ObjectiveThis study seeks to trace the source of HIV infection in a male adolescent (P1) with a newly recognized heterosexual orientation in Zhejiang Province on August 23, 2019.MethodsAn in-depth epidemiological interview was conducted with P1 and all sexual partners. For HIV-infected partners, sequential partner tracing was performed until no new HIV cases were detected. The survey assessed high-risk sexual behavior, HIV testing and treatment history, and demographic details. Serum samples were collected for HIV antibody testing, and plasma samples from HIV-positive individuals were taken before antiviral therapy. HIV DNA was extracted, and specific gene regions were amplified, cloned, and sequenced. Phylogenetic trees were created using MEGA V6.0 to identify HIV subtypes, calculate genetic distances, and analyze genetic associations. Genetic similarity was calculated using BioEdit V7.2.0.ResultsThe results indicated that P1, a 16-year-old male dropout and left-behind child, first tested positive for HIV-1 antibodies on August 23, 2019. P1’s heterosexual partner, W1, is HIV-negative. P1 had a same-sex partner, P2, who tested positive on November 9, 2018. P2 is an adult, did not communication with P1 about his HIV status and had unprotected sex with P1 before P1 tested HIV positive. P2 reported seven male sexual partners in same district, P1 was one of them and all other sexual partners were HIV-negative. Among these seven partners, two were with divorced parents, six were dropouts, and three were left-behind children. Phylogenetic analysis revealed that both P1 and P2 had CRF01_AE/CRF55_01B/CRF07_BC recombinant HIV, with genetic similarities in the gag, pol, and env regions of 98.8, 99.5, and 98.8% for P1 and 99.0, 99.7, and 99.0% for P2. The genetic similarity between two samples of P2 in these regions was 98.7, 99.6, and 99.9%. In the gag and env gene regions, interwoven branching patterns were observed, which are indicative of shared transmission chains. For the pol gene region, the C1 paraphyletic sequences of P1 and P2 clustered within the same evolutionary branch, with a bootstrap value of 100% and a mean genetic distance of 0.003 within this cluster.ConclusionEpidemiological and phylogenetic analyses concluded that P1 contracted HIV through unprotected sex with an HIV-positive P2 who did not disclosure his HIV infection.

[This corrects the article DOI: 10.3389/fpubh.2026.1619949.].

Objective To determine the incidence of hyperlipidemia and identify its associated risk factors among people living with HIV (PLWH) initiating antiretroviral therapy (ART) in Eastern China, with the aim of informing strategies for early identification and timely management. Methods We conducted a retrospective cohort study of PLWH who initiated antiretroviral therapy (ART) in Zhejiang Province from January 2019 to December 2021. Demographic characteristics, clinical details, and other relevant factors were retrieved from the National Free ART Database. Results A total of 4387 PLWH were observed, with an incidence of hyperlipidemia of 43.8/100 person-years. A higher baseline CD4 cell count was associated with a reduced risk of hyperlipidemia: 51–200 cells/μL (aHR 0.75, 95% CI 0.65,0.87), 201–500 cells/μL (aHR 0.67, 95% CI 0.58,0.78), 501+ cells/μL (aHR 0.70, 95%CI 0.58, 0.84). Zidovudine + lamivudine + efavirenz, tenofovir disoproxil fumarate + lamivudine + lopinavir/ritonavir, elvitegravir/cobicistat/emtricitabine/ tenofovir alafenamide had a higher risk of hyperlipidemia. An HIV load ≥1000 copies/mL (aHR 4.03, 95% CI 3.67,4.42) was linked to an increased risk of hyperlipidemia. Conclusions A high incidence of hyperlipidemia was observed in PLWH receiving ART. Strengthening blood lipid monitoring and managing modifiable risk factors are essential to prevent hyperlipidemia in PLWH.

