Awareness of HIV/AIDS and its routes of transmission as well as access to health knowledge among rural residents in Western China: a cross-sectional study

Knowledge About HIV/AIDS and its Transmission and Misconception Among Women in Thailand: A Structural Equation Modelling Approach

PurposeAsian and pacific region countries are considered to be high risk countries for Human Immunodeficiency Viruses (HIV). There is little literature quantifying the relationship between education of HIV/AIDS and its principal socioeconomic determinants through a spatial analysis. The purpose of this study was to assess the knowledge and awareness about HIV among the women in Thailand, and its direct and indirect association with sociodemographic factors including sexual education, level of education, area of living and wealth index through a structural equation modelling approach.DesignCross-sectional analysis using data from the 2022 UNICEF Multiple Indicator Cluster Survey (MICS).SettingThailand.SubjectsA total of 3671 women from the 2022 MICS dataset.MeasuresKey variables included knowledge and misconceptions about HIV, sexual education, education level, area of residence, marital status, and wealth index.AnalysisStructural equation modeling was used to assess direct and indirect effects of sociodemographic factors on HIV-related knowledge and misconceptions.ResultsThe direct effect of sexual education on knowledge, transmission and misconception about HIV/AIDS is significant (β = 0.051, P = .002). The mediation effect test found that the sexual education and education indirectly affected knowledge, transmission and misconceptions about HIV/AIDS through the mediation effect of women's marital status (β = -0.068, P = .018) and wealth index (β = 0.007, P = <.001).ConclusionSexual education alone is insufficient to improve health literacy on HIV/AIDS, as other mediating factors such as education level, wealth index, marital status and area of residence are also key drivers. To achieve Sustainable Development Goal (SDG) 3 by 2030, it is essential to enhance HIV/AIDS related health education for women through multifaceted intervention programs that address these mediating factors.

Transmission Network and Phylogenetic Analysis Highlight the Role of Suburban Population in HIV-1 Transmission Among Older Adults in Nanjing, Jiangsu Province, China

Describing the transmission characteristics among older adults is essential for designing tailored interventions. An epidemiological investigation combined with phylogenetic analysis was conducted to reveal potential transmission linkages among older adults in Nanjing. Between 2018 and 2022, 188 pol sequences were successfully amplified. Multiple genotypes were identified, including CRF07_BC (55.3%), CRF01_AE (30.3%), CRF08_BC (8.0%), B (3.2%), CRF55_01B (1.1%), CRF67_01B (0.5%), CRF68_01B (0.5%), and unique recombinant forms (URF) (1.1%). Transmission network analysis identified 120 genetically linked patients forming 23 clusters, ranging from 2 to 26 individuals. Multivariable logistic regression analysis showed that compared with farmers and heterosexuals, patients with other occupations (OR = 0.404, 95% CI: 0.173-0.945) and MSM (OR = 0.193, 95% CI: 0.050-0.738) were less likely to have high linkage. Subjects who lived in suburban areas were more likely to have high linkage (OR = 10.932, 95% CI: 3.335-35.830). The Sankey diagram suggested that patients living in suburban areas primarily transmitted the disease within the local district (χ2 = 24.192, p < 0.001). Among the 188 pol sequences, the prevalence of pretreatment drug resistance was 8%. In suburban areas with a rising HIV-1 epidemic, improving early detection and timely treatment is critical. More tailored interventions for this subgroup are urgently needed.

The prevalence of hepatitis B virus infection among HIV-infected patients in the Ningxia Hui Autonomous Region, China, November 2002 to July 2023

We tested HIV-infected people with HBV serological markers of Ningxia. Of 1008 HIV-positive individuals, 70 (6.9 %) tested positive for HBsAg, 570 (56.5 %) tested positive for anti-HBs, and 483 (47.9 %) tested positive for anti-HBc. Of 70 HBV-positive individuals, 13 (18.5 %) tested positive for HBeAg, 31 (44.3 %) tested positive for anti-HBe, 3 (4.2 %) exhibited acute infection.

