Due to concerns about privacy breaches and fear of social stigma, some individuals engaging in high-risk behaviors—particularly men who have sex with men (MSM)—may avoid in-person HIV testing services and instead choose to purchase HIV self-test kits online for self-testing. Unlike traditional e-commerce platforms that directly provide self-test kits without conducting risk assessments, the “Easy Test Know” platform integrates a structured behavioral risk assessment prior to HIVST kit purchase, allowing users to be categorized into different HIV risk groups. This study aimed to evaluate the performance of a digital HIV behavioral risk stratification tool integrated with online self-testing among MSM, and to determine whether incorporating multi-dimensional behavioral indicators—particularly high-risk venue diversity score—could improve the prediction of HIV positivity compared with the platform’s existing rule-based risk scoring algorithm. This retrospective observational study utilized data from the “Easy Test Know” platform between November 2023 and February 2025. The study included MSM classified as medium or high risk by the platform algorithm. Firth logistic regression models were developed to predict HIV positivity using behavioral variables, including high-risk venue diversity score. Model performance was evaluated using area under the receiver operating characteristic curve (AUC) and calibration analyses. A total of 9,961 participants were included, of whom 90.8% were classified as high risk by the platform. The overall HIV positivity rate was 0.59%, with a higher rate in the high-risk group. The platform’s baseline risk score demonstrated moderate discriminatory power for predicting HIV positivity (AUC = 0.646). High-risk venue diversity score showed a dose–response association with HIV positivity. The data-driven model incorporating the platform’s existing variables together with the newly derived high-risk venue diversity score improved discrimination compared with the rule-based platform algorithm (ΔAUC = +0.082). The fully adjusted model achieved the highest predictive performance (AUC = 0.752). Digital behavioral risk stratification demonstrated moderate ability to differentiate HIV risk among MSM using online HIV self-testing services. Compared with the platform’s original rule-based scoring system, data-driven behavioral models incorporating high-risk venue diversity score showed improved predictive performance. These findings support the potential value of data-driven approaches for optimizing digital HIV risk assessment tools.

Expanding HIV testing coverage is essential to achieving the first target of the UNAIDS 95-95-95 goals. Under current circumstances, a novel testing method, urine-based HIV self-testing (HIVST) will be essential to reach undiagnosed people living with HIV. This multicenter cross-sectional study conducted in three sites in China evaluated the diagnostic accuracy, usability, and acceptability of urine-based HIVST in untrained users under real-world conditions. Among 1,495 participants, the urine test demonstrated a sensitivity of 99.44% and a specificity of 100.00%, with perfect agreement between self-testers and professionals. Agreement between home-based and facility-based testing was 100.00%, confirming the reliability of self-testing in unsupervised settings. Most participants were able to perform the test correctly and interpret the results independently, achieving high comprehension and satisfaction levels. Urine-based HIVST is accurate, convenient, and highly acceptable, serving as a promising alternative to blood- or oral fluid-based approaches to better accommodate diverse needs and preferences. This non-invasive and user-friendly testing option is expected to expand testing coverage and contribute to achieving the first UNAIDS 95 target in China.