Objectives:To identify factors associated with casual sexual behavior mediated via the Internet (CSBI) and condom use with casual sexual partners found on the Internet (CSPI) among men who have sex with men (MSM) college students in Zhejiang Province, China, we conducted a cross-sectional study in six cities of Zhejiang in 2022. Methods:All subjects were recruited by four community-based organizations (CBOs), and information on demographic characteristics, risky sexual behavior, and health practices was collected. Univariate and multivariable logistic regression analyses were performed using SPSS software to identify factors associated with CSBI and condom use with CSPI. Results:Of the 671 participants, 73.3% (492/671) identified as gay, 317 (47.2%) reported CSBI in the past 6 months, and 31.5% (100/317) of these reported inconsistent condom use with these CSPI. The odds of engaging in CSBI in the past 6 months were significantly higher among MSM who watched pornographic videos ≥3 times per month (adjusted Odds Ratio (aOR) = 2.404, 95% confidence interval (CI): 1.598-3.617), and those who had a regular male sexual partner (aOR = 1.900, 95% CI:1.369-2.637). The odds of inconsistent condom use with CSPI in the past 6 months were significantly higher among participants who disclosed sexual orientation (aOR = 1.711, 95% CI: 1.010-2.898), those identified as bisexual or uncertain sexual orientation (aOR = 2.228, 95% CI: 1.241-3.999), and those had sexual contact with "both student and non-student partners" (aOR = 1.897, 95% CI: 1.092-3.297). In contrast, participants with a high level of condom use self-efficacy (aOR = 0.340, 95% CI: 0.212-0.657) and those who obtained human immunodeficiency virus (HIV) knowledge from the MSM communities (aOR = 0.447, 95% CI: 0.245-0.815) had a significantly lower odds of inconsistent condom use. Conclusion:A high prevalence of web-based casual sexual behavior was observed among MSM college students, particularly among those who frequently viewed pornography or maintained a stable male sexual partner. Students who have sexual contact with non-student partners were associated with inconsistent condom use. Additionally, MSM community-based interventions need more support to improve HIV knowledge and condom use with online casual partners.

In China, human immunodeficiency virus (HIV) poses a significant challenge to older heterosexual adults. This study explored the transmission dynamics of HIV infection among older adults in northern Zhejiang Province, China using phylogenetic analysis and transmission networks. HIV pol sequences without any antiretroviral therapy were obtained from newly diagnosed HIV-positive patients in Huzhou between 2017 and 2022. Pairwise genetic distances between sequences were calculated using HIV Trace based on the Tamura-Nei 93 method. The transmission network was constructed using Cytoscape v3.9.1. The effective reproductive number (Re) of each large cluster was estimated using the birth-death skyline model in BEAST v2.4.2. Multivariate logistic regression was performed to identify factors associated with clustering using R v4.4.3 software. A total of 931 HIV pol sequences were successfully obtained, of which CRF07_BC (51.7

Background: With the growing popularity and convenience of the internet, an increasing number of men who have sex with men (MSM) are seeking casual sexual partners online. However, the effect of online casual sexual behavior on other HIV-related risk behaviors remains unclear. Objective: This study aims to explore the characteristics of internet-based casual sexual behavior and its relationship with HIV-related risk behaviors among MSM. Methods: This cross-sectional study was conducted between June and December 2018 in 4 cities in Zhejiang Province, China. Peer-driven sampling was used for recruitment. Announcements were disseminated by 4 community-based organizations and 10 voluntary counseling and testing clinics online and offline. After informed consent, participants completed an electronic questionnaire covering demographic characteristics, casual sexual behaviors, HIV-related risk behaviors, and HIV prevention. SPSS (version 19.0; IBM Corp) was used to conduct chi-square tests, univariate and multivariate logistic regression analyses using a backward stepwise method based on the likelihood ratio test, and Poisson regression with robust variance to identify associations between finding casual sexual partners online and other risk behaviors. P values of <.05 were considered statistically significant. Results: In the past 6 months, 40.2% (302/751) of participants reported finding casual sexual partners online; 18.9% (142/751) reported finding casual sexual partners offline; 7.6% (57/751) reported having sexual intercourse with MSM without condoms after drinking alcohol; and 6.9% (52/751) reported condomless sex after using stimulants. Among those who found partners online, 62.5% (188/301) did so more than once per month and 39.5% (113/286) had more than one online sexual partner. In total, 39.3% (114/290) had sex with online partners at home and 10.1% (30/297) sought partners in other cities. Compared with participants who engaged in receptive anal intercourse (or both roles), those who engaged only in insertive intercourse reported a higher proportion of finding partners online more than once per month (72.7% vs 57.4%, P=.01), having more than 2 online sexual partners (52.1% vs 33.3%, P=.002), and conducting inconsistent condom use with online sexual partners (40.0% vs 25.8%, P=.01). Regression analysis showed that, compared with MSM who did not find partners online, those who did were more likely to report finding casual sexual partners offline (adjusted odds ratio [aOR] 9.398; 95% CI 5.956-14.829), having sex without condoms after drinking alcohol (adjusted prevalence ratio [aPR] 1.788; 95% CI 1.062-3.011), and having sexual intercourse without condoms after using stimulants (aPR 2.064; 95% CI 1.178-3.617). Conclusions: Internet-based casual sexual behavior is increasingly common among MSM. Finding partners online was associated with offline partner-seeking and condomless use after alcohol or stimulant use. Future HIV prevention efforts should emphasize behavioral interventions tailored to MSM who use dating apps.

