Humans ; Cost-Benefit Analysis ; HIV Infections/drug therapy* ; Cost-Effectiveness Analysis ; Decision Trees

Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are one of the global public health issues concerning health of human beings. Dyslipidemia is one of the major risk factors for cardiovascular events, while elevation of plasma cholesterol levels is associated with the onset of over 50% coronary heart disease. The incidence risks of cardiovascular diseases are higher in HIV/AIDS patients than those in normal populations. In addition to conventional risk factors, viral duplication and suboptimal treatments increase risks of atherosclerotic coronary vascular disease (ASCVD) in HIV/AIDS patients. Thus, a deep knowledge of lipid metabolism and dysregulation profiles, an efficient control of conventional ASCVD risk factors, as well as strengthened measures to lipid management, are of significance to improve long-term prognosis and life quality for HIV/AIDS patients. However, up to date, there is no particular consensus on lipid management for HIV/ADIS populations under long-term antiretroviral therapies (ART). Hereby, based on current status quo of ART in China and frontier achievements of fundamental researches and clinical trials, we invited domestic experts in fields of infectious diseases and cardiovascular diseases to compose this expert consensus on the integrated management of lipid in HIV/AIDS patients in China.
Humans ; Acquired Immunodeficiency Syndrome ; Cardiovascular Diseases/prevention & control* ; Consensus ; HIV Infections ; Lipids/blood* ; China

OBJECTIVE: The mode of human immunodeficiency virus (HIV) transmission via injection drug use (IDU) still exists, and the recent shift in IDU-related transmission of HIV infection is largely unknown. The purpose of this study was to analyze the spatiotemporal sources and dynamics of HIV-1 transmission through IDU in Guangxi. METHODS: We performed a molecular epidemiological investigation of infections across Guangxi from 2009 to 2019. Phylogenetic and Bayesian time-geographic analyses of HIV-1 sequences were performed to confirm the characteristics of transmission between IDUs in combination with epidemiological data. RESULTS: Among the 535 subjects, CRF08_BC (57.4%), CRF01_AE (28.4%), and CRF07_BC (10.7%) were the top 3 HIV strains; 72.6% of infections were linked to other provinces in the transmission network; 93.6% of sequence-transmitted strains were locally endemic, with the rest coming from other provinces, predominantly Guangdong and Yunnan; 92.1% of the HIV transmission among people who inject drugs tended to be transmitted between HIV-positive IDUs. CONCLUSION HIV recombinants were high diversity, and circulating local strains were the transmission sources among IDUs in Guangxi. However, there were still cases of IDUs linked to other provinces. Coverage of traditional prevention strategies should be expanded, and inter-provincial collaboration between Guangxi, Yunnan, and Guangdong provinces should be strengthened.
Humans ; HIV-1/genetics* ; HIV Infections ; Drug Users ; Phylogeny ; Bayes Theorem ; China/epidemiology* ; Genotype

Objective To analyze the genetic subtypes of human immunodeficiency virus (HIV) and the prevalence of pretreatment drug resistance in the newly reported HIV-infected men in Guangxi. Methods The stratified random sampling method was employed to select the newly reported HIV-infected men aged≥50 years old in 14 cities of Guangxi from January to June in 2020.The pol gene of HIV-1 was amplified by nested reverse transcription polymerase chain reaction and then sequenced.The mutation sites associated with drug resistance and the degree of drug resistance were then analyzed. Results A total of 615 HIV-infected men were included in the study.The genetic subtypes of CRF01_AE,CRF07_BC,and CRF08_BC accounted for 57.4% (353/615),17.1% (105/615),and 22.4% (138/615),respectively.The mutations associated with the resistance to nucleoside reverse transcriptase inhibitors (NRTI),non-nucleoside reverse transcriptase inhibitors (NNRTI),and protease inhibitors occurred in 8 (1.3%),18 (2.9%),and 0 patients,respectively.M184V (0.7%) and K103N (1.8%) were the mutations with the highest occurrence rates for the resistance to NRTIs and NNRTIs,respectively.Twenty-two (3.6%) patients were resistant to at least one type of inhibitors.Specifically,4 (0.7%),14 (2.3%),4 (0.7%),and 0 patients were resistant to NRTIs,NNRTIs,both NRTIs and NNRTIs,and protease inhibitors,respectively.The pretreatment resistance to NNRTIs had much higher frequency than that to NRTIs (2.9% vs.1.3%;χ²=3.929,P=0.047).The prevalence of pretreatment resistance to lamivudine,zidovudine,tenofovir,abacavir,rilpivirine,efavirenz,nevirapine,and lopinavir/ritonavir was 0.8%, 0.3%, 0.7%, 1.0%, 1.3%, 2.8%, 2.9%, and 0, respectively. Conclusions CRF01_AE,CRF07_BC,and CRF08_BC are the three major strains of HIV-infected men≥50 years old newly reported in Guangxi,2020,and the pretreatment drug resistance demonstrates low prevalence.
Male ; Humans ; Middle Aged ; Reverse Transcriptase Inhibitors/therapeutic use* ; HIV Infections/drug therapy* ; Drug Resistance, Viral/genetics* ; China/epidemiology* ; Mutation ; HIV-1/genetics* ; Protease Inhibitors/therapeutic use* ; Genotype