Background Incident HIV infection is a critical indicator of an ongoing epidemic, particularly in high-burden regions such as Liangshan Yi Autonomous Prefecture in China, where HIV prevalence exceeds 1% in 4 key counties (Butuo, Zhaojue, Meigu, and Yuexi). Identifying spatial clusters and drivers of recent infections is essential for implementing targeted interventions. Despite advancements in geospatial analyses of HIV prevalence, studies identifying drivers of incident HIV clustering remain limited, especially in low-resource settings. Objective This study aims to identify spatial clusters of recent HIV infections and investigate potential driving factors in 4 key counties of the Liangshan Yi Autonomous Prefecture to inform targeted intervention strategies. Methods From November 2017 to June 2018, we identified 246 (4.42%) recent HIV infection cases from 5555 newly diagnosed cases through expanded testing of the whole population in 4 key counties of Liangshan Yi Autonomous Prefecture. Recent infection cases were confirmed using limiting antigen avidity enzyme immunoassays or documented seroconversion within 6 months. The spatial distribution of incident HIV infection cases was analyzed using kernel density. Potential drivers, including population density, HIV prevalence, elevation, nighttime light index, urban proximity, and antiretroviral therapy (ART) coverage, were analyzed. The spatial lag regression model was used to identify factors associated with clustering of recent infection cases. The Geodetector q-statistic was used to quantify nonlinear interactive effects among these factors. Results Significant spatial autocorrelation was observed in the distribution of recent HIV cases (Moran I=0.11; P<.01). Six spatial clusters were identified, and all were located near urban centers or major roads. Furthermore, 5 factors were identified by the spatial lag regression model as being significantly correlated with the clustering of recent HIV infection cases, including population density (β=0.59; P<.001), HIV prevalence (β=0.02; P<.001), distance to local urban area (β=–3.10; P=.01), SD of elevation (β=–0.15; P=.02), and ART coverage rate (β=183.80; P<.01). Geodetector analysis revealed strong interactive effects among these 5 factors, with population density and HIV prevalence exhibiting the largest interactive effect (q=0.69). Conclusions This study reveals that besides HIV prevalence, urbanization-related factors (population density and proximity to urban area) and transportation accessibility drive incident HIV clustering in Liangshan Yi Autonomous Prefecture. Paradoxically, higher ART coverage was associated with increased transmission, suggesting the need for integrated prevention strategies beyond ART expansion. Furthermore, the township-level geospatial approach provides a valuable model for pinpointing transmission hot spots and tailoring interventions in high-burden regions globally.

Accurate identification of recent HIV-1 infections is critical for real-time epidemic monitoring. However, conventional Limiting Antigen Avidity Enzyme Immunoassays (LAg-EIAs) are restricted to laboratory settings. A novel rapid recency test based on the limiting antigen avidity principle was developed for point-of-care use. We evaluated the performance of the rapid HIV-1 recency test using 500 longitudinal plasma specimens from 107 seroconverters. The mean duration of recent infection (MDRI) was estimated via binomial regression with maximum likelihood modeling. The false recent rate (FRR) was assessed using samples from individuals with long-term infection, including those on antiretroviral therapy (ART). Concordance was compared with two commercial LAg-EIA kits (Maxim and KingHawk). The rapid assay yielded an MDRI of 123 days (95% CI: 87-138), shorter than Maxim (152 days, 95% CI: 137-172) and KingHawk (131 days, 95% CI: 107-140). Among ART-naïve individuals infected for over 1 year, FRR was 5.3%, similar to Maxim (5.9%) and slightly higher than KingHawk (2.7%). High concordance was observed with Maxim (93.1%, kappa = 0.743) and KingHawk (89.4%, kappa = 0.558). In ART-treated individuals, FRR was significantly higher in the early ART group (69.9%) compared to the late ART group (20.2%, P < 0.001). The novel rapid HIV-1 recency assay demonstrates acceptable MDRI and FRR and strong agreement with commercial LAg-EIA kits. Its simplicity and rapid turnaround make it a promising tool for decentralized surveillance and targeted HIV interventions, especially in resource-limited settings.IMPORTANCERapid detection of recent HIV-1 infections is essential for monitoring ongoing transmission and guiding targeted prevention efforts. However, currently used laboratory-based recency assays require specialized facilities and trained personnel, limiting their use in decentralized or resource-limited settings. In this study, we evaluated a newly developed rapid test that identifies recent HIV-1 infections within minutes using a simple, instrument-free format. The test showed strong agreement with two widely used laboratory assays and demonstrated performance suitable for surveillance applications. Its ease of use, rapid turnaround, and minimal infrastructure requirements make this rapid test a practical tool for expanding real-time HIV monitoring and improving the efficiency of public health responses.

