OBJECTIVETo understand the high risk behaviors of female sex workers (FSWs) in Yunnan province in 2013.

METHODSA cross-sectional investigation was conducted during April to June, 2013 in Yunnan province, census was used to the investigation where the number of FSWs was close to 200, while probability sampling was used where the number of FSWs was obviously over 200. A total of 25 574 cases were investigated, and data on demography and risk behaviors were obtained by questionnaires one by one.

RESULTSA total of 25 574 cases were investigated, AIDS awareness among FSWs in high-level places, middle-level places and low-level place were 98.8% (92/7 401), 98.6% (150/10 995), and 96.0% (281/6 655). FSWs from low-level place had a lower rate than those from the other two types of places (P < 0.01). The rate of condom use each time when having sex with clients within the recent one month among FESs from high-level places, middle-level places and low-level place were 93.4% (6 307/6 755), 93.8% (10 109/10 782) and 90.4% (6 053/6 697), and the FSWs working in low-level place had a lower rate than those from the other two types of places(P < 0.01). Multi-factor logistic regression analysis showed that the following had a lower rate of condom use: the FSWs working in low-level place (OR = 1.56, 95% CI:1.36-1.79; OR = 1.36, 1.16-1.59), over 30 years old (OR = 0.77, 95%CI:0.69-0.85), Yunnan citizen (OR = 0.88, 95% CI:0.77-1.00), minority (OR = 1.32, 95% CI:1.16-1.50), under senior high school (OR = 0.61, 95%CI:0.49-0.75), married (OR = 0.81, 95% CI:0.71-0.92), living together (OR = 0.70, 95% CI:0.51-0.96), divorced or lost spouses (OR = 0.81, 95% CI:0.65-1.02), worked less than 6 months in local areas (OR = 1.74, 95% CI:1.34-2.27), drug users (OR = 1.65, 95% CI:1.11-2.46), had not accepted HIV interventions (OR = 2.91, 95% CI:2.36-3.58), had no knowledge about AIDS (OR = 4.50, 95% CI:3.48-5.82). The main reasons for not using condoms were the clients' unwilling to use, which accounted for 47.62% (270/567). The total rate of drug use was 1.0% (264/25 567) and the FSWs working in middle-level places had the highest rate of injecting drugs, which accounted for 0.6% (70/11 141). The FSWs working in low-level places had a higher rate than those who worked in high-level places and middle-level places in venereal diseases, which accounted for 1.2% (85/6 934) (P < 0.01). The rate of receiving effective interventions was 96.7% (24 717/25 574), the rate of accepting treatment and clean needles among drug users was 21.6% (57/264).

CONCLUSIONHigh risk behaviors were serious among the FSWs who worked in low-level places, especially among the olders, the minorities, people who had lower educational level, the new-comer and drug users, which indicated that more attention needs to be paid among these populations.

Age Factors ; China ; Condoms ; Cross-Sectional Studies ; Demography ; Drug Users ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Marital Status ; Risk-Taking ; Safe Sex ; Sex Workers ; Sexually Transmitted Diseases ; Socioeconomic Factors ; Surveys and Questionnaires

Objective To understand the characteristics of newly detected HIV infection cases and related high risk behaviors in the areas with high HIIV infection prevalence in Yunnan province.Methods A questionnaire survey was conducted with census method during January to March 2016 among newly detected HIV infected persons in Dehong,Honghe,Lincang and Dali prefectures in Yunnan during 2012-2015.Results Among 451 HIV seropositive cases,the major transmission route of HIV was heterosexual contact,accounting for 92.5％ (417/451).The total awareness rate of AIDS related knowledge was 73.0％ (329/451).The rates of condom use at sex with regular sexual partners,occasional sexual partners,commercial sexual partners and men who have sex with men within 1 year before knowing their infection status were 48.7％ (167/343),4.2％ (7/165),9.9％ (15/151) and 0.0％ (0/3),respectively.The risk factors for using no condom at sex with regular sexual parmers included living at Dali,being farmer,unmarried,cohabitation,divorced and widowed,monthly income under 1 000 yuan (RMB),living in urban area before infection,knowing no AIDS related knowledge etc.The risk factors for using no condom at sex with occasional sexual partners included living in Dehong,Honghe and Lincang,aged ≤30 years and being farmer.The injecting drug users accounted for 8.2％ (37/450) and 75.5％ of these cases had received AIDS related intervention (340/450).Conclusion High prevalence of heterosexual transmission of HIV,poor AIDS related knowledge on awareness,high risk behavior and poor condom use and poor intervention service utilization were found among newly detected HIV infected persons in areas with high HIV infection prevalence in Yunnan.

