BACKGROUND: Men who have sex with men (MSM) have become a high risk population of HIV infection due to their risky sexual behaviors. The latent pattern of psychosocial characteristics plays an important effect in HIV-related risky behaviors among HIV-negative MSM. METHOD: Participants were recruited from Wuhan, Nanchang, and Changsha city from September 2017 to January 2018. Social support was assessed by the multidimensional scale of social support, Connor-Davidson Resilience scale-10 items for reliance, the assessment of Stigma towards Homosexuality for sexual minority stigma, the Likert subscale of nondisclosure for identity concealment, the ACE questionnaire-Kaiser-CDC for adverse childhood experience, the Centers for Epidemiological Studies Depression Scale for depression. Latent profile analysis (LPA) and multivariate regression were used to analyze the data. RESULTS: Three psychosocial characteristic patterns were revealed by the LPA. "Social support and resilience group" (SR group), "Identity concealment group" (IC group) and "Adverse childhood experience" (ACE group) were identified, respectively. In comparison with "SR group", "IC group" have a higher likelihood of one-night male partners (AOR = 2.74, 95%CI = [1.54, 4.90]), both fixed and one-night male partners (AOR = 2.01, 95%CI = [1.34, 3.01]) and HIV-unsure male partner (AOR = 2.12, 95%CI = [1.44, 3.13]). Similarly, "ACE group" were more likely having inconsistent condom use (AOR = 2.58, 95%CI = [1.41, 4.73]), and having sex with HIV-positive male partner (AOR = 4.90, 95%CI = [1.95, 12.30]) with comparison of "SR group". In addition, we further revealed that "ACE group" had a higher ratio (90.0%) of inconsistent condom use among MSM whose male partners were HIV-positive. CONCLUSIONS Six important psychosocial factors were divided into three latent pattern classes. Compared with "SR group", "IC group" and "ACE group" were more likely to engage in HIV-related risky sexual behaviors. Further research may pay more attention to "IC group" and "ACE group" for targeted intervention.
Humans ; Male ; HIV Infections/epidemiology* ; Homosexuality, Male/psychology* ; Risk Factors ; Sexual and Gender Minorities/psychology* ; Sexual Behavior/psychology*

OBJECTIVE: To explore the discrepancy between behavioral-indicated candidacy and perceived candidacy (behavioral-perceived gap) and its associated factors of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), so as to identify the focus population of PrEP interventions and to design and implement targeted interventions. METHODS: We recruited a sample of 622 HIV-negative MSM who were regular clients of a community-based organization located in Chengdu, China, from November to December 2021. A cross-sectional questionnaire was used to collect the participants' information on social demographics, PrEP-related knowledge and cognitions, and risk behaviors. In this study, behaviorally eligible for PrEP was defined as performing at least one type of high-risk behavior in the past six months, including inconsistent condom use, sex with an HIV-positive partner, confirmed sexual transmitted infections (STI) diagnosis, substance use, and post-exposure prophylaxis (PEP) experience. Logistic regression models were fitted, and multivariate analyses were adjusted for social demographics. RESULTS: Among the 622 eligible participants, 52.6% (327/622) were classified as behaviorally eligible for PrEP. Only 37.9% (124/327) of the participants perceived themselves as appropriate candidates for PrEP and 62.1% (203/207) had discrepancy between behavioral-indicated and perceived candidacy. 85.9% (281/327) had heard of PrEP, and 14.2% (40/281) accessed PrEP information through health care providers. Of the 327 participants eligible for behavior-indicated PrEP use, about half (47.1%) knew how to obtain PrEP medication and 33.0% had a professional PrEP counseling experience. The majority (93.3%) had no or few friends using PrEP. 54.1% scored eight or above in PrEP knowledge level. 66.7% reported having two or more sexual partners in the past six months. After adjusting for age and recruitment channel, we found six factors that were associated with perceived candidacy for PrEP, including PEP use [adjusted odds ratio (OR_A)=2.20; 95% confidence interval (CI): 1.33-3.63], PrEP availability (OR_A=1.69; 95%CI: 1.06-2.68), a greater number of PrEP-using friends (OR_A=4.92; 95%CI: 1.77-13.65), PrEP know-ledge (OR_A=2.21; 95%CI: 1.38-3.56), multiple sexual partnership (OR_A=1.77; 95%CI: 1.07-2.94), and perceiving a higher risk of HIV infection (OR_A=4.02; 95%CI: 1.73-9.32). Substance use during sex and PrEP information channel were not statistically associated with this beha-vioral-perceived gap. CONCLUSION We observed a high discrepancy between behavioral-indicated and perceived candidacy for PrEP among Chengdu MSM in China. Future PrEP implementation efforts should be made in skills training in assessing HIV infection risk, increasing PrEP knowledge, providing professional PrEP counselling, and fostering PrEP support environment.
Male ; Humans ; Homosexuality, Male/psychology* ; HIV Infections/psychology* ; Pre-Exposure Prophylaxis ; HIV ; Cross-Sectional Studies ; Sexual and Gender Minorities

