Objective:To identify the association between CD4 +T lymphocyte (CD4) counts and physical frailty among HIV-infected people aged 65 years and older, and evaluate whether this association will be modified by the indicators of body composition. Methods:From May to October 2022, 485 elderly HIV-infected patients receiving antiretroviral therapy (ART) were recruited from 7 antiviral treatment sites in Jiangjin District Center for Disease Control and Prevention, Chongqing. The data of basic characteristics (age and gender), living habits (smoking and drinking) and disease history (metabolic diseases, cardiovascular and cerebrovascular diseases, respiratory disease and malignant tumors) were collected through the face-to-face investigation with self-made questionnaires. Fried Frailty Scale was used to evaluate the status of physical frailty. Physical fitness (walking speed, grip strength, height, and weight) and body composition (skeletal muscle mass, body fat mass, and basal metabolic rate) were measured. The antiretroviral treatment data were obtained from the China AIDS Integrated Prevention and Treatment Data information management system. The prevalence of physical frailty was calculated among the HIV-infected patients. The potential effects of CD4 counts on physical frailty were explored by using multivariate logistic regression. Subgroup analyses were repeated in the logistic regression with muscle mass, body fat mass, and other indicators of body composition as subgroup variables to determine whether the association might be modified by body composition.Results:The age of 485 patients were (72±5) years old, of which 48.2% (234 cases) were>70 years old and 70.9% (344 cases) were male, and all of whom had initiated the ART treatment. The prevalence of physical frailty among these patients was 7.4% (36/485). Multivariate logistic regression showed that after adjusting for age, sex, smoking, drinking, body composition index, ART duration, viral load and the number of comorbidities, increased CD4 cell level was associated with decreased prevalent risk of physical frailty among elderly HIV-infected patients. For every increase of 5.0×10 7 CD4 cells/L, the prevalent risk of physical frailty decreased by 12% [ OR (95% CI): 0.88 (0.76-1.01)]. Compared with the low CD4 cell level group, the risk of physical frailty in those with normal CD4 cell level decreased by 69% [ OR (95% CI): 0.31 (0.10-0.92)]. Subgroup analysis of body composition indicators showed that the protective effect of normal CD4 cell level on physical frailty was more pronounced in the high skeletal muscle mass and high basal metabolic rate group ( Pinteraction<0.05). Conclusion:The prevalence of physical frailty among elderly HIV-infected patients is relatively lower in Chongqing, and the CD4 cell level, skeletal muscle mass and basal metabolic rate are related to physical frailty.

Objective:To identify the association between CD4 +T lymphocyte (CD4) counts and physical frailty among HIV-infected people aged 65 years and older, and evaluate whether this association will be modified by the indicators of body composition. Methods:From May to October 2022, 485 elderly HIV-infected patients receiving antiretroviral therapy (ART) were recruited from 7 antiviral treatment sites in Jiangjin District Center for Disease Control and Prevention, Chongqing. The data of basic characteristics (age and gender), living habits (smoking and drinking) and disease history (metabolic diseases, cardiovascular and cerebrovascular diseases, respiratory disease and malignant tumors) were collected through the face-to-face investigation with self-made questionnaires. Fried Frailty Scale was used to evaluate the status of physical frailty. Physical fitness (walking speed, grip strength, height, and weight) and body composition (skeletal muscle mass, body fat mass, and basal metabolic rate) were measured. The antiretroviral treatment data were obtained from the China AIDS Integrated Prevention and Treatment Data information management system. The prevalence of physical frailty was calculated among the HIV-infected patients. The potential effects of CD4 counts on physical frailty were explored by using multivariate logistic regression. Subgroup analyses were repeated in the logistic regression with muscle mass, body fat mass, and other indicators of body composition as subgroup variables to determine whether the association might be modified by body composition.Results:The age of 485 patients were (72±5) years old, of which 48.2% (234 cases) were>70 years old and 70.9% (344 cases) were male, and all of whom had initiated the ART treatment. The prevalence of physical frailty among these patients was 7.4% (36/485). Multivariate logistic regression showed that after adjusting for age, sex, smoking, drinking, body composition index, ART duration, viral load and the number of comorbidities, increased CD4 cell level was associated with decreased prevalent risk of physical frailty among elderly HIV-infected patients. For every increase of 5.0×10 7 CD4 cells/L, the prevalent risk of physical frailty decreased by 12% [ OR (95% CI): 0.88 (0.76-1.01)]. Compared with the low CD4 cell level group, the risk of physical frailty in those with normal CD4 cell level decreased by 69% [ OR (95% CI): 0.31 (0.10-0.92)]. Subgroup analysis of body composition indicators showed that the protective effect of normal CD4 cell level on physical frailty was more pronounced in the high skeletal muscle mass and high basal metabolic rate group ( Pinteraction<0.05). Conclusion:The prevalence of physical frailty among elderly HIV-infected patients is relatively lower in Chongqing, and the CD4 cell level, skeletal muscle mass and basal metabolic rate are related to physical frailty.

