and trends of non-martial and non-commercial heterosexual transmission of HIV/AIDS cases in Henan province between 2015 and 2020.Methods:Information of newly reported HIV/AIDS through non-martial and non-commercial heterosexual transmission was collected from National Comprehensive HIV/AIDS Information system, using SPSS 22.0 to analyze the characteristics and tend of cases.Results:During 2015-2020, a total of 10 877 HIV/AIDS cases infected by non-martial and non-commercial heterosexual transmission were newly reported in Henan province. This mode of infection increased from 32.6% in 2015 to 35.5% in 2020 (trend χ2=81.880, P<0.01). The male to female ratio was 1.9∶1 (7 105∶3 772). The mean age was (45.5±15.8) years, increasing annually ( F=5.184, P<0.01). For female cases, the proportion of aged 15-50 years group was decreased annually (trend χ2=69.888, P<0.01). Most HIV/AIDS cases were distributed in the early HIV epidemic areas and Zhengzhou city, the same as the cases of the first CD4 +T cells counts (CD4) below 200 cells/μl. The median ( P 25, P 75) first CD4 count was 298 (143, 462) cells/μl. The proportion of the first CD4<200 cells/μl was no significant change annually, while the proportion of the first CD4≥500 cells/μl was decreasing annually (trend χ2=18.961, P<0.01). Conclusions:The reported cases through non-martial and non-commercial heterosexual transmission increased, with most of them were male, married, junior, farmer, migrant laborer, and aged 40-59 years. It is needed to focus on the rural district and the middle-aged population, combined with biological and social factors to control the prevalence of AIDS through comprehensive prevention and control measures.

Objective To evaluate the effectiveness of the intervention on preventing mother to child transmission of HIV and identify the influencing factors.Methods The data regarding the pregnant women and their infants were collected,including demographic characteristics,pregnancy and delivery,access to antiviral therapy,HIV infection status at age 18 months and survival of infants between 2002 and 2013 through follow-up,Multivariate logistic regression model were used to identify the influencing factors.Results By the end of 2013,a total of 8 621 554 pregnant women received HIV test,among them 2 264 were infected with HIV.The positive rate of HIV is 0.03％.The HIV positive rate decreased year by year (x2=4.871,P=0.027).A total of 1 530 infants were born from 2002 to 2013,among them 1 384 survived and 92 died at age of 18 months,and 54 were lost for follow up.Sixty infants were tested to be HIV-positive,1 324 infants were tested to be HIV-negative.The mother to child transmission rate was 4.34％,the corrective mother to child transmission rate was 6.33％.Receiving HIV prevention service in early pregnancy (OR=0.26,95％ CI:0.09-0.77),standardized antiviral therapy OR=0.42,95％CI:0.21-0.82),artificial feeding (OR=0.06,95％CI:0.02-0.21) might be the mam protective factors,episiotomy on delivery (OR=3.91,95％ CI:1.74-8.80) might be the risk factors.Conclusion The HIV tested positive rate remained to be low and decreased year by year in pregnant women in Henan,but the mother to child HIV transmission rate was high.It is necessary to improve the prevention of mother to child HIV transmission.

Objective To understand the major high risk behaviors and related factors among reported HIV/AIDS cases aged ≥60 years in some areas of Henan province.Methods In Dengzhou,Xunxian county of Hebi and Xiangcheng county of Xuchang,where the reported number and proportion of HIV/AIDS cases aged ≥60 years were high,a face to face interview was conducted among the cases aged ≥60 years during July-August in 2016.The information about the high risk behaviors before HIV infection confirmation were collected by using a semi-structured questionnaire.Results A total of 33 HIV/AIDS cases aged ≥60 years were interviewed,including 28 males and 5 females.Their average age was 67.4 years.The infection route was sexual contact.The main findings revealed that the main factor for HIV infection in elder males was commercial heterosexual behavior with local female sex workers.The condom use rate was low.The poor awareness of the knowledge about AIDS prevention could explain why the elderly could not recognize the risk of HIV infection.There were also homosexual and bisexual behaviors in elder male HIV/AIDS patients.Late detection of HIV transmission among couples was the main cause of HIV infection in elder women.Conclusions The major epidemiological related factors for HIV infection in the elderly in some areas of Henan were unsafe sex behavior and the poor awareness of knowledge about AIDS prevention.A targeted strategy should be taken to control the spread of HIV in the elderly.