BACKGROUND: From 2010 to 2015, there was a twofold growth of new HIV/AIDS infection in Beijing among young students aged 15-24. HIV/AIDS education was found effective in promoting positive behavior change related to HIV/AIDS prevention. However, little evidence was found on the evaluation of HIV/AIDS education policy. This study aimed to evaluate the college-based HIV/AIDS education policy in Beijing. METHODS: By using a mixed method approach, the current study reviewed college-based HIV/AIDS education policy at national level and in Beijing from 1985 to 2016 and conducted policy content analysis to evaluate the policy ability to structure implementation. Cross-sectional surveys in 2006 and 2016 were used to evaluate college's implementation of relevant policies. T test, χ test, and logistic regression were used to analyze college students' perception of HIV/AIDS education provided in their colleges and their knowledge of HIV/AIDS and their risk factors. RESULTS: Fourteen pieces of national policy and four pieces of Beijing's policy were identified. Policy's ability to structure implementation was at moderate level. The percentage of students in Beijing who ever perceived HIV/ADIS education at colleges decreased from 71.14 to 39.80%, and the percentage of students with comprehensive knowledge of HIV/AIDS dropped from 50.00% in 2006 to 40.42% in 2016. CONCLUSIONS HIV/AIDS education in college had drawn considerable attentions from the Chinese government, while the policy implementation needs further strengthening.
Acquired Immunodeficiency Syndrome ; psychology ; Adolescent ; Beijing ; Cross-Sectional Studies ; Female ; HIV Infections ; psychology ; Health Education ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Health Policy ; Humans ; Male ; Universities ; statistics & numerical data ; Young Adult