Objective:To provide information reference for resource allocation and decision-making in related fields, the cost-effectiveness of HIV input among men who have sex with men (MSM) in Ningbo. Different intervention coverages were compared.Methods:Taking MSM as the target population, data were collected and modeled by Optima HIV for the corresponding HIV health output and the budget under different intervention coverages.Results:According to the estimated size of the MSM population, which was 19 584 in Ningbo in 2020, if the coverage of 2020 baseline intervention is maintained in the next ten years, the number of HIV cases, new HIV infections, and HIV-related deaths among this population will show an upward trend. It is estimated that from 2021 to 2030, 7.9% of new infections and 1.7% of deaths can be avoided and the relevant funding investment comed to 2.4 time the baseline if the intervention coverage rate expanded to 3.0 times the 2020 baseline. After the coverage rate of intervention expanded to 3 times the baseline, it continued to grow, the health effect did not increase.Conclusions:At present, expanding the baseline coverage of HIV-related intervention projects among MSM in Ningbo and increasing capital investment will still reverse HIV-related death and reduce new infections. Moreover, there is a saturation point of the intervention effect. Researchers and policymakers must explore more effective interventions/combinations to obtain more significant health outcomes.

Objective:To analyze the performance of emergency response to 2019 novel coronavirus (2019-nCoV) positive cases in an international test competition in an Winter Olympic Game venue and provide evidences for the COVID-19 prevention and control in similar competitions.Methods:A retrospective analysis on the epidemiological investigation and nucleic acid test results of the cases, the implementation of prevention and control measures, including the communication with sport teams and others, was conducted.Results:The positive cases of 2019-nCoV among entering people were detected before entry, at airport, hotel and venue. Two positive cases were reported before entry, 2 positive cases infected previously and 3 asymptomatic cases were reported after the entry. The venue public health team and local CDC conducted epidemiological investigation and contact assessment jointly in a timely and efficient manner. No local secondary transmission occurred, but the nucleic acid test results of positive persons fluctuated, posing serious challenges to the implementation of prevention and control measures.Conclusion:In large scale international competition, there is high risk of imported COVID-19. It is necessary to fully consider the fluctuation of nucleic acid test results, the criteria for determination and cancellation of positive results and give warm care to positive cases in the emergency response.

Objective:To assess the prevalence of psychoactive substances use in men who have sex with men (MSM) and its related risk factors.Methods:From July to December 2019, MSM in 6 provinces were recruited from social MSM organizations in communities. The inclusion criteria were male, age ≥18 years, having had sex with men or male homosexuality, voluntary participation and informed consent. Data collected through an anonymous self-filled online questionnaire including socio-demographic characteristics, sexual behavior and psychoactive substance use. Multivariate logistic regression was performed to examine factors correlated with psychoactive substances use.Results:A total of 2 616 MSM were included in the study. Overall, 32.2% (841/2 616) of MSM had ever used at least one psychoactive substances, of whom 92.4% (777/841) were Rush users and 14.4% (121/841) were multi drug users. Rush and tryptamine were used the most (79.7%,98/121). After adjusting the influence of province, factors associated with psychoactive substances use included age <35 years (<25: OR=1.28, 95% CI: 1.02-1.61; 25-34: OR= 1.34, 95% CI: 1.08-1.67) , active sexual role preference ( OR=1.47, 95% CI: 1.22-1.77), having non-regular partners in last sex ( OR=1.21, 95% CI: 1.01-1.45) and use of tobacco products in the past 6 months ( OR=1.29, 95% CI: 1.06-1.56). Conclusions:Psychoactive substances like Rush are popular among MSM, especially in the younger ones. MSM who played active sexual role, had non-regular sex partners and used tobacco also reported higher level of psychoactive substance use. Our findings suggest the urgent need for precise and comprehensive interventions to control the use of psychoactive substances and related hazards in young MSM.

Objective:To analyze the longitudinal characteristics of CD4 +T lymphocytes (CD4) among the adult HIV/AIDS on antiretroviral therapy (ART) and the related factors. Methods:A retrospective cohort of adult HIV/AIDS starting ART in Dehong Dai and Jingpo Autonomous Prefecture (Dehong) in 2007-2016 was followed up to December 31, 2018. Group-based trajectory models were utilized to identify CD4 subgroups based on immune recovery (whether and when CD4 reached the average level of >500 cells/μl). The demographics and information at ART baseline were described, and the related factors were analyzed with polytomous logistic regression. The SAS 9.4 software was used for statistical analysis.Results:A total of 7 605 adults with HIV/AIDS were included, of which the median ( P 25, P 75) age at ART were 36 (30,43) years old, 61.0% were male, 42.5% were Han nationality, and 60.8% with the education of primary school or below. The follow-up duration M ( P 25, P 75) was 6.1 (4.1,8.1) years. HIV/AIDS in Dehong showed four CD4 trajectory subgroups from low to high: below the average level, primary recovery to a normal level, full recovery to a moderate level, and normal steady level, accounting for 34.4%, 39.8%, 20.6%, and 5.2%, respectively. When compared with corresponding control groups, age <35 years at ART, female, education of middle school or above, sexual transmission, no opportunistic infection, CD4 ≥200 cells/μl, baseline regimen with tenofovir (TDF) and time from HIV diagnosis to ART <1 year were the related factors facilitating the higher CD4 subgroups. Conclusions:The various CD4 immune recoveries of HIV/AIDS were changing patterns after ART. Starting ART with a high CD4 level was beneficial to CD4 recovery to normal level during the follow-up period. Early initiation of ART and exceptional attention to CD4 immune recovery should be encouraged after the ART.