Objective To analyze the survival status and influencing factors of the AIDS patients under 14 years of age and receiving antiretroviral treatment in Henan Province. Methods Database of children AIDS patients receiving ART were download from China information system for disease preventioin and control-AIDS, AIDS cases from January, 2003 to June, 2014 were selected to be analyzed. Demographic characteristics baseline laboratory inclusion criteria: F First time receive national free ART during study;aged 14 years or below;and with relatively complete baseline information and follow-up information. 1 037 cases were selected. Patient information about survival status, death, demographic characteristics, and baseline laboratory test results were analyzed. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by COX proportional hazard model. Results A total of 1 037 AIDS children-cases ((9.52 ± 3.56) years old)which included 628 boys and 409 girls were recruited in the study, 939 cases survived 1 to 9 years from starting ART treatment and 98 cases died. Accumulated survival rate of AIDS children receiving ART from 1 year to 9 years were 96.11%, 94.17%, 92.74%, 91.28%, 90.54%, 89.47%, 88.52%, 88.52%, 86.84%, respectively. Results of multivariate analysis showed baseline count of CD4 +T lymphocyte (HR=0.51, 95%CI:0.36-0.72), duration from confirmation to the initial ART time (HR=0.85, 95%CI:0.75-0.97) and hemoglobin level (HR=2.26, 95%CI:1.09-4.70) were influence factors for survival time of AIDS children patients receiving ART. Conclusion Survival rate of AIDS children aged 14 years or below and receiving ART in Henan Province was relatively high. Timely surveillance of CD4+ T and the hemoglobin level of the AIDS patients so as to timely launch HARRT could extend survival time of AIDS patients.

Objective:To analyze the epidemiological characteristics of newly reported HIV/AIDS cases in Henan province during 2010-2018, and to provide theoretical evidence for strategies on prevention and control.Methods:Information about newly reported HIV/AIDS cases in Henan between January 1, 2010 and December 31, 2018 were collected from the National Comprehensive HIV/AIDS Information System. Excel 2010 and software SPSS 23.0 were used for data cleaning and statistical analysis.Results:During 2010-2018, a total of 41 223 HIV/AIDS cases were newly reported in Henan, and the number of newly reported HIV/AIDS cases increased from 3 087 in 2010 to 5 910 in 2018. Sexual contact was the predominant transmission route in newly reported HIV/AIDS cases, and the proportion of sexual transmission increased from 50.6 % (1 564/3 087) in 2010 to 98.8 % (5 839/5 910) in 2018. The proportion of heterosexual transmission firstly increased from 44.9 % (1 387/3 087) in 2010 and then declined to 65.7 % (3 885/5 910) in 2018, and the proportion of MSM behavior related transmission increased from 5.7 % (177/3 087) in 2010 to 33.1 % (1 954/5 910) in 2018. Among the newly reported heterosexual transmitted cases, the proportion of cases with non-marital heterosexual behaviors increased from 69.4 % (962/1 387) in 2010 to 91.7 % (3 562/3 885) in 2018 ( χ2=657.802, P<0.001). The number of newly reported HIV/AIDS cases in young people aged 15-24 years and old people aged ≥60 years increased year by year. The youth cases were mainly infected by MSM behavior transmission (52.7 %, 2 561/4 856), and heterosexual transmission was the main infection route of the elder cases (86.4 %, 5 907/6 833). Among the elder cases infected by heterosexual transmission, cases with non-marital heterosexual behaviors were mainly males, the number of male cases increased from 122 in 2010 to 738 in 2018, and sex composition ratio was between 82.2 % and 91.0 %, while the sex composition ratio of female cases was increased from 9.0 % (12/134) in 2010 to 17.8 % (160/898) in 2018. Conclusions:From 2010 to 2018, the number of newly reported HIV/AIDS cases in Henan increased. Sexual transmission had become the main transmission route. AIDS prevention and control should focus on the control of non-marital heterosexual transmission and MSM behavior transmission, and to pay more attention to young people and people aged 60 years and above.