The Acquired Immunodeficiency Syndrome Professional Group of the Society of Infectious Diseases of the Chinese Medical Association formulated the first edition of the Chinese 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.

BACKGROUND: Since the UNAIDS introduced HIV self-testing in 2014, its application has been widely adopted globally. Developed in China approximately 2015, HIV self-testing (HIVST), which involves the online purchase of testing kits via e-commerce platforms, has emerged as the most significant distribution method. This approach offers numerous benefits, including user-friendliness, speed, and enhanced privacy protection. OBJECTIVE: To understand the spatiotemporal heterogeneity of online HIVST purchasing behavior and its potential driving factors in China. METHODS: The online retail sales data of HIVST kits from the two largest e-commerce platforms in China from 2015 to 2020 were collected for this study. The Bayesian spatiotemporal hierarchical model (BSTHM) was used to investigate the spatiotemporal characteristics and identify the rapidly growing high-demand regions of online HIVST kit sales. Furthermore, the BSTHM was used to identify potential driving factors associated with online sales, including college students per 10,000 persons, GDP per capita, net per person, phone per person, population density, road density and HIV screening cases per 10,000 persons. RESULTS: From 2015 to 2020, the sales of online HIVST kits experienced a dramatic surge, increasing from 837,061 kits to reaching 7,827,411 kits annually, with a total of 23,987,155 kits sold, with annual peak sales in December. Four economically superior regions in China, the Pearl River Delta, Yangtze River Delta, Beijing-Tianjin areas, and Shandong Peninsula, presented relatively high spatial preferences for online purchased HIVST kits. Thirty-eight rapidly growing high-demand regions were identified, which were located mainly in northeastern China (28.9%, 11/38), the Pearl River Delta (28.9%, 11/38) and the Beijing-Tianjin areas (15.8%, 6/38). The number of college students per 10,000 persons, GDP per capita, net per person, population density and number of HIV screening cases per 10,000 persons were identified as the driving factors that were positively associated with the online purchase rate of HIVST kits. CONCLUSIONS: Our study illuminates the spatiotemporal dynamics and driving factors behind online HIVST kit sales across mainland China, offering pivotal insights for crafting detailed HIVST guidelines. We pinpointed regions with significant sales demand, guiding policymakers in resource reallocation and HIV care continuum optimization, particularly in identified critical ' rapidly growing high-demand’ regions.

BackgroundAdults with community-acquired pneumonia (CAP) in China suffer high morbidity. CAP is caused by a multitude of pathogens; however, pathogen-directed clinical symptoms are often lacking. Therefore, patients lacking an accurate microbiological diagnosis are administered with empirical antimicrobials.MethodsWe collected bronchoalveolar lavage fluid, as well as clinical and laboratory data from 650 adult patients with CAP admitted to three hospitals in Hubei, Sichuan, and Zhejiang provinces in China. Specimens were cultured and tested using real-time reverse transcription qPCR (RT-qPCR) assays for the presence of 42 respiratory bacteria and viruses. CAP was investigated with respect to regions, genders, and age and patterns of infections or co-infections. Employing clinical guidelines adapted for diagnosis, we assessed retrospectively the appropriate pathogen-directed therapy and compared it with the initial empirical therapies.ResultsOur study identified that 21.38% (139/650) of the patients were classified as having Severe CAP (S-CAP), with a higher prevalence among males, older adults, and during the warm season. Bacterial pathogens were detected in 35.53% (231/650) of cases. K. pneumoniae, H. influenzae, and S. aureus were the most prevalent bacteria across different demographics and regions. Viral pathogens were found in 48.76% (317/650) of patients Epstein-Barr, Human rhinovirus, and Cytomegalovirus were the most common viruses. Co-infections were present in 24.31% (158/650) of cases, with viral-bacterial co-infections being the most frequent. The RT-qPCR demonstrated significantly higher detection rates for key pathogens compared to standard culture methods. It showed potential in optimizing antimicrobial prescriptions by allowing for de-escalation in 18.30% (95/518) of patients, among which reducing the number of excessive antibiotics mainly comprised decreasing the use of 2nd or 3rd generation cephalosporins (5.79%, 30/518) and β-lactamase inhibitor combinations.ConclusionThe study highlights the significant burden of S-CAP, particularly among specific demographics and seasons. The prevalence of bacterial and viral pathogens, along with the high rate of co-infections, emphasizes the need for comprehensive diagnostic approaches. The RT-qPCR assays emerge as a superior diagnostic tool, offering enhanced pathogen detection capabilities and facilitating more precise antimicrobial therapy. This could lead to improved patient outcomes and contribute to the rational use of antimicrobials, addressing the growing concern of antibiotic resistance.

