Objective : To investigate the factors affecting multiple sexual partner behaviors among men who have sex with men (MSM) at ages of 16 to 24 years in Zhejiang Province, so as to provide the evidence for formulating the integrated interventions for HIV/AIDS among adolescents. Methods : The demographic features, sexual behaviors and HIV testing were collected from MSM at ages of 16 to 24 years in Zhejiang Province through the Management Information System of China AIDS Fund for Non-governmental Organizations (CAFNGO) in 2021. The factors affecting multiple sexual partner behaviors were identified among MSM at ages of 16 to 24 years using a multivariable logistic regression model. Results : A total of 1 253 participants were enrolled, with a mean age of (21.16±2.06) years. There were 1 219 unmarried respondents (97.29%), 807 (64.61%) with diploma and above, 250 (19.95%) with multiple sexual partners during the past 3 months, 344 (27.45%) with unprotected sexual behaviors in the past 3 months, 71 (5.67%) that had used rush or new drugs, 511 (40.78%) that were unaware of their sexual partners' HIV infections, 28 (2.23%) with symptoms or diagnosis of sexually transmitted diseases, and 35 (2.79%) with positive HIV testing. Multivariable logistic regression analysis identified age (19 years-, OR=2.563, 95%CI: 1.404-4.679; 22 to 24 years, OR=2.149, 95%CI: 1.180-3.913), having unprotected sexual behaviors in the past 3 months (OR=5.338, 95%CI: 3.938-7.237), having used rush or new drugs in the past 3 months (OR=3.669, 95%CI: 2.142-6.286), unaware of sexual partners' HIV infections(OR=1.402, 95%CI: 1.032-1.903), and positive HIV tests (OR=2.763, 95%CI: 1.298-5.880) as factors affecting multiple sexual behaviors among MSM at ages of 16 to 24 years. Conclusions The multiple sexual behaviors correlate with age, unprotected sexual behaviors, use of rush or new drugs and unawareness of sexual partners' HIV infections among MSM at ages of 16 to 24 years.

Objective: To investigate the characteristics of AHFtest-based HIV antibody self-testing among male adolescents at ages of 15 to 24 years, so as to provide insights into the promotion of HIV antibody self-testing. Methods: Data were collected from male adolescents at ages of 15 to 24 years that applied for HIV antibody self-testing in the AHFtest platform from 2019 to 2021, with mailing address showing as Zhejiang Province, and demographics, applying cause and testing results were analyzed. Results: A total of 268 male adolescents were enrolled, with a median age of 22.00 (interquartile range, 3.00) years. There were 160 cases with an educational level of junior college/bachelor (59.70%), 147 students (54.85%), 175 men who had sex with men (65.30%), and 126 cases with a history of previous HIV antibody self-testing (47.01%). The main causes for applying for HIV antibody self-testing through AHFtest were "easy to operate" (259 cases, 96.64%) and "privacy protect" (102 cases, 38.06%). There were 203 subjects that applied once HIV antibody self-testing (75.75%), and 65 subjects that applied multiple self-testing (24.25%). There were 123 subjects that uploaded their test results (45.90%), including 3 cases with HIV antibody positive, and 125 subjects that did not tell others the self-testing results (46.64%). Conclusions Among male applicants at ages of 15 to 24 years in Zhejiang Province from 2019 to 2021, students are predominant occupation. Easy to operate and privacy protect are the main cause for the application, but the proportion of detection results uploading is relatively low.

Objective: To investigate the factors affecting HIV testing among male college students with sexual behaviors, so as to provide the evidence for improving the detection of HIV testing among young college students. Methods: Four undergraduate universities and one junior college were randomly sampled from Hangzhou City using a purposive sampling method during the period between September and November, 2021, and male students with self-reported sexual behaviors were recruited as study students. Participants' demographics, AIDS-related knowledge, sexual behaviors and HIV testing were collected using questionnaires, and factors affecting HIV testing using a multivariable logistic regression model. Results: A total of 720 male college students with sexual behaviors were enrolled, including 180 freshmen (25.00%), 178 sophomores (24.72%), 163 juniors (22.64%), 50 seniors (6.94%) and 149 postgraduates (20.69%), and 94 students received HIV testing (13.06%), including 57.45% receiving self-testing. Multivariable logistic regression analysis identified postgraduates (OR=0.302, 95%CI: 0.127-0.719), sexual orientation (homosexual, OR=0.090, 95%CI: 0.028-0.294; bisexual/uncertain, OR=0.181, 95%CI: 0.066-0.495), awareness of HIV testing (low awareness, OR=0.411, 95%CI: 0.176-0.957; moderate awareness, OR=0.305, 95%CI: 0.123-0.757; high awareness, OR=0.087, 95%CI: 0.032-0.235) as factors affecting HIV testing among male college students with sexual behaviors. Conclusions The prevalence of HIV testing correlates with awareness of HIV testing among male college students with sexual behaviors. Improvements in health education of HIV testing and accessibility of HIV testing services are recommended.

