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Publications (253)
What is already known about this topic?
HIV transmission among serodiscordant couples remains a persistent issue in China. However, the practice of combining counseling with antiretroviral therapies (ART) to enhance ART adherence is not widely implemented or recommended in Chinese health guidelines.
What is added by this report?
This randomized co...
Background:
Men who have sex with men (MSM) in China hold a low-risk perception of acquiring HIV. This has resulted in an inadequate HIV testing rate.
Objective:
This study aims to investigate whether administering HIV risk self-assessments with tailored feedback on a gay geosocial networking (GSN) app could improve HIV testing rates and reduce...
Background:
As persons with HIV (PWH) live longer they may experience a heightened burden of poor health. However, few studies have characterized the multi-dimentional health of PWH. Thus, we aimed to identify the extent and pattern of health disparities, both within HIV infection status and across age (or sex) specific groups.
Methods:
We used...
BACKGROUND
Men who have sex with men (MSM) in China hold a low-risk perception of acquiring HIV. This has resulted in an inadequate HIV testing rate.
OBJECTIVE
This study aims to investigate whether administering HIV risk self-assessments with tailored feedback on a gay geosocial networking (GSN) app could improve HIV testing rates and reduce sexu...
Objectives
To investigate the association of low‐level viremia (LLV) with mortality among people living with HIV (PLHIV) on antiretroviral therapy (ART) in Dehong, Southwest China.
Methods
We analysed data collected from a cohort of PLHIV on ART in Dehong. PLHIV were enrolled in this cohort after they started ART, with viral load (VL) tested once...
Objectives
High HIV-related mortality is mainly associated with severe immunosuppression (CD4 count < 50 cells/μL) in people living with HIV (PLWH). This study intended to explore the trends in epidemic and early mortality among PLWH with severe immunosuppression for further targeted intervention.
Methods
We extracted the data of treatment-naïve P...
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Aim
High turnover rates among service providers have burdened addiction treatment clinics and affected patient care and treatment outcome. In this study, we identified factors associated with providers’ turnover intention in Chinese methadone maintenance treatment (MMT) clinics.
Subjects and methods
This study used the baseline data from a randomi...
The coronavirus disease 2019 (COVID-19) can be caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and has led to millions of deaths among more than 100 million infected people around the world according to the declaration from World Health Organization. Dysregulated immune response of both the innate and adaptive immu...
Background:
Knowledge of COVID-19 epidemiology remains incomplete and crucial questions persist. We aimed to examine risk factors for COVID-19 death.
Methods:
A total of 80 543 COVID-19 cases reported in China, nationwide, through April 8, 2020 were included. Risk factors for death were investigated by Cox proportional hazards regression and str...
Introduction
In British Columbia (BC), the HIV epidemic continues to disproportionally affect the gay, bisexual and other men who have sex with men (MSM). In this study, we aimed to evaluate how Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP), if used in combination, could lead to HIV elimination in BC among MSM.
Methods
Conside...
This population epidemiology study characterizes trends in the prevalence of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among international entrants testing positive for SARS-CoV-2 at Chinese border checkpoints between mid-April and mid-October 2020.
Objectives
The tear, as an important bodily secretion, plays a crucial role in preventing infection and maintaining homeostasis of ocular surfaces. Although accumulating studies have reported on the HIV-1 viral load profile among varying bodily fluids and secretions, little was known concerning HIV-1 dynamics in tears. Therefore, the objectives of...
In the era of “treat all”, using normalization of CD4 counts as the main evaluation parameter of complete immune restoration for HIV-1 patients under antiretroviral therapy (ART) might not enough. A comprehensive evaluation system more accurately reflecting immune restoration are urgently needed. We established a retrospective cohort of 91,805 HIV-...
Background:
The goal of this study was to describe the expenses related to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) management and care in Nantong Infectious Disease Hospital from October 2013 through June 2017.
Methods:
The information of 610 HIV/AIDS inpatients were collected from the Electronic Medical...
Nearly 17 years ago China launched its National HIV/AIDS Response Program, yet the epidemic still is not slowing. New cases and new deaths increase every year-in 2005, 40,711 people living with HIV (PLWH) were diagnosed and 5,729 died whereas in 2019, 148,598 PLWH were diagnosed and 31,522 died . Moreover, the estimated PLWH population in China has...
The epidemic of novel coronavirus diseases was first reported in China in late December 2019 and has been brought under control after some two months in China. However, it has become a global pandemic and the number of cases and deaths continues to increase outside of China. We describe the emergence of the pandemic, detail the first 100 days of Ch...
