OBJECTIVE: Antiretroviral drugs covered by medical insurance have been gradually used by people living with human immunodeficiency virus (PLWH) in recent years in China. This study aimed to analyze their willingness to pay (WTP) for antiretroviral drugs. METHODS: A mixed-methods study design involving a cross-sectional survey and in-depth interviews was conducted. A cross-sectional survey was performed to collect data on the general characteristics, economic status, antiretroviral therapy (ART) status, and WTP of PLWH in 18 Chinese cities from August 2022 to February 2023. Multivariate logistic regression was used to analyze the factors associated with WTP. Representatives of PLWH were interviewed via in-depth interviews, and the data were thematically analyzed. RESULTS: Among the 941 PLWH, 271 (28.80%) were willing to pay for antiretroviral drugs covered by medical insurance. For basic medical insurance for urban and rural residents, PLWH with the following characteristics were more willing to pay: an educational level of senior high school or technical secondary school, having an undergraduate degree or higher, frequently working away from their hometowns, and homosexual transmission. Off-farm workers and recipients of government medical aid were more unwilling to pay. For basic medical insurance for urban employees, PLWH with the following characteristics were more willing to pay: frequently working away from their hometowns; homosexual transmission; personal annual income ≥ 100,000 CNY; and adverse events of antiretroviral drugs. The main reasons for PLWH's WTP for antiretroviral drugs covered by medical insurance were that the drugs had fewer adverse events and were easier to administer. The main reasons for PLWH's unwillingness to pay were financial difficulties and privacy concerns. CONCLUSION Nearly one-third of PLWH are willing to pay for antiretroviral drugs covered by medical insurance. In the future, PLWH with a high WTP can be guided to use these drugs.
Humans ; HIV Infections/economics* ; China ; Male ; Female ; Adult ; Cross-Sectional Studies ; Middle Aged ; Anti-Retroviral Agents/economics* ; Cities ; Insurance, Health/economics* ; Young Adult

The effect of air pollution on the lung function of adults with asthma remains unclear to date. This study followed 112 patients with asthma at 3-month intervals for 2 years. The pollutant exposure of the participants was estimated using the inverse distance weight method. The participants were divided into three groups according to their lung function level at every visit. A linear mixed-effect model was applied to predict the change in lung function with each unit change in pollution concentration. Exposure to carbon monoxide (CO) and particles less than 2.5 micrometers in diameter (PM_2.5) was negatively associated with large airway function in participants. In the severe group, exposure to chronic sulfur dioxide (SO2) was negatively associated with post-bronchodilator forced expiratory flow at 50%, between 25% and 75% of vital capacity % predicted (change of 95% CI per unit: -0.34 (-0.55, -0.12), -0.24 (-0.44, -0.03), respectively). In the mild group, the effect of SO₂ on the small airways was similar to that in the severe group, and it was negatively associated with large airway function. Exposure to CO and PM_2.5 was negatively associated with the large airway function of adults with asthma. The negative effects of SO₂ were more evident and widely observed in adults with severe and mild asthma than in adults with moderate asthma. Patients with asthma react differently to air pollutants as evidenced by their lung function levels.
Adult ; Air Pollutants/analysis* ; Air Pollution/adverse effects* ; Asthma/epidemiology* ; Beijing/epidemiology* ; Environmental Exposure/adverse effects* ; Humans ; Lung ; Particulate Matter/analysis* ; Sulfur Dioxide/adverse effects*

Lymphangioleiomyomatosis (LAM) is a rare diffuse cystic lung disease. Knowledge on LAM-related pulmonary hypertension (PH) is limited. This study aimed to analyze the clinical characteristics of LAM with elevated pulmonary artery pressure (PAP) and evaluate the potential efficacy of sirolimus. The study involved 50 LAM patients who underwent echocardiography. According to the tricuspid regurgitation velocity (TRV), these patients were divided into the TRV ⩽ 2.8 m/s group and TRV > 2.8 m/s group. Both groups comprised 25 females with an average age of 38.6 ± 8.1 and 41.5 ± 8.9 years. In the TRV > 2.8 m/s group, the estimated systolic PAP (SPAP) was significantly elevated (52.08 ± 12.45 mmHg vs. 30.24 ± 5.25 mmHg, P < 0.01). Linear analysis showed that SPAP was correlated with forced expiratory volume in 1 s (FEV), diffusing capacity of the lungs for carbon monoxide, alveolar arterial oxygen gradient (PO), and 6 min walking distance (r =-0.392, -0.351, 0.450, and -0.591, respectively; P < 0.05), in which PO was a risk factor for SPAP elevation (β = 0.064, OR = 1.066, P < 0.05). Moreover, in 10 patients who received sirolimus therapy, SPAP decreased from 57.0 12.6 mmHg to 35.2 ± 11.1 mmHg. The study showed that LAM patients with PH exhibit poor pulmonary function and hypoxemia and may benefit from sirolimus treatment.
Adult ; Carbon Monoxide ; analysis ; Echocardiography ; Exercise Test ; Female ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; physiopathology ; therapy ; Logistic Models ; Lymphangioleiomyomatosis ; physiopathology ; therapy ; Male ; Middle Aged ; Multivariate Analysis ; Oxygen ; blood ; therapeutic use ; Respiratory Function Tests ; Sirolimus ; therapeutic use

Objective To describe the status of adherence to antiretroviral therapy (ART) in low endemic area,and to explore the factors affecting ART adherence so as to provide evidence for behavior management program.Methods A cross-sectional study was conducted in 53 patients receiving free ART in Chuanying and Yongji of Jilin Province.Structured face-to-face interview was carried out to determine sociodemographic characteristics,medical treatment information,medication adherence behaviors,health belief and self-efficacy,doctor-patient relationships and health service information.Results Among 53 patients,3 reported drug discontinuance.Of the other 50 patients,41 (82.0％) obeyed the request of the doctors (to be defined as adherence).All the participants had high levels of perceived benefits of adherence,perceived severity of non-adherence and self-efficacy.94.3％ of them reported using medication reminders,88.7％ reported receiving directly observed therapy (DOT),and 73.6％ reported falling into the habit of drug administration.Conclusions HIV/AIDS patients show relatively good adherence to medical treatment.Local comprehensive education and supportive programs may contribute to patients' good adherence to ART.