Objective:This study investigated characteristics and factors associated with initial antiretroviral medicine use among newly treated HIV/AIDS patients in Zhejiang Province, China, from 2019 to 2023. Methods:Data from the National Free Antiretroviral Therapy (ART) Database, covering the period from 2019 to 2023, were analyzed. ART regimens were classified as nationally free or medicare/self-paid. A multivariable logistic regression analysis was employed to identify factors influencing the initial ART regimen choice among those newly treated HIV/AIDS patients. Results:In total, 17,018 individuals with HIV who initiated ART were included in the analysis. The use of medicare/self-paid medicines increased from 2.8 % to 39.8 %. Individuals with HIV transmission through homosexual contact (aOR = 1.30, 95 % CI: 1.16-1.45), those who received a diagnosis through medical institutions (aOR = 1.59, 95 % CI: 1.41-1.80), those with World Health Organization clinical stage IV disease (aOR = 1.93, 95 % CI: 1.62-2.29), and patients with the baseline CD4 cell count <50 cells/μL were more likely to opt for medicare/self-paid medications. Conclusion:The proportion of medicare/self-paid medicine use among newly treated HIV/AIDS patients exhibited an increasing trend. Several factors, including the education level, transmission route, diagnosis approach, and WHO clinical stage, among others, were associated with the medication choice. Taken together, our results provide crucial evidence to aid policymakers in developing procurement plans and allocating medicines appropriately to better address the diverse needs of HIV/AIDS patients.

Yet studies fail to consider how a lack of concordance among sexual orientation, gender identity, and intent to marry or date a woman hinders the improvement of HIV prevention outcomes. We sought to explore the overlap of the three variables and examine associations between each aspect and HIV prevention outcomes among college students MSM. A cross-sectional study was conducted in six cities in Zhejiang province in 2022. All subjects were recruited by four community-based organizations, reporting sexual orientation, HIV knowledge, HIV self-testing, Post-exposure Prophylaxis(PEP), and Pre-exposure Prophylaxis (PrEP). Among 671 participants, 43.8%(294/671) reported a gay identity along with a male identity and no intent to marry or date a woman. The structural equation model showed that the effect of sexual orientation on the intent to marry or date a woman is positive (β = 0.035, p< 0.001); After controlling 4 confounders, sexual orientation had a negative effect on HIV self-testing (β=-0.129, p < 0.01), HIV knowledge (β=-0.099, p < 0.01); There was partial mediating effect of marriage intention on the influence of sexual orientation on HIV knowledge (β = 0.021, 95CI%:0.001-0.046), have taken PEP (β = 0.019, 95CI%:0.002 ~ 0.040) and ever heard of PrEP (β=-0.023, 95CI%:-0.048-0.003). For college students MSM, sexual orientation may affect HIV prevention outcomes both directly and indirectly through attitudes toward marriage.

