目的:探究医药卫生专科在校生职业成熟度现状及影响因素,为提高学生职业成熟度,提供理论依据.方法:采用便利抽样法,以苏州某职业院校645名医药卫生专科在校学生为研究对象,使用一般资料问卷、大学生职业成熟度量表及专业认同问卷进行调查,结合多元线性回归分析方法探讨医药卫生专科在校生职业成熟度的影响因素.结果:医药卫生专科在校生职业成熟度总均分为(3.11±0.36)分,多元线性回归分析显示,年级、生源地、专业认同感是医药卫生专科在校生职业成熟度的重要影响因素(p<0.05).结论:医药卫生专科在校生的职业成熟度处于中等水平,有待提高.医药卫生院校应尽早关注不同年级学生的职业成熟度情况,重视生源地对其的影响,同时培养学生正确识别影响自身职业发展的因素,全程系统地进行专业认同教育,以期提高学生的职业成熟度,完善职业发展.

目的 评价适龄儿童无细胞百白破b型流感嗜血杆菌联合疫苗(DTaP-Hib)与口服脊髓灰质炎减毒活疫苗(OPV)或灭活疫苗(IPV)联合接种的安全性和免疫原性.方法 在两个地区招募3月龄儿童,按3-4-5月龄免疫程序单独接种DTaP-Hib,或联合接种OPV、IPV,观察接种后0-28d不良事件,检测免疫前和全程免疫后28d血清百日咳毒素(PT)、百日咳丝状血凝素(FHA)、白喉毒素(DT)、破伤风毒素(TT)和b型流感嗜血杆菌(Hib)抗体,分析不良事件发生率和抗体阳转率.结果 在3416名(接种20334剂次)DTaP-Hib与脊灰疫苗联合接种和508名(接种1408剂次)DTaP-Hib单独接种的受试者中,不良事件发生率分别为7.62‰、17.05‰(95％CI:6.43‰-8.82‰、15.27‰-18.83‰);在25名DTaP-Hib与OPV联合接种、97名DTaP-Hib与IPV联合接种、22名DTaP-Hib单独接种的受试者中,免疫后PT抗体阳转率均为100％(95％CI:86.28％-100％、96.27％-100％、84.56％-100％),FHA抗体分别为100％、93.81％、95.45％(95％ CI:86.28％-100％、87.02％-97.70％、77.16％-99.88％),DT抗体分别为88.00％、92.78％、95.45％(95％CI:68.78％-97.45％、85.69％-97.05％、77.16％-99.88％),TT抗体分别为96.00％、91.75％、81.82％(95％ CI:79.65％-99.90％、84.39％-96.37％、59.72％-94.81％),Hib抗体分别为88.00％、84.54％、77.27％(95％CI:68.78％-97.45％、75.78％-91.08％、54.63％-92.18％).结论 DTaP-Hib与IPV或OPV联合接种与单独接种相比未增加不良事件发生率且免疫原性相当.