On characterizing gender and locational composition of adult PLHIV in Nigeria: Implications for HIV programming

Human Immunodeficiency Virus (HIV) remains a global public health menace, and studies have suggested variations across demographic characteristics. This study attempted to characterize the gender and locational variations in the spread and control of HIV among adult Persons Living with HIV (PLHIV) to identify the clustering of PLHIV in Nigeria. We conducted an ecological analysis of data from the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) report. To examine the statistical significance of differences between groups (by gender and location), chi-square and Fisher exact tests were conducted using the Real Statistics Resource Pack in Excel, and ArcGIS for visualization. Significance level was set at 5%. Overall, prevalence of HIV among adult PLHIV was 1.4%-the prevalence was slightly higher among women (1.8%) compared to men (1.0%). About 3/10 (29.3%) self-reported having received HIV test results. In the past 12 months before the survey, only 10.0% self-reported HIV testing among the population, with a significant difference (p<0.001) observed in the urban and rural area (12.4% in urban compared to 8.2% in rural). Another significant finding was the difference in the timing of HIV diagnosis between urban and rural areas (p<0.001). Adult PLHIV residing in rural areas had a higher rate of early detection (94.1%) compared to those in urban areas (70.3%). About 40.0% of HIV positive mothers reported awareness of their HIV status-approximately 58.0% of mothers living in the urban were aware of their HIV status compared to 29.8% in the rural area. The concentration of HIV was disproportionately higher in the rural populations compared to the urban. Findings from this study also show gender-disparities in HIV prevalence, diagnosis, and treatment. Interventions to bridge this gap should be promptly embraced in order to effectively combat the HIV epidemic in Nigeria and achieve an AIDS-free generation.

Spatial variation and predictors of composite index of HIV/AIDS knowledge, attitude and behaviours among Ethiopian women: A spatial and multilevel analyses of the 2016 Demographic Health Survey

BACKGROUND

Although the dissemination of health information is one of the pillars of HIV prevention efforts in Ethiopia, a large segment of women in the country still lack adequate HIV/AIDS knowledge, attitude, and behaviours. Despite many studies being conducted in Ethiopia, they mostly focus on the level of women's knowledge about HIV/AIDS, failing to examine composite index of knowledge, attitude, and behaviour (KAB) domains comprehensively. In addition, the previous studies overlooked individual and community-level, and spatial predictors. Hence, this study aimed to estimate the prevalence, geographical variation (Hotspots), spatial predictors, and multilevel correlates of inadequate HIV/AIDS-Knowledge, Attitude, and Behaviour (HIV/AIDS-KAB) among Ethiopian women.

METHODS

The study conducted using the 2016 Ethiopian Demographic and Health Survey data, included 12,672 women of reproductive age group (15-49 years). A stratified, two-stage cluster sampling technique was used; a random selection of enumeration areas (clusters) followed by selecting households per cluster. Composite index of HIV/AIDS-KAB was assessed using 11 items encompassing HIV/AIDS prevention, transmission, and misconceptions. Spatial analysis was carried out using Arc-GIS version 10.7 and SaTScan version 9.6 statistical software. Spatial autocorrelation (Moran's I) was used to determine the non-randomness of the spatial variation in inadequate knowledge about HIV/AIDS. Multilevel multivariable logistic regression was performed, with the measure of association reported using adjusted odds ratio (AOR) with its corresponding 95% CI.

RESULTS

The prevalence of inadequate HIV/AIDS-KAB among Ethiopian women was 48.9% (95% CI: 48.1, 49.8), with significant spatial variations across regions (global Moran's I = 0.64, p<0.001). Ten most likely significant SaTScan clusters were identified with a high proportion of women with inadequate KAB. Somali and most parts of Afar regions were identified as hot spots for women with inadequate HIV/AIDS-KAB. Higher odds of inadequate HIV/AIDS-KAB was observed among women living in the poorest wealth quintile (AOR = 1.63; 95% CI: 1.21, 2.18), rural residents (AOR = 1.62; 95% CI: 1.18, 2.22), having no formal education (AOR = 2.66; 95% CI: 2.04, 3.48), non-autonomous (AOR = 1.71; 95% CI: (1.43, 2.28), never listen to radio (AOR = 1.56; 95% CI: (1.02, 2.39), never watched television (AOR = 1.50; 95% CI: 1.17, 1.92), not having a mobile phone (AOR = 1.45; 95% CI: 1.27, 1.88), and not visiting health facilities (AOR = 1.46; 95% CI: 1.28, 1.72).