HIV testing is an important HIV control strategy—an opportunity to know one’s status and the first step for diagnosed individuals to link to care and enter treatment. Here, we describe HIV testing before and after antiretroviral therapy (ART) became available in China. We focus particularly on China’s innovations in promoting HIV testing, including...
Homosexuality has been documented throughout Chinese history with varying levels of societal tolerance—popular and thriving during the Ming and Qing dynasties to strictly prohibited and strongly stigmatized during the Mao era. With the dramatic social changes that have come to China as a result of its Opening Up and Reform Policy of the late 1970s,...
Co-infections common among people living with HIV (PLWH) in China include hepatitis B virus (HBV), hepatitis C virus (HCV), and Mycobacterium tuberculosis, the bacterium that causes tuberculosis (TB). On their own, each of these infectious diseases, HIV, HBV, HCV, and TB, are major contributors to the global burden of disease. In combination, they...
Heterosexual transmission now accounts for over two-thirds of all newly diagnosed HIV cases in China, making it the dominant transmission route. The significant societal changes, brought about by the opening of China’s boarders and the dramatic economic reform in the late 1970s and early 1980s, have increased personal wealth disparities, created la...
With HIV becoming the leading cause of infectious-disease mortality in Mainland China, this book focuses on tackling HIV/AIDS in the face of rapid political and economic change in China. Featuring contributions by over a dozen leading figures in the field, this book is the go-to text for any student or reader interested in how national and internat...
Purpose of Review
This study aims to review the history of the human immunodeficiency virus (HIV) infection epidemic in China.
Recent Findings
The HIV infection epidemic in China has evolved significantly over the past 35 years, from initially exclusively within people who inject drugs (PWID), to outbreaks due to plasma collection contamination in...
Promoting biosafety regulations and techniques supports human health and protects individuals and groups from harmful incidents. Particular attention should be paid to those potential infectious hazards associated with blood and other bodily fluids, especially those highly transmitted infectious diseases, such as human immunodeficiency virus (HIV),...
China has made remarkable achievements in advancing its HIV/AIDS prevention and treatment programs. Infrastructure for surveillance, laboratory testing, voluntary counseling and testing, outreach, intervention, and harm reduction for key populations, and antiretroviral therapy (ART) services for people diagnosed with HIV have been well developed. M...
China’s approach to HIV case management has evolved from little to none before the “Four Frees and One Care” policy was issued in 2004 to a complex two-stage system whereby people with diagnosed HIV infection were managed differently depending on whether they were or were not eligible for antiretroviral therapy (ART). Those in the pre-ART period we...
Drug use reemerged in China after the 1978 introduction of sweeping economic change initiated by the “Opening Up and Reform” policy, and the high-risk behavior of drug users was the major driver of China’s early HIV epidemic. To combat both the growing drug use and HIV epidemics, China’s National Methadone Maintenance Treatment (MMT) Program was pi...
Gay dating applications (apps) are popular among men who have sex with men (MSM) in China. This study examined the relationship between gay dating app use frequency and condomless anal intercourse (CAI) in a sample of MSM in Beijing. In October 2017, a web-based, cross-sectional survey was conducted among MSM from Beijing, China. Demographics, freq...
Background Human immunodeficiency virus (HIV) continues to be a global public issue and identifying viral reservoirs is needed in order to better understand the transmission of the disease. We aimed to identify the level of HIV viral load in tears of people living with HIV (PLWH) and study factors influencing their tear viral load.Methods This was...
Background:
In China, clients of female sex workers (CFSWs) have a low rate of condom use and a high prevalence of human immunodeficiency virus (HIV). However, little is known about the high-risk sexual behaviors of HIV-positive CFSWs.
Methods:
In 2014, 327 CFSWs diagnosed with HIV for 6 months or longer completed a face-to-face questionnaire fo...
Background The human immunodeficiency virus (HIV) epidemic has been drastically increasing among men who have sex with men (MSM) in China over the past decade. More so, the number of HIV infections among young adults in the country has also been on the rise, highlighting a unique sub-population, which may lead to increased incidence and transmissio...
Background
Although increasingly studied in high-income countries, there is a paucity of data from the Chinese population on the patterns of cancer among people living with HIV (PLHIV).
Methods
We conducted a nationwide follow-up study using routinely collected data for adult PLHIV diagnosed on or before 31 December 2011 and alive and in care as o...
A human immunodeficiency virus (HIV) risk assessment tool was previously developed for predicting HIV infection among men who have sex with men (MSM), but was not externally validated. We evaluated the tool's validity for predicting HIV infection in an independent cohort.
The tool was assessed using data from a retrospective cohort study of HIV-neg...
