1.Application of the back-calculation method for estimating new HIV infections in Dehong Dai and Jingpo Autonomous Prefecture, Yunnan Province, 2010-2023
Minyang XIAO ; Yuecheng YANG ; Manhong JIA ; Houlin TANG ; Yuhua SHI ; Liru FU ; Zuyang ZHANG ; Renhai TANG ; Xiaowen WANG ; Fangfang CHEN
Chinese Journal of Epidemiology 2025;46(4):669-675
Objective:New HIV infections serve as a crucial indicator for assessing the dynamic changes in the HIV epidemic. This study aims to estimate the number of new HIV infections in Dehong Dai and Jingpo Autonomous Prefecture of Yunnan Province (Dehong), using a back-calculation method that integrates diagnosis delay approaches and Bayesian theory. Additionally, it compares the differences between these two estimation methods.Methods:Data were obtained from the Chinese Information System for Disease Control and Prevention. Based on CD4 + T lymphocytes (CD4) counts depletion model, the first CD4 count prior to antiretroviral therapy of HIV-infected individuals diagnosed in Dehong from 2010 to 2023 was utilized to retroactively determine the infection date of HIV-infected individuals and ascertain the annual number of new HIV infections who had been diagnosed. Subsequently, the diagnosis delay distribution method and Bayesian theory were leveraged to assess the diagnosis probability of newly infected individuals, thereby projecting the number of new HIV infections in the region over the specified period. Results:During 2010-2023, a total of 5 693 individuals aged 15 and above, excluding mother-to-child transmission, were diagnosed with HIV in Dehong. After excluding 364 cases due to missing CD4 count results or abnormal first CD4 counts (≥2 000 cells/μl), 5 329 HIV-infected individuals were included in the final analysis. Through CD4 counts back-calculation from 2010 to 2023, the annual number of new infections diagnosed was 479, 427, 337, 305, 256, 219, 194, 193, 131, 166, 120, 71, 42 and 47. When using the diagnosis delay distribution method and life table analysis, the cumulative diagnosis probability rose from 0.301 within one year to 0.913 within 14 years, leading to a reduction in the number of estimated new infections from 577 in 2010 to 168 in 2023, with a total estimate of 4 412 (95% CI:4 350-4 480). Alternatively, based on Bayesian theory, the diagnosis probability increased from 0.413 within one year to 0.946 within 14 years, leading to a reduction in the number of estimated new infections from 557 in 2010 to 122 in 2023, with a total of 3 814 (95% CI: 3 787-3 837). Conclusions:Both methods yielded consistent results in estimating new HIV infections in Dehong from 2010 to 2023. Given the region's ongoing expansion of HIV testing, the estimates derived from Bayesian theory may more accurately reflect the actual situation. These findings provide a reference basis for formulating and optimizing HIV/AIDS prevention and control strategies in Dehong, facilitating progress toward the goal of eliminating AIDS by 2030 in the region.