CONCLUSION

The level of inadequate HIV/AIDS-KAB in Ethiopia was high, with significant spatial variation across regions, and Somali, and Afar regions contributed much to this high prevalence. Thus, the government should work on integrating HIV/AIDS education and prevention efforts with existing reproductive health services, regular monitoring and evaluation, and collaboration and partnership to tackle this gap. Stakeholders in the health sector should strengthen their efforts to provide tailored health education, and information campaigns with an emphasis on women who lack formal education, live in rural areas, and poorest wealth quintile should be key measures to enhancing knowledge. enhanced effort is needed to increase women's autonomy to empower women to access HIV/AIDS information. The media agencies could prioritise the dissemination of culturally sensitive HIV/AIDS information to women of reproductive age. The identified hot spots with relatively poor knowledge of HIV/AIDS should be targeted during resource allocation and interventions.

Homosexual identity and network overlap predictors of HIV infection among older men from rural China: a case-control study

Background

The number of newly reported older (≥50 years old) people living with HIV/AIDS in China has been steadily increasing, and heterosexual transmission has been identified as the major route.

Methods

In this study, based on biopsychosocial model, a case-control study (74 cases vs 296 controls) was applied to find out predictors (21 potential ones) of HIV infection among older men from rural China. Binary logistic regression with backward selection was applied.

Results

Out of 21 potential predictors of HIV infection, 4 were confirmed: receiving HIV-related health education (HRHE) (OR 0.449, 95% CI 0.238 to 0.848), self-reported homosexual identity (16.517 (95% CI 1.073 to 254.182)), visiting female sex workers (FSW) (58.427 (95% CI 7.895 to 432.403)), complete non-overlap of intimate social network and sexual network (2.912 (95% CI 1.372 to 6.177)), partial overlap (3.334 (95% CI 1.536 to 7.236)).

Discussion

Findings from this study suggest current comprehensive prevention and control services need to be strengthened to provide effective HRHE including condom use to older men and help them to improve condom use, especially during visiting FSW and among self-reported homosexual older men. Moreover, increasing intimacy in their sexual relationships is necessary.

The knowledge mapping of HIV/AIDS in Indonesians living on six major islands using the Indonesian version of the HIV-KQ-18 instrument

Indonesia's total number of HIV/AIDS cases is still high. Inadequate knowledge about the risk of HIV infection will influence HIV prevention and therapy. This study aimed to map the level of HIV-related knowledge among Indonesians living on six major islands in Indonesia and investigate the relationship between socio-demographic characteristics and HIV/AIDS knowledge. This cross-sectional study used the Bahasa Indonesia version of the HIV Knowledge Questionnaire-18 items (HIV-KQ-18) Instrument. Data collection was done online through the Google form application. A total of 5,364 participants were recruited. The participants from Java had the highest degree of HIV/AIDS knowledge, which was 12.5% higher than participants from Sumatra, Kalimantan, Sulawesi, Papua, and Maluku. Linear regression showed that region, educational level, monthly expenditure, occupation, background in health sciences, and workshop attendance were significantly correlated with HIV knowledge. Participants typically understand that "HIV/AIDS transmission" only happens when sex partners are changed. Additionally, the government still needs improvement in HIV/AIDS education, particularly in the HIV incubation period, HIV transmission from pregnant women to the fetus, and condom use as one method of protection. There are disparities in HIV/AIDS knowledge levels among the major islands of Indonesia. Based on these findings, the government's health promotion program to increase public awareness of HIV/AIDS must be implemented vigorously. Additionally, in line with our research findings, it is essential to broaden the scope of HIV/AIDS education and promotion materials.

Experiences of visiting female sex workers, social interaction, support and HIV infection among elderly men from rural China

OBJECTIVES

To make clear the roles of social interaction and social support in HIV infection among elderly men who visit female sex workers (FSW).

METHODS

We conducted a case-control study: 106 newly HIV (+) vs. 87 HIV (-) elderly men who visited FSW with similar age, education levels, marital statuses, monthly expenses for entertainment and migration experiences. Experiences of visiting FSW, social interaction, and intimate social support were obtained. Backward binary logistic regression was applied.

