With the advancement of combination antiretroviral therapy (cART), the global number of new human immunodeficiency virus (HIV) infections and HIV-related mortality has significantly declined. However, the high proportion of "late presentation" (defined as presenting to care with a low CD4 cell count or AIDS-defining events) among HIV-infected individuals remains a significant challenge in HIV prevention and treatment. HIV late presentation is associated with increased clinical risk, complex management, and higher risk of transmission, and represents a significant barrier to achieving the "95-95-95" targets and ending the HIV epidemic. Currently, both nationally and internationally, there is a lack of specific clinical guidelines for this population. Therefore, the China Association for Promotion of Health Science and Technology convened experts in the field to discuss the definition, clinical characteristics, risks, and cART of late presenters based on the latest research evidence and clinical practices both domestically and internationally. Specific recommendations were formulated to guide healthcare professionals in their clinical practice.
The Acquired Immunodeficiency Syndrome Professional Group of the Society of Infectious Diseases of the Chinese Medical Association formulated the first edition of theChinese Guidelines for the Diagnosis and Treatment of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (referred to as the Guidelines) in 2005. The 2024 edition of the Guidelines has been compiled by updating the 2021 fifth edition, incorporating the latest research advancements in antiviral therapy, comprehensive management, opportunistic infections, concurrent tumors, and the prevention and intervention of HIV infection. The new edition also introduces a new section on "Incomplete immune reconstitution", proposes the concept of "HIV vulnerable populations" for the first time with recommendations for their diagnosis and treatment. This edition of the Guidelines covers 14 sections: epidemiology, pathogenic characteristics, laboratory tests, pathogenesis, clinical presentation and staging, diagnostic criteria, common opportunistic infections, antiretroviral therapy, immune reconstitution inflammatory syndrome, incomplete immune reconstitution, AIDS-related neoplasms, prevention of mother-to-child transmission and conception in serodiscordant couples, pre- and post-exposure prophylaxis, and whole-course management of HIV infection. This edition of the Guidelines aims to assist clinical physicians in making informed decisions in the diagnosis, treatment, and management of HIV/AIDS and will be periodically revised and updated based on domestic and international research progress.
Cabotegravir (CAB-LA), the first long-acting injectable pre-exposure prophylaxis (PrEP), has been approved for use in the USA and is not currently on the market in China. However, willingness to use CAB-LA and associated factors among men who have sex with men (MSM) have not yet been evaluated in China. A cross-sectional study was conducted in Guangxi, China, in 2022 recruiting 1,006 MSM. Their mean age was 30.2 years, 74.2
Objective To investigate the effect of the self-disclosure intervention on psychological distress and selfdisclosure in people living with HIV（PLWH）. Methods PLWHs were selected by convenience sampling and divided into an observation group and a control group by random number table method. The control group received routine care and the observation group underwent additional 5-week self-disclosure intervention. The Chinese version of the Pain Disclosure Index Scale（DDI） and the Simple Psychological Status Rating Scale（Kessler 10） were used before the intervention（T0）, at the end of the intervention（T1） and 1 month after the intervention（T2） to compare the self-disclosure level and psychological distress level of the two groups. Results A total of 58 patients were enrolled, with 29 cases in the observation group and 29 in the control group. After the intervention, the self-disclosure scores of T1 and T2 in the observation group were（37.52±2.40） and（37.93±2.60）, which were significantly higher than those in T0（35.86±2.52）, and were higher than those in the control group（35.55±3.41） and（35.59±3.38）, with statistically significant differences（P＜0.05）. The psychological distress scores of T1 and T2 in the observation group were（19.34±4.84） and（18.83±4.69）.Compared with T0（21.28±4.78）, the difference was significantly lower than that of the control group（22.03±2.95） and（22.10±2.90）, and the difference was statistically significant（P＜0.05）. The interaction of time and intervention between the two groups was significant（P＜0.05）. There were no significant differences before and after the intervention in the control group（P＞0.05）. Conclusions Self-disclosure intervention guided by the disclosure process model can effectively improve the self-disclosure level of patients and reduce their psychological distress.
Objective To explore the effects of stigma and healthcare provider engagement on depression among people living with HIV（PLWH） at different disease stages. Methods 100 PLWH were selected as research subjects and questionnaires were conducted at baseline（T1） and 6 months（T2） after by the Berger HIV Stigma Scale, the Healthcare Provider Engagement Scale and Depression Scale for epidemiological surveys. Results The total depression scores of PLWH at T1 and T2 were 6.00（2.00, 14.75） and 4.00（1.00, 12.00）, respectively. The detection rates of depression were 39.00%（39 cases） and 31.00%（31 cases） and the difference was statistically significant（χ2=52.92, P＜0.01）. The total scores of stigma were（109.33±24.87） and（107.27±25.75）, respectively. The difference has no statistical significance（t=1.261, P=0.105）. Information disclosure in stigma and healthcare provider engagement were risk factors for depression（P＜0.01）. PLWH’s stigma can directly predict the occurrence of depression（95%CI: 0.065-0.132）. Healthcare provider engagement, however, can have an indirect impact on PLWH’s depression（95%CI: 0.002-0.022）. Conclusions PLWH generally have varying degrees of stigma and depression in their daily lives. The involvement of healthcare providers may play a part-mediating role in the way stigma affects depression. Focusing on the level of stigma and the involvement of healthcare providers can help to detect and actively intervene in patients with depression to reduce their depression.
