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This study aims to provide an estimate of lifetime sexual violence (SV) among male sexual minority college students with differing sexual orientations and contribute to the evidence base on the association between SV experience, stress, and depressive symptoms. The data stemmed from the 2019 Internet Survey on HIV/AIDS and Sexual Health in Colleges and Universities in Guangdong province, China. Lifetime SV victimisation (including non-sexual harassment, physical contact sexual harassment, and rape), level of stress, and depressive symptoms were examined among 1441 male sexual minority students from 37 colleges and universities in Guangdong province. Linear regression analyses were adopted to examine associations between independent variables and depressive symptoms. 23.4% (337/1441) of the participants reported lifetime non-contact harassment, while 8.8% (127/1441) and 2.4% (35/1441) of the participants reported physical contact sexual harassment and rape, respectively. Homosexual students reported the most physical contact sexual harassment (48/127, 37.8%) and bisexual students reported the most non-contact sexual harassment (102/337, 30.3%) and rape (10/35, 28.6%) among sexual minority participants; 85.6% participants reported high levels of stress. The experience of SV and the level of stress were significantly associated with depressive symptoms, and stress completely mediated the path from SV experiences to depressive symptoms. This study specifically showcases SV as a pervasive problem affecting Chinese male sexual minority college students and highlighting the severity of stress and depressive symptoms among this population. These findings emphasise the urgency of implementing effective practices and policies to address SV and depressive symptoms among male sexual minority college students in China.

The SARS-CoV-2 B.1.617.2 (Delta) variant flared up in late May in Guangzhou, China. Transmission characteristics of Delta variant were analysed for 153 confirmed cases and two complete transmission chains with seven generations were fully presented. A rapid transmission occurred in five generations within 10 days. The basic reproduction number (R0) was 3.60 (95% confidence interval: 2.50–5.30). After redefining the concept of close contact, the proportion of confirmed cases discovered from close contacts increased from 43% to 100%. With the usage of a yellow health code, the potential exposed individuals were self-motivated to take a nucleic acid test and regained public access with a negative testing result. Facing the massive requirement of screening, novel facilities like makeshift inflatable laboratories were promptly set up as a vital supplement and 17 cases were found, with 1 pre-symptomatic. The dynamic adjustment of these three interventions resulted in the decline of Rt from 5.00 to 1.00 within 9 days. By breaking the transmission chain and eliminating the transmission source through extending the scope of the close-contact tracing, health-code usage and mass testing, the Guangzhou Delta epidemic was effectively contained.

Background We estimated the predictive effects of ART-related perceptions on the actual ART uptake behavior among ART naïve PLWH stratified by different time of HIV diagnosis under the new strategy. Methods A prospective cohort study was conducted among ART naïve PLWH in Guangzhou, China from June 2016 to June 2017. Cox regression model was used to evaluate the predictive effects of ART-related perceptions on ART initiation among PLWH stratified by different timepoint of HIV diagnosis (i.e., before or after the update of the new treatment policy). Results Among 411 participants, 150 and 261 were diagnosed before (pre-scaleup group) and after (post-scaleup group) the implementation of the new strategy, respectively. The ART initiation rate in the post-scaleup group (88.9%) was higher than that in the pre-scaleup group (73.3%) (p p p = 0.006], has a predictive effect on ART initiation; in pre-scaleup group, all constructs of HBM-related ART perceptions were predictors of ART initiation (HRa = 0.71 to 1.83, p p > 0.05). Conclusions The ART initiation rate was high particularly among participants who diagnosed after the new treatment strategy. The important role of the time of HIV diagnosis on ART initiation identified in this study suggested that future implementation interventions may consider to modify the ART-related perceptions for HIV patients who diagnosed before the implementation of the new ART strategy, while expand the accessibility of ART service for those who diagnosed after the implementation of the new strategy.