RESULTS

Cases' first visit to FSW happened at the age of 44.01 ± 12.25, older than controls (33.90 ± 13.43). 23.58% cases had gotten HIV-related health education (HRHE) before, less than controls (57.47%). More cases (48.91%) "always" got material support than controls (34.25%). Less cases gave "close" (38.04%) comments toward daily life, "satisfied" (34.78%) with their sexual life, "agree" being emotional fulfilled (46.74%) than controls (71.23% ,64.38%, and 61.64%). Risky factors for HIV infection among elderly men were having 3000 YUAN and above monthly income, visiting teahouse with friends, living without spouses, visiting different FSW, visiting FSW for other reason, receiving material support from most intimate sexual partner, older age of first visit to FSW. The protective factors were receiving HRHE, visiting FSW due to loneliness, and giving positive comments toward daily life with most intimate sexual partner.

CONCLUSIONS

Elderly men's social interactions are mainly visiting teahouse which is a potential sexual venue. Getting HRHE is formal protective social interactions but very rare for cases (23.58%). Social support from sexual partner is not enough. Emotional support is protective meanwhile material support only is risky for becoming HIV-positive.

Knowledge About HIV/AIDS and Its Transmission and Misconception Among Women in Bangladesh

BACKGROUND

Asian and pacific region countries are high risk countries for human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS). Although the prevalence of HIV/AIDS is low in Bangladesh but women in Bangladesh have been identified as susceptible due to associated socioeconomic exposures. There are various misconceptions associated with HIV/AIDS transmission among the women in low- and middle-income countries including Bangladesh, which lead to a negative attitude towards the HIV/AIDS-infected. The purpose of this study was to assess the overall knowledge, transmission, and misconception about HIV/AIDS among the women in Bangladesh as well as its spatial distribution across the country.

METHODS

The study used data from the UNICEF (United Nations Children's Fund) Multiple Indicator Cluster Survey (MICS) 2019, with a sample of 64 346 women. This was a cross-sectional, population-based survey of Bangladeshi women aged 15-49 conducted using a multistage, cluster sampling technique. Three binary outcome variables considered were knowledge about HIV/AIDS, knowledge about HIV/AIDS transmission and knowledge on myths and misconceptions on HIV/AIDS along with 10 predictors based on past literature. Bivariable analysis using chi-square tests of association was conducted to examine the unadjusted percentage differences of the outcome variables for each of the predictor variables and their associations. Multiple binary logistic regression models were then fitted to evaluate the association between the outcome variables and the predictors after adjusting for survey cluster, strata, and weights. All analysis was conducted in R software (V 2.5.0).

RESULTS

The percentage of women who held knowledge about HIV/AIDS, knowledge about HIV/AIDS transmission and knowledge on misconceptions about transmission of HIV were on average 60.3%, 52.2% and 71.7% respectively. The models indicated that women regularly exposed to media were 79%, 18% and 19% significantly more likely (odds ratio, OR: [95% CI] = 1.79: [1.70, 1.89]; 1.18: [1.10 1.26] and 1.19: [1.11, 1.27]) to have heard about HIV, aware about HIV transmission, and have less misconceptions about HIV respectively compared to those who were not exposed to media. Overall results indicate that women from peripheral districts living far from metropolitan cities were most unaware of HIV and had higher misconceptions about AIDS.

CONCLUSION

The findings of this study should assist policy-makers and program implementers to focus on raising awareness to educating women about how HIV/AIDS is transmitted. Furthermore, interventions should be made by targeting the most disadvantaged groups, including younger women with low education living in rural areas, from poor households and limited access to information. Also, education on HIV transmission in Bangladesh should integrate cultural and ethnic considerations of HIV/AIDS.

Temporal trends in ocular manifestations of HIV/AIDS patients in the past 18 years in a tertiary hospital in China

PURPOSE

To investigate the ocular manifestation changes in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patents in a tertiary eye clinic in China over the past 18 years.

METHODS

In this retrospective cross-sectional study, 264 HIV/AIDS patients (528 eyes) were recruited at the Department of Ophthalmology, Peking Union Medical College Hospital, from 2001 to 2018. Patients underwent ophthalmic examinations, including best-corrected visual acuity (BCVA), slit-lamp microscopy, and indirect ophthalmoscopy, and completed a registration form including demographic characteristics, medical history, and immune status data. Kruskal-Wallis test or Mann-Whitney test was used to compare continuous variables, and Pearson's chi-squared test or Fisher's exact test was performed to compare categorical variables.

RESULTS

Regarding demographic characteristics, there was a significant increasing trend in male patients, sexual transmission, and HIV/AIDS-syphilis coinfection (all P < 0.001). For systemic features, more patients received cART, and fewer patients had systemic syndromes after 2003 (P < 0.001). For ocular manifestations, there were no significant changes between time intervals in CMVR and HIV retinopathy patients (P = 0.149, P = 0.643), but the proportion of patients with uveitis increased from 1.14% to 19.32% (P < 0.001).