BackgroundWuhan was the epicentre of the COVID-19 outbreak in China. We aimed to determine the seroprevalence and kinetics of anti-SARS-CoV-2 antibodies at population level in Wuhan to inform the development of vaccination strategies.MethodsIn this longitudinal cross-sectional study, we used a multistage, population-stratified, cluster random sampling method to systematically select 100 communities from the 13 districts of Wuhan. Households were systematically selected from each community and all family members were invited to community health-care centres to participate. Eligible individuals were those who had lived in Wuhan for at least 14 days since Dec 1, 2019. All eligible participants who consented to participate completed a standardised electronic questionnaire of demographic and clinical questions and self-reported any symptoms associated with COVID-19 or previous diagnosis of COVID-19. A venous blood sample was taken for immunological testing on April 14–15, 2020. Blood samples were tested for the presence of pan-immunoglobulins, IgM, IgA, and IgG antibodies against SARS-CoV-2 nucleocapsid protein and neutralising antibodies were assessed. We did two successive follow-ups between June 11 and June 13, and between Oct 9 and Dec 5, 2020, at which blood samples were taken.FindingsOf 4600 households randomly selected, 3599 families (78·2%) with 9702 individuals attended the baseline visit. 9542 individuals from 3556 families had sufficient samples for analyses. 532 (5·6%) of 9542 participants were positive for pan-immunoglobulins against SARS-CoV-2, with a baseline adjusted seroprevalence of 6·92% (95% CI 6·41–7·43) in the population. 437 (82·1%) of 532 participants who were positive for pan-immunoglobulins were asymptomatic. 69 (13·0%) of 532 individuals were positive for IgM antibodies, 84 (15·8%) were positive for IgA antibodies, 532 (100%) were positive for IgG antibodies, and 212 (39·8%) were positive for neutralising antibodies at baseline. The proportion of individuals who were positive for pan-immunoglobulins who had neutralising antibodies in April remained stable for the two follow-up visits (162 [44·6%] of 363 in June, 2020, and 187 [41·2%] of 454 in October–December, 2020). On the basis of data from 335 individuals who attended all three follow-up visits and who were positive for pan-immunoglobulins, neutralising antibody levels did not significantly decrease over the study period (median 1/5·6 [IQR 1/2·0 to 1/14·0] at baseline vs 1/5·6 [1/4·0 to 1/11·2] at first follow-up [p=1·0] and 1/6·3 [1/2·0 to 1/12·6] at second follow-up [p=0·29]). However, neutralising antibody titres were lower in asymptomatic individuals than in confirmed cases and symptomatic individuals. Although titres of IgG decreased over time, the proportion of individuals who had IgG antibodies did not decrease substantially (from 30 [100%] of 30 at baseline to 26 [89·7%] of 29 at second follow-up among confirmed cases, 65 [100%] of 65 at baseline to 58 [92·1%] of 63 at second follow-up among symptomatic individuals, and 437 [100%] of 437 at baseline to 329 [90·9%] of 362 at second follow-up among asymptomatic individuals).Interpretation6·92% of a cross-sectional sample of the population of Wuhan developed antibodies against SARS-CoV-2, with 39·8% of this population seroconverting to have neutralising antibodies. Our durability data on humoral responses indicate that mass vaccination is needed to effect herd protection to prevent the resurgence of the epidemic.FundingChinese Academy of Medical Sciences & Peking Union Medical College, National Natural Science Foundation, and Chinese Ministry of Science and Technology.TranslationFor the Chinese translation of the abstract see Supplementary Materials section.

目的:评价抑郁症行为激活量表中文版(the Chinese version of behavioral activation for depression scale，C-BADS)应用于美沙酮维持治疗(methadone maintenance treatment，MMT)患者的信度和效度。方法:在武汉市MMT门诊随机招募162例阿片类物质成瘾患者接受C-BADS量表调查，采用SPSS 21.0软件进行项目分析和探索性因子分析( exploratory factors analysis，EFA)，AMOS 24.0软件进行验证性因子分析(confirmatory factor analysis，CFA)。结果:各维度与总分之间的相关系数为0.228～0.813(均 P<0.01)，除激活维度外，其余各维度间的相关系数均低于各维度与总分之间的相关系数。各条目与总分之间的相关系数为0.060～0.716。探索性因子分析提取了4个公因子，分别命名为回避/沉思(avoidance/rumination，AR)、激活(activation，AC)、社会功能减退(social impairment，SI)和工作/学习功能减退(work/school impairment，WS)，对总方差的累积贡献率为51.153%，各条目在所属因子上的因子负荷为0.328～0.797。验证性因子分析模型的整体拟合度指标为：χ 2/ df＝1.594，CFI＝0.839，TLI＝0.820，IFI＝0.844，RMSEA＝0.069，SRMR＝0.089。量表内部一致性信度Cronbach's α系数为0.790，分半信度为0.827。 结论:C-BADS用于测量MMT患者行为激活状况具有较好的内部一致性信度和结构效度，但仍需要进一步修改。

Objective:To evaluate the reliability and validity of the Reward Probability Index-Chinese version (C-RPI) among individuals with opioid dependence.Methods:A total of 160 individuals with opioid dependence were recruited from the methadone maintenance treatment(MMT) programs in Wuhan.The C-RPI was used in the investigation, and items/exploratory factors and confirmatory factors were adopted to analyze with IBM SPSS 22.0 and AMOS 24.0, respectively.Results:The correlation between each item and the total score of the scale was 0.325-0.657 (all P<0.01) and the item discrimination of the scale was good.Exploratory factor analysis extracted two factors, including reward probability and environmental suppressors, and a load of each item on its factor ranged from 0.519 to 0.744.The fitting indexes of confirmatory factor analysis were as follows: χ 2/ df=1.623, RMR=0.030, RMSEA=0.063, IFI=0.902, TLI=0.885, CFI =0.900.The internal consistency coefficient (Cronbach's α) of the C-RPI was 0.800; and there was no ceiling/floor effect on each dimension and total scale. Conclusion:The classification of dimensions for the C-RPI is reasonable, and the scale has good reliability and validity to measure the ability to obtain environmental rewards for individuals with opioid dependence.

