Non-suicidal self-injury (NSSI) poses a significant public health concern, characterized by its high prevalence, recurrence, and association with suicide. While prior research has identified a connection between negative life events (NLEs) and NSSI, only a few studies have longitudinally explored this relation and its underlying mechanisms. Our study investigated the longitudinal association between NLEs and NSSI among Chinese college students. We also examined the mediating role of rumination and emotional regulation difficulties, as well as the moderating role of sex. We recruited 4892 students from six colleges in northern China. We assessed NLEs, NSSI, rumination, and emotional regulation difficulties at baseline (T1) and after a 1-year follow-up (T2). The longitudinal moderated mediation model revealed that early NLEs exerted significant direct predictive effects on later NSSI and indirect predictive effects on NSSI through the independent mediation of rumination and emotional regulation difficulties, as well as a chain mediating effect through them. The first stage (predicting the effect of NLEs on NSSI) and second stage (predicting the effect of NLEs on rumination) were moderated by sex. Our findings underscore the importance of considering recent stressors in assessing risks and implementing interventions for college students involved in NSSI. Mental health professionals should prioritize helping students develop emotional regulation skills and reduce rumination while being mindful of sex differences.

In the tumor microenvironment (TME), CD8+ T cells showed stage exhaustion due to the continuous stimulation of tumor antigens. To evaluate the status of CD8+ T cells and reverse the exhaustion is the key to evaluate the prognosis and therapeutic effect of tumor patients. The aim of this study was to establish a prognostic signature that could effectively predict prognosis and response to immunotherapy in patients with hepatocellular carcinoma (HCC). We used univariate Cox analysis to obtain transcription factors associated with CD8+ T cell exhaustion from The Cancer Genome Atlas dataset. Then, the prognostic signature for transcription factors basic leucine zipper ATF-like transcription factor, Eomesodermin, and T-box protein 21 regulating T cell exhaustion was constructed using LASSO Cox regression. The relative expression levels of the mRNA of the 3 transcription factors were detected by reverse transcription-quantitative polymerase chain reaction in 23 pairs of HCC and paracancer tissues, and verified internally in The Cancer Genome Atlas dataset and externally in the International Cancer Genome Consortium dataset. Cox regression analysis showed that risk score was an independent prognostic variable. The overall survival of the high-risk group was significantly lower than that of the low-risk group. The low-risk group had higher immune scores, matrix scores, and ESTIMATE scores, and significantly increased expression levels of most immune checkpoint genes in the low-risk group. Therefore, patients with lower risk scores benefit more from immunotherapy. The combination of the 3 transcription factors can evaluate the exhaustion state of CD8+ T cells in the TME, laying a foundation for evaluating the TME and immunotherapy efficacy in patients with HCC.

Hepatitis C still poses a threat to public safety, and there are few reports of hepatitis C virus (HCV) in Heilongjiang Province. Therefore, we aimed to study the epidemiology and resistance-associated substitutions (RASs) of HCV in Heilongjiang and explore the efficacy of treatment. 7019 specimens from Heilongjiang Province were subjected to the genotype identification. The Autoregressive Integrated Moving Average (ARIMA) model was utilized to predict HCV infection trends from 2024 to 2030. The Sanger sequencing was performed on samples of genotype(GT) 1b and 2a to investigate RASs. Phylogenetic analysis was conducted to assess the similarity of local HCV sequences with those from other countries. In addition, we tracked the effect of patients treated with DAAs and the relationship between efficacy and RASs. The predominant HCV subtypes in Heilongjiang were 1b (47.51 %) and 2a (43.85 %). From 2012 to 2023, the proportions of GT2a, GT3a, GT3b, and GT6a gradually increased. And the prevalence of GT2a will exceed that of GT1b over the next seven years. The proportion of RASs in GT1b and GT2a NS5A region was 73.47 % and 15.22 %, respectively. And the proportion of RASs in GT1b NS5B region was 100 %. Local HCV sequences exhibited phylogenetic relationships with sequences from other countries. The GT1b R30Q and GT2a C92S were correlated with drug efficacy. K107R and P206S, which have not been reported in the literature, were also related to drug efficacy. The epidemiology of HCV genotypes in Heilongjiang is becoming increasingly diverse. HCV GT1b has a large variety and a high proportion of RASs, and patients infected with this genotype of HCV need to be sequenced before treatment.

