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 understand the source and related factors among heterosexual casual partners among male college students for providing AIDS prevention strategies in this population.Methods:Stratified cluster sampling method was used to conduct a questionnaire survey among 31 674 college students in 13 colleges in Zhejiang Province, from October to November, 2018. A total of 2 665 male college students who reported having had heterosexual casual behavior and the source of their sexual partners were recruited. Data on demographic characteristics, knowledge of HIV/AIDS prevention, sexual behavior, and having received AIDS-related interventions were collected. The multivariable logistics regression model was used to analyze the related factors of the source of casual heterosexual behavior partners among male college students.Results:A total of 423 male college students having casual heterosexual sex were investigated, accounting for 15.9% (423/2 665) of the male college students who self-reported having sexual behaviors and informed their sexual partners. Among them, 39.4% (147/373), 37.5% (140/373), and 23.1% (86/373) of participants had 1, 2-4, and 5 or more heterosexual casual sexual partners, respectively. 40.1% (167/416) of participants used condoms consistently with casual partners. 143 (33.8%) participants with social individual's partners were an average age of (20.27±1.40) years old. Multivariate logistic regression analysis showed that: when compared with one person, common acquaintances, and no heterosexual casual partners in the previous year, the factors that related to the source of heterosexual casual partners of male college students appeared as follows: the number of heterosexual casual sexual partners ≥5 (a OR=3.00, 95% CI:1.53-5.89), seeking the casual sexual partners through entertainment venues (a OR=3.04,95% CI:1.64-5.64), male college students having sex with a regular partner in the last one year (a OR=0.41, 95% CI:0.25-0.68). Conclusions:Some of the male college students had heterosexual casual sexual behaviors, with the related factors as having five or more heterosexual casual sexual partners, seeking casual sex partners through entertainment venues, and low condom use. Self-protection awareness and ability should be emphasized to advocate safe sex to reduce the risk of AIDS transmission among college students.

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 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 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 investigate the relationship between the expression of CENPF in NSCLC adenocarcinoma (LUAD) and the clinical prognosis of patients and its effect on the metastasis of lung adenocarcinoma cells. Methods The expression of CENPF in LUAD and its relationship with patient prognosis were analyzed by online bioinformatics. The expression of CENPF was verified by LUAD tissue microarray immunohistochemical staining. Kaplan-Meier analysis was performed to analyze the relationship between the expression of CENPF and the prognosis of patients with lung adenocarcinoma. Cox survival hazard ratio was used to analyze the factors affecting the survival of patients. Chi-square analysis was adopted to examine the relationship between CENPF expression and clinicopathological stage and grade of patients. The expression of CENPF in NCI-H2126 cells were knocked out by lentivirus, and then the proliferation, invasion, and migration abilities of the cells were detected. Changes in mRNA expression profiles after CENPF knockout were detected by RNA-seq. Bioinformatics analysis of downstream signaling pathways and the target genes of CENPF was also performed. Western blot was used to verify the target gene. Results CENPF was significantly upregulated in LUAD tumor tissue (P < 0.05) and significantly correlated with pathological stage (P=0.013). The higher expression of CENPF, the worse the prognosis of patients (P=0.01, P=0.027). After the expression was CENPF of knocked out, the cell proliferation, migration, and invasion abilities significantly reduced (P < 0.01). The expression of chemokine pathway genes in cells was enriched significantly (P < 0.001). ACKR3/CXCR7 and CDH2/N-cadherin were significantly downregulated, whereas CDH1/E-cadherin was significantly upregulated. After CENPF was knocked out, ACKR3/CXCR7 and N-cadherin were significantly downregulated, whereas E-cadherin significantly increased. Conclusion The expression of CENPF is negatively correlated with the clinical prognosis of patients with LUAD, and it promotes the occurrence of EMT by regulating the expression levels of N-cadherin and E-cadherin related to EMT through ACKR3/CXCR7.

Objective:To analyze the willingness of post-exposure prophylaxis (PEP) to prevent HIV transmission and related factors in men who have sex with men (MSM).Methods:Cross sectional survey design was used in this study. After informed consent, MSM aged 18 years or above and having had homosexual anal or oral sex in the past 6 months were recruited through "i WeChat" official account between September and November, 2019.Results:Of 1 517 MSM were surveyed, the proportion of MSM who had ever heard of PEP were 72.5% (1 100/1 517) and 87.9%(1 333/1 517) of the MSM said they would like to use PEP if it is needed.Multivariate logistic regression analysis suggested that aged above 25 year ( OR=1.807, 95% CI: 1.090-2.995), HIV test history ( OR=1.953, 95% CI: 1.171-3.256) and being aware of PEP ( OR=2.163, 95% CI: 1.468-3.186) were the positive factors for PEP use, but an aware of the HIV status of sexual partner was the negative factor for PEP ( OR=0.602, 95% CI: 0.407-0.890). Among MSM who had ever heard of PEP, the positive factors for PEP use included living in Zhejiang ( OR=1.942, 95% CI: 1.097-3.438), aged above 25 years ( OR=2.431, 95% CI: 1.331-4.439), being aware of PEP ( OR=3.714, 95% CI: 1.532-9.007) obtaining information about PEP service from MSM organization/volunteer/health organization. Conclusions:MSM's willingness to use PEP services was relatively high. Age, awareness of PEP related knowledge, and awareness of sexual partner's HIV infection status were the related factors. MSM organization/volunteer/health organization were the main forces for PEP promotion in MSM.

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.