目的:了解餐饮服务人员丙型肝炎防治知识知晓率、相关行为及影响因素,为防治丙型肝炎提供参考依据.方法:采用分层随机整群抽样的方法,对武汉市中心城区和郊区2家体检机构1195名接受体检服务的餐饮服务人员进行问卷调查,并进行χ2检验和logistic回归分析.结果:餐饮服务人员的丙型肝炎防治知识的知晓率为16.6％.有16.4％接受过纹身(包括纹唇、纹眉)、打耳洞等,3.8％有多个性伴侣;1.2％曾与他人共用注射器、针头,24.7％检测过丙型肝炎.受教育程度影响丙型肝炎防治知识的知晓率,高中或中专及以下较中专及以上的从业人员知晓率低.结论:餐饮服务人员丙型肝炎防治知晓率较低,存在一定程度的高危行为,接受过丙型肝炎检测的比例较低,应制定相应的干预策略,加强从业人员的健康教育.

The number, intensity and order of emergence of HIV-1 specific antibodies in serum or plasma were associated with the stage of HIV-1 infection. In this study, we retrospectively analyzed the HIV-1 confirmatory results tested by western blot (WB) or recombination immunoblot assay (RIBA) in Wuhan, 2012-2018, to access the profiles of HIV-1 specific antibodies. A total of 14432 HIV-suspected serum or plasma samples collected from local hospitals and other HIV screening laboratories were further screened by two 4(th)generation enzyme-linked immunosorbent assay (ELISA) kits in our laboratory, of which 11068 specimens (76.69%) had at least one positive ELISA result and thereby were finally confirmed with WB or RIBA. RIBA had identified 652 (81.09%) positive and 13 (1.62%) indeterminate cases from July 1, 2014 to January 7, 2015, while WB had identified 8358 (81.43%) positive and 643 (6.26%) indeterminate cases in the other times during 2012-2018. The indeterminate rate of WB was significant higher than that of RIBA (p<0.001). Although the number of HIV-1 infected subjects increased significantly from 2012 (n = 911) to 2018 (n = 1578), the positive rate of HIV-1 antibodies decreased markedly from 70.08% in 2012 to 58.79% in 2018 (p<0.001). The most commonly observed antibody profile was gp160+gp120+p66+(p55+)p51+gp41+p31+p24+p17+ (4131, 49.43%) for WB-MP and gp160+gp120+gp41+p31+p24+p17+ (382, 58.59%) for RIBA-WANTAI, and the absence of reactivity to three possible serologic markers for recent HIV-1 infection, p31, p66, and p51, increased significantly from 2012 to 2018, with the overall rate of 17.03%, 9.40%, and 15.15%, respectively. The suspected acute HIV-1 infection was also observed to be increased in recent years, with an overall rate of 1.00%. Our results indicated the detection rate had decreased for HIV-1 infection, but increased for suspected recent and acute HIV-1 infection during 2012-2018, reflecting the efforts of intervention among high risk population.

目的 分析武汉市病毒性肝炎流行病学特征及规律,为制定防控措施提供依据.方法 运用描述性流行病学方法对2004-2017年武汉市病毒性肝炎疫情数据进行分析,不同地区、性别等分布差异采用x2检验,探讨影响武汉市病毒性肝炎流行病学特征的相关因素.结果 2004-2017年武汉市累计报告病毒性肝炎病例数124 415例,年均发病率98.76/10万,总体呈下降趋势.乙肝报告病例数最多,占71.68％,其次为丙肝,占14.70％.年均报告发病率前三位的地区均为中心城区(x2=9 510.51,P＜0.05),男性发病率(年平均发病率130.52/10万)高于女性(年平均发病率65.08/10万)(x2=13 662.96,P＜0.05).乙肝发病率最高峰在50～岁年龄组,甲肝、乙肝、丙肝、戊肝及未分型肝炎的报告发病率均随年龄增加而增加(甲肝:x2 =583.05,P＜0.05;乙肝:x2=12 774.17,P＜0.05;丙肝:x2=10 076.97,P＜0.05;戊肝:x2 =4 350.77,P＜0.05;未分型肝炎:x2 =1 548.14,P＜0.05).职业以家政、家务及待业、离退休人员及农民为主.结论 武汉市病毒性肝炎的报告发病率虽然呈下降趋势,但在传染病报告发病中仍占重要位置,其防治应以乙肝为重点.在做好免疫预防工作的基础上,应针对性地加强重点地区重点人群的防控工作.