Background:
Low-fee female sex workers (FSW) lack power to effectively negotiate male condom use with clients. Female condoms (FCs) may provide an alternative strategy. This study was conducted to assess the acceptability of FC use among low-fee FSWs, and to identify appropriate candidates for future FC promotion.
Methods:
A one-month follow-up...
Background
Why some persons living with human immunodeficiency virus (HIV) (PLWH) progress quickly and others remain “healthy” for a decade or more without treatment remains a fundamental question of HIV pathology. We aimed to assess the epidemiological characteristics of HIV long-term nonprogressors (LTNPs) based on a cohort of PLWH in China obser...
Objective:
Service providers' job satisfaction is critical to the stability of the work force and thereby the effectiveness of methadone maintenance treatment (MMT) programs. This study aimed to explore MMT clinic service providers' job satisfaction and associated factors in Jiangsu, China.
Methods:
This secondary study used baseline data of a r...
The benefits of "early" antiretroviral therapy (ART; ie, initiation when CD4 ≥500 cells/mm3) are now well accepted as reflected in the removal of the CD4-based eligibility from new ART guidelines by the World Health Organization (WHO). However, neither the "treat-all" strategy recommendations presented in the guidelines nor the HIV care cascade goa...
Background:
Service providers including doctors, nurses, and other healthcare professionals play an essential role in methadone maintenance treatment (MMT). This study evaluated the impact of an intervention targeting MMT providers on their clients' treatment retention.
Methods:
This study was conducted in 68 MMT clinics in five provinces of Chi...
Objectives
One-third of people living with HIV in China are still unaware of their status, so we sought to better understand HIV testing in the general hospital setting in China.
Methods
A cross-sectional study was conducted using the electronic medical records of all patients who attended Xuanwu Hospital in Beijing, January 1, 2011 to December 31...
STROBE_checklist_v4_combined_PlosMedicine.
(DOCX)
Background
In China, antiretroviral therapy (ART) clinics focus on treating people living with HIV and are not required to undertake testing of high-risk populations. To improve partner testing among MSM, we implemented a health communication pilot intervention integrating partner testing with ART services. We aimed to assess the feasibility of the...
Introduction
Increasing evidence suggests an association between synthetic drug use and HIV infection among men who have sex with men (MSM). The aim of this study was to evaluate synthetic drug use prevalence, describe characteristics of synthetic drug users, and investigate whether synthetic drug use is associated with HIV infection among Chinese...
Background:
People living with HIV (PLWH) are still being diagnosed late, rendering the benefits of "early" antiretroviral therapy (ART; based on CD4 count) unattainable. Therefore, we aimed to evaluate the benefits of "immediate" ART (based on the time interval between diagnosis and treatment, regardless of CD4 count).
Methods:
A nationwide coh...
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Background:
Human immunodeficiency virus (HIV) care continuum attrition is a major global public health challenge. Few studies have examined this problem in resource-limited settings. We aimed to assess cumulative, current, and historical achievement along China's HIV continuum of care.
Methods:
A nationwide, serial cross-sectional study of all...
Background:
Clinical trials have demonstrated that immediate initiation of antiretroviral therapy (ART) reduces AIDS-related morbidity and mortality. We tested the hypothesis that initiating ART ≤30 days after HIV diagnosis would be associated with reduced mortality among people living with HIV (PLWH) with CD4 counts >500 cells/mm3.
Methods:
PLW...
Objective:
This study aims to examine the role that nitrite inhalants play in HIV infection and risky sex behaviors among Chinese men who have sex with men (MSM).
Methods:
The study consisted of a baseline and a follow-up survey conducted in Beijing and Nanning, China. The baseline study recruited participants through online advertisements and p...
Background:
Multistage, stepwise HIV testing and treatment procedures can result in lost opportunities to provide timely antiretroviral therapy (ART). Incomplete engagement of patients along the care cascade translates into high preventable mortality. We aimed to identify whether a structural intervention to streamline testing and linkage to HIV h...
Background
The high rate of attrition along the care cascade of infection with human immunodeficiency virus (HIV) results in lost opportunities to provide timely antiretroviral therapy (ART) and to prevent unnecessarily high mortality. This study aims to assess the effectiveness of a structural intervention, the one-stop (“One4All”) strategy that s...
We used nationally reported cases (NCAIDS/China CDC, 2016) and published literature to summarize up-to the end of 2015 epidemiologic trends in the HIV/AIDS epidemic in China. HIV-positive cases are distributed unevenly with most infections found in southwest China and the most affected population being men who have sex with men. Transmission mode o...
Background:
The validity and concordance of two main measures of drug use behavior, self-report and urinalysis, has long been discussed. More understanding is needed about the underlying factors associated with discordance between these two methods.