2.Application of the back-calculation method for estimating new HIV infections in Dehong Dai and Jingpo Autonomous Prefecture, Yunnan Province, 2010-2023
Minyang XIAO ; Yuecheng YANG ; Manhong JIA ; Houlin TANG ; Yuhua SHI ; Liru FU ; Zuyang ZHANG ; Renhai TANG ; Xiaowen WANG ; Fangfang CHEN
Chinese Journal of Epidemiology 2025;46(4):669-675
Objective:New HIV infections serve as a crucial indicator for assessing the dynamic changes in the HIV epidemic. This study aims to estimate the number of new HIV infections in Dehong Dai and Jingpo Autonomous Prefecture of Yunnan Province (Dehong), using a back-calculation method that integrates diagnosis delay approaches and Bayesian theory. Additionally, it compares the differences between these two estimation methods.Methods:Data were obtained from the Chinese Information System for Disease Control and Prevention. Based on CD4 + T lymphocytes (CD4) counts depletion model, the first CD4 count prior to antiretroviral therapy of HIV-infected individuals diagnosed in Dehong from 2010 to 2023 was utilized to retroactively determine the infection date of HIV-infected individuals and ascertain the annual number of new HIV infections who had been diagnosed. Subsequently, the diagnosis delay distribution method and Bayesian theory were leveraged to assess the diagnosis probability of newly infected individuals, thereby projecting the number of new HIV infections in the region over the specified period. Results:During 2010-2023, a total of 5 693 individuals aged 15 and above, excluding mother-to-child transmission, were diagnosed with HIV in Dehong. After excluding 364 cases due to missing CD4 count results or abnormal first CD4 counts (≥2 000 cells/μl), 5 329 HIV-infected individuals were included in the final analysis. Through CD4 counts back-calculation from 2010 to 2023, the annual number of new infections diagnosed was 479, 427, 337, 305, 256, 219, 194, 193, 131, 166, 120, 71, 42 and 47. When using the diagnosis delay distribution method and life table analysis, the cumulative diagnosis probability rose from 0.301 within one year to 0.913 within 14 years, leading to a reduction in the number of estimated new infections from 577 in 2010 to 168 in 2023, with a total estimate of 4 412 (95% CI:4 350-4 480). Alternatively, based on Bayesian theory, the diagnosis probability increased from 0.413 within one year to 0.946 within 14 years, leading to a reduction in the number of estimated new infections from 557 in 2010 to 122 in 2023, with a total of 3 814 (95% CI: 3 787-3 837). Conclusions:Both methods yielded consistent results in estimating new HIV infections in Dehong from 2010 to 2023. Given the region's ongoing expansion of HIV testing, the estimates derived from Bayesian theory may more accurately reflect the actual situation. These findings provide a reference basis for formulating and optimizing HIV/AIDS prevention and control strategies in Dehong, facilitating progress toward the goal of eliminating AIDS by 2030 in the region.
3.Analysis on the proportion of men who have sex with men and related factors among male over 15 years old in Kunming
Minyang XIAO ; Zuyang ZHANG ; Xiaowen WANG ; Yumiao WANG ; Yongnian CAI ; Liru FU ; Lijun SONG ; Hongbing LUO
Chinese Journal of Epidemiology 2021;42(8):1482-1486
Objectives:To investigate the proportion of MSM among males over 15 years old and analyze its related factors to provide a reference for estimation of MSM size.Methods:Using cross-sectional survey design, multi-stage sampling method, and street interception survey method, a survey was conducted on males over 15 years old in Kunming from October to December 2019, with an estimated sample size of 9 908.Results:Totally, 10 707 males were recruited from 30 sites in 5 counties, and 10 283 were effectively surveyed with a response rate of 96.0%. Respondents aged 16 to 40 accounted for 75.3% (7 748), senior high school or above 71.1% (7 312), and unmarried 49.8% (5 121). The proportion of homosexual behavior in the past half-year was 1.06% (95% CI: 0.86%-1.26%), and the age-adjusted rate was 0.97% (95% CI: 0.78%-1.16%). And multivariate logistic regression showed the associated factors for homosexual behavior as following: proportion of main urban area was 2.217 times (95% CI:1.004-4.895) that of the outer suburbs, registered residence outside Kunming was 0.421 times (95% CI:0.260-0.682) that of in Kunming, having been in Kunming ≤6 months was 2.282 times (95% CI:1.262-4.126) that of >6 months, senior middle school or above was 0.336 times (95% CI:0.228-0.495) that of junior middle school and below, and being married was 0.462 times (95% CI:0.303-0.705) that of unmarried. Conclusions:The proportion of over 15-year-old males who have recently practiced male-male behavior was close to 1.00% in Kunming. The relevant factors included survey areas with a permanent residency of Kumming, short-time residency, education level, and marital status. This study obtained the data and related factors, which provided a reference for estimating MSM size in Yunnan province.
