[Characteristics and trends of newly reported HIV infection in young students in China, 2010-2019]

Influence of HIV/AIDS knowledge on HIV testing behavior among young students (14-27 years) with a history of sexual activity: chain mediation analysis of social discrimination, self-efficacy, and sexual behavior characteristics

This study used a self-administered questionnaire to investigate the relationship between HIV/AIDS knowledge, social discrimination, HIV self-efficacy, sexual behavioral characteristics and HIV testing behavior among young students with a history of sexual activity in Chongqing. Propensity score matching was used to construct a control group with similar demographic characteristics to the HIV testing group, only without HIV testing behaviors. Structural equation modeling was used to conduct chain-mediated effect analysis. The HIV testing rate among young students with a history of sexual behavior was 17.16%. Young students with HIV testing behavior had higher levels of HIV/AIDS knowledge, lower social discrimination, better self-efficacy, and no difference in sexual behavior characteristic scores between the two groups (P = 0.062). The mediated effect values of social discrimination and self-efficacy were 0.022 and 0.063, respectively, while their chain mediated effect value was 0.007. There was no mediated effect of sexual behavior characteristics. The level of young students' HIV/AIDS knowledge does not directly influence their HIV testing behavior but plays a complete chain mediating effect on HIV testing behavior through social discrimination and self-efficacy. HIV testing behavior should be promoted through the perspectives of enhancing HIV/AIDS knowledge level, reducing social discrimination, and improving self-efficacy.

Study on HIV/AIDS knowledge, sexual attitudes, sexual behaviors, and preventive services among young students in Chongqing, China

Objectives

This study aimed to describe the HIV/AIDS knowledge, sexual attitudes, and sexual behaviors of young students (14-25 years) in Chongqing, China, and to examine their use of preventive services and related factors.

Method

A cross-sectional study was conducted with students from 67 schools from December 2019 to June 2021. The chi-square test, non-parametric test to assess the differences between respondents with different characteristics in the above aspects. Additionally, univariate and multivariate logistic regression analyses were conducted to examine factors associated with the awareness of HIV/AIDS knowledge. Confidence intervals without crossover or P < 0.05 was considered significant.

Results

A total of 31,782 participants were included in the study. A total of 62.62% of the respondents were considered to be aware of basic HIV/AIDS knowledge, including 78.44%, 62.15%, and 52.08% in undergraduate colleges, junior colleges and secondary vocational schools, respectively. In total, 60.96% of males and 29.42% of females accepted premarital sex, 15.49% of males and 6.18% of females reported being sexually experienced, and only 57.18% of the students used condoms every time they had sex. The percentage of condom use among students who were aware of HIV/AIDS knowledge was higher than that among students who were not aware. A total of 85.60% of the students thought they needed HIV/AIDS prevention and control knowledge, and 94.60% thought more health education activities on HIV/AIDS prevention needed to be conducted in schools. Entrance education, lectures or consultation hotlines, WeChat official accounts and other media platforms were rated as the most acceptable HIV/AIDS prevention education methods.

Conclusion

These respondents lacked knowledge about HIV/AIDS, and an increasing number of students show an open attitude toward premarital sex and engage in risky sexual behaviors. It is urgent to enhance and widely disseminate comprehensive HIV/AIDS and sexual health education in multiple formats.

HIV-1 Drug Resistance Profiles of Low-Level Viremia Patients and Factors Associated With the Treatment Effect of ART-Treated Patients: A Cross-Sectional Study in Jiangsu, China

Objectives

Evaluating the drug resistance (DR) profiles of LLV patients and the influencing factors of treatment effects in Jiangsu Province.

Method

The Pol gene (Reverse transcriptase and protease) was amplified and sequenced to identify the genotypes and DR profiles among LLV patients in 2021. Questionnaire survey was conducted among HIV/AIDS patients to investigate the potential influence factors of treatment effects.

Results

242 Pol genes were amplified from 345 specimens, and ten genotypes were detected. The DR rate was 40.5%, with 66, 86, and 14 being resistant to NRTIs, NNRTIs, and PIs, respectively. Patients treated with the 2NRTIs+PIs regimen were detected with more DR; and drug resistance was less detected in married or cohabiting patients than unmarried patients. Non-smokers were less likely to develop LLV at follow-up than smokers; patients with stage II clinical stage at diagnosis and using 2NRTIs+PIs regimen were also more likely to develop LLV at follow-up.

Conclusion

Drug resistance profiles in LLV patients are severe and differ in treatment regimens and marital statuses. Meanwhile, smoking history, clinical stage, and treatment regimen may influence the therapeutic effect. It is necessary to include LLV people in the free drug resistance testing program.

Associations between impulsive personality traits and HIV-related knowledge, beliefs and behaviours among college students in Chengdu, China: a cross-sectional study

BACKGROUND

Impulsive personality traits (IPTs) are key predictors of individuals' engagement in sexual risk behaviours. This study investigated the associations between IPTs and HIV-related knowledge, beliefs and behaviours among Chinese college students.

