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*

Acquired Immunodeficiency Syndrome/epidemiology* ; Bayes Theorem ; COVID-19/prevention & control* ; China/epidemiology* ; Communicable Disease Control/trends* ; Disease Notification/statistics & numerical data* ; Forecasting ; Humans ; Incidence ; Interrupted Time Series Analysis ; SARS-CoV-2

Objective: To analyze the work indicators of China Comprehensive AIDS Response Program (China CARES) and provide reference for future work of the program. Methods: The scores of each indicator were calculated, and different scores among different types of program areas were compared. The M(Q₁,Q₃) was used to describe the score of each indicator. The entropy weight method was used to calculate the composite score of each indicator and the composite score was translated into a 100-point system and compared among indicators. Results: In terms of the first-level indicators, organizational leadership and management (96.0 points), publicity and education (94.0 points), and innovative strategies and measures (98.0 points) got relatively high scores; while comprehensive social governance of AIDS prevention (72.0 points) was with the lowest score. The scores of publicity and education and comprehensive intervention in county-level program areas were significantly lower than those in urban areas. For secondary indicators, the indicator with relatively lower scores included "condom use among female sex workers last time" (70.0 points)", "at least one local key population has an increase in the number of people receiving HIV testing compared with the previous year" (70.0 points)", "colleges and occupational schools set up AIDS-related self-service facilities" (65.0 points), "HIV testing among the arrested people suspected of prostitution, adultery, drug users and traffickers" (55.0 points) and "condom use among men who have sex with men during last episode" (50.0 points). The "indicator 3 comprehensive intervention" contributed most to the evaluation, while "indicator 7 innovation strategies and measures" played a minor role in the evaluation results. Conclusions: The overall situation of AIDS Response Program in 2020 was good, but the progress in different word areas was not yet balanced. The two areas of comprehensive intervention and comprehensive social governance of AIDS prevention should be strengthened. It is also suggested that relevant indicators be adjusted appropriately to improve evaluation indicators system and comprehensively promote the program.
Acquired Immunodeficiency Syndrome/prevention & control* ; China/epidemiology* ; Female ; HIV Infections/epidemiology* ; Homosexuality, Male ; Humans ; Male ; Program Evaluation ; Sex Workers ; Sexual and Gender Minorities

In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.
Acquired Immunodeficiency Syndrome/prevention & control* ; China/epidemiology* ; Disease Outbreaks ; HIV Infections/prevention & control* ; Humans ; Prevalence

This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country.
Acquired Immunodeficiency Syndrome/*epidemiology/prevention & control ; Computer Simulation ; Developing Countries/*economics/statistics & numerical data ; Economic Development/statistics & numerical data ; Fraud/economics/*statistics & numerical data ; Fuzzy Logic ; HIV Infections/*epidemiology/prevention & control ; Humans ; Models, Statistical ; Prevalence ; Risk Factors ; Socioeconomic Factors

OBJECTIVETo analyze the allocation and trend of central government AIDS special funding in 4 priority sites of HIV/AIDS prevention and control across calendar years.

METHODSInformation about the allocation of central government special AIDS funding and cumulative HIV/AIDS survivor numbers of Z city, D prefecture, L prefecture and D prefecture were collected until 2013. Data were collected from 2004-2013 for Z city and D prefecture, and data from 2009-2013 were collected for L and Y prefecture. Funding allocation among all working areas and their trend over time were analyzed.

