Objective To obtain the information on the frequency of diagnostic X-ray examinations in Guangdong province in order to provide reference data for the rational application of diagnostic radiology.Methods A typical stratified sampling method was used to select 56 medical institutions in 7 districts in Guangdong province for the survey of the frequencies of diagnostic X-ray examinations.Multiple linear regression analysis was performed using the relevant variables of the surveyed sample (total number of hospitals,number of outpatients,number of inpatients,number of radiation workers,and number of diagnostic equipment).The dependent independent variables were fitted to the linear regression equation to estimate the frequency of routine diagnostic X-ray examinations and diagnostic CT examinations and the total frequency of diagnostic medical X-ray examinations in Guangdong province in 2016.Results By the largest percentage contribution,chest radiography accounted for 60.84％ of the routine diagnostic X-ray examinations,brain scans 28.03％ of diagnostic CT examinations,and cardiovascular interventions 48.83％ of interventional radiology.For the group of above 40 years old,the largest percentage contributions were,respectively,routine diagnostic X-ray examination 47.95％,diagnostic CT examinations 65.41％,and interventional radiology 75.64％.All types of medical X-ray examinations are concentrated in the tertiary and secondary hospitals.Based on this survey,the examination frequencies for 2016 in Guangdong were estimated to be,respectively,diagnostic X-ray examination 699 examinations per 1 000 population and CT diagnostic 231 examinations per 1 000 population,with the total of 992 examinations per 1 000 population.Conclusions This survey was completed to a limited degree and less investment.The results showed that the diagnostic radiology in Guangdong province is developing with increased frequencies,with wide varieties of X-ray examination types in the tertiary and secondary hospitals.Relevant competent defpartments should pay attention to strengthening the radiation protection of examined individuals and actively providing guidance on the correct and rational applicc ation of diagnostic radiology so as to achieve profit and avoid disadvantages.

Objective: To analyze the epidemiological characteristics of HIV/AIDS infected students in Shandong Province, to provide a basis for the prevention and control of AIDS transmission in the student population. Methods: All 863 HIV/AIDS students cases during 2010-2019 were collected in Shandong Province. Epidemiological characteristics was described and the trends in the 10 years since 2010 was analyzed. Results: These 863 HIV/AIDS students were mainly transmitted through homosexual sex (763 cases, 88.41%), and the samples were mainly from voluntary consultation testing (433 cases, 50.17%). From 2010 to 2019, the proportion of student cases in the total number of cases showed an increasing trend ( χ 2 trend =30.21, P <0.01). Among them, the proportion of homosexual transmission cases increased year by year ( χ 2 trend =6.35, P =0.01), the proportion of cases aged 18-22 years increased year by year ( χ 2 trend =6.10, P =0.01), the proportion of cases with college degree or above increased year by year ( χ 2 trend =4.26, P =0.04). At present, voluntary consultation testing were the main source.There was no significant difference between the years of sample sources ( χ 2 trend =2.97, P =0.09). Conclusion The report number of students in Shandong Province are on the rise in recent years, especially those infected by same sex transmission, mainly with high education background, which calls for targeted strategies and intervention measures.

Objective: To understand the survival status of AIDS patients after initiation of antiretroviral treatment (ART) in Shandong province during 2003 to 2017, and to determine the factors associated with survival status. Methods: A retrospective cohort study was conducted among AIDS patients initially received antiretroviral therapy from 2003 to 2017. The epidemiological characteristics of the subjects were described, and life tables were used to estimate the survival rates, the influencing factors were analyzed by Cox regression model. Results: A total of 9 813 cases were enrolled in this study, of the subjects, the median age was 34.9±11.0 years. The median of baseline CD4+ T lymphocyte count was 300.0(P₂₅-P₇₅: 163.0, 428.0)cells/μl, and 83.2% of them were at clinical stage Ⅰ (World Health Organization, WHO). The cumulative survival rates were 97.7%, 96.7%, 95.8% and 93.7%, 1, 3, 5, and 10 years after the initiation of ART respectively. Multivariate Cox regression model analysis showed that the risk of the mortality among those infected through homosexual behavior was 38% lower than that of patients infected via blood or other routes, and HR was 0.62 (95%CI: 0.43-0.89). Higher education level had lower mortality risk(the mortality risk of those with university degree or above was lower, compared to those with primary and lower cultural level, HR=0.41, 95%CI: 0.26-0.65). At baseline, AIDS patients at clinical stage Ⅰ(WHO) had lower mortality risk than those who were at clinical stageⅡ, Ⅲ, and Ⅳ(WHO). Lower baseline CD4+ T lymphocyte count had higher mortality risk. Conclusions Survival rate was higher after initial antiretroviral therapy among AIDS patients in Shandong province. CD4+ T lymphocyte count level, WHO clinical stage, and presence or absence of clinical symptoms at baseline are the main factors influencing the survival time of AIDS patients after ART.