Human immunodeficiency virus (HIV) strains are important national biological resources, and the establishment of HIV standard strains forms material basis for HIV diagnostic testing, epidemic surveillance, disease prevention and control, reagent evaluation, drug research and vaccine development. The National Center for AIDS/STD Control and Prevention of China took the lead in development and publication of the Chinese Preventive Medicine Association (CPMA) group standard, Standard strains of pathogenic microorganism-technical specifications for establishment of HIV strains (T/CPMA 027—2023). Published on February 2, 2023, the standard, for the first time, specifies all technical requirements for establishment of HIV standard strains, covering sampling, isolation, culture, titration, identification, evaluation, preservation, archiving, quality control and biosafety management, and it also standardizes HIV isolation and characterization procedure, and relevant information description. This paper provides in-depth views on development of HIV standard strains, formulation and application of relevant standards, in order to pave solid ground for establishment of HIV standard strain banks and improvement of repository quality control, utilization and biosafety management.

Background In the effort to prevent and control HIV/AIDS, China has established a national sentinel surveillance system. However, some sentinel sites face limitations in environmental resources and accessibility, prompting the exploration of alternative sample strategies. Dried plasma spots (DPS) samples are viewed as promising alternatives to traditional plasma samples due to their advantages, including sample stability, easy storage, and convenient transport. This study aims to develop a method for screening HIV, Treponema pallidum (TP), and Hepatitis C Virus (HCV) using DPS samples and assess their performance. Methods Based on existing commercial assay kits, a detection method was established through the optimization of experimental parameters, including the amount of plasma on filter paper, the volume of elution solution applied to dried plasma spots, the size of dried plasma spots, elution solution volume, elution solution components, elution temperature, and elution time. A series of laboratory evaluation panels were constructed for laboratory assessments, including the laboratory basic panel, laboratory interference panel, and laboratory precision panel. Additionally, clinical samples were used for evaluation. Results Optimal conditions for DPS sample extraction were: plasma volume, 100 µL; DPS size, whole spot; eluent volume, 500 µL; eluent, PBS with 1‰ Tween20; elution time, 2 h; elution temperature, room temperature. A total of 619 paired plasma/DPS samples were tested by both methods. The DPS-based ELISA method exhibited 100% sensitivity/specificity for HIV, 98.6%/100% for TP, and 99.6%/100% for HCV. Kappa values between the plasma samples and DPS samples were 100% for HIV, 99% for TP, and 100% for HCV. The DPS-based ELISA method failed to detect 1 HCV mono-infected sample and TP in 1 HIV/HCV/TP co-infected sample. For the HIV/HCV/TP co-infected sample, the S/CO in the plasma sample was 2.143 and in the DPS sample was 0.5. For HCV, the S/CO (sample OD/cut-off) was 3.049 in the plasma sample and 0.878 in the DPS sample. Conclusions A single DPS, following one-time standardized processing, can be used to detect HIV, HCV, and TP. Researching and establishing laboratory testing methods better suited for China's sentinel surveillance have significant practical applications in improving HIV testing in resource-constrained environments.