Background: We estimated the predictive effects of ART-related perceptions on the actual ART uptake behavior among ART naïve PLWH stratified by different time of HIV diagnosis under the new strategy. Methods: A prospective cohort study was conducted among ART naïve PLWH in Guangzhou, China from June 2016 to June 2017. Cox regression model was used to evaluate the predictive effects of ART-related perceptions on ART initiation among PLWH stratified by different timepoint of HIV diagnosis (i.e., before or after the update of the new treatment policy). Results: Among 411 participants, 150 and 261 were diagnosed before (pre-scaleup group) and after (post-scaleup group) the implementation of the new strategy, respectively. The ART initiation rate in the post-scaleup group (88.9%) was higher than that in the pre-scaleup group (73.3%) (p A significant difference of mean score was detected in each HBM construct between pre- and post- scaleup groups (pp=0.006), has a predictive effect on ART initiation; in pre-scaleup group, all constructs of HBM-related ART perceptions were predictors of ART initiation (HRa=0.71 to 1.83, pp>0.05). Conclusions: The ART initiation rate was high particularly among participants who diagnosed after the new treatment strategy. The important role of the time of HIV diagnosis on ART initiation identified in this study suggested that future implementation interventions may consider to modify the ART-related perceptions for HIV patients who diagnosed before the implementation of the new ART strategy, while expand the accessibility of ART service for those who diagnosed after the implementation of the new strategy.

BackgroundChina started the new antiretroviral therapy (ART) strategy since 2016, after which free ART could be provided for all people living with HIV. We aimed to understand the prevalence of ART initiation among men who have sex with men (MSM) living with HIV and to explore how ART-related perceptions, psycho-social status etc. predict ART initiation under the new strategy.MethodsA cohort study (maximum follow-up period = 578 days) was conducted in Guangzhou, China. A total of 303 ART-naïve MSM were recruited from community. Baseline information collected demographic characteristics, HIV/AIDS-related health status, ART-related perceptions, weighting of pros versus cons and psycho-social status. The outcome was ART initiation. Cox regression models were fitted for data analyses.ResultsThe prevalence of ART initiation was 83.8% of all participants and 92.6% of MSM diagnosed recently (within 30 days). In multivariate Cox regression models, HIV-positive MSM received HIV diagnosis ≤30 days were less likely to initiate ART (HR = 0.37, 95% CI: 0.28-0.49). In adjusted analyses, belief that immediate ART initiation would have more benefit for themselves associated with increased ART initiation (HRa = 1.44, 95% CI: 1.06-1.96). In the final model, weighting of pros versus cons and time since diagnosis of HIV infection remained significant.ConclusionThe prevalence of ART initiation was high among MSM living with HIV in Guangzhou. To reach the second 90% target, measures should be focused on MSM previously diagnosed. Interventions showing HIV-positives the benefits of ART were also needed.

Background The early initiation of antiretroviral therapy (ART) for people living with HIV (PLWH) benefits both individuals and societies. However, little is known about the intention to initiate ART among PLWH in China in the context of a scaling-up of treatment or how the recommendations of healthcare workers affect this intention. Methods A total of 451 ART-naïve PLWH were recruited from communities in Guangzhou, China for this study. Data were collected by trained physicians via face-to-face interviews. Logistic regression models were fitted for the data analyses. Results Of the participants, 93.8% were male, 72.7% were infected via homosexual behaviour and 68.5% reported an intention to initiate ART. In the latter category, 77.8, 41.9 and 20.0% of respondents received strong recommendations to initiate ART from healthcare workers at the Centres for Disease Control and Prevention (CDC), community healthcare centres and non-governmental organisations (NGOs), respectively. After adjusting for potential confounders, depression, anxiety and strong recommendations from healthcare workers at the CDC and NGOs correlated significantly with ART intention. In the adjusted final hierarchical logistic regression model, the duration of infection [multivariate odds ratio (ORm) = 0.30, p