Aim:Men who have sex with men (MSM) contribute increasingly to the burden of HIV infection due to their high-risk sexual behaviors; however, studies focusing on the sexual behaviors among student MSM population remain limited. This study aims to investigate the incidence of HIV infection among MSM, while exploring high-risk sexual behavior in student MSM in Zhejiang province, China. Method:Prospective cohort study was conducted among MSM population in four cities in Zhejiang province. Information including socio-demographic characteristics as well as sexual behaviors were collected at baseline. Follow-up surveys and testing for HIV infection were conducted every 3 months. Univariable and multivariable logistic regression were performed to assess risk factors for HIV infection, investigate the sexual behavior differences between student and non-student MSM groups. Cox regression analyses were employed to discover potential association among various risk factors. Result:2081 HIV-negative MSM were enrolled in our cohort and 36 participants were infected with HIV. The incidence density of HIV infection was 2.15 per 100 person-years among this population. Student MSM are more likely to take sexual role of versatile (OR: 1.56, 95% CI: 1.05-2.32, p = 0.029) and receptive only (OR: 2.65, 95% CI: 1.62-4.08, p < 0.001) during anal intercourse, with a lower rate of previous HIV testing (OR: 0.45, 95% CI: 0.31-0.66, p < 0.001). Cox regression discovered that MSM who had more than 6 partners in anal sexual intercourse were more likely to obtain HIV-seroconversion than who had one fixed partner (HR: 5.14, 95% CI: 1.67-10.59, p < 0.001), participants who sometimes use condoms (HR: 4.11, 95% CI: 1.28-13.16, p = 0.017) and never use condoms (HR: 2.57, 95% CI: 1.16-5.66, p = 0.020) were more vulnerable to be infected by HIV compared to those use condoms constantly. Versatile (HR: 5.30, 95% CI: 1.65-17.06, p = 0.005) and receptive only role (HR: 3.23, 95% CI: 1.05-9.96, p = 0.042) in anal intercourse were more likely to be infected by HIV than insertive only. Conclusion:High-risk behaviors, particularly inconsistent condom uses during anal sex, significantly increase the risk of HIV infection. Student MSM exhibited persistent high-risk behaviors and low HIV testing rates. Greater attention and tailored interventions are needed to promote safer sexual practices and reduce HIV transmission in this population.

Background:Effective management of people living with HIV (PLWH) can block the sexual transmission as there is a zero risk of sexual transmission (by U=U campaign); however, few studies have aimed to addressed the risk of transmission among PLWH in China. Method:We conducted a cross-sectional survey among PLWH in 2022. PLWH were categorized into four HIV transmission risk groups: on antiretroviral therapy (ART) and HIV viral load (VL) < 50 copies/mL as minimum risk; on ART and 50 ≤ VL < 1,000 copies/mL as low-risk; on ART and VL ≥ 1,000 copies/mL, or on ART but without VL testing as medium-risk; not on ART as high-risk. Multivariable logistic regression was used to identify risk factors associated with risk of HIV transmission. Result:A total of 39,744 PLWH were enrolled in the study. The proportion of those at risk for HIV transmission was 11.4%: low-risk 3.4%, medium-risk 6.9% and high-risk 1.1%. 33,764 (95.0%) patients were tested for syphilis, of whom 5.6% (1,879) had a current syphilis infection. Multivariable logistic regression analysis showed that compared with patients at minimum risk of transmission, individuals who were male (adjusted odds ratio [aOR]: 1.17, 95% confidence interval [CI]: 1.06-1.29), 16-24 age group (aOR: 2.13, 95% CI: 1.75-2.60), primary school or literate (aOR: 1.50, 95% CI: 1.36-1.65), heterosexual route of HIV infection (aOR: 1.50, 95% CI: 1.38-1.63), with a non-local registered residence (aOR: 1.55, 95% CI: 1.39-1.72), current CD4 + T count ≤200 cells/μL (aOR: 5.03, 95% CI: 4.52-2.59), and follow-up years less than 2 years (aOR: 2.02, 95% CI: 1.77-2.30) were associated with increased odds of HIV transmission. Being married (aOR: 0.62, 95% CI: 0.55-0.69) was associated with a decreased risk of HIV transmission. Conclusion:We concluded that 8.0% of PLWH were at moderate to high risk for HIV transmission. 88.6% of HIV positive patients in Zhejiang province, China were found to be at minimum risk of HIV transmission. Promoting HIV knowledge and education among younger adults, while linking individuals to ART to reduce their viral load could help reduce the persistently risk of HIV transmission.

