Objective:To analyze the HIV antibody positivity of new type drug users in drug abuse monitoring sites in Zhejiang Province from 2017 to 2023 and its influencing factors.Methods:From 2017 to 2023, a continuous cross-sectional survey was carried out in HIV monitoring posts among new type drug users in Zhejiang Province,the sample size was 400 people per site of 9 drug abuse surveillance sites in 7 cities. Questionnaires were conducted to investigate their social demographic information, related behavioral information, AIDS awareness, and acceptance of intervention measures, and blood was collected for HIV and syphilis antibody detection, with new type drugs users in the monitoring population as the research object. SPSS 22.0 software was used for statistical analysis.Results:A total of 13 955 new drug users were surveyed, and the number of new drug users was 2 518, 2 292, 2 526, 2 119, 2 161, 1 064 and 1 275 from 2017 to 2023, respectively, the HIV antibody positive rate of new type drugs users was 0.44%, 1.09%, 2.06%, 1.09%, 1.39%, 1.50%, 2.90%, respectively, and the HIV antibody positive standardized rate showed an increasing trend (all P<0.001). The results of multivariate logistic regression analysis showed that marital status: unmarried/divorced/widowed (a OR=3.92, 95% CI: 2.46-6.25), provincial household registration (a OR=3.54, 95% CI: 2.34-5.35), high school education or above (a OR=5.42, 95% CI: 3.68-7.98), sexual activity within the last 1 year after drug use (a OR=1.84, 95% CI: 1.19-2.84), and knowledge that the use of new drugs increases the risk of HIV infection (a OR=2.27, 95% CI: 1.17-4.39) were associated with increased HIV antibody favorable rates among new type drugs users. Conclusions:During 2017-2023, the HIV antibody-positive rate of new type drug users in Zhejiang Province showed an upward trend. It is necessary to strengthen the monitoring and intervention of this population.

Objectives:To understand the awareness of HIV pre-exposure prophylaxis and post-exposure prophylaxis (PrEP/PEP) and related factors among female sex workers (FSWs) in Zhejiang Province to provide a reference for promoting PrEP/PEP.Methods:From April to July 2023, a questionnaire survey was conducted at the surveillance posts of prostitutes in 17 counties (cities and districts) in Zhejiang Province. The sample size of each post was at least 400 FSWs, and the information on social demography, sexual behavior, AIDS knowledge, prevention services, and detection were collected.Results:A total of 6 899 FSWs were surveyed. Most of them were ≥30 years old (57.7%), had secondary school education or below (61.8%), and had worked locally for ≥12 months (52.6%). The prevalence of HIV PrEP and PEP awareness among FSWs was 52.0% (3 589/6 899) and 58.6% (4 045/6 899), respectively. Multivariate logistic regression analysis showed that the negative related factors of awareness of PrEP/PEP among FSWs included age ≥30 years, local working time <6 months, and condom use during commercial sex in the last 1 month. The positive related factors of awareness of PrEP/PEP among FSWs included marital status was married or cohabiting, aware of HIV/AIDS knowledge, working in medium or high-end venues, finding clients primarily online in the past 6 months, receiving HIV prevention services in the past year, and having self-tested for HIV in the past year.Conclusions:The overall awareness of PrEP/PEP was relatively low among FSWs in Zhejiang Province. Efforts should be made to strengthen the publicity and education of PrEP/PEP, especially for those who are older and more mobile and working in low-end venues, combined with HIV prevention services to increase the use of PrEP/PEP.