In China, a pilot project for the prevention of mother-to-child transmission (PMTCT) of the HIV was initiated in 2001. For the PMTCT of HIV, the Chinese government has released versions of the guidelines since 2004. In 2014, the World Health Organization released guidance on global processes and criteria for the validation of elimination of mother-to-child transmission of HIV and syphilis. To promote the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B virus in China, the Chinese government updated the Guideline for PMTCT of HIV, Syphilis, and Hepatitis B in 2020 (briefly as Guideline-2020). The Guideline-2020 comprises 5 parts: goals, interventions, support measures, duties and cooperation of departments, and definition indicators for PMTCT of HIV and corresponding calculation formulas. Compared with the previous versions, the key points updated in the Guideline-2020 are that the goals are set again, and health education and promotion, the procedure of HIV testing for pregnant women, and the antiretroviral therapy regimen for HIV-positive pregnant women and antiretroviral) prophylaxis regimen for infants are all updated. The antiretroviral prophylaxis regimen as zidovudine-lamivudine-nevirapine/lopinavir/ritonavir twice per day for 6 weeks is recommended for infants at high exposure risk to HIV, whereas the third antiretroviral therapy regimen as tenofovir-lamivudine-lopinavir/ritonavir is recommended for HIV-positive pregnant women, and indicators for PMTCT of HIV and corresponding calculation formulas are defined.

目的 分析我国6市城乡地区3岁以下婴幼儿睡眠时间及其年代发展趋势,为国内婴幼儿睡眠时间提供新的数据支持.方法 2019年7月至11月在我国6市随机选取1234名0～35月龄婴幼儿为研究对象,采用简明婴儿睡眠问卷对受试婴幼儿看护人进行现场调查,并进行数据的统计分析.结果 婴幼儿白天睡眠时间和24小时总睡眠时间随月龄增加逐渐减少(χ2值分别为479.03、388.84,P<0.01),从出生到3岁前平均分别减少了6.0小时和5.0小时,且在3个月内减少幅度最为明显;3岁前婴幼儿夜间睡眠时间平均为9.0～9.5小时,且不同月龄间差异无统计学意义(χ2=16.24,P=0.06).夜间睡眠时间占比随月龄增加逐渐增加(χ2=450.63,P<0.01),由0～1月龄的55.6％ 增至30～35月龄的81.8％.婴幼儿白天睡眠时间、夜间睡眠时间及24小时总睡眠时间的城乡间比较差异均无统计学意义(P>0.05).与2004年相比,3岁以下婴幼儿睡眠时间呈减少趋势,且夜间睡眠时间之间的差异有统计学意义(Z=-2.10,P=0.04).参照我国2017年发布的《0岁～5岁儿童睡眠卫生指南》,婴幼儿睡眠时间不足中,0～3月龄、4～11月龄及12～35月龄分别占14.4％、21.7％ 和13.8％.结论 婴幼儿期为其睡眠时间的快速发展阶段,其睡眠时间有长期减少的发展趋势.