The purpose of this study is to explore and investigate Chinese male consumers’ perceptions and behaviours towards low involvement and privately consumed product – pyjamas. According to our literature review, little research has been devoted to this particular topic. In this study, multiple product cues were used to measure and uncover what constitute consumers’ evaluation and purchase decisions. The questionnaire survey for this study was conducted in a second-tier city by using the convenience sampling method. In total, 256 useable questionnaires were collected and analysed. This study shows evidence that a majority of the Chinese male respondents did not wear pyjamas for sleeping. The intrinsic cues of sleepwear were ranked relatively higher than extrinsic cues, and the comfort cue was the most important criterion for product evaluation. Further research on this topic focusing on different products, samples and cities are recommended. The findings of this study provide insight and implications for fashion practitioners to develop their product and business in China.

Background: Since the introduction of HIV self-testing by UNAIDS in 2014, the practice has been extensively implemented around the world. HIV self-testing (HIVST) was developed in China around 2015, and the online purchase of HIVST kits through e-commerce platforms has since become the most important delivery method for self-testing, with advantages such as user-friendliness, speed, and better privacy protection. Objective: Understanding the spatiotemporal characteristics of online HIVST kit purchasing behavior and identifying potential impacting factors will help promote the HIV self-testing strategy. Methods: The online retail data of HIVST kits from the 2 largest e-commerce platforms in China from 2015 to 2017 were collected for this study. The Bayesian spatiotemporal hierarchical model was used to investigate the spatiotemporal characteristics of online purchased HIVST kits. Ordinary least squares regression was used to identify potential factors associated with online purchase, including GDP per capita, population density, road density, HIV screening laboratory density, and newly diagnosed HIV/AIDS cases per 100,000 persons. The q statistics calculated by Geodetector were used to determine the interactive effect of every 2 factors on the online purchase. Results: The online purchase of HIVST kits increased rapidly in China from 2015 to 2017, with annual peak sales in May and December. Five economically superior regions in China, Pearl River Delta, Yangtze River Delta, Chengdu and surrounding areas, Beijing and Tianjin areas, and Shandong Peninsula, showed a comparatively higher spatial preference for online purchased HIVST kits. The GDP per capita (P<.001) and the rate of newly diagnosed HIV/AIDS cases per 100,000 persons (P<.001) were identified as 2 factors positively associated with online purchase. Among the factors we investigated in this study, 2 factors associated with online purchase, GDP per capita and the rate of newly diagnosed HIV/AIDS cases per 100,000 persons, also displayed the strongest interactive effect, with a q value of 0.66. Conclusions: Individuals in better-off areas are more inclined to purchase HIVST kits online. In addition to economic status, the severity of the HIV epidemic is also a factor influencing the online purchase of HIVST kits.

Objective: Bats are the hosts of multiple pathogens, but the microbial composition of their lung tissues remains unknown. Our study investigated the species compositions and genera of important respiratory tract pathogenic bacteria in bat lung tissue. Methods: A microbiota study was conducted in Hebei, Henan and Guizhou provinces in China. Lung tissues were collected from 104 healthy bats. The lung tissue was subjected to 16S ribosomal ribonucleic acid gene sequencing. Results: We obtained 7,708,734 high-quality bacterial sequences from 104 healthy bats. Overall, the annotations indicated 55 phyla, 73 classes, 164 orders, 322 families and 953 genera. The lung microbiota was highly polymorphic and variable among bats from Hebei, Henan and Guizhou. The genetic characteristics of the main recognized respiratory pathogens in the samples were analyzed. Conclusions: The findings indicate that the lungs of bats carry numerous bacteria with pathogenic importance. Pathogens disseminate through the respiratory tract in bats and are widely distributed among bats. Because bats prefer to inhabit areas placing them in close contact with humans, such as eaves and old buildings, further investigations are warranted to identify bat microbiota and their potential effects on humans.