A survey was conducted to analyze the HIV testing status and related influencing factors of male sexually transmitted diseases(STD) patients attending 18 county-level hospitals in Shandong Province from July 2015 to August 2016. The HIV detection rate of 1 570 subjects was 77.58% (1 218/1 570), and the HIV-antibody positive rate was 0.99% (12/1 218). Compared with general hospitals patients, urinary and anorectal patients, non-sexual patients, and patients with negative attitudes toward HIV testing, patients were more likely to be tested for HIV from specialized hospitals (OR=3.74, 95%CI:2.53-5.54), the skin and venereal section (OR=1.92, 95%CI: 1.31-2.79), the STD group (OR=2.02, 95%CI: 1.34-3.03) and patients with positive attitude (OR=15.20, 95%CI:10.74-21.52).

Objective: To analyze the epidemic features of male HIV-infected and AIDS patients by sexual transmission in Shandong Province. Methods: Data on HIV-infected people and AIDS patients (HIV/AIDS) were derived from HIV/AIDS Comprehensive Response Information Management System. To analysis the epidemiological data of male HIV/AIDS by sexual transmission reported in Shandong Province from 1997 to 2016. Results: A total of 8 584 HIV/AIDS were reported by heterosexual transmission or homosexual transmission from 2007 to 2016. 2 421 cases were reported by heterosexual transmission and 6 163 cases were reported by homosexual transmission. Among cases infected by heterosexual transmission. The average age of cases infected by heterosexual transmission was (38.13±12.39) and (31.62±10.22) among cases who infected by homosexual transmission (t=24.95, P<0.001). 84 cases were reported by homosexual transmission and 138 cases by heterosexual transmission from 2007 to 2008, and 6 079 cases were reported by homosexual transmission and 2 283 cases by heterosexual transmission from 2009 to 2016. A total of 770 cases were dead after reported. Among the dead cases, 337 cases were infected by homosexual transmission and 433 cases by heterosexual transmission (χ²=328.21, P<0.001). 61.4% of the dead cases by heterosexual transmission were no longer than 6 months after reported and 54.3% in homosexual transmission (χ²=3.96, P=0.047). Conclusion Homosexual transmission has been the main transmission of HIV/AIDS in Shandong Province. Epidemiological features and social demographic characteristics of each sexual transmission were different. As part of HIV cases developed to death in 6 months.