CONCLUSION

CMVR was the most common ocular compilation in HIV/AIDS patients, followed by uveitis and HIV retinopathy. The proportion of patients with CMVR and HIV retinopathy was stable over time, but the proportion of patients with uveitis showed a significant increasing trend. Therefore, immediate ophthalmic examination should be performed at the point of care or as soon as possible after entry into the health care system.

Mean generation function model in AIDS epidemic estimation

Background

Since the first case of HIV infection was reported in China in 1985, the incidence and mortality of AIDS have been increasing rapidly, which has caused serious damage to the life and health of people in China and all over the world. Therefore, it is of great significance to study the technique for predicting AIDS morbidity and mortality. The purpose of this research is to explore the applicability of the mean generation function model (MGFM) in the early warning of AIDS morbidity and mortality, to predict its prevalence trend, to enrich the prediction techniques and methods of AIDS research and to provide suggestions for AIDS transmission control.

Methods

In this research, the MGFM was applied to predict the incidence and mortality of AIDS in China. AIDS incidence and mortality data in China from 2008 to 2019 were used to construct the prediction model.

Results

The MGFM can predict the annual incidence and mortality of AIDS. The model constructed in this research predicted that the incidence and mortality of AIDS in China will continue to increase from 2020 to 2023.

Conclusion

The mean birth function model was an effective method to monitor and predict the changing trend of AIDS incidence and mortality in China.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01825-6.

Misdiagnosis of HIV With Toxoplasmosis Encephalopathy With Progressive Memory Loss as the Initial Symptom: A Case Report

Toxoplasmosis encephalopathy (TE) is a kind of encephalopathy parasitic disease caused by Toxoplasma gondii. It is the most common opportunistic for central system infection in patients with acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus. Without early diagnosis and proper treatment, this opportunistic infection can be life-threatening. The common clinical manifestations of the disease include altered mental state, epilepsy, cranial nerve damage, paresthesia, cerebellar signs, meningitis, motor disorders, and neuropsychiatry. The most common presentation in about 75% of cases is a subacute episode of focal neurological abnormalities such as hemiplegia, personality changes, or aphasia. Imaging needs to be differentiated from multiple sclerosis, lymphoma, and metastases. We report a case of acquired immune deficiency syndrome complicated with toxoplasma encephalopathy with rapid progressive memory loss as the initial symptom and misdiagnosed as multiple sclerosis. Through the comprehensive analysis of the clinical symptoms and imaging examination of this disease, we hope to enhance the confidence of clinicians in the diagnosis of this disease.

Association between ethnicity and health knowledge among the floating population in China

Background

Health equity remains a priority concerns by central government in China. This study aimed to explore ethnic gaps in access to health knowledge categories and sources based on the survey data from a publicly available dataset.

Methods

Data were from 2015 China Migrants Dynamic Survey issued by The National Health Commission in China. Descriptive analyses were performed to reflect geodemographic differences in the floating population of ethnic minority (EMFP) and Han majority (HMFP) with Chi-square test. Ethnic gaps in access to health knowledge categories and sources were explored with Poisson regressions, logistic regressions, and bivariate ordered probit regressions.

Results

In the sample, most of participants had inadequate health information literacy. There were significant differences regarding geodemographic factors between EMFP and HMFP. Illiterate EMFP had likelihood to obtain less health knowledge categories (IRR = 0.80, 95% CI 0.77–0.84) and sources (IRR = 0.83, 95% CI 0.80–0.86) as compared to illiterate HMFP. Most of correlations between health knowledge categories and sources were weak in the samples of EMFP and HMFP.

Conclusion

Ethnic disparities in access to health knowledge categories and sources among the floating population in China were confirmed. Further effective efforts should be provided to reduce ethnic disparities in access to health knowledge under the ethnicity-orientated support of public health resource.

Lifetime commercial heterosexual behavior among HIV negative elderly men from rural Chengdu, China: a modified knowledge-attitude-practice perspective

Background

China is facing big challenges to achieve the “90–90-90 targets”. The HIV prevalence of elderly (≥50 years) men have been steadily increasing in China, mainly through the sexual transmission route, but sexual behaviors of them are far from well-studied. In 2019, elderly men accounted for 59.2% of HIV/AIDS cases in Sichuan, China.