Objective To propose the blood detection strategies for human immunodeficiency virus (HIV) among blood donors, and provide reference for the detection, early diagnosis and transmission blocking of HIV. Methods A total of 117 987 blood samples from blood donors were screened using the third- and fourth-generation ELISA HIV detection reagents. Western blot analysis was used to verify the reactive results of the third-generation reagent alone, or both the third-generation and fourth-generation reagents. HIV nucleic acid test was carried out for those with negative test results of the third- and fourth-generation reagents. For those with positive results of the fourth-generation reagent only, nucleic acid test followed by a confirmatory test by Western blot analysis was carried out. Results 117 987 blood samples from blood donors were tested by different reagents. Among them, 55 were tested positive by both the third- and fourth-generation HIV detection reagents at the same time, accounting for 0.047% and 54 cases were confirmed HIV-positive by Western blot analysis, and 1 case was indeterminate, then turned positive during follow-up testing. 26 cases were positive by the third-generation reagent test alone, among which 24 cases were negative and 2 were indeterminate by Western blot analysis. The band types were p24 and gp160 respectively detected by Western blot analysis, and were confirmed to be HIV negative in follow-up testing. 31 cases were positive by the fourth-generation HIV reagent alone, among which 29 were negative by nucleic acid test, and 2 were positive according to the nucleic acid test.Western blot analysis was used to verify that the two cases were negative. However, after 2~4 weeks, the results turned positive when the blood sample was retested by Western blot analysis during the follow-up of these two cases. All the specimens that were tested negative by both the third- and fourth-generation HIV reagents were validated negative by HIV nucleic acid test. Conclusion A combined strategy with both third- and fourth-generation HIV detection reagents can play a complementary role in blood screening among blood donors. The application of complementary tests, such as nucleic acid test and Western blot analysis, can further improve the safety of blood supply, thus contributing to the early diagnosis, prevention, transmission and treatment of blood donors potentially infected by HIV.
Humans ; HIV Infections/diagnosis* ; HIV Antibodies ; Blood Donors ; HIV-1 ; Blotting, Western ; Nucleic Acids

Objective: To understand the current status of fertility safety cognition among married HIV-infected people aged 18-45 years and to provide evidence for fertility safety intervention in HIV-infected families. Methods: Six districts in Chongqing and Zigong City in Sichuan Province were selected. A questionnaire survey was conducted among married HIV-infected people aged 18-45 years who were followed up from November 2021 to April 2022 to collect their general demographic characteristics, histories of sex experience, fertility intention, and knowledge of birth safety. Unconditional logistic regression and Poisson regression were used to analyze the factors affecting the cognition of birth safety. Results: A total of 266 HIV-infected people were included in the study; 58.3% (155/266) were women, and 48.9% (130/266) had fertility desire. The cognition rate of knowledge of birth safety was 59.4% (158/266). The cognition rate of women's knowledge of birth safety was 2.14 (95%CI: 1.25-3.66) times that of men's. The cognition rate of knowledge of birth safety among HIV-infected persons with a high school education level or above was 1.88 (95%CI: 1.08-3.27) times that of those with a low education level. The cognition rate of knowledge of reproductive safety among HIV-infected people with fertility intention was 1.88 (95%CI: 1.10-3.22) times that of those without fertility intention. The cognition rate of knowledge of birth safety among HIV-infected persons who received AIDS knowledge promotion and education was 9.06 (95%CI: 2.46-33.32) times that of those who did not. The cognition rate of measures of birth safety was 5.3% (14/266). The Poisson regression analysis showed no significant difference in the cognition rate of specific measures among gender, age, education and other factors. Conclusions: HIV-infected people aged 18-45 years and married with a spouse have a low awareness of birth safety, and there are risks of HIV transmission between couples and mother-to-child in the family. Targeted birth safety education and intervention should be strengthened to reduce HIV transmission.
Male ; Humans ; Female ; HIV Infections ; Spouses ; Infectious Disease Transmission, Vertical ; Fertility ; Surveys and Questionnaires ; Cognition

HIV cluster detection and response (CDR) is a critical strategy to end the HIV epidemic by offering information to identify prevention and care services gaps. The risk metrics for HIV clusters can be classified into three groups: growth-based metrics, characteristic-based metrics, and phylogeny-based metrics. When identifying HIV risk clusters, the public health response can reach people in the affected networks, including people with undiagnosed HIV, people with diagnosed HIV who might not be accessing HIV care or other services, and people without HIV who would benefit from prevention services. To provide references for HIV precise prevention in China, we summarized the risk metrics and the intervention measures for CDR.
Humans ; HIV Infections/prevention & control* ; Acquired Immunodeficiency Syndrome/epidemiology* ; Public Health ; Epidemics/prevention & control* ; China/epidemiology*