PURPOSE:To understand the geographic origins, transmission hotspots, and drug resistance mutations (DRMs) of HIV-1 CRF08_BC in Zhejiang Province, China. METHODS:This study analyzed HIV-1 CRF08_BC pol sequences collected between 2020 and 2023. Bayesian inference was employed to investigate temporal epidemic trends, while HIV-TRACE and MCODE were used to identify transmission clusters (TCs), key hotspots and super-spreaders. DRMs associated with CRF08_BC were also characterized. Additionally, demographic data were integrated with these findings, allowing for a description of the transmission dynamics. RESULTS:This study revealed that CRF08_BC strains in Zhejiang likely originated from Guangxi, with significant transmission among individuals aged 50 and older, particularly those with low educational levels. Molecular transmission analysis showed that 58.9% of CRF08_BC sequences were in TCs, with geographic concentrations in Taizhou (TZ) and Lishui (LS). 14 large clusters maintained effective reproductive numbers (Re) above 1, representing considerable epidemic growth. Hangzhou (HZ) emerged as a key transmission hub, with 10 TCs showing active transmission. LS established strong epidemiological links with HZ, Ningbo (NB), Taizhou (TZ), and Wenzhou (WZ), creating a pattern of viral spread radiating from LS to surrounding areas. DRMs were identified in 76 cases (6.0%), with NNRTI and NRTI mutations exhibiting distinct geographic clustering. CONCLUSIONS:The CRF08_BC strains in Zhejiang likely originated from Guangxi and are mainly found in individuals aged 50 and older with low education. The current epidemic hotspots are in TZ and LS, where NNRTI and NRTI mutations are clustered, significantly impacting treatment efficacy.

Objective: To investigate syphilis infection and related factors among HIV-infected patients being followed up for more than one year in Zhejiang Province. Methods: Data were collected from the China Disease Control and Prevention Information System, and information such as demographic characteristics, viral load levels, and syphilis serologic test results was collected from HIV-infected persons who were diagnosed with HIV more than 1 year, aged ≥15 years with a current address in Zhejiang Province through December 31, 2022. The logistic regression model analyzed the prevalence of syphilis and the related factors. The SPSS 19.0 software was used for statistical analysis. Results: A total of 33 734 HIV-infected patients, with the prevalence of syphilis was 5.6% (1 879/33 734). Among the syphilis cases, the prevalence of syphilis was 6.4% (1 774/27 934) of males, 7.5% (640/8 543) of 25-34 years old age group, 7.6% (1 025/13 423) of unmarried, 8.3% (1 239/14 862) of homosexual transmission, 6.9% (214/3 080) with a non-local registered residence and 9.6% (602/6 267) with a history of STD before the HIV diagnosis. Multivariate Logistic regression analysis showed that participants who were male (aOR=2.19, 95%CI:1.77-2.72), 25-34 years old age group (aOR=1.80, 95%CI:1.47-2.20), homosexual transmission (aOR=1.67, 95%CI:1.49-1.88), with other provinces registered residence (aOR=1.26, 95%CI:1.09-1.47), and with a history of sexually transmitted disease (STD) before the HIV diagnosis (aOR=1.98, 95%CI:1.78-2.20) were associated with increased risk of syphilis. Being married (aOR=0.79, 95%CI:0.68-0.92) was associated with a decreased risk of syphilis. Conclusions: Syphilis infections were high in HIV-infected patients followed up more than one year in Zhejiang Province. It is recommended that syphilis surveillance and screening frequency should be strengthened among HIV-infected persons with characteristics such as male, homosexual transmission, and STD history.