ObjectiveThis study aimed to examine the sleep arrangements and soothing methods and to assess their associations with sleep problems among children aged < 3 years in China.MethodsA cross-sectional survey was conducted in 2019 from six provinces in China. A total of 1,195 caregivers of children aged 0-35 months were included in the study. Data on sleep arrangements, soothing methods, and sleep problems (i.e., frequent night awakenings and difficulty falling asleep) were assessed using the Brief Infant Sleep Questionnaire. The reasons for bed-sharing in sleep arrangements were recorded using a self-designed questionnaire.ResultsThe bed-sharing practice was very prevalent at any age, which ranged from 69.9% to 78.3%. Most infants fell asleep while feeding or being rocked/held before age 12 months. By age 35 months, 62.4% of the children fell asleep in bed near parents. The most common reasons for bed-sharing were breastfeeding/feeding and convenience. Parental involvement when falling asleep was significantly related with frequent night awakenings and difficulty falling asleep. No association was found between bed-sharing and sleep.ConclusionBed-sharing and parental involvement were very common among Chinese children aged < 3 years. Children who fall asleep with parental involvement were more likely to have sleep problems.

目的 了解婴幼儿看护人睡眠认知和养育行为的现状及其一致性.方法 采用多阶段随机抽样方法,于2019年7-11月在6市社区和乡镇对婴幼儿看护人进行问卷调查,共1213例问卷纳入分析,采用x2检验、Kappa系数分析睡眠认知和睡眠养育行为的特征及一致性.结果 在认知层面,看护人中76.8％认为应该让孩子独自入睡,60.9％认为与家人同屋单独小床最有利孩子睡眠,75.8％认为最佳夜醒处理方式是观察几分钟再处理.农村地区、家庭月收入≤5000元、大学/大专以下文化程度、(外)祖父母、1岁以下婴儿的看护人睡眠认知相对较差(P＜0.05).在实际养育时,让孩子独自入睡、与家人同屋单独小床睡眠和夜醒后观察几分钟再处理的比例分别为26.2％、22.2％和54.2％.看护人在入睡方式、睡床方式和夜醒处理方式上的认知和养育行为之间的Kappa系数分别为0.193、0.131和0.419.结论 多数看护人对婴幼儿睡眠有正确认知,但个体差异较大,且养育行为与认知之间一致性较差.

我国的预防艾滋病母婴传播工作实施20余年以来,经历了从无到有,从一个试点地区,到全国覆盖,从单一的预防艾滋病母婴传播,到整合的预防艾滋病、梅毒和乙肝母婴传播综合干预服务不断发展的历程.2001年,在联合国儿童基金会的支持下,我国在河南省上蔡县启动了预防艾滋病母婴传播试点工作.2003年,扩展到5个省的8个县(市、区).

AbstractIn China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government‐funded nutrition programme, Ying Yang Bao (YYB; soybean powder‐based iron‐rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6–23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling intervention was delivered through a home visit based on the YYB programme in Liangshan. Child health messages were given by trained village child health assistants while distributing YYB. Surveys were conducted before and after the intervention to analyse changes in child health check‐up frequency, complementary feeding practice and prevalence of undernutrition. After the intervention, the proportion of children who had regular health check‐ups, who were vaccinated and who met the minimum YYB consumption significantly increased from 26.0%, 81.6%, and 67.8% to 59.7%, 95.0%, and 79.2%. Increased rates of IYCF indicators (introduction of solid, semisolid, or soft foods, minimum dietary diversity and consumption of iron‐rich or iron‐fortified foods) were observed after the intervention. The prevalence of stunting, underweight, wasting, and anaemia significantly decreased from 26.3% to 10.8%, 13.4% to 8.7%, 14.0% to 10.5%, and 52.1% to 43.9%. This intervention can be well integrated into the YYB programme with less additional resources. Children in resource‐limited areas will benefit more from a comprehensive nutritional package, including food supplements and child health education.