HIV testing is the first step in HIV prevention and control, the rate of HIV infection is high and the rate of HIV testing is low among men who have sex with men (MSM) in China. HIV self-testing provides MSM with a new choice and plays a vital role in expanding the coverage of HIV testing in this population. This paper reviews HIV self-testing and associated factors among MSM in China and provides a reference for promoting HIV self-testing in this population.
Male ; Humans ; HIV Infections/epidemiology* ; Homosexuality, Male ; Self-Testing ; Sexual and Gender Minorities ; HIV Testing ; China/epidemiology*

Objective: To understand the compliancy to on-demand HIV pre-exposure prophylaxis (PrEP) and related factors in men who have sex with men (MSM) accessing to PrEP service through an Internet platform. Methods: A cross-sectional study method was used to recruit survey respondents through the Heer Health platform from July 6 to August 30, 2022, and a questionnaire survey on the current status of medication use was conducted in MSM who use PrEP through the platform and take medication on demand. The MSM's information collected in the survey mainly included socio-demographic characteristics, behavioral characteristics, risk perception characteristics, PrEP awareness and the status of dose taking. Univariate and multivariate logistic regression analyses were used to evaluate factors related with compliancy to PrEP. Results: A total of 330 MSM who met the recruitment criteria were included during the survey period, with a valid response rate of 96.7% (319/330) to the questionnaire survey. The age of the 319 MSM was (32.5±7.3) years. Most of them had education level of junior college or college and above (94.7%, 302/319), most of them were unmarried (90.3%, 288/319), most of them had full-time works (95.9%, 306/319), and 40.8% of them had average monthly income ≥10 000 yuan (130/319). The proportion of the MSM with good compliancy to PrEP was 86.5% (276/319). The results of univariate and multivariate logistic analyses showed that the MSM with good awareness of PrEP had relatively better compliancy to PrEP compared with those with poor awareness of PrEP (aOR=2.43, 95%CI:1.11-5.32). Conclusions: The compliancy to on-demand PrEP was good in MSM who accessed to the services through Internet platform, but there is still a need to strengthen PrEP promotion in MSM for the further improvement of PrEP compliancy and reduction of the risk for HIV infection in this population.
Male ; Humans ; Adult ; HIV Infections ; Cross-Sectional Studies ; Homosexuality, Male ; Pre-Exposure Prophylaxis ; Sexual and Gender Minorities ; Internet

Objective: To understand and analyze the incidence of club drug abuse and influencing factors in men who have sex with men (MSM) in Qingdao, and provide reference for the AIDS prevention and intervention in this population. Methods: From March 2017 to July 31, 2022, MSM who did not abuse club drug were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every 6 months. The survey collected the information about the MSM's demographic characteristics, sexual characteristics, club drug abuse and others. The incidence of club drug abuse was the outcome dependent variable and the interval between the recruitment into the cohort and the incidence of club drug abuse was the time dependent variable. Cox regression analysis was conducted to identify the influencing factors for club drug abuse. Results: A total of 509 MSM were recruited at baseline survey, and 369 eligible MSM were enrolled in this cohort. A total of 62 MSM began to abuse club drug during the study period, and the cumulative follow-up time was 911.54 person-years, the incidence of club drug abuse was 6.80/100 person-years. All the club drug abusers shared drugs with others in the first club drug abuse, and 16.13% (10/62) had mix-use of club drugs. The multivariate Cox proportional risk regression analysis showed that being students (aHR=2.17, 95%CI: 1.15-4.10), receiving no HIV testing or receiving 1 HIV testing during past 6 months (aHR=4.57, 95%CI:1.80-11.60; aHR=5.15, 95%CI: 2.83-9.36), having sex only with regular sexual partners during past 6 months (aHR=4.75,95%CI:2.32-9.75), having more than 4 homosexual partners (aHR=1.70, 95%CI:1.01-2.87) and abuse of club drug of sexual partners during past 6 months (aHR=12.78, 95%CI:3.06-53.35) were significantly associated with club drug abuse in the MSM. Conclusions: The incidence of club drug abuse was at a high level in the MSM cohort in Qingdao, indicating a high risk for HIV infection. Being student, receiving less HIV testing, having sex only with regular sexual partners, having more homosexual partners and abuse of club drug of sexual partners during past 6 months were risk factors for the incidence of club drug abuse in the MSM. Targeted surveillance and intervention measures should be strengthened to reduce the risk of club drug abuse in MSM.
Male ; Humans ; Homosexuality, Male ; Cohort Studies ; Illicit Drugs ; Incidence ; HIV Infections ; Prospective Studies ; Sexual and Gender Minorities ; Substance-Related Disorders