BackgroundHIV notification and testing integrated into partner service (PS) practices among HIV-positive individuals have been proven to be an efficient approach for case finding, although it remains a weak link in China. Although nonmarital sexual activities accounted for a large proportion of newly diagnosed HIV-positive cases in China, little is known about PS uptake and associated factors within nonmarital partnerships. ObjectiveThis study aimed to describe HIV PS utilization and its associated factors among HIV-positive individuals with nonmarital sexual partners. MethodsWe recruited newly diagnosed HIV-positive individuals who had nonmarital sexual partners in 2022 in Zhejiang Province and offered them PS. We described the PS uptake cascade within sexual partner categories and analyzed the associated factors with 3 primary outcomes from the participants’ perspective: nonmarital partner enumeration, HIV testing, and HIV positivity. ResultsIn this study, 3509 HIV-positive individuals were recruited as participants, and they enumerated 2507 nonmarital sex partners (2507/14,556, 17.2% of all nonmarital sex partners) with contact information. Among these, 43.1% (1090/2507) underwent an HIV test, with an HIV-positive rate of 28.3% (309/1090). Heterosexual commercial partners were the least likely of being enumerated (441/4292, 10.3%) and had the highest HIV-positive rate (40/107, 37.4%). At the participant level, 48.1% (1688/3509) of the participants enumerated at least one nonmarital sex partner with contact information, 52.7% (890/1688) had a sex partner tested for HIV, and 31% (276/890) had at least one nonmarital sex partner who tested positive. Multivariate analysis indicated that gender and transmission route were associated with both nonmarital sex partner enumeration and HIV testing. Age and occupation were associated with nonmarital sex partner enumeration and HIV positivity. Compared with participants who had no regular nonmarital sex partner, those who had a regular nonmarital sex partner were more likely to enumerate nonmarital sex partners (adjusted odds ratio [aOR] 3.017, 95% CI 2.560-3.554), have them get tested for HIV (aOR 1.725, 95% CI 1.403-2.122), and have an HIV-positive nonmarital sex partner (aOR 1.962, 95% CI 1.454-2.647). ConclusionsThe percentage of partner enumeration was low, and HIV testing rate was moderate among nonmarital partnerships of HIV-positive individuals. More efforts should be made to improve PS practices among HIV-positive individuals and address the gap in partner enumeration, especially for heterosexual commercial nonmarital partnerships. Additionally, enhancing PS operational skills among health care personnel could increase the overall efficiency of PS uptake in China.

BackgroundMen who have sex with men (MSM) are increasingly using the internet to meet casual sexual partners. Those who do are at higher risk of sexually transmitted diseases. However, little is known about the rates and associations of frequent HIV testing and self-testing among such MSM. ObjectiveWe aimed to examine HIV serostatus communication and perceptions regarding the HIV infection risk of internet-based partners, along with their associations with frequent HIV testing and self-testing. MethodsA cross-sectional study was conducted between May 2018 and April 2019 in Zhejiang Province, China. The study participants were assigned male at birth, were aged 18 years or older, had had casual sex with another male found through the internet in the last 6 months, and were HIV-negative. Information was obtained on HIV-testing behavior, along with demographic characteristics, HIV-related knowledge, internet-based behaviors, sexual behaviors with male partners, HIV serostatus communication, and perceptions regarding the HIV infection risk of internet-based partners. Uni- and multivariate logistic regression models were used to measure the associations of HIV testing and self-testing. ResultsThe study recruited 281 individuals who had sought casual sexual partners through the internet during the previous 6 months. Of the participants, 61.9% (174/281) reported frequent HIV testing (twice or more frequently) and 50.9% (119/234; 47 with missing values) reported frequent HIV self-testing. MSM who always or usually communicated about the HIV serostatus of internet-based partners in the previous 6 months had 3.12 (95% CI 1.76-5.52) and 2.45 (95% CI 1.42-4.22) times higher odds of being frequently tested or self-tested for HIV, respectively, compared with those who communicated about this issue minimally or not at all. ConclusionsThere remains a need to improve the frequency of HIV testing and self-testing among internet-based MSM. HIV serostatus communication should be improved within the context of social networking applications to promote frequent HIV testing among internet-based MSM, especially for those who communicated about this issue minimally or not at all.