Objective:To analyze the HIV antibody positivity of new type drug users in drug abuse monitoring sites in Zhejiang Province from 2017 to 2023 and its influencing factors.Methods:From 2017 to 2023, a continuous cross-sectional survey was carried out in HIV monitoring posts among new type drug users in Zhejiang Province,the sample size was 400 people per site of 9 drug abuse surveillance sites in 7 cities. Questionnaires were conducted to investigate their social demographic information, related behavioral information, AIDS awareness, and acceptance of intervention measures, and blood was collected for HIV and syphilis antibody detection, with new type drugs users in the monitoring population as the research object. SPSS 22.0 software was used for statistical analysis.Results:A total of 13 955 new drug users were surveyed, and the number of new drug users was 2 518, 2 292, 2 526, 2 119, 2 161, 1 064 and 1 275 from 2017 to 2023, respectively, the HIV antibody positive rate of new type drugs users was 0.44%, 1.09%, 2.06%, 1.09%, 1.39%, 1.50%, 2.90%, respectively, and the HIV antibody positive standardized rate showed an increasing trend (all P<0.001). The results of multivariate logistic regression analysis showed that marital status: unmarried/divorced/widowed (a OR=3.92, 95% CI: 2.46-6.25), provincial household registration (a OR=3.54, 95% CI: 2.34-5.35), high school education or above (a OR=5.42, 95% CI: 3.68-7.98), sexual activity within the last 1 year after drug use (a OR=1.84, 95% CI: 1.19-2.84), and knowledge that the use of new drugs increases the risk of HIV infection (a OR=2.27, 95% CI: 1.17-4.39) were associated with increased HIV antibody favorable rates among new type drugs users. Conclusions:During 2017-2023, the HIV antibody-positive rate of new type drug users in Zhejiang Province showed an upward trend. It is necessary to strengthen the monitoring and intervention of this population.

Objectives:To understand the awareness of HIV pre-exposure prophylaxis and post-exposure prophylaxis (PrEP/PEP) and related factors among female sex workers (FSWs) in Zhejiang Province to provide a reference for promoting PrEP/PEP.Methods:From April to July 2023, a questionnaire survey was conducted at the surveillance posts of prostitutes in 17 counties (cities and districts) in Zhejiang Province. The sample size of each post was at least 400 FSWs, and the information on social demography, sexual behavior, AIDS knowledge, prevention services, and detection were collected.Results:A total of 6 899 FSWs were surveyed. Most of them were ≥30 years old (57.7%), had secondary school education or below (61.8%), and had worked locally for ≥12 months (52.6%). The prevalence of HIV PrEP and PEP awareness among FSWs was 52.0% (3 589/6 899) and 58.6% (4 045/6 899), respectively. Multivariate logistic regression analysis showed that the negative related factors of awareness of PrEP/PEP among FSWs included age ≥30 years, local working time <6 months, and condom use during commercial sex in the last 1 month. The positive related factors of awareness of PrEP/PEP among FSWs included marital status was married or cohabiting, aware of HIV/AIDS knowledge, working in medium or high-end venues, finding clients primarily online in the past 6 months, receiving HIV prevention services in the past year, and having self-tested for HIV in the past year.Conclusions:The overall awareness of PrEP/PEP was relatively low among FSWs in Zhejiang Province. Efforts should be made to strengthen the publicity and education of PrEP/PEP, especially for those who are older and more mobile and working in low-end venues, combined with HIV prevention services to increase the use of PrEP/PEP.

Objective:To investigate syphilis infection and related factors among HIV-infected patients being followed up for more than one year in Zhejiang Province.Methods:Data were collected from the China Disease Control and Prevention Information System, and information such as demographic characteristics, viral load levels, and syphilis serologic test results was collected from HIV-infected persons who were diagnosed with HIV more than 1 year, aged ≥15 years with a current address in Zhejiang Province through December 31, 2022. The logistic regression model analyzed the prevalence of syphilis and the related factors. The SPSS 19.0 software was used for statistical analysis.Results:A total of 33 734 HIV-infected patients, with the prevalence of syphilis was 5.6% (1 879/33 734). Among the syphilis cases, the prevalence of syphilis was 6.4% (1 774/27 934) of males, 7.5% (640/8 543) of 25-34 years old age group, 7.6% (1 025/13 423) of unmarried, 8.3% (1 239/14 862) of homosexual transmission, 6.9% (214/3 080) with a non-local registered residence and 9.6% (602/6 267) with a history of STD before the HIV diagnosis. Multivariate Logistic regression analysis showed that participants who were male (a OR=2.19, 95% CI:1.77-2.72), 25-34 years old age group (a OR=1.80, 95% CI:1.47-2.20), homosexual transmission (a OR=1.67, 95% CI:1.49-1.88), with other provinces registered residence (a OR=1.26, 95% CI:1.09-1.47), and with a history of sexually transmitted disease (STD) before the HIV diagnosis (a OR=1.98, 95% CI:1.78-2.20) were associated with increased risk of syphilis. Being married (a OR=0.79, 95% CI:0.68-0.92) was associated with a decreased risk of syphilis. Conclusions:Syphilis infections were high in HIV-infected patients followed up more than one year in Zhejiang Province. It is recommended that syphilis surveillance and screening frequency should be strengthened among HIV-infected persons with characteristics such as male, homosexual transmission, and STD history.