Objectives:
Describe the pattern and associated factors of discordance between self-reported hero...
Background:
This study examined clients' treatment satisfaction with the services provided by methadone maintenance treatment (MMT) in China and explored relevant factors that are directly or indirectly associated with treatment satisfaction.
Methods:
The study used baseline data from a randomized controlled trial conducted among 2,448 clients f...
To explore models to improve HIV testing, linkage to care and treatment among men who have sex with men (MSM) in cooperation with community-based organizations (CBOs) in China.We introduced a new model for HIV testing services targeting MSM in six cities in 2013.These models introduced provision of rapid HIV testing by CBO staff and streamlined pro...
We examined the effect of combination antiretroviral therapy (cART) on liver fibrosis among HIV-infected patients with or without Hepatitis B (HBV) or C virus (HCV) co-infection. This was a retrospective cohort study of HIV-infected patients receiving cART during 2004–2016. Liver fibrosis was assessed using Fibrosis-4 (FIB-4) score with 3 classific...
Logistic regression analysis of initiating ART for newly identified HIV positives who were referred to ART hospitals on service delivery models (n = 2052)
(DOCX)
Logistic regression analysis of receiving CD4 test for newly identified HIV positives on service delivery models (n = 2706)
(DOCX)
Logistic regression analysis of referring newly identified HIV-positives to ART hospitals on service delivery models (n = 2706)
(DOCX)
Sample characteristics of MSM screened in 2013
(DOCX)
Logistic regression analysis of receiving WB test on service delivery models (n = 3089)
(DOCX)
Background:
In Guangxi Zhuang Autonomous Region, China, an estimated 80% of newly-identified antiretroviral therapy (ART)-eligible patients are not engaged in ART. Delayed ART uptake ultimately translates into high rates of HIV morbidity, mortality, and transmission. To enhance HIV testing receipt and subsequent treatment uptake in Guangxi, the Ch...
Objective:
HIV-infected people who inject drugs (PWID) have a disproportionally low rate of access to antiretroviral therapy (ART). We aimed to assess the impact of ART on 12-month mortality and virological failure of HIV-infected PWID in China, stratified by methadone maintenance treatment (MMT) and active drug use status.
Methods:
HIV-infected...
Background:
Patients who are newly screened HIV positive by EIA are lost to follow-up due to complicated HIV testing procedures. Because this is the first step in care, it affects the entire continuum of care. This is a particular concern in rural China.
Objective(s):
To assess the routine HIV testing completeness and treatment initiation rates...
Background
Antiretroviral therapy (ART) and condom use have been proven to reduce the risk of sexual transmission of human immunodeficiency virus (HIV) among HIV sero-different couples, but its full implementation remains a challenge. This study aims to assess HIV seroconversion rate of HIV-negative spouse and its associated risk factors among HIV...
Provider–client interaction is an integral of clinical practice and central to the delivery of high-quality medical care. This article examines factors related to the provider–client interaction in the context of methadone maintenance treatment (MMT). Data were collected from 68 MMT clinics in China. In total, 418 service providers participated in...
Objective:
We sought to explore the experiences of drug users in China who were recently diagnosed with HIV infection while engaged in methadone maintenance treatment (MMT) and to better understand their perceptions of MMT, HIV risk, and HIV prevention.
Methods:
We recruited clients of MMT clinics in Chongqing and Kunming who had a baseline HIV-...
Background:
Men who have sex with men (MSM) are highly vulnerable to human immunodeficiency virus (HIV) infection and more likely to migrate due to widespread stigma and discrimination in China. Their mobility complicates estimation of local MSM population sizes and the provision of HIV services, and may also contribute to the spread of HIV.
Meth...
Little is known about the acceptance and actual uptake of pre-exposure prophylaxis (PrEP) and associated factors in men who have sex with men (MSM) in China. This study is the baseline survey of an intervention study designed to evaluate the effectiveness of tenofovirdisoproxil fumarate (TDF) on a daily use for human immunodeficiency virus (HIV) pr...
Introduction
HIV incidence is an important measure for monitoring the development of the epidemic, but it is difficult to ascertain. We combined serial HIV prevalence and mortality data to estimate HIV incidence among key affected populations (KAPs) in China.
Methods
Serial cross-sectional surveys were conducted among KAPs from 2010 to 2014. Trend...
Background
Hepatitis C virus (HCV) is the most common viral infection among injecting drug users worldwide. We aimed to assess HCV antibody prevalence and associated risk factors among clients in the Chinese national methadone maintenance treatment (MMT) program.
Methods
Data from 296,209 clients who enrolled in the national MMT program between Ma...