Objectives To investigate the impact of the Three Gorges Dam on the local ecological environment. We conducted a 3-year cross-sectional survey of natural focus infectious diseases in the area before and after the water level rose to 156 m to evaluate the dam's health impacts. Methods Direct and indirect immunofluorescence methods were applied to detect rat antigen and antibody of haemorrhagic fever with renal syndrome (HFRS). Fresh rat kidneys were inoculated in Korth's culture medium to detect Leptospira. A group of captured crabs were ground to observe the metacercariae of Paragonimus. Serum samples were collected from healthy local individuals. ELISA kits were used to detect human antibody against HFRS and paragonimiasis. Human Leptospira infections were detected by a microscopic agglutination test. Results Upstream rodent density increased significantly with Rattus flavipectus and Apodemus agrarius as the major pathophoric genera. The infection rate of human HFRS and Leptospira in the upstream human population samples was significantly higher than in the downstream samples and correlated with the increase in rodent density. Paragonimus infection rates remained at a low level during the study. Culex pipiens fatigan and Armigeres obturbans were the dominant species of mosquito. Conclusions The creation of the Three Gorges Dam changed the proliferation of intermediary agents of diseases, but not notably. However, the ecological effects on the environment may require a prolonged period of time to manifest themselves; thus, long-term and effective surveillance of vectors and related diseases needs to be established. Objectifs Investiguer l'impact du barrage des Trois Gorges sur l'environnement ecologique local. Nous avons mene une enquete transversale de focalisation naturelle de trois ans sur les maladies infectieuses dans la region avant et apres l’elevation du niveau de l'eau a 156 m, afin d’evaluer les impacts du barrage sur la sante. Methodes Des methodes d'immunofluorescence directe et indirecte ont ete appliquees pour detecter l'antigene de rat et les anticorps de la fievre hemorragique a syndrome renal. Des reins de rat frais ont ete inocules dans le milieu de culture de Korth pour detecter Leptospira. Un groupe de crabes captures ont ete broyes pour observer les metacercaires de Paragonimus. Des echantillons de serum ont ete preleves chez des individus locaux sains. Des Kits ELISA ont ete utilises pour detecter les anticorps humains contre la FHRS et la paragonimose. Les infections humaines a Leptospira ont ete detectees au moyen d'un test d'agglutination microscopique. Resultats La densite de rongeurs en amont a augmente de facon significative avec Rattus flavipectus et Apodemus agrarius comme principaux agents intermediaires de maladies. Le taux d'infections FHRS humaines et a Leptospira dans les echantillons de la population humaine en amont etait significativement plus eleves que dans les echantillons en aval, et en correlation avec l'augmentation de la densite des rongeurs. Les taux d'infection a Paragonimus sont restes a un niveau bas durant l’etude. Culex pipiens fatigan et Armigeres obturbans etaient les especes de moustiques dominantes. Conclusions La creation du barrage des Trois Gorges a change la proliferation des agents intermediaires de maladies, mais pas de facon notable. Cependant, les effets ecologiques sur l'environnement peuvent exiger une periode prolongee de temps pour se manifester. Ainsi une surveillance a long terme et efficace des vecteurs et des maladies connexes doit etre etablie. Objetivos Investigar el impacto de la presa de las Tres Gargantas sobre el medio ambiente ecologico local. Para ello, hemos llevado a cabo un estudio croseccional de tres ano sobre los focos naturales de enfermedades infecciosas en el area, antes y despues de que el nivel del agua aumentase 156 m, con el fin de evaluar el impacto de la presa sobre la salud. Metodos Se aplicaron metodos de inmunofluorescencia directa e indirecta para detectar antigeno de rata y anticuerpos de fiebre hemorragica con sindrome renal. Se inocularon rinones frescos de rata en medio de cultivo de Korth para detectar Leptospira. Se buscaron metacercos Paragonimus en un grupo de cangrejos capturados. Se recolectaron muestras de suero de individuos locales sanos. Se utilizaron kits de ELISA para detectar anticuerpos humanos frente a fiebre hemorragica con sindrome renal (FHSR) y paragonimosis. Las infecciones humanas por Leptospira se detectaron mediante una prueba microscopica de aglutinacion. Resultados La densidad de roedores rio arriba aumento de forma significativa, siendo Rattus flavipectus y Apodemus agrarius los generos mas patogenicos. La tasa de infeccion humana con FHSR y leptospira en las muestras de la poblacion rio arriba era significativamente mayor que en las muestras rio abajo, y estaban correlacionadas con un aumento en la densidad de roedores. Las tasas de infeccion por Paragonimus continuaban siendo bajas durante el estudio. Culex pipiens fatigan y Armigeres obturbans eran las especies dominantes de mosquito. Conclusiones La construccion de la presa de las Tres Gargantas cambio la proliferacion de los agentes intermediarios de la enfermedad, pero no de manera notable. Sin embargo, los efectos ecologicos sobre el medio ambiente podrian requerir de un periodo de tiempo prolongado antes de manifestarse, por lo que seria necesario establecer una vigilancia efectiva y a largo plazo de los vectores y de las enfermedades relacionadas.