Objective:To investigate the prevalence of syphilis in HIV-infected patients with transmission risk and influencing factors in Zhejiang Province.Method:The information about the HIV-infected patients, who were alive, had been diagnosed with HIV for >1 year, had received no antiviral treatment or had HIV viral load ≥50 copies/ml, and were aged ≥15 years, reported in Zhejiang as of December 31, 2018 were collected from China Information System for Disease Control and Prevention. The information included general demographic characteristics, sexual behavior characteristics and antiretroviral therapy and syphilis serological test results. The prevalence of syphilis and the influencing factors were analyzed by logistic regression model. The SPSS 19.0 software was used for statistical analysis.Results:A total of 2 275 HIV-infected patients were at risk of HIV transmission, and 75.5% (1 717/2 275) of them were tested for syphilis, the prevalence rate of syphilis was 8.7% (150/1 717). Among the HIV-infected patients with syphilis, 11.3% (17/150) received no antiviral treatment, 38.7% (58/150) had viral load of 50-999 copies/ml and 50.0% (75/150) had ≥1 000 copies/ml. Multivariate logistic regression analysis showed that being men (a OR=2.04, 95% CI:1.06-3.96), homosexual transmission (a OR=1.53, 95% CI:1.04-2.27), history of sexually transmitted diseases (STDs) before HIV diagnosis (a OR=1.98, 95% CI:1.35-2.92) and HIV viral load ≥1 000 copies/ml (a OR=1.90, 95% CI:1.09-3.30) were the risk factors for syphilis. Marriage (a OR=0.47, 95% CI: 0.29-0.76) was a protective factor for syphilis. Conclusions:The prevalence of syphilis was high in HIV-infected patients with transmission risk in Zhejiang. It is urgent to carry out classified management and targeted intervention in HIV-infected patients, explore multi-disease prevention and treatment mechanism, strengthen syphilis screening and treatment in HIV-infected patients to reduce the transmission of HIV and syphilis.

Objective:To analyze the trends and related factors of HIV self-testing willingness in young students in Zhejiang Province, and provide evidence for the development of AIDS prevention and control measures in young students.Methods:From 2017 to 2021, HIV/AIDS sentinel surveillance was carried out in students of colleges and universities in all 11 cities of Zhejiang Province. One university or vocational and technical college in each city was selected as a sentinel school. An anonymous questionnaire survey was conducted among 800 students aged ≥16 years and selected by phased cluster sampling in each university or college from April to June in each year to collect information about their social demographic characteristics, sexual behavior, HIV prevention and test services acceptance. The HIV self-testing willingness and the influencing factors were analyzed.Results:A total of 45 483 students were surveyed from 2017 to 2021, and the proportions of those with willingness of HIV self-testing were 0.4% (35/9 107), 3.7% (334/9 150), 5.2% (475/9 203), 6.3% (563/8 962)and 7.4% (674/9 061) respectively (trend χ2=582.74, P< 0.001). Among young students who had sexual contact history, the multivariate logistic regression analysis showed that factors related with higher willingness of HIV self-testing included those majoring in medicine ( OR=1.57, 95% CI:1.06-2.33), seeking sexual partners through internet or social-dating application ( OR=1.96, 95% CI:1.33-2.89), receiving HIV prevention services in the last year ( OR=1.33, 95% CI:1.02-1.74), and being heard of vending machines selling HIV test kits ( OR=1.80, 95% CI:1.34-2.41). The factors related with lower willingness of HIV self-testing inclued those who had multiple heterosexual partners ( OR=0.57, 95% CI: 0.36-0.89). Conclusions:The willingness of HIV self-testing in young students increased in Zhejiang during 2017-2021, the young students who had sex were more willing to self-test among them but the level was still low. It is necessary to further strengthen the health education of HIV/AIDS prevention and control and provide better testing services to promote HIV self-testing.

