Ways of HIV transmission in China: The effect of age, period, and cohort

Assessment of HIV Infection in HIV Patients Admitted to Pakistan Institute of Medical Sciences, Islamabad, Pakistan

Aims: This study aims to assess the correlation between risky behaviors (unprotected sexual intercourse with multiple partners, men who have sex with men (MSM), and injectable drug users) and HIV infection among patients. The study focus on evaluating risk behaviors associated with HIV transmission among HIV-positive individuals. Background: HIV is an RNA virus that primarily attacks the immune system. Currently, there are 39 million people infected with HIV. Methodology: This study is a cross-sectional analysis involving 67 HIV patients admitted to the Pakistan Institute of Medical Sciences (PIMS) during the years 2023-2024. All patients were interviewed regarding their HIV infection, and various questions concerning risk factors were posed to them. Results: Our research demonstrates a significant prevalence of HIV among unmarried individuals, with a statistical significance of p < 0.01. Furthermore, engaging in the high-risk behavior of sharing syringes and needles (standard beta = 0.73) and associating with drug users (standard beta = 0.061) might be considered forms of unsafe practices. There is a strong positive correlation (r = 0.867∗∗) between drug users and the practice of sharing syringes and needles, which is highly statistically significant (p < 0.01). The results indicate a substantial association between drug users, the sharing of needles and syringes, and HIV infection. Conclusion: Drug users often share needles and syringes with other users, which significantly contributes to the outbreak of HIV in society. Unmarried men exhibit a higher prevalence of HIV compared to married men. Increasing public awareness and implementing robust government policies could help reduce the rate of HIV infections.

Trends, Age-Period-Cohort Effects, and Projections in the Incidence and Mortality of Human Immunodeficiency Virus/AIDS Among the Elderly in China

BACKGROUND

Human immunodeficiency virus (HIV)/AIDS among elderly persons presents a new public health challenge in China. We aimed to explore historical trends (2004-2018) and project the future (2019-2030) burden of HIV/AIDS incidence and mortality among the elderly in China.

METHODS

We utilized data from the Data Center of China Public Health Science database on HIV/AIDS incidence and mortality, employing the Bayesian age-period-cohort model to reveal the age-period-cohort effect in the HIV/AIDS burden, and projecting the incidence and mortality rates up to 2030.

RESULTS

From 2004 to 2018, HIV/AIDS incidence rates increased from 0.56 to 20.78 per 100 000 for men and 0.28 to 7.84 per 100 000 for women. The mortality rates also increased in both sexes. We observed the highest age effect in incidence among men aged 70-74 years and women aged 55-59 years, with the effect estimates being 0.02 (95% confidence interval [CI], -.10 to .13) and 0.46 (95% CI, .35-.57), respectively. Similar sex disparities were observed for mortality, with the highest age effect observed in men aged 75-79 years and women aged 50-54 years. However, no significant disparities were found between men and women in the period and cohort effects. By 2030, the incidence rates were projected to be 96.25 per 100 000 in men and 44.90 per 100 000 in women, while the mortality rates were projected to be 48.27 and 13.67 per 100 000, respectively.

CONCLUSIONS

HIV/AIDS incidence and mortality rates rose notably among the elderly in China and are expected to keep increasing in the coming decades. Rates were consistently higher in men than in women. Tailored interventions for older men are crucial.

Complexity and Variation in Infectious Disease Birth Cohorts: Findings from HIV+ Medicare and Medicaid Beneficiaries, 1999-2020

The impact of uncertainty in information systems is difficult to assess, especially when drawing conclusions from human observation records. In this study, we investigate survival variation in a population experiencing infectious disease as a proxy to investigate uncertainty problems. Using Centers for Medicare and Medicaid Services claims, we discovered 1,543,041 HIV+ persons, 363,425 of whom were observed dying from all-cause mortality. Once aggregated by HIV status, year of birth and year of death, Age-Period-Cohort disambiguation and regression models were constructed to produce explanations of variance in survival. We used Age-Period-Cohort as an alternative method to work around under-observed features of uncertainty like infection transmission, receiver host dynamics or comorbidity noise impacting survival variation. We detected ages that have a consistent, disproportionate share of deaths independent of study year or year of birth. Variation in seasonality of mortality appeared stable in regression models; in turn, HIV cases in the United States do not have a survival gain when uncertainty is uncontrolled for. Given the information complexity issues under observed exposure and transmission, studies of infectious diseases should either include robust decedent cases, observe transmission physics or avoid drawing conclusions about survival from human observation records.