OBJECTIVETo understand the change trend of the awareness rate of HIV/AIDS related knowledge, risk behaviors among men who have sex with men (MSM) in Yunnan and the factors influencing their condom use, and evaluate the effect of comprehensive intervention.

METHODSThe data about the MSM's demographic information, HIV/AIDS related knowledge awareness, and sex behavior, condom use, drug use and intervention receiving were obtained from AIDS sentinel surveillance among MSM in Yunnan province during 2010-2013 to conduct change trend and influencing factor analysis.

RESULTSA total of 9 073 MSM were surveyed. The awareness rate of the HIV/AIDS related knowledge, homosexual behavior and condom use rate increased year by year (P < 0.01). The condom use rate was lower in heterosexual behavior, and the drug use rate and sexually transmitted disease prevalence declined with year (P < 0.01). Multivariate logistic regression analysis indicated that cohabiting, low awareness of HIV/AIDS related knowledge, being from other provinces, local residence for <1 year, low education level, receiving no intervention, frequent anal sex and receiving no HIV/AIDS detection were the risk factors influencing persistent condom use among MSM.

CONCLUSIONThe effect of HIV/AIDS comprehensive intervention was observed after 4 years implantation, but most of the index were at low level. More attention should be paid to the intervention among MSM with cohabiting habit, low education level, frequent anal sex, and heterosexual sex. It is necessary to expand intervention coverage, strengthen HIV test and promote condom use among MSM.

Acquired Immunodeficiency Syndrome ; epidemiology ; China ; epidemiology ; Communicable Diseases ; Data Collection ; HIV Infections ; Habits ; Heterosexuality ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; Prevalence ; Risk Factors ; Risk-Taking ; Safe Sex ; Sentinel Surveillance ; Sexual Behavior ; Sexually Transmitted Diseases

BACKGROUNDIn order to minimize the injury reaction during the surgery and reduce the morbidity rate, hence reducing the mortality rate of esophagectomy, minimally invasive esophagectomy (MIE) was introduced. The aim of this study was to compare the postoperative outcomes in patients with esophageal squamous cell carcinoma undergoing minimally invasive or open esophagectomy (OE).

METHODSThe medical records of 176 consecutive patients, who underwent minimally invasive esophagectomy (MIE) between January 2009 and August 2013 in Cancer Institute & Hospital, Chinese Academy of Medical Sciences, were retrospectively reviewed. In the same period, 142 patients who underwent OE, either Ivor Lewis or McKeown approach, were selected randomly as controls. The clinical variables of paired groups were compared, including age, sex, Charlson score, tumor location, duration of surgery, number of harvested lymph nodes, morbidity rate, the rate of leak, pulmonary morbidity rate, mortality rate, and hospital length of stay (LOS).

RESULTSThe number of harvested lymph nodes was not significantly different between MIE group and OE group (median 20 vs. 16, P = 0.740). However, patients who underwent MIE had longer operation time than the OE group (375 vs. 300 minutes, P < 0.001). Overall morbidity, pulmonary morbidity, the rate of leak, in-hospital death, and hospital LOS were not significantly different between MIE and OE groups. Morbidities including anastomotic leak and pulmonary morbidity, inhospital death, hospital LOS, and hospital expenses were not significantly different between MIE and OE groups as well.

CONCLUSIONSMIE and OE appear equivalent with regard to early oncological outcomes. There is a trend that hospital LOS and hospital expenses are reduced in the MIE group than the OE group.

Aged ; Carcinoma, Squamous Cell ; surgery ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Laparoscopy ; Length of Stay ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Thoracoscopy ; Treatment Outcome