Methods

The research design is a cross-sectional study. Face-to-face interviews were conducted among 795 HIV negative elderly men from rural Chengdu, capital City of Sichuan. Bivariate and multivariate logistic regression models were applied to examine factors associated with commercial heterosexual behavior from a modified Knowledge-Attitude-Practice (KAP) perspective.

Results

129 (16.23%) respondents admitted high-risk sexual behaviors, including 11.07% commercial heterosexual behavior, 6.16% extramarital, 2.89% casual and 0.25% homosexual behavior, and no one used condom consistently. 427(68.43%) had ever gotten HIV-related Health Education (HRHE), mainly through mass media (70.49%). The HIV-related knowledge awareness rate was only 31.41%. Migration history (AOR =2.46,95% CI = 1.02–5.91), age(≥60 vs. 50–59, OR = 0.41, 95% CI = 0.19–0.91), receiving HRHE from mass media (OR = 0.37, 95%CI = 0.16–0.85), marital status (married vs. never married, OR = 0.04, 95%CI = 0–0.52), and undecided (AOR =0.02, 95%CI = 0.01–0.09) and objection (AOR =0.04, 95%CI = 0.01–0.1) attitude toward commercial sex were related to lifetime commercial heterosexual behavior.

Conclusions

High-risk sexual behaviors are common among elderly men from rural areas in Chengdu. Receiving HRHE from mass media and undecided and objection attitude toward commercial sex prevent elderly from being involving in commercial heterosexual behavior. According to the results, health facilities should continue to conduct systematic interventions, paying more attention to 50–59 years old group. Sex and condom use need to be talked in public. Working with mass media, health facilities give elderly men education not only focusing on HIV/AIDS, but also on knowledge and skills of condom use.

AIDS fighter health defense: protocol for a randomized controlled trial to test a game-based intervention to improve adolescents' AIDS prevention ability

Background

Although great progress has been made in the prevention and treatment of AIDS, there are still a considerable number of new infections annually, especially in adolescents. With the advance of technology, game-based education has gradually become an important tool for changing healthy behaviors among youth.

Methods

A protocol for conducting a randomized controlled trial to evaluate the “AIDS Fighter · Health Defense”, a game-based AIDS education project aimed at improving the ability of adolescents to prevent AIDS. During the four-week intervention, participants will receive: 1) A virus combat game; 2) Goal setting to eliminate HIV; 3) Questions to be answered to be resurrected in the game; 4) Points ranking; 5) Recognition and Rewards. The primary outcomes include changes in participants’ knowledge, stigma attitude, and risk behaviors attitude related to AIDS after four weeks of intervention. The secondary outcomes are the participants’ AIDS-related risk behaviors three and six months after the intervention.

Discussion

AIDS Fighter· Health Defense may be an innovative approach to help adolescents improve AIDS prevention capabilities, fill the gap in game-based AIDS prevention education in China, and gain experience of AIDS management.

Trial registration

Chinese Clinical Trial Registry: ChiCTR2000040195. Registered 25 November 2020.

Analysis of factors influencing casual sexual behavior among male college students in Zhejiang Province, China

OBJECTIVE

The purpose of this study was to explore the situations and factors influencing casual sexual behavior among male college students, in order to provide scientific evidences and measures of the prevention and control for HIV/AIDS.

METHOD

Using the stratified cluster sampling method, male college students who self-reported sexual behavior were selected as survey subjects in 13 colleges and universities in 11 cities of Zhejiang Province from October to November 2018. We used a custom online questionnaire to collect information on the demographic characteristics, sexual attitudes, sexual behaviors, and HIV interventions of the respondents. The χ2 test was performed on the composition ratios between different groups. With the occurrence of casual sexual behavior as the dependent variable, logistic regression was used to analyze the factors influencing casual male sexual behavior.