Aims To investigate the incidence of dropout and the prevalence of poor adherence among newly admitted first-time clients of methadone maintenance treatment (MMT) clinics, and the associations between MMT-related misconceptions and these two treatment outcomes. Design A cohort study (maximum follow-up period = 17.6 months) was conducted. Setting Three of the nine MMT clinics in Guangzhou, China participated in the study. Participants The sample included 158 newly admitted first-time MMT clients. Measurements Information collected included background characteristics, history of drug use, MMT-related misconceptions, dropout during the entire study period and poor adherence within the first 6 months since admission to MMT. Findings Of all newly admitted MMT clients, 98.2% possessed at least one and 50.6% possessed all four types of MMT-related misconception; 51.3% had dropped out before the completion of the study [95% confidence interval (CI): 43.5–59.1%] and 62% exhibited poor adherence within the first 6 months since admission (95% CI: 54.2–69.6%). Adjusting for significant background variables, the number of misconceived responses predicted significantly both dropout [hazard ratio (HR) = 3.80 for two to three misconceived items, HR = 7.13 for four misconceived items, with zero to one misconceived item being the reference] and poor adherence within the first 6 months [relative risk (RR) = 4.13 for two to three misconceived items; RR = 4.40 for four misconceived items, with zero to one misconceived item being the reference. Conclusions Among opiate addicts in China prescribed methadone maintenance therapy for the first time, misconceptions about this medication are prevalent and are associated with poor adherence to the medication regimen and a high a rate of dropout from the treatment programme.

The methadone maintenance treatment (MMT) program is scaling up in China, but little is known about drug users' cognitions of MMT. To investigate the prevalence and associated factors of MMT-related misconceptions, a totally of 300 newly admitted MMT users were interviewed in three MMT clinics in Guangzhou. Four statements were used to assess MMT-related misconceptions. The results showed that the majority of participants misconceived that MMT is intended primarily for detoxification (92.3%), that one could be completely detoxified and quit using methadone after using it for 2-3months (64.2%), that MMT is not a long-term or even lifetime treatment (77.9%); and that one should attempt to reduce its treatment dosage as methadone is harmful to one's health (84.3%); 48.5% of the respondents possessed all four types of misconceptions. Prior experience of methadone use in voluntary drug detoxification centers (OR=1.82 to 2.55, p

Although methadone maintenance treatment (MMT) is an important means of HIV control, MMT clinics commonly have high attrition rates. The randomized controlled trial investigated the relative efficacy of adding a psycho-social intervention to the standard-of-care MMT in reducing attrition and non-attendance among first-time newly admitted MMT users in China (n = 288). Social workers implemented this three-phase intervention that was based on a behavioral maintenance theory. It also involved participants' family members and rectified some MMT-related misconceptions. As compared to the control group, the intervention group showed significantly lower likelihood of attrition (HR = 0.55, 95% confidence interval 0.39-0.80), lower estimated probability of attrition at Month 12 (0.35 vs. 0.55), and higher median number of days of attendance (Month 6: 147 vs. 91 days, p < 0.001; end-date: 225 vs. 142 days, p < 0.001). Further psycho-social services and translational research are warranted.

To investigate the incidence of dropout and the prevalence of poor adherence among newly admitted first-time clients of methadone maintenance treatment (MMT) clinics, and the associations between MMT-related misconceptions and these two treatment outcomes.A cohort study (maximum follow-up period = 17.6 months) was conducted.Three of the nine MMT clinics in Guangzhou, China participated in the study.The sample included 158 newly admitted first-time MMT clients.Information collected included background characteristics, history of drug use, MMT-related misconceptions, dropout during the entire study period and poor adherence within the first 6 months since admission to MMT.Of all newly admitted MMT clients, 98.2% possessed at least one and 50.6% possessed all four types of MMT-related misconception; 51.3% had dropped out before the completion of the study [95% confidence interval (CI): 43.5-59.1%] and 62% exhibited poor adherence within the first 6 months since admission (95% CI: 54.2-69.6%). Adjusting for significant background variables, the number of misconceived responses predicted significantly both dropout [hazard ratio (HR) = 3.80 for two to three misconceived items, HR = 7.13 for four misconceived items, with zero to one misconceived item being the reference] and poor adherence within the first 6 months [relative risk (RR) = 4.13 for two to three misconceived items; RR = 4.40 for four misconceived items, with zero to one misconceived item being the reference.Among opiate addicts in China prescribed methadone maintenance therapy for the first time, misconceptions about this medication are prevalent and are associated with poor adherence to the medication regimen and a high a rate of dropout from the treatment programme.