The identification of recent HIV-1 infection is clinically important for the effective treatment and prevention of transmission. However, the window period for seroconversion with respect to various HIV-1 antibodies is not well characterized. In addition, the routine HIV testing algorithms are not particularly appropriate for the identification of recent HIV-1 infection. In this study, we enrolled individuals who showed seroconversion from negative Western blot (WB) or indeterminate WB results and analyzed the window periods for appearance of HIV-1 antibodies. A total of 10,934 individuals with suspected HIV infection were tested by Wuhan CDC between 2012 and 2017; of these, 40 individuals with initial negative WB and 102 individuals with initial indeterminate WB who showed positive WB results within 100 days were included in the analysis. The mean time for seroconversion was 43.90 (95% confidence interval [CI]: 37.30-50.50) days and 42.15 (95% CI: 37.99-46.30) days, respectively. The time duration for p31 seroconversion among people with negative WB and indeterminate WB was 58.11 (95% CI, 44.30-71.92) days and 51.91 (95% CI, 44.55-59.28) days, respectively, both of which were significantly longer (p = 0.0169) than those in people without p31 seroconversion. A similar difference was observed with respect to p66 seroconversion, with a window time of 53.53 (95% CI, 43.54-63.52) days and 47.87 (95% CI, 43.16-52.57) days among people with negative WB and indeterminate WB, respectively. These data suggest that HIV-1 antibody p66, like p31, may serve as a potential serological marker for distinguishing Fiebig stage V and stage VI at day 70 post-infection.

目的 了解武汉市青年学生艾滋病疫情,为制定针对性的高校艾滋病防控策略提供科学依据.方法 利用武汉市2001—2016年艾滋病综合防治信息系统中的HIV/AIDS病例报告数据,选择其中15～24岁病例1537例建立数据库,其中包括青年学生病例348例,校外青年病例1189例,运用SPSS 22.0软件进行描述性比较分析.结果 武汉市2001年报告首例15岁及以上学生HIV/AIDS病例.截至2016年底,武汉市累计报告15～24岁青年学生HIV/AIDS病例348例,占所有15～24岁病例的22.6％,男女比例为37.7:1,大专及以上文化程度为89.4％,同性途径传播91.1％,主要样本来源为专题调查,其次为自愿咨询检测(VCT).历年新报告青年学生病例数呈增长趋势,特别是19～24岁年龄段.与校外青年病例比较发现,青年学生文化程度、同性传播比例及VCT检测比例均较高.结论 近年来武汉市报告的15～24岁青年学生病例数增长较快,19～24岁是主要的累及年龄段,同性性行为是主要危险行为,应及时加强对青年学生的性健康和预防艾滋病知识的宣传干预工作,进一步提高有高危行为青年学生的H IV主动检测意识.

Exosomes play an important role in cell-to-cell communication as they can transfer functional molecules such as microRNAs (miRNAs) from one cell to another, exerting biological and immunological functions. Here, we investigated the impact of HIV infection and/or heroin use on the expression of the miRNAs in plasma exosomes. We found that HIV infection or heroin use upregulated the majority (98%) of a panel of plasma exosomal miRNAs associated with immune regulation and inflammation. We also observed the enhanced effect of HIV infection and heroin use on some of these upregulated miRNAs. Our further investigation showed that the levels of four of neuro-inflammation-related miRNAs (146a, 126, 21, and let-7a) were higher in HIV-infected heroin users as compared with the control subjects. These findings indicate that the dysregulations of the plasma exosomal miRNAs support further studies to determine the role of the miRNAs in HIV and/or heroin use-mediated immune modulation and neuro-inflammation.