RESULTS

A total of 2734 male college students were surveyed, aged 20.20±1.41 years, of which 595 had casual sex, accounting for 21.7%. The rate of HIV prevention awareness among the participants was 85.1%. Multivariate analysis showed that receiving a self-assessment of HIV risk conducted by the school (Ajusted OR = 1.45, 95% CI = 1.14-1.84), knowing that HIV self-test kits were available at school (Ajusted OR = 2.02, 95% CI = 1.56-2.62), accepting one-night stands (Ajusted OR = 2.82, 95% CI = 2.18-3.66), accepting commercial sex (Ajusted OR = 1.95, 95% CI = 1.53-2.48), being a man who has sex with men (Ajusted OR = 1.81, 95% CI = 1.37-2.39), being a senior (Ajusted OR = 0.46, 95% CI = 0.30-0.71), having knowledge of HIV/AIDS prevention and treatment (Ajusted OR = 0.66, 95% CI = 0.51-0.86), and knowing that the CDC provides HIV testing services (Ajusted OR = 0.56, 95% CI = 0.41-0.77) were factors influencing male college students' casual sexual behavior.

CONCLUSION

Male college students who have causal sexual behaviors have a high degree of openness in sexual attitudes, insufficient knowledge of AIDS prevention, and knowledge of HIV testing-related information but low testing rates. For male college students' HIV prevention education intervention, it is necessary to emphasize the establishment of correct sexual attitudes and concepts and promote safe sexual behaviors to prevent the spread of HIV.

High HIV prevalence, low awareness of and willingness to use HIV pre-exposure prophylaxis among male migrant workers in Southwestern, China: a short report

Little is known about pre-exposure prophylaxis (PrEP) awareness and willingness among male rural-to-urban migrant workers, a high-risk population of HIV infection and transmission in China. The aim of this study was to assess the awareness of and willingness to use PrEP among this vulnerable population in two cities in Guangxi Zhuang autonomous region, a province in southwestern China. A cross-sectional survey was conducted among male rural-to-urban migrant workers in Guangxi province, during June to August, 2015. Multivariable logistic regression analysis was used to examine the factors related to PrEP acceptance. Among 669 male rural-to-urban migrant workers surveyed, the HIV prevalence was 1.79%. Among the 657 HIV-negative participants, 23.0% had heard of PrEP, 1.2% had used PrEP, and 64.7% were willing to use PrEP. Being afraid of HIV/AIDS (OR = 2.08, 95%CI: 1.04-4.19) and willing to have an HIV test (OR = 3.74, 95%CI: 1.64-8.52) were associated with willingness to use PrEP. The findings suggest that among male migrant workers in Southwestern China, the awareness of and willingness to use PrEP were relatively low. Given the fact that the HIV prevalence was high among this population, more educational campaigns about PrEP and targeted interventions are necessary for this high-risk population in Guangxi.

Comparative Circulation Dynamics of the Five Main HIV Types in China

The HIV epidemic in China accounts for 3% of the global HIV incidence. We compared the patterns and determinants of interprovincial spread of the five most prevalent circulating types. HIV pol sequences sampled across China were used to identify relevant transmission networks of the five most relevant HIV-1 types (B and circulating recombinant forms [CRFs] CRF01_AE, CRF07_BC, CRF08_BC, and CRF55_01B) in China. From these, the dispersal history across provinces was inferred. A generalized linear model (GLM) was used to test the association between migration rates among provinces and several measures of human mobility. A total of 10,707 sequences were collected between 2004 and 2017 across 26 provinces, among which 1,962 are newly reported here. A mean of 18 (minimum and maximum, 1 and 54) independent transmission networks involving up to 17 provinces were identified. Discrete phylogeographic analysis largely recapitulates the documented spread of the HIV types, which in turn, mirrors within-China population migration flows to a large extent. In line with the different spatiotemporal spread dynamics, the identified drivers thereof were also heterogeneous but are consistent with a central role of human mobility. The comparative analysis of the dispersal dynamics of the five main HIV types circulating in China suggests a key role of large population centers and developed transportation infrastructures as hubs of HIV dispersal. This advocates for coordinated public health efforts in addition to local targeted interventions.IMPORTANCE While traditional epidemiological studies are of great interest in describing the dynamics of epidemics, they struggle to fully capture the geospatial dynamics and factors driving the dispersal of pathogens like HIV as they have difficulties capturing linkages between infections. To overcome this, we used a discrete phylogeographic approach coupled to a generalized linear model extension to characterize the dynamics and drivers of the across-province spread of the five main HIV types circulating in China. Our results indicate that large urbanized areas with dense populations and developed transportation infrastructures are facilitators of HIV dispersal throughout China and highlight the need to consider harmonized country-wide public policies to control local HIV epidemics.