RESULTSFrom 2004-2013, the total amount of special funding in Z prefecture was 110.15 million RMB. The largest three areas of allocation were key population response (29%, 3 190/11 015), surveillance and testing (23%, 2 535/11 015) and human resource (13%, 1 498/11 015). The least area of allocation was follow-up and prevention of discordant couple transmission (2%, 251/11 015). The total amount of special funding in D prefecture from 2004-2013 was 109.77 million RMB. The largest three areas of allocation were treatment and care (25%, 2 691/10 977), follow-up and prevention of discordant couple transmission (17%, 1 843/10 977) and surveillance and testing (15%, 1 656/10 977). The least area was blood safety (1%, 135/10 977). From 2009 to 2013, the total amount of special funding in L prefecture was 55 million RMB. The largest three areas of allocation were surveillance and testing (60%, 3 298/5 500), high risk population intervention (14%, 768/5 500) and follow up and prevention of discordant couple transmission (12%, 675/5 500). The least area was blood safety (0.1%, 8/5 500). From 2009-2013, the total amount of special funding in Y prefecture was 55 million RMB and the largest three areas of allocation were project management and others (28%, 1 527/5 500), key population response (19%, 1 046/5 500) and high risk population intervention (17%, 922/5 500). The least area of special funding was blood safety (2%, 106/5 500). Among three HIV/AIDS epidemic related key areas (surveillance and testing, follow-up and prevention of discordant couple transmission, treatment and care), 2004-2013, allocated funds were between 2.96-3.36, 0-0.37, 0.37-1.97 million RMB in Z city; 0.64-2.35, 0.00-3.00, 2.00-4.70 million RMB in D prefecture; 2009-2013, allocated funds were between 2.67-8.85, 0.41-2.39, 0.35-1.84 million RMB in L prefecture, 1.18-2.84, 0.70-1.05, 0.46-0.89 million RMB in Y prefecture.

CONCLUSIONThe allocation patterns of central government AIDS special funding among key working areas were different across 4 different sites; in each individual site, the trend of special funding allocation was stable among HIV epidemic related key areas over calendar years.

Acquired Immunodeficiency Syndrome ; epidemiology ; prevention & control ; therapy ; Communicable Diseases ; Epidemiological Monitoring ; Government ; HIV Infections ; epidemiology ; prevention & control ; therapy ; Health Care Rationing ; Humans ; Mass Screening ; National Health Programs ; Survival Rate

Along with the rapid spread of HIV / AIDS and TB prevalence, prevention and control of AIDS and tuberculosis has become an urgent problem in the field of public health. Recent studies demonstrate dual infections of HIV and TB are not a simple superposition of two diseases, but a course of mutual promotion. This article has summarized the pathological mechanisms and mutual interactions of HIV/TB dual infections.
Acquired Immunodeficiency Syndrome ; complications ; epidemiology ; prevention & control ; Coinfection ; HIV-1 ; pathogenicity ; Humans ; Mycobacterium tuberculosis ; pathogenicity ; Prevalence ; Public Health ; Tuberculosis ; complications ; epidemiology ; prevention & control

OBJECTIVETo comprehensive evaluate the rationality of Acquired Immune Deficiency Syndrome (AIDS) expenditure through the analysis of AIDS expenditure circumstances based on the application of National AIDS Spending Assessment in Dehong prefecture in 2010.

METHODSDemographic and economic indicators of Mang City, Yingjiang, Longchuan, Ruili City, Lianghe and Wanting zone in Dehong prefecture of Yunnan province were collected from the reports issued by Dehong Statistical Bureau of 2010, and HIV/AIDS epidemic indicators were collected from the annual report of national AIDS prevention and control data.NASA method was used to analyze the actual spending and demand index was used to calculate the demand of AIDS funding in these counties (cities). The correlations between HIV/AIDS expenditures and demographic, economic and HIV/AIDS epidemic index were analyzed, respectively, as well as the correlation between the expenditures of AIDS prevention and control and proportion of major transmission approaches.

RESULTSIn 2010, the actual expenditures on HIV/AIDS in the 5 counties (cities) of Dehong prefecture was ¥28 752 772, the population was 1 211 400, and Gross Domestic Product (GDP) was ¥11 693. The intervention expenditures in injection drug users, sexually transmitted people, and prevention of mother to child transmission in Ruili county were ¥130 345, ¥71 484 and ¥164 100, the proportions of HIV transmission in these groups were 23.9% (49/205), 73.7% (151/205), and 0.5% (1/205), respectively; and in Lianghe county was ¥141 665, ¥257 142, and ¥99 961, and the proportions of HIV transmission were 17.1% (6/35), 80.0% (28/35) and 0.0% (0/35), respectively. The intervention expenditures in Ruili and Lianghe counties were positive related to the proportion of corresponding people with HIV infection (both r values were 0.99, all P values < 0.05). In the other 4 counties (cities) and the development zone, no correlations. The expenditures of government departments, international projects, domestic research programs and personal and family pays (r value were 0.94, 0.83, 0.99 and 0.88, respectively, all P values < 0.05) were positive related to the number.Except the personal and family pays, other sources of expenditures were all positive related to the number of reported HIV/AIDS cases (r values were 0.94, 0.89 and 0.81, respectively, all P values < 0.05).