Objective: To understand the prevalence of drug resistance in treatment-naive injecting drug users (IDUs) infected with HIV-1 in Guangzhou. Methods: HIV-1 RNA were extracted from the serum specimens of the newly confirmed HIV-1 positive IDUs living in Guangzhou, being infected through injecting drug use and receiving no antiretroviral therapy at the time of confirmation during 2008-2015. Full sequence of pol protease (PR) gene and partial sequence of reverse transcriptase (RT) gene were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced. After that, data were submitted to the HIV resistance database of Stanford University for drug resistance analysis. Results: Among the 518 HIV-1 infected IDUs, HIV-1pol gene segments were successfully obtained from the serum samples of 407 HIV-1 infected IDUs (78.57%) aged 18-64 (37.44±8.14) years. Among them, males accounted for 89.68% (365/407), those of Han ethnic group accounted for 89.93% (366/407), the unmarried accounted for 55.28% (225/407), and those with education level of junior high school or below accounted for 83.78% (341/407). The distribution of subtypes was predominated by CRF07_BC (47.18%, 192/407), followed by CRF01_AE (23.83%, 97/407), CRF08_BC (22.85%, 93/407), and other subtypes (6.14%, 25/407). The overall prevalence of drug resistance was 3.44% (14/407). The prevalence of drug resistance to protease inhibitors, nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors were 1.47%(6/407), 0.25% (1/407) and 1.72% (7/407) respectively. The mutation rate was 12.29% (50/407). No major drug resistance mutation was detected in protease and nucleoside reverse transcriptase regions. Higher rate of V179E mutation in the non-nucleoside reverse transcriptase region was detected in other subtypes and subtype CRF07_BC. Mutation seemed to have occurred in all 8 cases of subtype CRF55_01B in other subtypes. The highest mutation rate of E138A was detected in subtype CRF08_BC (3.23%). Two cases were resistant to all four drugs of NNRTIs. Conclusions: The prevalence of drug resistance in treatment-naive HIV-1 positive IDUs remained at a relatively low level during 2008-2015, in Guangzhou. Most infections were sensitive to existing antiviral drugs. However, drug resistance surveillance in IDUs infected with HIV should be strengthened to prevent the prevalence of multi-drug resistance and cross drug resistance.
Adolescent ; Adult ; Child ; Drug Resistance, Viral/genetics* ; Drug Users ; Genes, pol/genetics* ; Genotype ; HIV Infections/psychology* ; HIV-1/isolation & purification* ; Humans ; Male ; Mutation ; Prevalence ; RNA, Viral/genetics* ; Young Adult

Objective: To describe the characteristics of newly reported HIV/AIDS cases via non-marital or non-commercial heterosexual transmission and to find out the relative factors in Hangzhou, from 2015 to 2017. Methods: Data were collected through the national HIV/AIDS comprehensive control and prevention data system. Study subjects would include those reported HIV/AIDS cases who were residents of Hangzhou and were infected via non-marital heterosexual transmission, between January 1, 2015 and December 31, 2017. Demographic characteristics and behavioral information were collected. χ(2) test was used to compare different characteristics of the non-married heterosexual transmission subjects. Logistic regression was used to assess factors that associated with non-marital but non-commercial HIV heterosexual transmission with SPSS. 20 software used to analyze statistically. Results: Non-marital HIV heterosexual transmission accounted for 38.03% (1 393/3 663) of the total new reported HIV/AIDS cases in 2015-2017. Out of the 1 393 HIV/AIDS cases, those infected through non-marital but non-commercial heterosexual transmission accounted for 50.83% (708/1 393), and those through non-martial commercial transmission was accounted for 49.17% (685/1 393). Male to female ratio was 3.51 ∶ 1 (1 084/309). Male HIV cases reported that their major way of infection was via non-marital commercial transmission (670/1 084, 61.81%), while female patients reported the way was via non-marital non-commercial (294/309, 95.1%). Results from multivariate logistic analysis showed that the related risk factors and ORs for non-marital but non-commercial transmission appeared as: female (aOR=48.25, 95%CI: 26.94- 88.44),<30 year olds (aOR=2.43, 95%CI: 1.31-4.51), 30-39 year olds (aOR=1.92, 95%CI: 1.11- 3.33), 40-49 year olds (aOR=1.80, 95%CI: 1.08-3.00), married or unmarried (vs. divorced or widowed, aOR=1.57, 95%CI: 1.10-2.24; aOR=1.78, 95%CI: 1.15-2.78), high school and above of education level (vs. primary school and under of education level, aOR=1.82, 95%CI: 1.18-2.80), administrative officers or employee (vs. farmers, aOR=2.03, 95%CI: 1.04-1.91). Number of non- marital partners less than 5 (vs. number of non-marital partners more than 5, aOR=10.65, 95%CI: 6.41-17.42). Conclusions: HIV/AIDS cases with non-marital heterosexual transmission accounted for considerable proportion regarding the HIV transmission in Hangzhou from 2015 to 2017. Differences were found in the following factors as non-marital and non-commercial heterosexual transmission with diverse gender, age, marital status, educational level and occupation among of the HIV/AIDS patients.
Female ; HIV ; HIV Infections/transmission* ; Heterosexuality ; Humans ; Male ; Risk Factors ; Sexual Behavior/psychology* ; Sexual Partners ; Single Person