;目的 调查武汉市医院丙型病毒性肝炎(简称丙肝)报告病例,探讨丙肝疫情控制策略.方法 采用分层随机抽样方法选取武汉市6家医院作为调查单位,对2017年4月-2018年3月期间诊断并报告的丙肝病例进行问卷调查,并进行统计学分析.结果 本研究共调查272例新发丙肝报告病例,男女比例为2.18∶1,平均年龄为(53.41±13.50)岁.病人因医疗服务前筛查、转氨酶升高和急性丙肝症状进行HCV感染检测的比例分别为67.65％、63.60％和13.24％,病人主动要求检测或因体检进行HCV感染检测的比例为23.16％.病例中,78.68％无高危行为,11.03％曾接受过血液或血制品,8.46％曾进行过不安全注射、共用针具吸毒或街边店美容纹身等操作.丙肝病例诊断类型的正确率为94.12％.病例中,29.00％天冬氨酸氨基转移酶/血小板比值指数(APRI》＞2.确诊病例中本次选择抗病毒治疗的比例为25.81％,其中90.00％为小分子药物抗病毒治疗.结论 有针对性地开展丙肝防制工作,促进丙肝病例早发现、早诊断和早治疗,有助于控制丙肝疫情的发展.

目的 分析2012-2017年武汉市丙型病毒性肝炎(丙肝)流行病学特征,并预测武汉市丙肝短期发病趋势.方法 采用描述性流行病学方法 分析武汉市丙肝流行病学分布特征,并利用指数平滑法预测2018年武汉市丙肝发病趋势.结果 2012-2017年累计报告丙肝病例数9 175例,年均发病率15.03/10万,年平均增长率3.15％;季节效应明显,春季发病率最高;男女性别比1.33:1;年龄呈单峰分布,50～55岁为发病高峰;在职业构成中,家务及待业人群所占比例最高,为33.26％;地区分布上,报告前四位的地区均为中心城区;使用Winters加法模型预测2018年武汉市丙肝发病率为14.76/10万,较2017年略有下降.结论 2012-2017年武汉市丙肝发病呈上升趋势,Winters加法模型能较好的预测短期丙肝发病趋势,可结合预测结果与实际流行病学特征制定科学防控策略.

目的 分析HIV/AIDS患者合并HBV、HCV感染的流行特征和影响因素,为制定防治措施提供依据.方法 调查武汉市HIV/AIDS患者队列相关信息和HBV、HCV感染状况,运用卡方检验、非条件Logistic回归模型、Kaplan-Meier生存分析等方法对HIV合并HBV、HCV感染的流行特征和影响因素进行分析.结果 2615例HIV/AIDS患者纳入研究,其中,男性占90.2％,未婚占52.9％,平均年龄(37.1±13.9)岁,感染途径以男男同性传播为主,占68.1％;HIV合并HBV/HCV感染呈逐年增加态势,HIV-HBV、HIV-HCV、HIV-HBV-HCV合并感染率分别为9.6％(251/2615)、4.5％(117/2615)、0.6％(16/2615);HIV-HBV合并感染的主要影响因素包括年龄(≥50岁与<25岁比较,OR=2.067,95％CI:1.172～3.644)、婚姻(已婚与未婚比较,OR=1.480,95％CI:1.007～2.177,离异或丧偶与未婚比较,OR=1.554,95％CI:1.077～2.243)、近3个月性行为是否用安全套(未用者与使用者比较,OR=1.922,95％CI:1.045～3.535),HIV-HCV合并感染的主要影响因素为感染途径(注射吸毒与同性传播比较,OR=53.985,95％CI:24.704～117.972)和HIV确证至抗病毒治疗(ART)间隔天数(>360 d与≤90 d比较,OR=1.754,95％CI:1.058～2.907);HIV合并HBV/HCV感染者抗病毒治疗后5年生存率小于无合并肝炎病毒感染者(Log Rankχ2=11.947,P=0.008).结论 ≥50岁、离异/丧偶、已婚男性以及无保护性行为、注射吸毒行为和延迟治疗,HIV/AIDS合并HBV/HCV感染的风险较高,针对性地预防干预、早期HBV/HCV筛查和个体化的ART提供可作为防治合并感染的重要措施.