Objective:To analyze the epidemiological characteristics of newly reported HIV-infected cases aged 50 years and above in Henan province during 1995-2020, and to provide evidence for strategies on HIV/AIDS prevention and control.Methods:Information about newly reported HIV-infected cases aged 50 years and above in Henan between 1995 and 2020 were collected from the National Comprehensive HIV/AIDS Information System. The demographic and behavioral characteristics of HIV-infected cases aged ≥50 were analyzed, and the mixed linear model based on CD4 + T lymphocyte (CD4) counts back calculation was used to estimate the years, time and age of the HIV infection. Results:During 1995-2020, a total of 25 038 HIV-infected cases aged 50 years and above were newly reported, accounting for 25.8% (25 038/96 867) of the total number of newly reported HIV-infected cases in Henan. The proportion of newly reported cases over 50-years-old gradually increased from 4.5% (18/396) in 1995-2000 to 35.5% (9 666/27 239) in 2016-2020, with statistically significant difference ( χ2=3 105.53, P<0.001). Among them, the proportion of HIV-infected cases aged 60 years and above were increasing year by year. The proportion of male cases were increasing along with ageing. The proportion of HIV-infected cases detected by medical institutions also showed an upward trend. The newly reported HIV-infected cases aged 50 years and above were mainly transmitted through sexual contact. The proportion of heterosexual transmission increased from 5.5% (1/18) in 1995-2000 to 86.2% (8 334/9 666) in 2016-2020, and the proportion of MSM-behavior-related transmission increased from 0.0% in 1995-2000 to 13.5% (1 304/9 666) in 2016-2020. The majority of cases had extra-marital and/or non-commercial heterosexual behavior (48.1%, 4 007/8 334) and the proportion showed an upward trend. The majority of male cases had commercial heterosexual behavior (54.9%, 3 169/5 775), and with increasing proportion along with the increase of age. The majority of female cases had extra-marital and/or non-commercial heterosexual behavior (62.5%, 1 600/2 559), with increasing proportion of extra-marital and/or non-commercial heterosexual behavior. The proportion of heterosexual behavior with spouse or stable sexual partners showed a downward trend. The estimations based on CD4 counts back calculation model showed that among the newly reported HIV-infected cases aged 50 years and above, the average age being infected was (54.8±10.2) years, with 33.8% (4 263/12 621) infected before 50. The interval between infection and diagnosis was (5.7±6.2) years, of which 52.6% (6 636/12 621) were infected for 5 years or longer and 34.7% (4 384/12 621) were in the last 3 years. There was no linear correlation trend in the composition of infection years among the newly reported HIV-infected cases over 50-years-old. Conclusions:In Henan, from 1995 to 2020, the number of newly reported HIV-infected cases aged 50 years and above was increasing and sexual transmission becoming the main transmission route. The increase of prevalence was mostly seen in 60-years-old men, low education level and detected mainly by medical institutions. For this age group, the focus of HIV/AIDS prevention and control should target on those who were transmitted through extra-marital and/or non-commercial heterosexual, commercial heterosexual and MSM behavior and it is necessary to strengthen the HIV testing and detection in this population and in the elderly floating group.

Objective:To identify the spatial clustering and its temporal trends among newly reported HIV/AIDS cases in Henan Province during 1995-2020, and to provide evidence for strategies on prevention and control of the disease.Methods:Information about newly reported HIV/AIDS cases in Henan between 1995 and 2020 were obtained from China Information System for Disease Control and Prevention and to describe their demographic characteristics, spatial autocorrelation and changing trends. This program was conducted at county level, using the ArcGIS 10.2.Results:A total of 96 528 HIV/AIDS cases with complete current address information in counties (districts) were newly reported during 1995-2020 in Henan, and the spatial autocorrelation analysis showed that Global Moran's I index was 0.249, Z G value of the Global Getis-Ord G coefficient was 6.472 (all P<0.001), indicating that there was a high clustered positive spatial autocorrelation of HIV/AIDS. The newly reported HIV/AIDS cases from 1995 to 2000, 2001 to 2005, 2006 to 2010, 2011 to 2015, and 2016 to 2020 in Henan Province all exhibited high values of global spatial clustering. Their Moran's I indices were 0.197, 0.103, 0.491, 0.411 and 0.383, respectively. The Z G values of the Global Getis-Ord G coefficient were 4.580, 3.386, 10.246, 8.378 and 8.093, respectively. All of global spatial correlation were statistically significant (all P<0.001). The results of local spatial autocorrelation analysis showed that newly reported HIV/AIDS cases in Henan Province had high-high clustering areas at each time stage mentioned above. The number of high-high clustering counties/districts gradually increased from 6 in 2001-2005 to 21 in 2016-2020, spreading from Zhumadian City and Zhoukou City in southeast Henan to Nanyang City in southwest Henan, Zhengzhou City and its surrounding counties/districts in central Henan. Conclusions:In Henan Province, an increasing trend of clusters appeared on HIV epidemic among newly reported HIV/AIDS cases from 1995 to 2020, and high-high clustering areas gradually expanded from Zhumadian City and Zhoukou City to Nanyang City, Zhengzhou City and its surrounding counties/districts, indicating that it is necessary to strengthen the AIDS prevention and control programs in these areas in Henan.