Poor retention in care (RIC) is associated with higher antiretroviral therapy (ART) failure and worse survival. Identifying high risk patients for poor RIC is important for targeted intervention. A retrospective cohort study was conducted at a tertiary care hospital in Korea. HIV-infected patients initiating ART during 2002-2008 were included. 5 year-RIC was measured by hospital visit constancy (HVC) at 5 years after initiating ART. Among 247 enrolled patients, 179 (72.5%) remained in care, 20 (8.1%) were transferred to other hospitals, 9 (3.6%) died and 39 (15.8%) were lost to follow-up. We compared the demographic, psychosocial, and clinical characteristics between the groups with 100% HVC (n = 166, 67.2%) and < or = 50% HVC (n = 33, 13.4%). In multivariable analysis, ART-starting age < or = 30 years (odds ratio [OR] 4.08 vs. > 50; 95% confidence interval [CI] 1.10-15.15, P = 0.036), no non-HIV related comorbidity (OR 2.94 vs. comorbidity > or = 1; 95% CI 1.02-8.49, P = 0.046), baseline CD4 cell count > 300 cells/muL (OR 3.58 vs. < or = 200; 95% CI 1.33-9.65, P = 0.012) were significant predictable factors of poor RIC. HIV/AIDS care-givers should pay attention to young patients with higher baseline CD4 cell counts and no non-HIV related comorbidity.
Adult ; Anti-HIV Agents/*therapeutic use ; CD4 Lymphocyte Count ; CD4-Positive T-Lymphocytes/cytology ; Cohort Studies ; Comorbidity ; Demography ; Female ; HIV Infections/*drug therapy/mortality/psychology ; Hospitals ; Humans ; Male ; *Medication Adherence/psychology ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Republic of Korea ; Retrospective Studies

OBJECTIVETo understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.

METHODSFace to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.

RESULTSAmong the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9% (28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32 (7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents (4.5%, 9/198), the difference was statistically significant (χ(2)=11.715, P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.

CONCLUSIONSRisk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.

China ; epidemiology ; Condoms ; utilization ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Risk-Taking ; Sex Work ; psychology ; statistics & numerical data ; Sexual Behavior ; psychology ; statistics & numerical data ; Surveys and Questionnaires

OBJECTIVETo estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risky behaviors among rural youth in China.

METHODSA cross-sectional, anonymous, investigative questionnaire for 1710 unmarried, out-of-school rural youth, aged between 15 and 24 years, was handed out in Gongzhuling county of Jilin province, China.

RESULTS58.5% of participants had a history of migration, irrespective of gender. There were gender differences observed in other factors such as drug abuse (4.3% for males and 5.5% for females, P<0.01), multiple sexual partners (24.1% for males and 44.1% for females, P<0.01), and HIV knowledge rate (35.2% for males and 25.5% for females, P<0.001). While controlling for gender, age, and educational levels, the relationships between migration and drug abuse, selling sex, and non usage of condoms during last instance of sexual activity were found to be significant. The cases of premarital sex and multiple sexual partners were both not found to be related to migration.

CONCLUSIONAmong rural youth, the HIV risky behavior such as drug abuse, selling sex, and lack of condom use, is significantly related to migration, while premarital sex and multiple sexual partners seem unrelated to migration.