4. The usage of comprehensive geriatric assessment in elderly patients with acute myeloid leukemia: a multicenter, prospective study
Qi WU ; Rong FU ; Mingfeng ZHAO ; Yigai MA ; Hao JIANG ; Liangding HU ; Yu JING ; Hui LIU ; Liru WANG ; Li SU ; Yongqing ZHANG ; Chunlin ZHOU ; Yan ZHANG ; Hanyun REN ; Bin JIANG ; Hebing ZHOU ; Lin KANG ; Lu ZHANG ; Daobin ZHOU ; Jian LI
Chinese Journal of Hematology 2019;40(1):35-39
Objective:
To evaluate the feasibility and potential value of comprehensive geriatric assessment (CGA) in elderly (≥60 years) patients with newly diagnosed acute myeloid leukemia (AML) in China.
Methods:
The CGA results of 83 newly diagnosed AML (non-APL) patients from 16 hospitals in Beijing and Tianjin between March 2016 and December 2017 were prospectively collected and analyzed. The clinical data, treatment and follow-up information were also collected.
Results:
Of 83 newly diagnosed elderly AML patients, 81 patients (97.6%) completed all designated CGA assessment. The median number of impaired scales of the CGA assessment in the studied population was 2(0-6). Sixteen patients (19.3%) showed no impairments according to the geriatric assessment scales implem ented by this study. The distributions of impaired scales were as follows: impairment in ADL, 55.4%; IADL impairment, 42.2%; MNA-SF impairment, 48.2%; cognitive impairment, 15.7%; GDS impairment, 31.7%; HCT-CI impairment, 19.5%, respectively. In patients with "good" ECOG (
5.A large scale cohort study on AIDS in communities in Dali, Yunnan province, 2014-2015
Minyang XIAO ; Xiaoming CHEN ; Yanling MA ; Liru FU ; Jin NIU ; Zhijuan CHEN ; Hongyuan LI ; Qinli WANG ; Lijun SONG ; Hongbing LUO
Chinese Journal of Epidemiology 2017;38(7):916-920
Objective To understand HIV incidence in community residents and epidemiological characteristics of newly detected HIV infection cases in Dali,Yunnan province.Methods A cohort study was conducted among 146720 community residents who were tested to be HIV negative during 2010-2011,they were followed-up from June 1,2014 to May 31,2015.Results A total of 136356 community residents received follow up (92.9%).The follow-up time was 0.23-5.40 years (medium:3.43 years),cumulatively 459675 person years,and 78 people were found to be HIV positive.The incidence rate of HIV infection was 0.170/1000 person years.The incidence rate was 0.037/1000 person years in age group 15-29 years,0.288/1000 person years in age group 30-44 years,0.210/1000 person years in age group 45-59 years,0.204/1000 person years in age ≥60 years;0.213/1 000 person years in males,0.130/1000 person years in females;0.248/1000 person years inHan ethnic group,0.149/1000 person years in Minorities;0.194/1000 in people with education level ≤junior middle school,0.046/1000 person years in people with education level > junior middle school;0.070/1000 person years in the unmarried,0.194/1000 person years in the married and 0.425/1000person years in the divorced/widowed.Cox proportional hazards regression analysis showed that being male (HR=l.731),aged 30-44 years (HR=13.158),aged 45-59 years (HR=10.329),aged ≥60years (HR=8.291),unmarried (HR=3.162) and divorced/widowed (HR=2.689) were the risk factors for HIV infection,while the education level > junior middle school (HR=0.132) was the protective factor for HIV infection.Conclusions By medium 3.43 years follow up,the cohort study showed that incidence rate HIV infection was 0.170/1000 person years in the community residents in Dali.Male,middle aged and old people,people with low education level,the unmarried and the divorced/widowed had relatively higher risk to be infected with HIV,Close attention should be paid to the prevention and control of AIDS in these populations.
6.Characteristics of HIV seropositive cases and related high risk behaviors in a community in Yunnan province, 2012-2015
Zuyang ZHANG ; Minyang XIAO ; Liru FU ; Jin NIU ; Xuehua LI ; Lijun SONG ; Hongbing LUO
Chinese Journal of Epidemiology 2017;38(8):1068-1072
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.

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