Background Hepatitis B virus (HBV) infection is a serious global health problem and China has the largest disease burden. Literatures focusing on economic-related inequalities in HBV infection among pregnant women are scarce. We aimed to quantify the economic-related inequalities and the change over time in HBV infection among pregnant women in mainland China from 2013 to 2020 to inform strategies considering economic-related inequalities. Methods We used national cross-sectional secondary data of pregnant women in 30 provinces from the National Integrated Prevention of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B Programme (iPMTCT Programme) from 2013 to 2020. We calculated concentration index and adjusted difference between the rich and the poor in the multivariable generalized estimating equation (GEE) model to measure economic-related inequality, after adjusted other risk factors. Findings In this study, a total of 115,789,148 pregnant women of mainland China from 2013 to 2020 were included, the overall hepatitis B surface antigen (HBsAg) prevalence was 6.27% (95%CI: 6.26%-6.28%). The curve lay above the equality line, with the negative value of the concentration index of -0.027, which indicated that economic-related health disparities exist in the distribution of HBV infection and the inequality disadvantageous to the poor (propoor). The concentration index showed a trend of fluctuating decline, indicating that economic-related inequalities in HBsAg prevalence were narrowing. The adjust difference between counties with lowest economic level and counties with highest economic level (reference group) were 46.3% in HBsAg prevalence (all p < 0.05) in the multivariable GEE model, after controlling other confounders. A significant dose-response relationship was observed between low economic level and high HBsAg prevalence that the adjust difference increased from 15.6% (aOR=1.156, 95% CI: 1.064-1.257) in the high-economic group to 46.3% (aOR=1.463, 95% CI: 1.294-1.824) in the lowest-economic group, compared with the highest-economic group. The association between low economic level and high HBsAg prevalence was stable in the sensitivity analysis. Interpretation HBV infection was more concentrated among population with lower economic status. Economic-related inequalities in HBV infection decreased in the past decade. Our findings highlight the importance of developing equity-oriented policies and targeted interventions to reduce HBV infection among the poor and hard-to-reach populations to achieve the 2030 HBV elimination goals on time.

我国自1992年加入国际爱婴医院行动,已走过30年,经历了早期探索、早期创建、全面创建及复核创新阶段,拥有爱婴医院7000多所.爱婴医院创建行动对我国妇幼卫生工作起到积极推动作用,促进了保健与临床工作的结合,推动了妇幼卫生资源的合理利用,通过提升卫生保健服务质量保障我国妇女和儿童健康.随着时代发展与人民生活水平的提高,爱婴医院行动的服务内涵在不断延伸,如何应对我国爱婴医院行动中面临的诸多挑战,亟需总结以往经验,探索相应挑战的应对策略.

目的 编制适用于我国1岁以下婴儿的睡眠状况评估量表,评价其信度、效度和可行性.方法 根据婴儿睡眠发育年龄特点,将量表划分为0～3个月和4～11个月两个年龄段.首先按照量表编制框架的睡眠节律、入睡行为、夜醒、睡眠呼吸4个维度建立条目池,然后依次通过条目初筛、修改、项目分析、效度分析、信度分析和验证性因子分析完成量表的编制和评价.结果 婴儿睡眠状况评估量表(0～3个月)和婴儿睡眠状况评估量表(4～11个月)均包含睡眠节律、入睡行为、夜醒和睡眠呼吸4个因子14个条目,条目内容略有不同,累积解释总变异量分别为56.61％、55.02％.两个量表所有条目的内容效度指数介于0.83～1.00.两个量表在入睡潜伏期、夜醒次数、睡眠时间3个条目与简明婴儿睡眠问卷(BISQ)呈正相关,相关系数分别为0.31、0.41、0.39和0.32、0.66、0.38.社区婴儿与门诊婴儿在两个量表总分以及绝大部分因子(除0～3个月量表睡眠呼吸因子)上的差异均有统计学意义(P＜0.05).两个量表的Cronbach's α系数为0.681、0.673,重测信度分别为0.75和0.74.结论 两个量表具有比较稳定的因子结构及较好的信效度,可以用于婴儿睡眠问题的早期筛查.