Spatiotemporal Pattern and Its Determinants for Newly Reported HIV/AIDS Among Older Adults in Eastern China From 2004 to 2021: Retrospective Analysis Study

BACKGROUND

In recent years, the number and proportion of newly reported HIV/AIDS cases among older adults have increased dramatically. However, research on the pattern of temporal and spatial changes in newly reported HIV/AIDS among older adults remains limited.

OBJECTIVE

This study analyzed the spatial and temporal distribution of HIV/AIDS cases and its influencing factors among older adults in Eastern China from 2004 to 2021, with the goal of improving HIV/AIDS prevention and intervention.

METHODS

We extracted data on newly reported HIV/AIDS cases between 2004 and 2021 from a case-reporting system and used a Joinpoint regression model and an age-period-cohort model to analyze the temporal trends in HIV/AIDS prevalence. Spatial autocorrelation and geographically weighted regression models were used for spatial aggregation and influence factor analysis.

RESULTS

A total of 12,376 participants with HIV/AIDS were included in the study. The newly reported HIV infections among older adults increased from 0.13 cases per 100,000 people in 2004 to 7.00 cases per 100,000 people in 2021. The average annual percent change in newly reported HIV infections was 28.0% (95% CI -21.6% to 34.8%). The results of the age-period-cohort model showed that age, period, and cohort factors affected the newly reported HIV infections among older adults. The newly reported HIV/AIDS cases among men who have sex with men (MSM) had spatial clustering, and the hotspots were mainly concentrated in Hangzhou. The disposable income of urban residents, illiteracy rate among people aged 15 years or older, and number of hospital beds per 1000 residents showed a positive association with the newly reported HIV infections among older MSM in the Zhejiang province.

CONCLUSIONS

HIV/AIDS among older adults showed an increasing trend and was influenced by age, period, and cohort effects. Older MSM with HIV/AIDS showed regional clustering and was associated with factors such as the disposable income of urban residents, the illiteracy rate among people aged 15 years or older, and the number of hospital beds per 1000 people. Targeted prevention and control measures are needed to reduce HIV infection among those at higher risk.

Association of Polymorphisms in NHEJ Pathway Genes with HIV-1 Infection and AIDS Progression in a Northern Chinese MSM Population

Background and Aims

Men who have sex with men (MSM) are at high risk of HIV infection. The nonhomologous end joining (NHEJ) pathway is the main way of double-stranded DNA break (DSB) repair in the higher eukaryotes and can repair the DSB timely at any time in cell cycle. It is also indicated that the NHEJ pathway is associated with HIV-1 infection since the DSB in host genome DNA occurs in the process of HIV-1 integration. The aim of the present investigation was to evaluate associations of single-nucleotide polymorphisms (SNPs) in NHEJ pathway genes with susceptibility to HIV-1 infection and AIDS progression among MSM residing in northern China.

Methods

A total of 481 HIV-1 seropositive men and 493 HIV-1 seronegative men were included in this case-control study. Genotyping of 22 SNPs in NHEJ pathway genes was performed using the SNPscan™ Kit.

Results

Positive associations were observed between XRCC6 rs132770 and XRCC4 rs1056503 genotypes and the susceptibility to HIV-1 infection. In gene-gene interaction analysis, significant SNP-SNP interactions of XRCC6 and XRCC4 genetic variations were found to play a potential role in the risk of HIV-1 infection. In stratified analysis, XRCC5 rs16855458 was significantly associated with CD4+ T cell counts in AIDS patients, whereas LIG4 rs1805388 was linked to the clinical phases of AIDS patients.

Conclusions

NHEJ gene polymorphisms can be considered to be risk factors of HIV-1 infection and AIDS progression in the northern Chinese MSM population.