Objective: To investigate the characteristics of temporary heterosexual behaviors among male college students through Internet dating, so as to provide insights into HIV/AIDS control among young college students. Methods: A total of 15 universities/colleges were sampled from Zhejiang Province using a stratified cluster sampling method, and 3 schools/departments were sampled from each university/college. Male college students with temporary heterosexual behaviors during the past year were recruited. Participants' demographics, AIDS-related knowledge, compliance to HIV/AIDS interventions, Internet dating and sexual behaviors were collected, and the characteristics of male college students with Internet dating were analyzed. Results : A total of 326 students were enrolled, including 202 participants from regular institutions of higher education (61.96%) and 124 students from higher vocational colleges (38.04%). There were 79 freshmen (24.23%), 99 sophomores (30.37%), 104 juniors (31.90%) and 44 seniors (13.50%), and there were 100 participants (30.67%) with temporary heterosexual behaviors through Internet dating during the past year. Among the 100 participants, there were 75.00% of participants knowing “man who have sex with man is the main transmission pattern of AIDS among young students in China”, 93.00% knowing “insisting on accurate use of condoms may reduce the risk of HIV infections and transmission” and 93.00% knowing “seeking HIV testing and counseling actively following high-risk behaviors”. There were 77 participants (77.00%) with students as their temporary heterosexual partners, 17 participants (17.00%) that had received HIV self-testing and 17 participants (17.00%) that had received HIV testing in medical institutions, 22 participants (22.00%) that had never used condoms during temporary heterosexual behaviors during the past year, and 29 participants (29.00%) with commercial sexual behaviors during the past year. In addition, male college students with temporary heterosexual behaviors through Internet dating were more unlikely to use condoms and more likely to have commercial sexual behaviors than those with dating through other ways (P<0.05). Conclusions Male college students with temporary heterosexual behaviors through Internet dating are more likely to have high-risk sexual behaviors than those with dating through other ways. Internet-based mobile sexual education and HIV/AIDS health education are recommended.

Objective : To analyze the problems in the AIDS control strategy in key areas of Zhejiang Province, so as to provide insights into the improvement of the control strategy. Methods : The AIDS control data were collected from 10 key counties (districts) in Zhejiang Province, and the AIDS control strategy was comprehensively evaluated using a SWOT analysis. Results : The strengths of the AIDS control strategy in key counties (districts) of Zhejiang Province included distinct working objectives, well-organized leadership, and effective control measures, the weaknesses included large number of HIV-infected cases, high burden of disease, difficulty in management of AIDS transmission and insufficient AIDS control capability, and the opportunities included the AIDS control in key counties (districts) conforming to the current status of AIDS control, strong support of innovative strategies and technical support from professional teams, while the threats included insufficient working mechanisms for AIDS control, the gap between the effectiveness of AIDS control and the target goal and unverified scientific evidence of the control strategy. Supported policies should be fully used, working mechanisms need to be improved, control strategies need to be innovated, and assessments need to be implemented for AIDS control in key counties (districts). Conclusions There are both opportunities and challenges for AIDS control in key counties (districts) of Zhejiang Province. Optimization of the working mechanisms, promotion of precision interventions, and search for repeatable control strategy in other disease-affected regions are required for AIDS control.

Objective To discuss application of dynamic contrast-enhanced MR scan combined with DWI in diagnosis of benign and malignant breast disease. Methods A total of 71 cases with breast disease and 50 healthy volunteers were selected. All subjects received MRI conventional scanning, conventional scanning and DWI, sensitivity, specificity, the positive predictive value and the negative predictive value of different methods for diagnosis of benign and malig-nant breast disease. Results MR morphology in diagnosis of benign and malignant breast disease, sensitivity was 90.0%, specificity was 73.7%, the positive predictive value was 78.3%, the negative predictive value was 87.5%. Dy-namic contrast-enhanced MR scan in diagnosis of benign and malignant breast disease, sensitivity was 92.5%, speci-ficity was 66.4%, the positive predictive value was 74.0%, the negative predictive value was 89.3%. Dynamic con-trast-enhanced MR scan combined with DWI and MR morphology in diagnosis of benign and malignant breast disease, sensitivity was 95.0%, specificity was 89.5%, the positive predictive value was 90.5%, the negative predictive value was 94.4%. Conclusion Dynamic contrast-enhanced MR scan combined with DWI and MR morphology in diagnosis of benign and malignant breast disease can improve sensitivity, specificity, the positive predictive value and the negative predictive value.