目的 探究2017年全国梅毒感染孕产妇的梅毒治疗情况及其影响因素.方法 利用"中国预防艾滋病、梅毒和乙肝母婴传播管理信息系统"上报的2017年全年分娩的梅毒感染孕产妇相关信息进行单因素和多因素分析,探究孕产妇的社会人口学特征、疾病进程、实验室相关检测及诊断时期等相关因素对妊娠梅毒治疗的影响.结果 本研究共纳入33 070名梅毒感染孕产妇,有80.93％接受过梅毒治疗,其中孕早、中、晚期开始治疗的孕产妇分别占45.27％,28.40％和12.78％.多因素分析结果发现年龄越大、汉族、受教育程度较高、非务农、经产妇、产时或产后确诊梅毒、有既往梅毒感染史、隐性梅毒、梅毒滴度较低的孕产妇接受治疗的可能性越低.结论 2017年全国梅毒感染孕产妇接受治疗的比例距"消除艾滋病、梅毒和乙肝母婴传播"目标要求的95％还有一定差距.多种因素对于梅毒感染孕产妇接受治疗均有影响.建议相关机构有针对性地为孕产妇提供梅毒筛查服务,做到早发现、早诊断、早治疗,进一步降低先天梅毒的发生.

BACKGROUND:China has the largest disease burden of hepatitis B virus (HBV) infection and is considered as a major contributor to the global elimination of hepatitis B by 2030. However, the national prevalence of HBV infection among Chinese pregnant women was not reported yet. We evaluated the national and regional prevalence of HBV infection among pregnant women in China between 2015-2020, aiming to provide the latest baseline data.METHODS:We assessed the prevalence of HBV infection from data gathered through a nationwide cross-sectional study of Chinese pregnant women. Data were obtained from the National Integrated Prevention of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B Programme (iPMTCT Programme) in China, which covered all the 2856 counties from 31 provinces from 2015 to 2020. HBV infection was defined as being tested seropositive for hepatitis B surface antigen (HBsAg).FINDINGS:A total of 90.87 million pregnant women in mainland China were testing for HBV between 2015 and 2020, with 5.60 million (6.17%, 95%CI: 6.16-6.18%) tested positive for HBsAg. From 2015 to 2020, the prevalence of HBV infection among pregnant women declined by 25.44%, from 7.30% in 2015 to 5.44% in 2020 (p for trend < 0.001), with an estimated annual percentage change (EAPC) of -5.27% (95% CI: -3.19% to -7.32%). Compared with the prevalence in 2015, reginal disparities in eastern, central, and western China were narrowed. Declines were also observed at provincial level and county level. HBV prevalence declined in most provinces (90.3%, 28/31) and counties (76.96%, 2198/2856) from 2015 to 2020. However, disparities still exist.INTERPRETATION:HBV prevalence in pregnant women in China was intermediate endemic and declined continuously from 2015 to 2020. The decline has been widespread across regions, but disparities remain. Regions with relatively higher disease burden on HBV infection should receive most attention in achieving the 2030 elimination goals.FUNDING:National Natural Science Foundation of China.

What is already known on this topic? The national program of prevention of mother-to-child transmission (PMTCT) of syphilis was initiated in 2011 and scaled to a national level since 2015. A better understanding of the implementation and outcomes of the program on PMTCT of syphilis is needed for future strategies to achieve the World Health Organization (WHO) goal of elimination of mother-to-child transmission (EMTCT) of syphilis. What is added by this report Between 2011 and 2018, as the coverage of syphilis screening of pregnant women and treatment for syphilis-seropositive pregnant women and their infants have increased consistently, the incidence of congenital syphilis was significantly reduced from 91.6 cases per 100,000 live births to 18.4 cases per 100,000. Treatment rates and adequate treatment rates of syphilis-seropositive pregnant women were below the criteria of validation of EMTCT of syphilis and regional disparities were found. What are the implications for public health practice? We recommend continuing to strengthen the current PMTCT intervention strategies with further commitments to achieve the targets set by the WHO’s dual EMTCT of HIV and syphilis. Barriers to achieving high coverage of adequate treatment should be investigated and addressed at the provincial level to ensure prompt treatment for syphilis-seropositive pregnant women.