BACKGROUND:Micrococcus yunnanensis (M. yunnanensis) is an endophytic actinomycete that was originally isolated from the roots of Polyspora axillaris in 2009, and no human infections caused by this organism have yet been reported. We report the first case of community-acquired pneumonia caused by M. yunnanensis and propose that M. yunnanensis should be considered as an emerging pathogen in medical practice. A 30-year-old woman was admitted to our hospital with fever, paroxysmal dry cough with sputum, and pharyngalgia. Laboratory tests revealed an increase in several inflammatory indicators, and a computerized tomography scan of the chest showed scattered infection foci in both lungs. Bronchoalveolar lavage fluid was collected via bronchoscopy for microbial culture and pathological examination.METHODS:The isolate from bronchoalveolar lavage fluid was identified as M. yunnanensis by 16S rRNA gene sequencing. The patient was diagnosed with community-acquired pneumonia based on the diagnostic criteria.RESULTS:The patient was treated with intravenous amoxicillin/clavulanate potassium, levofloxacin hydrochloride tablets, and compound methoxyphenamine capsules on the day after admission. After 3 days of treatment, the patient's physiological conditions and inflammatory indicators normalized, and 6-month follow-up showed no abnormalities.CONCLUSION:Although the pathogenicity of M. yunnanensis is unclear, the present case indicates an emerging pathogen in medical practice. MALDI-TOF MS has a limited ability to identify novel or rare pathogenic species, and 16S rRNA gene sequencing is of great value in some circumstance.

实验室检测是艾滋病临床诊断、病程进展监测、抗病毒治疗启动、治疗效果监测、耐药性检测及调整治疗方案等诊疗工作不可或缺的技术支撑.为满足不断增加的艾滋病诊断和治疗相关的防治需求,全国艾滋病实验室网络不断发展壮大.特别是实施"四免一关怀"政策以来,实验室网络建设快速持续发展,检测技术和检测策略也适时进行完善、更新,为艾滋病诊断和治疗提供了有力的技术支持和质量保证,助力我国艾滋病防治工作取得显著成效.

BACKGROUND:HIV-1 viral load (VL) testing is essential for monitoring the effects of antiretroviral therapy in HIV-infected patients. In order to identify factors that impact testing performance of HIV-1 VL testing laboratories, this study performed a retrospective analysis on data from the domestic HIV-1 VL proficiency testing (PT) program in China during 2005 to 2019.METHODS:Analysis was conducted on testing results of 155 PT panel specimens that were distributed to HIV-1 VL testing laboratories nationwide during 2005 to 2019. Follow-up on-site inspection records on unqualified laboratories were also analyzed.RESULTS:By 2019, 267 HIV-1 VL testing laboratories in China enrolled in the national PT assessment. Overall, HIV-1 VL testing performance has been consistently good after 2012, with less than 5% of participants reporting an unqualified score. Unsatisfactory equipment conditions and poor laboratory administration were the two main reasons causing unqualified scores in the PT assessment. Interestingly, we found that HIV-1 VL testing laboratories had better performance in the CDC system than in hospitals. In analysis on the variance of specimen testing results by different assays, we found that variation in results existed across different assay platforms, and HIV-1 VL testing assays based on real-time PCR technology showed comparatively smaller inter-laboratory variability.CONCLUSIONS:To maintain high performance in HIV-1 VL testing laboratories, it is important to strengthen laboratory management and preserve equipment conditions. Due to the variation of testing results among different assay platforms, we suggest using the same assay platform for longitudinal monitoring of patient viral load.