Adolescent ; China ; epidemiology ; Condoms ; utilization ; Female ; HIV Infections ; complications ; epidemiology ; transmission ; Health Knowledge, Attitudes, Practice ; Human Migration ; statistics & numerical data ; Humans ; Male ; Risk-Taking ; Rural Population ; statistics & numerical data ; Sex Factors ; Sex Work ; statistics & numerical data ; Substance-Related Disorders ; complications ; epidemiology ; Surveys and Questionnaires ; Transients and Migrants ; psychology ; statistics & numerical data ; Unsafe Sex ; psychology ; statistics & numerical data ; Young Adult

PURPOSE: The purpose of this study was to examine validity and reliability of Webel and colleagues' HIV Self-Management Scale when used with a Korean sample. METHODS: The original 20-item HIV Self-Management Scale was translated into Korean using translation and back-translation. Nine HIV nurse experts tested content validity. Principal component analysis (PCA) and confirmatory factor analysis (CFA) of data from 203 patients was used to test construct validity. Concurrent validity was evaluated using correlation with patients' self-rating as a "smart patient" measured using a visual analogue scale. Internal consistency was tested by Cronbach's alpha coefficients. RESULTS: All items were rated as having satisfactory content validity. Based on PCA and consideration of conceptual meaning, a three-factor solution was selected, explaining 48.76% of the variance. CFA demonstrated the adequacy of the three-domain structure of the construct HIV self-management: daily self-management health practices, social support and HIV self-management, and chronic nature of HIV self-management. Goodness-of-fit indices showed an acceptable fit overall with the full model (chi2/ df(164)=1.66, RMSEA=0.06, SRMR=0.05, TLI=0.91, and CFI=0.92). The Korean version of the HIV Self-Management Scale (KHSMS) was significantly correlated with patients' self-rated smart patient (r=.41). The subscale Cronbach's alpha coefficients ranged from .78 to .81; alpha for the total scale was .89. CONCLUSION: The KHSMS provides a valid and reliable measure of self-management in Korean patients with HIV. Continued psychometric testing is recommended to provide further evidence of validity with this population.
Adult ; Female ; HIV Infections/*psychology ; Humans ; Male ; Middle Aged ; Principal Component Analysis ; Program Evaluation ; Psychometrics ; Republic of Korea ; *Self Care ; Surveys and Questionnaires ; Translating ; Young Adult

OBJECTIVETo understand the incidence of HIV infection among men who have sex with men (MSM) in China.

METHODSMeta-analysis was performed to systematically and quantitatively review all the original research papers and reports published during 2010-2015 on the incidence of HIV infection among MSM in China. Pooled incidence, pooled hazard ratios, publication bias, heterogeneity and sensitivity analysis for those studies were calculated or analyzed by using Stata 12.0 software.

RESULTSA total of 24 studies were analyzed. Pooled incidence of HIV infection among MSM in China was 5.0/100 person year; Based on HIV case report, severe epidemic areas had higher HIV incidence than other areas (4.9/100 person year vs. 3.4/100 person year). Low education level (HR = 1.61, 95% CI: 1.21-2.15), syphilis prevalence (HR = 3.22, 95% CI: 2.21-4.70), unprotected anal sex (HR = 2.92, 95% CI: 1.51-5.63), minority ethnic group (HR = 4.01, 95% CI: 1.96-8.21), commercial sex (HR = 4.11, 95% CI: 1.47-11.46) and multiple sexual partners (HR = 2.31, 95% CI: 1.60-3.34) were the risk factors for HIV incidence.

CONCLUSIONPooled incidence of HIV infection among MSM was 5.0% in China. Low education level, syphilis prevalence, unprotected anal sex, minority ethnic group, commercial sex and multiple sexual partners were the risk factors for HIV infection.

China ; epidemiology ; Educational Status ; Ethnic Groups ; statistics & numerical data ; HIV Infections ; epidemiology ; Homosexuality, Male ; psychology ; statistics & numerical data ; Humans ; Incidence ; Male ; Minority Groups ; statistics & numerical data ; Prevalence ; Risk Factors ; Sex Work ; statistics & numerical data ; Sexual Partners ; Syphilis ; epidemiology ; Unsafe Sex ; statistics & numerical data