Objective:To understand the epidemiological characteristics and transmission routes of newly reported HIV/AIDS cases with non-martial and non-commercial (NMNC) heterosexual behaviors in Zhejiang province.Methods:A retrospective survey was conducted among HIV/AIDS cases that had NMNC heterosexual behavior history and diagnosed with HIV infection in Zhejiang between January 1 st, 2017 and September 30 th, 2019. The multiple correspondence analysis (MCA) was used to explore the association of social demographic characteristics with NMNC heterosexual partner types in the cases. Results:A total of 406 participants with NMNC heterosexual behaviors before HIV diagnoses were recruited in this study. Most of them were males (67.2%, 273/406), aged 25-49 years at HIV diagnoses (59.1%, 240/406). Prior to HIV infection confirmation, 36.0% (146/406) participants only had casual sexual partners, 52.0% (211/406) only had regular sexual partners, and 12.0% (49/406) had both. Statistical differences in marital status, occupation and income level were found among participants with different types of NMNC heterosexual partners (all P<0.05). Result of MCA indicted that monthly income ≤3 000 yuan RMB, self-employed, being married were only associated with casual NMNC heterosexual partner; working in service industry, education level of junior high school were only associated with regular heterosexual partner; working in enterprise, high school education level or above, monthly income ≥5 000 yuan RMB were associated with both casual and regular sexual partner. Conclusion:The HIV/AIDS cases with NMNC heterosexual behaviors before HIV diagnoses accounted for a large proportion in Zhejiang province during 2017-2019. Active intervention efforts should be made to improve the health awareness of the public to reduce the risk behaviors for HIV transmission.

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 epidemiological characteristics of newly diagnosed HIV/AIDS cases aged 50 years or over in Zhejiang Province from 2015 to 2019, so as to provide reference for the development of prevention and control strategies. Methods : The data of newly diagnosed HIV/AIDS cases in Zhejiang Province were collected through the China HIV/AIDS Comprehensive Response Information Management System, and the demographic characteristics, infection routes,regional distribution and time distribution of the cases were analyzed. Results: A total of 6 726 HIV/AIDS patients were recruited in this study, and the number of new patients from 2015 to 2019 showed an increasing trend ( P <0.05 ) . The number of participants diagnosed at the age of 50-59, 60-69 and 70-91 years old were 3 433( 51.04% ), 2 242 ( 33.33% ) and 1 051 ( 15.63% ). The majority of them were males ( 5 180, 77.01% ) , married ( 4 286, 63.72% ) , Zhejiang residents ( 5 304, 78.86% ) , and lived in rural areas ( 4 095, 60.88% ) . In terms of exposure history,6 586 cases ( 97.92% ) were infected by sexual contact. Among the 5 083 males infected by sexual contact, 82.63% were through heterosexual contact, 94.79% had extramarital sex partners, among whom 76.61% were commercial sex partners. The married women patients who confirmed HIV positive accounted for 75.44%. There were increasing trends in the proportion of the cases living in rural areas, male cases infected through heterosexual contact and those with extramarital and commercial sex partners, and female cases with their husbands positive along with age ( P <0.05 ) . Conclusions The number of newly diagnosed HIV/AIDS cases aged ≥50 years is increasing in Zhejiang Province. Many of them live in rural areas. Commercial sexual contact is the main route of HIV transmission among males and further lead to HIV transmission within couples.