CONCLUSIONPopulation and HIV/AIDS epidemic index were considered as factors in AIDS spending. The expenditures corresponded with the demand of different areas basically.

Acquired Immunodeficiency Syndrome ; economics ; epidemiology ; prevention & control ; China ; epidemiology ; Health Expenditures ; Humans

OBJECTIVETo analyze the key indicators of China Comprehensive AIDS Response Program (China CARES) and the effects of this program during 2008 and 2011.

METHODSData were obtained from National AIDS Comprehensive Prevention and Control Information System. The general population HIV test rate and spouse of people living with HIV or AIDS (PLWHA) HIV test rate were chosen as the indicators for HIV testing expansion; anti-retroviral therapy (ART) coverage and PLWHA CD4 test rate during the past 6 months as the indicators for treatment expansion; femal sex worker (FSW) intervention coverage and injection drug users (IDU) intervention coverage as the Indicators for behavior intervention expansion. The Key working quality indicators of 309 program sites were calculated and the results were compared.

RESULTSDuring 2008 and 2011, for China CARES, the Median of general population HIV test rate were 1.8%, 2.5%, 3.2% and 5.5%, the Median of spouse of PLWHA HIV test rate were 80.9%, 85.7%, 91.8% and 100.0%, the Median of ART coverage were 60.0%, 66.7%, 76.1% and 92.0%, the Median of PLWHA CD4 test rate during the past 6 months were 27.7%, 45.4%, 58.6% and 75.3%, the Median of FSW intervention coverage were 43.8%, 67.8%, 73.3% and 90.9%, the Median of IDU intervention coverage were 18.2%, 24.0%, 34.0% and 72.4%. The indicators of China CARES increased steadily from 2008 to 2011 in HIV testing expansion, treatment expansion and behavior intervention expansion; Compared to 2008, the percentage of the China CARES which had great progress of the 6 indicators were 98.4% (304/309), 98.3% (286/291), 94.0% (281/299), 93.5% (288/308), 91.8% (279/304) and 90.0% (223/247). in 2008, 3 indicators which were ART coverage, PLWHA CD4 test rate during the past 6 months and FSW intervention coverage were lower than national average (6.9%, 17.9% and 30.9%), the general population HIV test rate, spouse of PLWHA HIV test rate and IDU intervention coverage were higher than national average (3.4%, 64.3% and 22.8%), with the China CARES project going on, in 2011, key indicators which were general population HIV test rate, spouse of PLWHA HIV test rate, ART coverage, PLWHA CD4 test rate during the past 6 months, FSW intervention coverage and IDU intervention coverage were all higher than national average (6.5%, 80.6%, 81.9% and 55.9%).the proportions of China CARES sites whose 6 indicators were higher than national average in 2008 were 32.7% (101/309), 60.6% (149/246), 37.4% (99/265), 61.1% (181/296), 64.0% (174/270) and 45.3% (73/161), and the proportions increase annually to 2011 were 44.0% (136/309), 89.3% (260/291), 76.6% (229/299), 77.9% (240/308), 91.4% (278/304) and 64.8% (160/247).

CONCLUSIONAn obvious achievements have been made in the areas of HIV/AIDS prevention and control among China CARES sites during 2008 and 2011 than the national average.

Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; prevention & control ; Anti-Retroviral Agents ; therapeutic use ; China ; epidemiology ; Humans ; Quality Indicators, Health Care

Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; prevention & control ; China ; epidemiology ; Female ; HIV Infections ; drug therapy ; epidemiology ; prevention & control ; Health Policy ; Humans ; Male