A respondent-driven sampling survey was conducted to investigate HIV related serological and behavioral characteristics of men who have sex with men (MSM) in Guangzhou, China, and to identify associated factors potentially driving the epidemic. Respondent-Driven Sampling Analysis Tool and SPSS were used to generate adjusted estimates and to explore associated factors. Three hundred seventy-nine eligible participants were recruited. The adjusted prevalence of HIV and current syphilis infection are 5.2% and 17.5% respectively. 60.3% have unprotected anal sex in the past 6 months. Unprotected anal sex, having receptive anal sex and current syphilis infection are significant factors associated with HIV infection. The potential for a rapid rise of HIV and syphilis infections among MSM in Guangzhou exists. Targeted interventions with voluntary counseling and testing (VCT) and sexually transmitted infection (STI) services are needed to address the epidemic, with a focus on such subgroups as those of with current syphilis, and non-official Guangzhou residence status.

OBJECTIVE: To explore the feasibility of offering HIV counseling and testing in community health centers (CHCs) and to provide evidence for the HIV/AIDS response in China. METHODS: Forty-two CHCs were selected from the eight cities that participated in the study. Rapid testing was mainly provided to: clients seeking HIV testing and counseling (HTC); outpatients with high-risk behavior of contracting HIV; inpatients and outpatients of key departments. Aggregate administrative data were collected in CHCs and general hospitals and differences between the two categories were compared. RESULTS: There were 23,609 patients who underwent HIV testing, accounting for 0.37% of all estimated clinic visits at the 42 sites (0.03%-4.35% by site). Overall, positive screening prevalence was 0.41% (95% confidence interval [CI] 0.33%-0.49%, range 0.00%-0.98%), which is higher than in general hospitals (0.17%). The identification efficiency was 0.22% (95% CI: 0.16%-0.27%) in pilot CHCs, 3.5 times higher than in general hospitals (0.06%) (Chi square test = 95.196, p

Background We conducted molecular analyses to confirm four clustering HIV-1 infections (Patient A, B, C & D) in Guangzhou, China. These cases were identified by epidemiological investigation and suspected to acquire the infection through a common heterosexual transmission chain. Methods Env C2V3V4 region, gag p17/p24 junction and partial pol gene of HIV-1 genome from serum specimens of these infected cases were amplified by reverse transcription polymerase chain reaction (RT-PCR) and nucleotide sequenced. Results Phylogenetic analyses indicated that their viral nucleotide sequences were significantly clustered together (bootstrap value is 99%, 98% and 100% in env, gag and pol tree respectively). Evolutionary distance analysis indicated that their genetic diversities of env, gag and pol genes were significantly lower than non-clustered controls, as measured by unpaired t-test (env gene comparison: p < 0.005; gag gene comparison: p < 0.005; pol gene comparison: p < 0.005). Conclusion Epidemiological results and molecular analyses consistently illustrated these four cases represented a transmission chain which dispersed in the locality through heterosexual contact involving commercial sex worker.

Background China experiencing an increasing HIV epidemic among men who have sex with men (MSM), and unprotected anal intercourse (UAI) has played a key role in this process. The aims of this study were to examine the trend of UAI and to explore the factors correlated with UAI among MSM in Guangzhou, China. Methods Data from 2008 to 2013 were retrieved from the annual serological and behavioral surveys system. We collected information on demographic, HIV related sexual behavior with men and women, access to HIV prevention services, and symptoms of sexually transmitted infections. Chi-square test was used to examine the similarity of the participants during the study period. Univariate and multivariate logistic regression were conducted to test the factors associated with UAI. Trend test was used to check the change of UAI in different characteristic stratums during the study period. Results In total, 58.4% (range from 54.5% to 62.0%) of the participants reported that they engaged in UAI in the past six months. Participants who aged less than 20 [Adjusted Odds Ratio (AOR): 2.22, 95% Confidential Interval (CI): 1.07-4.61], only attended elementary school (or less) (AOR: 1.41, 95% CI: 1.04-1.90), cohabiting with male partner (AOR: 2.15, 95% CI: 1.66-2.79), divorced or widowed (AOR: 2.80, 95% CI: 1.54-5.07), did not test for HIV in the past year (AOR: 1.36, 95% CI: 1.12-1.65), and had 10 or more partners in the past six months (AOR: 1.85, 95% CI: 1.18-2.91) had higher odds of UAI. However, the proportions of UAI were stable in different stratums during the study period. Conclusions The proportion of MSM engaged in UAI was consistently high during the study period. Effective intervention strategies, which include but not limit to risk reduction counseling and testing services, are urgently needed to bring down the risk behaviors of the MSM in Guangzhou, in order to control HIV/STIs epidemic in this specific population.