目的 探讨武汉市人类免疫缺陷病毒携带者/艾滋病(human immunodeficiency virus carriers/acquired immune deficiency syndrome,HIV/AIDS)患者死亡情况、生存时间及其影响因素.方法 收集武汉市1998年1月1日～2015年12月31日所管理HIV/AIDS患者的生存、死亡等信息.计算患者的全死因死亡率,应用单因素和多因素分析探讨患者生存时间的影响因素.结果 共有3 310例患者进入研究,死亡363例,全死因死亡率为4.22/100人年,平均死亡年龄为52岁.单因素分析显示,年龄、婚姻状况、文化程度、接触史、病程阶段、是否提供宣传咨询、是否提供抗机会性感染药物、是否提供关怀救助、是否患有结核、是否进行抗逆转录病毒治疗(antiretroviral therapy,ART)、基线CD4+细胞计数对HIV/AIDS患者生存时间有影响(均有P＜0.05);Cox比例风险模型分析显示,65～88岁年龄组、低文化、处于AIDS期、没有提供宣传咨询、患有结核、没有接受ART、基线CD4+细胞计数＜200个/mm3者有较高的死亡风险(均有P ＜0.05).结论 武汉市HIV/AIDS患者的死亡率逐年下降,ART是影响HIV/AIDS患者生存时间的重要因素,应针对性地进行干预,以进一步延长患者寿命.

目的 了解武汉市2005-2016年丙型病毒性肝炎(简称丙肝)的流行情况,以及医疗机构丙肝病例报告的质量,发现存在的问题,为提高武汉市丙肝监测数据的质量和正确评估丙肝疫情提供依据.方法 采用描述流行病学方法收集武汉市2005-2016年传染病报告信息管理系统中丙肝疫情资料,分析丙肝的流行情况及变化趋势;抽取武汉市丙肝病例报告较多的某三级甲等传染病专科医院作为调查对象,对该医院2015-2016年网络直报丙肝病例进行报告质量核查,并对其检验科丙肝病毒核糖核酸(HCV RNA)阳性结果报告情况进行分析.结果 武汉市2005-2016年累计报告丙肝病例20 963例,年平均报告发病率为18.05/10万.2016年丙肝的报告病例数比2005年增长了1.19倍,年平均增长速度为6.73％.所调查医院2015-2016年共报告丙肝病例479例,错报率为29.02％;检验科共检测出HCV RNA阳性病例987例,共报告509例,HCV RNA阳性报告率为51.57％.结论 近年来武汉市丙肝报告病例数和报告发病率呈上升趋势,医院的丙肝病例报告质量较低,存在对武汉市丙肝疫情低估的可能性.

目的 比较艾滋病病毒(HIV)扩大检测、扩大治疗措施在男男性行为者(MSM)中实施期间,该人群中HIV感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)早发现与早治疗相关指标的变化趋势,分析扩大检测、扩大治疗措施的实施效果,为制定下一步艾滋病防治措施提供依据.方法 收集武汉市2008-2015年报告的经同性性途径感染的2 036例HIV/AIDS病人的相关信息,比较不同时间阶段报告患者的社会人口学特征、首次CD4+T淋巴细胞(简称CD4细胞)检测时间及结果、晚发现比例、抗病毒治疗(ART)比例及其随时间的变化趋势等指标.结果 2008-2009年至2014-2015年间,≤24岁、大专及以上、已婚、有职业、非本地户籍、郊区及医疗机构来源的病例数,占当年报告总数的比例由22.8％、39.1％、6.5％、39.1％、23.9％、15.2％、19.6％分别上升为34.4％、57.2％、11.6％、54.2％、38.5％、26.9％、45.4％.经趋势x2检验结果,各比例随时间变化的差异均有统计学意义(P＜0.05).按中国疾病预防控制中心2013年的晚发现标准,MSM中AIDS病例的晚发现率由2008-2009年间的51.4％,下降至2014-2015年间的25.3％.确证至首次CD4细胞检测时间间隔中位数分别为12天,6天;确证至ART时间间隔中位数分别为910天,38天;确证后3个月内接受ART的比例由2008-2009年间的7.6％,上升为2014-2015年间的75.1％,差异均有统计学意义(P＜0.05).不同时间段患者确证后首次CD4细胞累积检测率和ART累积率随时间变化,差异有统计学意义(P＜0.05).结论 扩大检测、扩大治疗措施实施对本地区MSM中HIV/AIDS病人早发现、早治疗效果明显,该策略可以推广至其他高危人群,也可为其他地区相关工作开展提供借鉴.