Objective:To analyze the timeliness and influencing factors of antiretroviral treatment (ART) among HIV/AIDS patients from 2017 to 2019 in Shandong province.Methods:Data were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System, HIV/AIDS cases enrolled in antiretroviral therapy, from January 1, 2017 to December 31, 2019, ≥15 years of age and from the mainland of China were the subjects of the study. The general demographic characteristics (gender, age, ethnicity, education level, marital status, etc), infection routes, sample sources, date of diagnosis, baseline CD4+ T cell level, and clinical stage and other information were collected from the database. Univariate analysis was conducted for the timeliness of ART of the subjects by Chi square test, and the influencing factors associated with timeliness of ART were analyzed by binary non-conditional Logistic regression.Results:Among the 7 425 cases of HIV/AIDS, 6 813(91.8%) were male, 5 236(70.5%) had homosexual transmission, the age at the ART initiation was(36.05±12.51)years. The proportion of timeliness of ART within 30 d increased from 55.9% (1145/2050) in 2017 to 65.3% (1821/2789) in 2019. The possibility of timeliness of ART among HIV/AIDS who were married or cohabiting, education of high school and above were higher, with OR values at 1.136, 1.299. The possibility of timeliness of ART among HIV/AIDS cases whose domicile place is outside Shandong province were lower, with OR values at 0.664. The possibility of timeliness of ART in group of HIV/AIDS aging≥55, 45~54 and 35~44 years old were higher than that in 15~24 years old, with OR values at 1.530, 1.505 and 1.394. The possibility of timeliness of ART among the heterosexuals were lower than that of homosexuals, with OR values at 0.803. The possibility of timeliness of ART is lower for cases in places of detention centers than cases from volunteer testing and counseling, with OR values at 0.204. The possibility of timeliness of ART among HIV/AIDS cases whose CD4+ T lymphocyte at >500 cells/μL were lower than that of the cases whose CD4+ T lymphocyte at≤500 cells/μl, with OR values at 0.545. Patients without symptoms at baseline were less likely to receive prompt treatment than those with clinical symptoms, with OR values at 0.727. Patients with baseline clinical staging of stage Ⅳ, period of HIV/AIDS treatment with timeliness was longer than the cases with baseline clinical stages ofⅠ, Ⅱ, Ⅲ, with OR values at 1.307. Conclusions:The proportion of timeliness of ART increased from 2017 to 2019. Marital status, educational level, age, sample source, infection routes, baseline clinical stage, and CD4+ T lymphocyte levels were associated with the timeliness of ART.

Objective:To analyze the status of first viral load (VL) suppression for newly diagnosed HIV/AIDS on antiretroviral therapy (ART) from 2014 to 2016 in Shandong province, to provide theoretical evidence for improvement of ART effectiveness.Methods:Based on a retrospective cohort study, logistic regression model was used to identify influencing factors about VL suppression.Results:There were 4 833 newly diagnosed HIV/AIDS cases who received ART from 2014 to 2016 in Shandong province, and 3 449 cases achieved VL suppression at the first VL testing. The rate of first VL suppression was 71.36%. The possibilities of first VL suppression among patients on ART with education at junior high school, junior college and above were higher than those with education at primary school and below, with OR values at 1.75 and 2.00, separately. The possibilities of first VL suppression for patients treated at medical institutions was higher than those by CDC, with OR value 1.29. The possibilities of first VL suppression among patients whose CD4 count level at 201-350, 351-500 and ≥501 cells/μl were higher than that of the patients whose CD4 count level at ≤200 cells/μl, with OR values at 2.36, 2.11 and 2.66, respectively. The possibilities of first VL suppression among patients who missed doses was lower than those who did not miss doses, with OR value at 0.55. All the Pvalues for the above comparisons was <0.05. Conclusions:The suppression of viral load for HIV/AIDS on ART was influenced by culture level, CD4 count level at the entry of ART, treatment institutions and adherence to the therapy. Earlier diagnosis, treatment services provided by medical institutions and improvement of drug adherence can enhance ART effectiveness.

Objective This study aimed to analyze the behavior change and related factors regarding HIV/STD epidemics among female sex workers (FSWs) in Qingdao city.Methods According to the requirements set by the "National HIV/AIDS sentinel surveillance program",information on demographics,sexual and drug use behaviors,and HIV-related services among female sex workers (FSWs) was collected from ten consecutive annual cross-sectional surveys from 2006 to 2015.Blood samples were drawn for serological tests on both HIV and syphilis antibodies.Results Data from the sampled FSWs over the ten years,a higher proportion of participants who were aged 30 or more,married or cohabited and on-call FSW were followed.The prevalence of syphilis increased significantly from 1.0％ (4/420) in 2006 to 13.3％ (53/400) in 2015 (trendx2=54.22,P＜0.001).Rates on illicit drug use were ranging from 12.0％ (48/400) and 55.5％ (222/400) while the rate on consistent condom use with clients in the last month showed decreasing,with trendx2=170.62,P＜0.001.The proportion of HIV-related knowledge score ≥ 6 (trend x2 =152.96,P＜ 0.001),or ever been tested for HIV (trendx2=114.87,P＜0.001) were both significantly increased over the last ten years.Between 2009 and 2015,results from the annual stratified analysis showed that the FSWs who used drugs were more likely than the FSWs who were non-drug users less consistently using condoms with clients in last month and being syphilis positive (P＜0.05).On-call FSWs were more likely to be syphilis positive (P＜0.05) than the non on-call FSWs.Conclusions The prevalence of syphilis among FSWs in Qingdao city had been rising over the last ten years,with synthetic drug abuse as an important risk factor.Better targeted surveillance and intervention efforts among those drug-using FSWs seemed important to reduce the epidemics.