Objective To analyze the epidemiological characteristics of hepatitis C in Zhejiang Province from 2004to 2021 to provide data for eliminating hepatitis C as a public health hazard. Methods The data on hepatitis C in Zhejiang Province from 2004 to 2021 were collected from the infectious disease surveillance system of the China Information System for disease control and prevention. Distribution analysis and Cochran-Armitage analysis were used by SAS 9.4 software. Distribution of characteristics of age, gender, occupation, and key cities of reported cases and trend analysis in Zhejiang from 2004-2021. Results HCV reported infection rate was up trend（Z-value=69.539, P＜0.001）,number of reported cases were from 978 in 2004 to 3520 in 2021. Wenzhou, Hangzhou, Ningbo, and Taizhou city were reported a higher number of cases with an increasing trend. Cochran-Armitage testing was Z=6.717, P＜0.001;Z=45.941,P＜0.001;Z=35.445, P＜0.001;Z=16.595, P＜0.001 respectively. The number of males was higher than females, decreasing from 2.02∶1 in 2004 to 1.72∶1 in 2021. The highest cases was among 15-49 years old. The proportion of 50 years old and above was increased from 27.61% in 2004 to 41.45% in 2021. Main occupation were farmers/migrant workers.Conclusions Zhejiang province’s prevalence of hepatitis C was at a low level, but with an up trend. Reported cases were high in some cities and male higher than female. Although 15-49 years old is the main population, the number of people over 50 has increased significantly.

Objective: To identify the transmission relationship between HIV infection cases the non-marital non-commercial heterosexual contact in Zhejiang Province. Methods: When HIV positive was informed during January 2020 to January 2022, the staff conducted an epidemiological investigation to collect cases information on sociodemographic characteristics, mobility information, past HIV testing history, high-risk sexual behaviors, sexual partners, and etcetera. At the same time, 6-8 ml of blood from the new diagnosis of people infected with HIV before antiviral treatment was collected to separate the bleeding plasma. pol gene was amplified by nucleic acid extraction and PCR, sequenced by Sequencer 5.0 software, and Cytoscape 3.6.0 software was used to draw HIV molecular transmission network. Results: From January 2020 to January 2022, 88 HIV infected individuals were found in Pujiang County, of which 74 were transmitted through heterosexual transmission, of which 31 were infected through non-marital non-commercial heterosexual contact. Preliminary case studies have found that three female cases have engaged in unprotected non-marital non-commercial heterosexual contact with one male case. Among the 4 infected individuals, 2 of their spouses tested positive for HIV antibodies. Molecular transmission network monitoring was carried out on 65 newly diagnosed cases of heterosexual transmission with acquired sequences, forming 9 transmission clusters. The largest cluster contained 10 cases. A total of 11 HIV-infected individuals were involved in this HIV cluster epidemic. They were 3 males and 8 females, all over 50 years old and were farmers or rural housewives. They were traced to 7 sexual partners (6 negatives of HIV, 1 undetected). Among the 18 respondents' sexual social network relationships, there were 6 couples, 8 permanent partners, and 3 temporary partners. Among 11 HIV infected individuals, there were 9 cases of non-marital non-commercial heterosexual transmission and 2 cases of intramarital transmission. The epidemiological association between 7 non-married non-commercial heterosexual partners and case 2 (56-year-old male farmer), 3 cases confirmed by epidemiological investigation and molecular transmission cluster results, 3 cases confirmed by molecular transmission cluster and epidemiological investigation results, and 1 case confirmed by epidemiological investigation results. Conclusions: The transmission mode of this cluster epidemic was to spread HIV through heterosexual sex with a male case as the core, then cause the transmission within marriage and between fixed sexual partners. The combination of epidemiological investigation and molecular transmission network traceability survey supports the conclusion of this study.

Objective: To investigate the prevalence of syphilis in HIV-infected patients with transmission risk and influencing factors in Zhejiang Province. Method: The information about the HIV-infected patients, who were alive, had been diagnosed with HIV for >1 year, had received no antiviral treatment or had HIV viral load ≥50 copies/ml, and were aged ≥15 years, reported in Zhejiang as of December 31, 2018 were collected from China Information System for Disease Control and Prevention. The information included general demographic characteristics, sexual behavior characteristics and antiretroviral therapy and syphilis serological test results. The prevalence of syphilis and the influencing factors were analyzed by logistic regression model. The SPSS 19.0 software was used for statistical analysis. Results: A total of 2 275 HIV-infected patients were at risk of HIV transmission, and 75.5% (1 717/2 275) of them were tested for syphilis, the prevalence rate of syphilis was 8.7% (150/1 717). Among the HIV-infected patients with syphilis, 11.3% (17/150) received no antiviral treatment, 38.7% (58/150) had viral load of 50-999 copies/ml and 50.0% (75/150) had ≥1 000 copies/ml. Multivariate logistic regression analysis showed that being men (aOR=2.04, 95%CI:1.06-3.96), homosexual transmission (aOR=1.53, 95%CI:1.04-2.27), history of sexually transmitted diseases (STDs) before HIV diagnosis (aOR=1.98, 95%CI:1.35-2.92) and HIV viral load ≥1 000 copies/ml (aOR=1.90, 95%CI:1.09-3.30) were the risk factors for syphilis. Marriage (aOR=0.47, 95%CI: 0.29-0.76) was a protective factor for syphilis. Conclusions: The prevalence of syphilis was high in HIV-infected patients with transmission risk in Zhejiang. It is urgent to carry out classified management and targeted intervention in HIV-infected patients, explore multi-disease prevention and treatment mechanism, strengthen syphilis screening and treatment in HIV-infected patients to reduce the transmission of HIV and syphilis.