Background The co-infection of Human Immunodeficiency Virus (HIV) and syphilis is risky for pregnant women and their expected children. In 2015, the Integrated Prevention of Mother-to-Child Transmission (iPMTCT) programwas established to offer all pregnant women with free screening, counseling, and testing of HIV and syphilis during regular obstetric inspections. To summarize the phase progress of this program, we reported the trends of maternal HIV-syphilis co-infection in China. We tried to socioeconomic factors associated with HIV-syphilis co-infection to inform the stratified control strategy for future work. Methods We obtained the prevalence data of HIV and syphilis over 2011–2018 by reviewing the Sexually Transmitted Infection (STI) monthly update reporting to the central surveillance system. With health status, background characteristics, and health outcomes reported, we collected the case reports from 2,578 HIV-positive pregnant women who accepted the screening at the local clinic. The trends of HIV and syphilis prevalence were examined using the Cochran-Armitage trend test. Logistic regression was applied to detect the features associated with syphilis infection among HIV-positive women and the potential risk factor to neonatal death. Results The prevalence of HIV decreased from 0.076–0.039% among registered pregnant women but increased slightly to 0.054% in 2018. The trend of syphilis prevalence in HIV-infected pregnant women fluctuated slightly around an average of 1.80% (p = .378). Multivariate logistic regression indicated finishing education of junior high school or below (aOR: 1.79, 95%CI: 1.31–2.43; p < .001), on regular Antiretroviral Therapy (ART) (aOR: 1.89, 95%CI: 1.47–2.45; p < .001) and exposed HIV from injective drug use (aOR: 5.49, 95%CI: 3.51–8.61; p < .001) are associated with high syphilis infection risk. Syphilis co-infection with HIV (aOR: 2.81, 95%CI: 1.32–5.96; p < .007) significantly increases the risk of newborns death. Conclusion Syphilis infection is still very prevalent in HIV-positive pregnant women five years after the implementation of iPMTCT program. Promoting the health education for maternal infection of STIs and increasing the availability of early intervention to link more marginalized women with care service should be the focuses of work in the next stage.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解我国中西部农村地区高危儿管理服务现状,为探索我国中、西部地区促进儿童早期发展服务模式提供参考依据。方法以河北、山西、河南、江西和贵州5省11县的儿童保健服务人员为调查对象,采用自填式调查问卷了解我国农村地区儿保人员提供高危儿童管理服务的现状。结果本研究共调查695名儿童保健服务人员,其中区/县级妇幼保健机构人员65名,乡镇卫生院及村卫生室人员630名,过去一年参加过高危儿保健业务培训的人员占48.6%（251/516）。目前项目地区高危儿管理的主要目标人群以早产低体重儿和体弱儿为主（82.1%和80.0%）。基层医疗卫生机构中的儿保人员,分别有73.1%（408/558）和61.8%（345/558）提供了高危儿登记和高危儿转诊服务。区/县妇幼保健机构的儿保人员中,开展高危儿发育监测和筛查者为74%（35/47）,进行专案登记管理的仅为49%（23/47）。对于影响高危儿管理业务开展的因素,业务人员认为最主要的因素是管理手续繁琐（77.8%,402/517）)和人手不够（76.8%,397/517）。对于高危儿管理知识的知晓情况,被调查者中10个题目答对6题以上的占59.2%（409/691）,答对8题以上的为30.0%（207/691）。结论高危儿管理作为我国儿童保健的重要内容,在中西部农村地区已经起步,但针对发育风险儿童服务和专案管理能力尚有待加强。建议针对高危儿管理提供相应的政策保障,开展针对性的解决措施,促进风险儿童的早期发展。</span>