Background Oral pre-exposure prophylaxis (PrEP) is recommended as an additional prevention choice for men who have sex with men (MSM) at substantial risk of HIV. The aim of this study was to evaluate the extent, and reasons, for MSM’s willingness to use oral PrEP in Wuhan and Shanghai, China. Methods Between May and December 2015, a cross-sectional survey was conducted among 487 MSM recruited through snowball sampling in physical locations frequented by MSM and through social media applications. Exploratory factor analysis was used to group reasons for being willing or not willing to use PrEP. Chi-square tests were used to explore bivariate associations between groupings of reasons for being willing or unwilling to use PrEP, and key sociodemographic and sexual-behavioral characteristics of MSM. Results Overall, 71.3% of respondents were willing to use PrEP. The most commonly reported reasons for being willing to use PrEP were preventing HIV infection (91.6%), taking responsibility for own sexual health (72.6%) and protecting family members from harm (59.4%). The main reasons for being unwilling to use PrEP were being worried about side effects (72.9%), the necessity of taking PrEP for long periods of time (54.3%) and cost (40.4%). Individual characteristics that influenced the type of reasons given for being willing or unwilling to use PrEP included being married to a woman, having a regular sex partner, rates of condom use with regular and casual sex partners, and the number of casual sex partners. Conclusion The introduction of PrEP in China could benefit from promotion campaigns that emphasize its role in preventing HIV infection, in taking responsibility for own sexual health, and in protecting family members from potential harm. To reduce uptake barriers, it will be essential to provide accurate information to potential PrEP users about the mild and short-term nature of side effects, and the possibility of taking PrEP only during particular periods of life when the risk of HIV exposure might be highest.

Objective To analysis HIV/AIDS related knowledge,attitudes,behaviors and influencing factors a mong lower grade college students in Wuhan City,and provide scientific evidence for health education among young students.Methods A self-questionnaire survey was conducted among 908 students who entered college in 2014 and 2015 in 9 colleges by using convenience sampling method.Statistics analysis were performed by chi-square test and logistics regression.Results The HIV/AIDS awareness rate of lower grade college students was 66.1％,66.6％ of them had fear of AIDS,49.1％ of them had lower score of anti-discrimination and compassion,39.1％ of them agreed with premarital sex.The influencing factors of awareness of premarital sex among classmates were gender (OR =1.662),nationality (OR =0.449),love experience (OR =2.224),fear of AIDS (OR =1.707),attitude to premarital sex (OR =3.739).The influencing factors of condom use intention were residence (OR =1.569),HIV/AIDS awareness (OR--0.407),AIDS distance perception (OR =0.630),attitude topremarital sex (OR =0.664).Conclusion The lower grade college students had lower HIV/AIDS awareness rate with a certain degree of discrimination to people living with HIV/AIDS.The students who agreed with premarital sex had lower condom use intentionand more acceptance of existence among classmates,and greater likelihood of AIDS high-risk behavior.It needs to carry out effective interventions integrated sex education and AIDS prevention education for young students.

The methadone maintenance treatment (MMT) has been initiated in Wuhan, China since early 2006. To understand the social-demographic, behavioral, and infectious diseases characteristics of drug users enrolled in their first-ever-MMT between 2006 and 2015, a retrospective observational study was implemented to also provide evidence for health policy-decisions to reduce harm and control disease. Pearson chi-square tests and t-tests were used to assess significant differences between two 5-year periods, 2006–2010 and 2011–2015. We observed increases in the mean age (38.65 vs. 42.43 years, P < 0.001), mean age of initial opioid drug use (28.18 vs. 31.07 years, P < 0.001), employment (11.9% vs. 30.7%, P < 0.001), married/co-habiting (42.4% vs. 47.8%, P < 0.001), and declines in higher education level (93.6% vs. 84.8%, P < 0.001), injection (82.3% vs. 75.1%, P < 0.001), syringe sharing (27.7% vs. 9.9%, P < 0.001), HCV infection rates (72.9% vs. 70.5%, P = 0.017). The number of drug users enrolling each year reduced following a continuous rapid growth in the first 3 years. The findings imply for adjusting in treatment services and allocation of resources to respond to emerging trends. In addition, the data will also be helpful for identifying needs and getting a baseline insight of the social-demographic and behavioral characteristics of the opioid abusers in the area.