Objective To analyze the survival status and influencing factors of the AIDS patients under 14 years of age and receiving antiretroviral treatment in Henan Province. Methods Database of children AIDS patients receiving ART were download from China information system for disease preventioin and control-AIDS, AIDS cases from January, 2003 to June, 2014 were selected to be analyzed. Demographic characteristics baseline laboratory inclusion criteria: F First time receive national free ART during study;aged 14 years or below;and with relatively complete baseline information and follow-up information. 1 037 cases were selected. Patient information about survival status, death, demographic characteristics, and baseline laboratory test results were analyzed. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by COX proportional hazard model. Results A total of 1 037 AIDS children-cases ((9.52 ± 3.56) years old)which included 628 boys and 409 girls were recruited in the study, 939 cases survived 1 to 9 years from starting ART treatment and 98 cases died. Accumulated survival rate of AIDS children receiving ART from 1 year to 9 years were 96.11%, 94.17%, 92.74%, 91.28%, 90.54%, 89.47%, 88.52%, 88.52%, 86.84%, respectively. Results of multivariate analysis showed baseline count of CD4 +T lymphocyte (HR=0.51, 95%CI:0.36-0.72), duration from confirmation to the initial ART time (HR=0.85, 95%CI:0.75-0.97) and hemoglobin level (HR=2.26, 95%CI:1.09-4.70) were influence factors for survival time of AIDS children patients receiving ART. Conclusion Survival rate of AIDS children aged 14 years or below and receiving ART in Henan Province was relatively high. Timely surveillance of CD4+ T and the hemoglobin level of the AIDS patients so as to timely launch HARRT could extend survival time of AIDS patients.

OBJECTIVETo analyze the survival status and influencing factors of the AIDS patients under 14 years of age and receiving antiretroviral treatment in Henan Province.

METHODSDatabase of children AIDS patients receiving ART were download from China information system for disease preventioin and control-AIDS, AIDS cases from January, 2003 to June, 2014 were selected to be analyzed. Demographic characteristics baseline laboratory inclusion criteria: F First time receive national free ART during study; aged 14 years or below; and with relatively complete baseline information and follow-up information. 1 037 cases were selected. Patient information about survival status, death, demographic characteristics, and baseline laboratory test results were analyzed. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by COX proportional hazard model.

RESULTSA total of 1 037 AIDS children-cases ((9.52 ± 3.56) years old) which included 628 boys and 409 girls were recruited in the study, 939 cases survived 1 to 9 years from starting ART treatment and 98 cases died. Accumulated survival rate of AIDS children receiving ART from 1 year to 9 years were 96.11%, 94.17%, 92.74%, 91.28%, 90.54%, 89.47%, 88.52%, 88.52%, 86.84%, respectively. Results of multivariate analysis showed baseline count of CD4⁺ T lymphocyte (HR = 0.51, 95% CI: 0.36-0.72), duration from confirmation to the initial ART time (HR = 0.85, 95% CI: 0.75-0.97) and hemoglobin level (HR = 2.26, 95% CI: 1.09-4.70) were influence factors for survival time of AIDS children patients receiving ART.

CONCLUSIONSurvival rate of AIDS children aged 14 years or below and receiving ART in Henan Province was relatively high. Timely surveillance of CD4⁺ T and the hemoglobin level of the AIDS patients so as to timely launch HARRT could extend survival time of AIDS patients.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adolescent ; Antiretroviral Therapy, Highly Active ; CD4-Positive T-Lymphocytes ; Child ; Child, Preschool ; China ; Female ; Humans ; Male ; Proportional Hazards Models ; Survival Analysis ; Survival Rate