Objective:To explore incidences of HIV and HCV infections in injecting drug users (IDUs) in community.Methods:A community-based survey was conducted to recruit 200 HIV sero-negative IDUs for a prospective cohort study based on the local needle and syringe exchange program in Longyang district of Baoshan city, Yunnan province from June 2014 to June 2019, China. Follow-up was carried out every six month to investigate the prevalence of drug use behavior and sexual behavior in IDUs. Blood samples were collected from them to test HIV and HCV serum antibodies. The cohort was opened for recvuitment every year to replenish the cohort to 200 subjects.Results:A total of 231 IDUs were recruited after 5 years of follow-up. Cohort retention rate was 82.0% (164/200) in 5 years. No HIV sero-positive conversion was found during the 5-year study. There were 89 HCV negative IDUs. Totally, 384.6 person years were observed and the HCV sero-positive conversion in this cohort was 0.26 per 100 person-years.Conclusion:It was found that the incidences of HIV and HCV in IDUs in communities of the study area were at low levels, while comprehensive and effective intervention measures are still needed to control HIV and HCV infections in this population.

The asymptomatic carrier state of COVID-19 has become a topic of concern for preventing a possible epidemic rebound. This review describes and defines the COVID-19 asymptomatic carrier state and outlines methods for identifying counting and reporting these cases. The author elaborates that the asymptomatic carrier state can be further divided into asymptomatic infection and pre-symptomatic infection after extended follow-up based on the nature of disease progression. The author presents the limited available data about infectiousness of asymptomatic and pre-symptomatic cases and their possible contributions to the overall epidemic of COVID-19 observed so far in China. Challenges of a possible second epidemic wave of COVID-19 caused by asymptomatic and pre-symptomatic cases are discussed and suggestions for control strategies and scientific research are provided.

Objective:To understand the routes of newly reported HIV/AIDS cases with heterosexual mode of transmission in six districts of Chongqing city, and to provide evidence for HIV/AIDS prevention and control programs regarding heterosexual mode of transmission on HIV.Methods:HIV/AIDS cases that were newly reported as with heterosexual mode of transmission in six districts of Chongqing from July 1st to October 1st in 2019, were recruited in the study. Information related to their sociodemographic characteristics and heterosexual behaviors was collected. A self-designed questionnaire was used in this face-to-face survey.Results:A total of 312 HIV/AIDS cases with heterosexual mode of transmission were recruited. Most of them were males (207, 66.3 %), aged 50 years or over (210, 67.3 %), having junior high school or lower education (252, 80.8 %), married or cohabitating (200, 64.1 %). 48.7 % (152/312) of them were infected through commercial sexual contact while 40.4 % (126/312) of them were infected by spouses or stabled partners. 10.9 % (34/312) of them were infected by non-marital and non-commercial sexual contacts. Significant differences were noticed on the infection mode of heterosexual transmission in gender, age and occupation ( P<0.05). Results from the multivariate logistic regression analysis revealed that: male ( OR=822.34, 95 %CI: 103.99-6 503.10), junior high school and lower education level ( OR=3.02, 95 %CI: 1.05-8.66), household chores and underemployed ( OR=0.23, 95 %CI: 0.07-0.76) were influencing factors on HIV infection that were through commercial sexual contacts. Male ( OR=29.20, 95 %CI: 9.40-90.75), junior high school and lower education level ( OR=4.28, 95 %CI: 1.24-14.81) were influencing factors on HIV infection, through non-marital and non-commercial sexual contacts. In addition to meeting sexual partners in offline places, some HIV/AIDS patients with heterosexual mode of transmission had developed sexual partnerships through online dating and with low-grade venue as the main place for sex engagement. Conclusions:Newly reported HIV/AIDS cases under heterosexual mode of transmission in Chongqing were mainly infected from offline low-grade venues, and caused by commercial sexual engagement. The routes of HIV infections that caused by heterosexual contact should be deeply understood in order to develop targeted intervention programs.

Novel coronavirus spreads very fast and is not easy to control. It has spread over 200 countries or territories. China has taken action to implement containment strategies, including active COVID-19 case finding, tracing, and 14-day quarantine of close contacts, and home isolation of 1.39 billion of people countrywide for at least 2 weeks, etc. The combination of these strategies has brought the epidemic under control in China. The United Kingdom had deliberately not implemented containment measures for a while, instead opting to allow herd immunity strategy to develop over time. This is a "do-nothing" strategy whereby the virus is allowed to move through communities naturally until certain proportion of people has been infected, and the epidemic ends without intervention. The author assesses containment strategies versus this herd immunity strategy in real-world application to the COVID-19 epidemic. The author suggests an innovative strategy to balance controlling the epidemic and preventing impediment to economic and social development.