Objective To investigate the clinical features,CT imaging features of benign and ma-lignant pulmonary nodules,as well as the indicators for diagnosing the infiltration degree of malignant ground-glass nodules(GGN).Methods A total of 205 patients with pulmonary nodules who under-went thoracoscopic surgery were selected as research subjects.According to the postoperative patholog-ical results,they were divided into benign nodule group and malignant nodule group.The clinical fea-tures and imaging features of the two groups were analyzed.Based on the postoperative pathological re-sults(infiltration degree),the patients with malignant GGN were further divided into preinvasive le-sion(PL)group,minimally invasive adenocarcinoma(MIA)group,and invasive adenocarcinoma(IAC)group.Quantitative and qualitative analyses were conducted to screen for independent influen-cing factors of malignant GGN infiltration degree and evaluate their diagnostic value.Results There were significant differences in nodule location,nodule type,pleural indentation sign,and vascular clustering sign between the benign nodule group and the malignant nodule group(P＜0.05).Multiva-riate Logistic regression analysis showed that nodule type,pleural indentation sign,and vascular clus-tering sign were independent influencing factors of benign and malignant pulmonary nodules(P＜0.05).There were significant differences in age,vascular clustering sign,nodule length,average CT value,and nodule type between the PL group and the MIA group(P＜0.05);there were significant differ-ences in nodule length,average CT value,solid component length,vascular clustering sign,and pleural indentation sign between the MIA group and the IAC group(P＜0.05).Multivariate Logis-tic regression analysis showed that nodule length and average CT value were independent influencing factors of malignant GGN infiltration degree(P＜0.05).The receiver operating characteristic curve analysis showed that the area under the curve(AUC)of nodule length and average CT value for dif-ferential diagnosis of PL and MIA were 0.805 and 0.857,respectively,with cutoff values of 7.2 mm and-612.3 HU,respectively.The AUC of their combined diagnosis was 0.923;the AUC of nod-ule length and average CT value for differential diagnosis of MIA and IAC were 0.860 and 0.703,respectively,with cutoff values of 16.2 mm and-338.1 HU,respectively.The AUC of their com-bined diagnosis was 0.893.Conclusion For GGN,especially those with pleural indentation sign and vascular clustering sign,a high suspicion of malignant pulmonary nodules should be raised.The length and average CT value of pulmonary nodules have certain diagnostic value for the infiltration degree of malignant GGN,and their combined application has higher diagnostic value.

Objective To investigate the clinical features,CT imaging features of benign and ma-lignant pulmonary nodules,as well as the indicators for diagnosing the infiltration degree of malignant ground-glass nodules(GGN).Methods A total of 205 patients with pulmonary nodules who under-went thoracoscopic surgery were selected as research subjects.According to the postoperative patholog-ical results,they were divided into benign nodule group and malignant nodule group.The clinical fea-tures and imaging features of the two groups were analyzed.Based on the postoperative pathological re-sults(infiltration degree),the patients with malignant GGN were further divided into preinvasive le-sion(PL)group,minimally invasive adenocarcinoma(MIA)group,and invasive adenocarcinoma(IAC)group.Quantitative and qualitative analyses were conducted to screen for independent influen-cing factors of malignant GGN infiltration degree and evaluate their diagnostic value.Results There were significant differences in nodule location,nodule type,pleural indentation sign,and vascular clustering sign between the benign nodule group and the malignant nodule group(P＜0.05).Multiva-riate Logistic regression analysis showed that nodule type,pleural indentation sign,and vascular clus-tering sign were independent influencing factors of benign and malignant pulmonary nodules(P＜0.05).There were significant differences in age,vascular clustering sign,nodule length,average CT value,and nodule type between the PL group and the MIA group(P＜0.05);there were significant differ-ences in nodule length,average CT value,solid component length,vascular clustering sign,and pleural indentation sign between the MIA group and the IAC group(P＜0.05).Multivariate Logis-tic regression analysis showed that nodule length and average CT value were independent influencing factors of malignant GGN infiltration degree(P＜0.05).The receiver operating characteristic curve analysis showed that the area under the curve(AUC)of nodule length and average CT value for dif-ferential diagnosis of PL and MIA were 0.805 and 0.857,respectively,with cutoff values of 7.2 mm and-612.3 HU,respectively.The AUC of their combined diagnosis was 0.923;the AUC of nod-ule length and average CT value for differential diagnosis of MIA and IAC were 0.860 and 0.703,respectively,with cutoff values of 16.2 mm and-338.1 HU,respectively.The AUC of their com-bined diagnosis was 0.893.Conclusion For GGN,especially those with pleural indentation sign and vascular clustering sign,a high suspicion of malignant pulmonary nodules should be raised.The length and average CT value of pulmonary nodules have certain diagnostic value for the infiltration degree of malignant GGN,and their combined application has higher diagnostic value.