艾滋病是世界范围内流行的以经性传播为主的重大慢性传染病,对人类健康构成严重威胁.2020年全球有150万HIV新发感染和68万艾滋病相关死亡,存活HIV感染者中有16％未被检测发现,27％未接受抗病毒治疗,34％未得到有效病毒抑制[1].2020年我国尚有约20％的HIV感染者不知道自己的感染状况,高于全球平均水平(根据中国疾病预防控制中心性病艾滋病预防控制中心2020年疫情估计结果).尽早发现感染者、尽快开展抗病毒治疗,实现有效病毒抑制是全球终结艾滋病流行的重要策略.HIV检测不仅是这一策略的重要前提,也是有效干预易感染HIV危险行为人群的重要环节.为促进主动检测和早检测,最大限度发现感染者,有效遏制HIV传播,早日实现终结艾滋病流行的目标,专家就进一步扩大艾滋病检测促进早检测达成以下共识.

目的 对德宏州2016-2018年男男性行为者(MSM)进行描述及艾滋病病毒(HIV)新发感染率分析.方法 利用"德宏州HIV数据库系统"收集纳入监测工作中MSM,进行人口学特征描述,并应用LAg-AvidityEIA法在历年MSM中进行HIV新发感染率的计算.结果 德宏州2016-2018年共1081例MSM被纳入本研究,三年中人群基本特征较为稳定,以25岁以上为主,HIV新发感染率依次为5.40％[95％可信区间(CI):0.11％～10.69％],5.84％(95％CI:1.50％～10.10％)和4.84％(95％CI:0.96％～8.64％).结论 德宏州MSM的HIV感染率及新发感染率显著高于其他高危人群,提示MSM是今后HIV防制工作的重点.

Background: Identifying young individuals living with human immunodeficiency virus (HIV) who are unaware of their status is a major challenge for HIV control in China. To address this, an innovative, anonymous vending machine-based urine self-collection for HIV testing (USCT) program was implemented in 2016 in colleges across China. Methods: From June 2016 to December 2019, 146 vending machines stocked with urine self-collection kits were distributed on 73 college campuses across 11 provinces of China. Urine samples were collected, delivered, and tested in an anonymous manner. We analyzed the returned rate, reactive rate (likelihood of HIV screening positive), testing effectiveness (the annual number of college students living with HIV screened by USCT or other testing methods), and the spatiotemporal relationship between USCT usage and student activity per college generated from the usage of a social networking application. Results: Among the 5178 kits sold, 3109 (60%) samples were returned; of these, 2933 (94%) were eligible for testing. The HIV reactive rate was 2.3% (66 of 2933). The average effectiveness ratio among the 34 participating Beijing colleges was 0.39 (12:31) between USCT and conventional testing methods. A strong spatiotemporal correlation between USCT numbers and online student activity was observed during school semesters in Beijing. Conclusions: USCT is a powerful complement to current interventions that target at-risk students and promote HIV testing. The social networking-based evaluation framework can be a guide in prioritizing at-risk target populations.

目的 评价男男性行为者(MSM)对艾滋病病毒(HIV)唾液快速检测试剂说明书的理解力.方法 设计调查问卷,包括基本信息和15道针对HIV唾液快检试剂说明书中关键信息的问题.在自愿咨询检测点,MSM阅读说明书(无时间限制)并填写调查问卷.结果 招募225人,其中33.78％(76人)答对11～15道题,充分理解关键信息;66.22％(149人)答对1～10道题不等,对关键信息理解不充分.9道问题的回答正确率≤70％,其中问题"患有牙周炎时是否可用本试剂检测HIV"最低,仅13.33％.单因素分析结果显示,MSM对关键信息的理解受民族和HIV唾液快检试剂的知晓情况的影响.多因素分析结果显示,与汉族相比,少数民族对说明书的理解更充分[比值比(OR)=5.206];与了解HIV唾液快检试剂者相比,未听说过者对说明书的理解更不充分(OR=0.224).结论 MSM对HIV唾液快检试剂的说明书理解不充分,与民族和HIV唾液快检试剂的知晓情况有关.当用于艾滋病自检时,自检结果的准确性可能会受影响,建议合理修改说明书.