METHODS

A sample of 1062 freshmen (first year) and sophomore (second year) students was obtained through stratified random sampling from 11 universities and colleges in Chengdu, China. The sociodemographic information, and HIV-related knowledge, beliefs and behaviours were investigated. A 20-item Short UPPS-P Impulsive Behaviour Scale (S-UPPS-P) was employed to estimate IPTs. Contingency table analyses (χ2) and adjusted logistic regression were used to analyse the association between IPTs and HIV-related knowledge, beliefs and behaviours.

RESULTS

The S-UPPS-P scale measure of IPTs yielded scores among college students ranging from 26 to 70. Students with a greater level of IPTs were more likely to have a high level of HIV stigma (aOR=1.46, 95% CI: 1.13-1.89), and a low level of HIV knowledge (aOR=1.41, 95% CI: 1.11-1.80) and HIV prevention beliefs (aOR=1.40, 95% CI: 1.09-1.80). All variables of HIV-related behaviours were not significantly associated with IPTs (all P>0.05).

CONCLUSIONS

Future campus health education should provide HIV education without neglect of early identification of students' IPTs.

Trends in HIV Prevalence and HIV-Related Risk Behaviors Among Male Students Who Have Sex With Men From 2016 to 2020 in Nanjing, China: Consecutive Cross-Sectional Surveys

Background

The growing HIV epidemic among student men who have sex with men (MSM) necessitates immediate attention from public health. In China, male students who have sex with men (SMSM) were also at an increasing risk of HIV transmission. The aim of this study was to investigate the trends in HIV prevalence, HIV-related risk behaviors, and HIV testing, as well as analyze the factors associated with HIV infection among SMSM in Nanjing.

Methods

Data were collected through face-to-face questionnaire interviews and laboratory testing in Nanjing. The participants were recruited among SMSM by snowball sampling and internet-recruited convenience sampling annually from 2016 to 2020. The self-report data primarily included demographics, HIV knowledge, HIV-related behaviors, and HIV testing, while the laboratory test results of HIV and syphilis were collected. Linear-by-linear chi-square test was used to analyze the trends of HIV/syphilis prevalence and its risk behaviors. The binary logistic regression model was used to explore the factors associated with HIV infection.

Results

During the 5 years from 2016 to 2020, a total of 775 SMSM were recruited in our survey (220, 112, 171, 142, and 120, respectively). The HIV prevalence was 5.2, 6.3, 5.3, 7.0, and 8.3%, without a significant increasing trend (P = 0.277). Syphilis prevalence fluctuated from 5.7% in 2016 to 4.2% in 2020, without a significant decreasing trend (P = 0.318). The proportion of consistent condom use in anal intercourse (48.5 to 56.2%, P < 0.05), and HIV testing in the past 12 months (51.0 to 59.2%, P < 0.05) were increasing. A remarkable growing trend has been reported in the percentage of MSM with more than one male sex partner (46.2 to 59.2%, P < 0.05). Multivariate analysis showed that HIV testing in the past 12 months was a protective factor against HIV infection. MSM who had unprotected anal intercourse (UAI) in the past 6 months, recreational drug use, and currently syphilis infection were risk factors for HIV infection.

Conclusions

We observed stable HIV/ syphilis prevalence, increasing consistent condom use, increasing HIV testing rate, and increasing multiple male sex partners dramatically among SMSM in China. The original comprehensive intervention measures should be continuously strengthened for the subgroup. To satisfy the current HIV prevention requirements, new biological interventions should be introduced and carried out as major components of combination prevention programs.

Research Progress in the Epidemiology of HIV/AIDS in China

After thirty-two years since the first domestic outbreak of human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) among injection drug users (IDUs) and almost two decades of comprehensive response efforts by the Chinese government, HIV/AIDS remains a major public health problem. The increasing burden of HIV/AIDS and comorbidities, the emergence of new HIV subtypes and/or circulating recombinant forms and drug mutations, the changing transmission networks, and the urgency of immediate antiretroviral therapy initiation upon an HIV diagnosis are increasingly challenging and altogether likely to have significant impact on the HIV epidemic in China. Upon the call for the global AIDS response to end AIDS by 2030, China needs to develop an innovative and pragmatic roadmap to address these challenges. This review is intended to provide a succinct overview of what China has done in efforts to achieve the global goal of ending AIDS by 2030 and the recently proposed "95-95-95-95" target (95% combination prevention, 95% detection, 95% treatment, 95% viral suppression), and to summarize the most recent progresses in the epidemiological research of HIV/AIDS in China with the aim of providing insights on the next generation of HIV control and prevention approaches and to shed light on upgrading the national strategy to end AIDS in this country.