Objective: To evaluate the third round of Zhejiang Comprehensive AIDS Response (CARES) program (nine national areas and three provincial areas) and the control effect of AIDS, so as to provide reference for AIDS prevention and control. Methods: According to the final assessment protocol of the third round of China CARES, the data of 23 assessment items which were collected from online database and field investigation for 12 response areas of Zhejiang in 2014 and 2018 were evaluated. The endemic situation and detection of AIDS in CARES areas was compared with those in non-CARES areas, in order to evaluate the achievement of Zhejiang CARES areas. Results: The rates of reaching the standard ranged from 91.30% to 100.00% in 12 CARES areas. Six indexes in leadership and innovation, fifteen (seventeen in total) indexes in HIV/AIDS control and prevention reached the standard. The items that failed included the awareness rates of AIDS and indicators in “prevention and intervention”. The rates of of reaching the standard in “publicity and education”, “monitoring and testing”, “prevention and intervention”, and “treatment and follow-up” increased from 55.56%, 79.17%, 79.76% and 65.00% in 2014 to 91.67%, 100.00%, 90.48% and 100.00% in 2018, respectively. The proportion of HIV testing people in permanent residents was 30.94% in CARES areas in 2018, which was significantly higher than 20.70% in non-CARES areas (P<0.05). The proportion of new reported HIV/AIDS in CARES areas was 50.87%, and the average increase was 4.48%, which was lower than 9.95% in non-CARES areas. Conclusion The third round of Zhejiang CARES program has remarkable achievement and plays a positive role in the prevention and control of AIDS.

Objective:To analyze the prevalence of anal sex and related factors in low-tier female sex workers (FSWs) in the demonstration areas of comprehensive AIDS responses (DACAR) in Zhejiang province.Method:In 2013, a survey on low-tier FSWs was carried out in 21 Demonstration Areas of AIDS Responses in Zhejiang. Experience of having anal sex with clients in the last month was taken as dependent variable while independent variables would include perception and characteristics related to behavior of the FSWs. The multivariate logistic regression analyses were conducted to identify the factors related to anal sex in low-tier FSWs.Results:A total of 2 645 low-tier FSWs were interviewed. Among these FSWs, 67.9% (1 796/2 645) were over 26 years old, 89.9% (2 378/2 645) were with education level of junior high school or below, 58.4% (1 546/2 645) were married, 78.2% (2 068/2 645) were from other provinces, 68.6% (1 814/2 645) had income level less than 4 000 Yuan, and rates of anal sex with client in the last month were 5.03% (133/2 645). Results from the multivariate logistic regression analysis of related factors of anal sex with client in the last month showed that among the low-tier FSWs, the venues of having commercial sex were in hair salons/massage parlors ( OR=7.31, 95 %CI: 2.27-23.59), roadside shops ( OR=7.89, 95 %CI: 2.27- 27.40) or other places ( OR=4.65, 95 %CI: 1.23-17.53), when compared with the street-women service. FSWs often engaged in commercial sex business in three or more counties ( OR=1.68, 95 %CI: 1.01-2.81), when compared with FSWs often engaged in commercial sex business just one county. FSWs had sex with only middle-aged and the elderly clients ( OR=0.45, 95 %CI: 0.30-0.66), when compared with FSWs had sex with young or middle-aged and the elderly clients. FSWs had risk perception for sexually transmitted disease (STD) ( OR=2.00, 95 %CI: 1.20-3.32), when compared with FSWs with no risk perception. FSWs had oral sex experience with their clients in the last month ( OR=7.29, 95 %CI: 4.78-11.12), when compared with the ones without oral sex. The above said factors were all related to the incidence of anal sex. Conclusions:Certain numbers of low-tier FSWs had anal sex experiences with their clients, especially those who had oral sex were more likely to have anal sex in DACAR in Zhejiang province. Attention should be paid to anal sex behavior when conducting behavior-related intervention programs, targeting on the low-tier FSWs.