目的 了解学龄前儿童超重、肥胖身高增长特点,为儿童体格发育干预提供依据.方法 采取多阶段分层整群随机抽样的方法,在我国7座城市随访儿童的身高和体重,调查儿童的出生日期、性别等.根据WHO《学龄前儿童生长发育标准》进行身高和体质量指数评价,采用方差分析、Wilcoxon秩和检验进行统计分析.结果 将基线、第1年和第2年随访时均为体型正常、超重和肥胖的2 479名儿童纳入分析.1年随访后,超重和肥胖儿童身高的年度增长值均＞8 cm且高于体型正常儿童,3组间差异有统计学意义(P＜0.05);2年随访后,肥胖儿童的身高增幅最高,为15.48 cm,高于超重和体型正常的儿童,3组间差异有统计学意义(P＜0.05).2年随访发现,体型正常、超重和肥胖儿童中,身高＜P25的比例逐年减少(12.08％,3.70％,2.21％),身高≥P75的比例逐年增加(35.20％,55.56％,73.48％);超重、肥胖儿童的年度增长值＞7 cm的比例分别为40.74％,49.72％,每年的增长幅度均高于体型正常儿童.结论 儿童家长和妇幼卫生工作者应重视超重、肥胖儿童的身高增长,学龄前儿童身高与体型的关联仍需深入的探讨.

Objective: To understand the status of maternal testing, detection and trends of HIV infection among pregnant women in Liangshan Yi Autonomous Prefecture (Liangshan) of Sichuan province during 2008-2016. Methods: Data were collected from the monthly work report on maternal HIV testings and the case-reporting records of HIV-positive pregnant women, from the National Management Information System of China's Prevention of Mother-to-child transmission of HIV, syphilis, and HBV Program. Descriptive method was applied to show both the maternal HIV and predelivery HIV testing rates and maternal HIV positive rates as well as the distribution in different counties, between 2008 and 2016. Results: During 2008-2016, both maternal HIV test rates and predelivery maternal HIV testing increased from 40.7% (8 191/20 125) and 8.0% (1 607/20 125) to 95.7% (88 000/91 946) and 70.1% (64 421/91 946), respectively (trend χ(2)=94 497.28, P<0.001; trend χ(2)=90 655.03, P<0.001). A total of 3 271 HIV-positives were detected from 436 519 pregnant women, with the HIV positive rate as 0.75% (95%CI: 0.72%-0.77%). Among 3 271 HIV-positive pregnant women, 1 527 (46.7%) of them were tested at labor. The maternal HIV-positive rates at labor increased yearly (trend χ(2)=9.21, P=0.002). In 2016, the maternal HIV-positive rate at labor was 1.32% (95%CI: 1.18%-1.47%), which was higher than that (0.67%, 95%CI: 0.61%-0.73%) in the pregnant women who received HIV test predelivery (χ(2)=88.23, P<0.001). The maternal HIV- positive rates in Butuo, Zhaojue, Jinyang, Meigu, and Yuexi counties all appeared ≥1%, in 2016,respectively. Conclusions: The maternal HIV test rates increased in Liangshan during 2008-2016, but the maternal HIV test rates at labor were relatively high. The HIV prevalence among pregnant women in Liangshan was severe and late for pregnant women to receive testing.

Prevention of mother-to-child transmission (PMTCT) of HIV infection has been recognized as a high-priority component of China's national HIV/AIDS response since it launched its National HIV PMTCT Program in 2005. However, the growing realization of the high rate of mother-to-child transmission of other serious infectious diseases, particularly syphilis and hepatitis B virus (HBV), led the Chinese Central Government to design a more comprehensive program and to integrate that program into the existing maternal and child health (MCH) system. Thus, the National PMTCT Program for HIV, Syphilis, and HBV was launched in 2010. Three years later coverage had already increased to 40% and today is universal. As a result, HIV testing rates among pregnant women have increased from 58% in 2005 to over 99% in 2017, the proportion of HIV-infected pregnant women receiving treatment increased from 65% in 2005 to 90% in 2017, and the rate of HIV MTCT fell from 13% in 2005 to 5% in 2017. Similarly, improved outcomes were also observed for syphilis- and HBV-infected mothers and their infants.