Objective:To identify the status and determinants of sharing personal HIV information with sexual partners among men who have sex with men (MSM) meeting their casual sexual partners on the internet.Methods:A cross-sectional study was conducted in five cities (Hangzhou, Ningbo, Wenzhou, Taizhou and Shaoxing) in Zhejiang province. The recruitment was enrolled by MSM social organization and in voluntary counseling and testing clinics, with a sample size of 793. A self-designed network questionnaire collected essential characteristics, HIV knowledge, sexual behavior, and sharing personal HIV status. SPSS 20.0 software was used for statistical analysis.Results:Among 767 MSM enrolled 302 MSM who reported finding casual sexual partners on the internet were enrolled in the analysis. MSM reported finding casual partners on the internet only, finding sexual partners online and in places were 62.6% (189/302) and 37.4% (113/302), respectively. Among those reporting web-based sexual behavior in the last six months, 54.6% (165/302) informed their partners of their HIV status, 49.2% (146/297) inquired about HIV status, and 42.9% (82/191) knew HIV status before sex intercourse, 75.8% (113/149) reported consistent condom use with HIV negative partners. The multivariable logistic regression analysis showed that related factors of inconsistent inquired HIV status of partners included 25-34 years old (a OR=2.17, 95% CI: 1.20-3.91), >2 partners on the internet in the last six months (a OR=2.13, 95% CI: 1.27-3.57), low-risk perception of HIV infection with online partners (a OR=1.96, 95% CI:1.14-3.35), numbers of HIV testing >1 times (a OR=0.38, 95% CI: 0.22-0.66). Conclusions:The willingness to know the HIV status of partners among MSM who met sexual partners on the internet was high but with a low rate of knowing their sex partner's HIV status in Zhejiang province. However, the successful implementation proportion was low. Therefore, it is necessary to pay attention to people who are elderly, with less conscience about the risk of the sex partners on the internet, have more sex partners, and have received few HIV tests. In addition, peer education was needed to promote related intervention programs.

目的 了解发生性行为的男大学生HIV检测情况并分析影响因素,为提高青年学生HIV检测提供依据.方法 于2021年9-11月,采用立意抽样方法抽取杭州市4所本科院校和1所大专院校,选择自述发生性行为的男大学生为调查对象.通过问卷调查收集人口学信息、预防艾滋病相关知识、性行为和HIV检测资料;采用多因素logistic回归模型分析HIV检测的影响因素.结果 调查发生性行为的男大学生720人,大一至研究生阶段分别为180、178、163、50和149人,占25.00％、24.72％、22.64％、6.94％和20.69％.接受过HIV检测94人,占 13.06％;其中自我检测占57.45％.多因素logistic回归分析结果显示,研究生(OR=0.302,95％CI:0.127～0.719)、性取向(同性,OR=0.090,95％CI:0.028～0.294;双性/不确定,OR=0.181,95％CI:0.066～0.495)、对 HIV 检测的了解程度(略有了解,OR=0.411,95％CI:0.176～0.957;比较了解,OR=0.305,95％CI:0.123～0.757;非常了解,OR=0.087,95％CI:0.032～0.235)是发生性行为的男大学生HIV检测的影响因素.结论 发生性行为的男大学生HIV检测与了解HIV检测的程度有关,建议加强HIV检测宣传,提升检测服务可及性.

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.