Objective:To explore the impact of achievement of the "90-90-90" goals on reductions in HIV incidence in Shandong province.Methods:An algebraic method was developed to link new HIV infections and the "90-90-90" goals in Shandong province. The risk estimation equation was used to analyze the effect of achievement of the "90-90-90" goals on reductions of HIV incidence, and explore the impact of application of antiviral therapy based prevention and control strategy on reduction of new HIV infections.Results:If "90-90-90" goals were achieved in 2020 in Shandong compared with annual new HIV infections in 2010, the percentage of reduction would be 17.27%, 35.99% and 67.55% respectively when transmission rate decreased by 26.00%, 53.00% and 96.00% respectively. Compared with 2017, when the transmission rate decreased by 53.00%, the annual new HIV infections would has a decrease of 10.10% if the rates of diagnosis and ART reached 90.00%; the annual new HIV infections would has a decrease of 20.80% if the rates of diagnosis and viral suppression reached 90.00%; the annual new HIV infections would has a decrease of 12.29% if the rates of ART and viral suppression reached 90.00%.Conclusions:HIV incidence would decrease with the achievement of "90-90-90" goals in Shandong. Compared with the improvement of ART, the improvement in diagnosis of HIV infection and viral suppression would result in more rapid decrease of new HIV infections. Besides expanding ART coverage, more attention should be paid to the strengthening of the diagnosis of HIV infection and viral suppression in Shandong.

Objective:To understand the relationship between new-type drug use and high risk behavior in men who have sex with men (MSM) in Shandong province.Methods:Cross-sectional surveys was conducted to collect the information about demographics, sexual and drug use behaviors of MSM and HIV-related services in MSM in three sentinel surveillance sites in Shandong from April to July in 2019. Blood samples were taken from the MSM for serological tests of HIV antibody and syphilis antibody.Results:A total of 1 203 MSM were included in this study. The average age of the MSM was 30.2±8.9 years. Among these MSM, 67.7 % (815) were unmarried; 66.9 % (805) had education level of college or above; 62.2 % (721/1 160) had unprotected sex behaviors and 16.3 % (189/1 160) had group sex behavior in the past six months and 54.2 % (652/1 203) ever used new-type drugs. HIV infection and syphilis prevalence rates were 3.1 % (37/1 203) and 4.7 % (56/1 203), respectively. Multivariable logistic analysis indicated that MSM who had unprotected anal sex in the past six months were more likely to be from Qingdao (a OR=1.59, 95 %CI:1.13-2.23), with education level of high school or below (a OR=1.61, 95 %CI: 1.20-2.16), with male sex partners from bars/dance halls or other venues (a OR=1.69, 95 %CI: 1.06-2.69), with HIV knowledge awareness score <6 (a OR=1.55, 95 %CI: 1.01-2.37), with ≥2 sex partner in the past week (a OR=1.48, 95 %CI: 1.12-1.95), to have group sex behaviors in the past six months (a OR=2.43, 95 %CI:1.61-3.67) and to use new-type drugs (a OR=1.46, 95 %CI: 1.11-1.91). MSM who had group sex were more likely to have following features: being from Qingdao (a OR=2.21, 95 %CI: 1.45-3.38), non-Shandong residents (a OR=2.13, 95 %CI: 1.28-3.55), HIV knowledge awareness score ≥6 (a OR=3.11, 95 %CI: 1.55-6.25), ever having unprotected anal sex behaviors (a OR=2.60, 95 %CI: 1.71-3.96) and ever having male commercial sex (a OR=3.38, 95 %CI: 1.92-5.95) in the past six months, ever using new-type drugs (a OR=2.71, 95 %CI: 1.82-4.04), and never having HIV testing in the past year (a OR=2.66, 95 %CI: 1.59-4.43). Conclusion:New-type drug use is common in MSM in Shandong. The use of new-type drugs promotes unprotected sex and group sex in MSM. Surveillance and intervention measures targeting this population should be strengthened.