Objectives:To understand the prevalence of HIV nucleic acid using internet-based dry blood spots HIV testing strategy in men who had sex with men (MSM) and to probe the factors associated with HIV infection.Methods:Using convenient sampling method, 1 375 MSM were recruited and their dry blood spots samples were collected before being mailed to the laboratories for HIV nucleic acid testing. Results were showed to these MSM on a specific website by inputting their codes to it. Non-conditional binary logistic regression method was used to identify the associated factors on HIV infection.Results:The overall proportions of HIV nucleic acid positives appeared as 9.7 % (131/1 349) and HIV antibody positives as 8.3 % (112/1 349). Fresh infections accounted for 14.5 % (19/131) among the newly-identified HIV nucleic acid positives, and the interval was ranging from 6 to 120 days, between the laboratory testings and the closest date that experiencing high risk behavior. Risk factors that related to HIV infection would include: 30 to 39 years of age (comparing to those under the age of 30, OR=1.88, 95 %CI: 1.07-3.29), ≥8 000 Yuan of monthly income (comparing to those without income, OR=0.42, 95 %CI: 0.19-0.96), inconsistent condom use during anal sexual contacts in the last six months (compared with those who had not anal sex or used condoms consistently in anal sex in the past six months, OR=2.22, 95 %CI: 1.45-3.40), ever use of Rush Poppers (compared with those who never used Rush Poppers, OR=2.33, 95 %CI: 1.49-3.64), addictive drug abuse (compared with those who never abused addictive drugs, OR=5.43, 95 %CI: 2.32-12.69), and not having regular sexual partners (compared with having regular sexual partners, OR=1.74, 95 %CI: 1.13-2.68) etc.. Conclusions:Dry blood spots HIV nucleic acid testing could help to identify the fresh HIV infections at an early stage, so as to prevent further transmission in the MSM population, among which fresh HIV infections accounted for a fairly large proportion. It is necessary to set up programs in reducing the abuse of drugs or Rush Poppers, and to promote condom use and advocate on stable sexual partnership etc., among the MSM population.

Objective:To explore the characteristics of HIV-1 genotypic drug resistance for protease-reverse transcriptase (PR-RT) and integrase (IN) among antiretroviral therapy (ART)-naive individuals in Beijing, and provide evidence for clinical diagnosis and treatment.Methods:Newly diagnosed individuals or cases initiating ART were recruited in Beijing covering 2019 to 2020, then pol gene fragments and integrase gene were synchronously amplified and sequenced. Phylogenetic analyses were performed to determine subtypes, and the pol gene and integrase gene sequences were submitted to Stanford University HIV drug resistance database for the interpretation of mutations and drug resistance. Results:Among 168 ART-naive individuals, 93.6% were infected via men who have sex with men (MSM). The top two subtypes were CRF01_AE (41.0%) and CRF07_BC (30.3%), and unique recombinant forms accounted for 16.1% infections. Six individuals carried surveillance drug resistance mutations in PR-RT, with a prevalence of transmitted drug resistance (TDR) at 3.7%. And one case carried nucleoside reverse transcriptase inhibitor mutation of K65R, accompanied with major integrase mutation of T66I (0.6%), conveying resistance to elvitegravir and raltegravir at high and low levels, respectively.Conclusions:The prevalence of transmitted drug resistance was considerably low among ART-naive individuals in Beijing, and the surveillance of genotypic drug resistance should be strengthened, including integrase drug resistance.

Under the current legal framework， living will， as an important legal tool for safeguarding patients’ autonomy and dignity， have been widely recognized and implemented in many countries and regions. In China， the promotion of living will also has a solid legal foundation， with their legitimacy reflected in several provisions of the Civil Code of the People’s Republic of China. One of the highlights of the Medical Regulations of the Shenzhen Special Economic Zone （revised in 2022） is the clarification of the legal effect of living will. To ensure that patients’ living will can be accurately implemented at critical moments， the rights and obligations of patients， family members， and healthcare professionals should be clearly defined within the legal framework， and clear guidance should be provided at every stage of implementation.