Objective To examine HIV self-testing uptake and its determinates among men who have sex with men （MSM） in Beijing, China. Methods A cross-sectional online survey was conducted in Beijing, China in 2016. Participant...Objective To examine HIV self-testing uptake and its determinates among men who have sex with men （MSM） in Beijing, China. Methods A cross-sectional online survey was conducted in Beijing, China in 2016. Participants were users of a popular Chinese gay networking application and had an unknown or negative HIV status. Univariate and multivariate logistic regression analyses were conducted to examine factors associated with HIV self-testing based on adjusted odds ratio （AOR） and 95% confidence interval （CI）. Results Among the 5,996 MSM included in the study, 2,383 （39.7%） reported to have used HIV self-testing kits. Willingness to use an HIV self-test kit in the future was expressed by 92% of the participants. High monthly income （AOR = 1.49; CI = 1.10-2.02; P = 0.010）, large number of male sex partners （≥2： AOR = 1.24; CI = 2.09-1.43; P = 0.002）, sexual activity with commercial male sex partners （〉 2： AOR = 1.94; CI = 1.34 -2.82; P = 0.001）, long-term drug use （AOR = 1.42; CI = 1.23-1.62; P 〈 0.001）, and long-term HIV voluntary counseling and testing （VCT） attendance （AOR = 3.62; CI = 3.11-4.22; P 〈 0.001） were all associated with increased odds of HIV self-testing uptake. Conclusion The nearly 40% rate of HIV self-testing uptake among MSM in our sample was high. In addition, an over 90% willingness to use kits in the future was encouraging. HIV self-testing could be an important solution to help China achieve the global target of having 90% of all people living with HIV diagnosed by 2020.展开更多
Background: Human Immuno-Deficiency Virus Self-Testing (HIVST) is a process where an individual who wants to know their HIV status collects a specimen, performs a test and interprets the result by themselves. HIVST da...Background: Human Immuno-Deficiency Virus Self-Testing (HIVST) is a process where an individual who wants to know their HIV status collects a specimen, performs a test and interprets the result by themselves. HIVST data from the Zimbabwe AIDS and TB Program (ATP) directorate showed that between 2019-2020, only 31% of the target HIVST kits were distributed in the country. Mashonaland West Province was one of the least performing provinces in meeting targets for HIVST kits distribution. Gaps in the implementation of the HIVST in the province ultimately affect the nationwide scaleup of targeted testing, a key enabler in achieving HIV epidemic control. We analyzed HIVST trends in Mashonaland West Province to inform HIV testing services programming. Methods: We conducted a cross-sectional study using HIVST secondary data obtained from the District Health Information Software 2 (DHIS2) electronic database. We conducted regression analysis for trends using Epi Info 7.2 and tables, bar graphs, pie charts and linear graphs were used for data presentation. Results: A total of 31,070 clients accessed HIVST kits in Mashonaland West Province from 2019-2020. A slightly higher proportion (50.4% and 51.7%) of females as compared to males accessed HIVST kits in 2019 and 2020 respectively. Overall, an increase in the trend of HIVST kits uptake was recorded (males R<sup>2</sup> = 0.3945, p-value = 0.003 and females R<sup>2</sup> = 0.4739, p-value = 0.001). There was generally a decline in the trend of community-based distribution of HIVST kits from the third quarter of 2019 throughout 2020 (R<sup>2</sup> = 0.2441, p-value = 0.006). Primary distribution of HIVST kits remained the dominant method of distribution, constituting more than half of the kits distributed in both 2019 (67%) and 2020 (86%). Conclusion: Mashonaland West Province was mainly utilising facility-based distribution model for HIVST over the community-based distribution model. We recommended training more community-based distribution agents to increase community distribution of HIVST kits.展开更多
Globally, there is increasing evidence that HIV self-testing (HIVST) is commonly practiced among health care workers (HCWs). Although HIVST kits are available in South Africa, their distribution and use remain unregul...Globally, there is increasing evidence that HIV self-testing (HIVST) is commonly practiced among health care workers (HCWs). Although HIVST kits are available in South Africa, their distribution and use remain unregulated and its acceptability, undocumented. The aim of the study was to explore the acceptability of HIV self-testing among student nurses, examine their willingness to use self-testing, and evaluate their views on the implementation of a regulated HIV self-testing programme. This was a qualitative explorative study, and six focus group discussions were conducted with 67 student nurses recruited from a private nursing college, in Pretoria, South Africa. Thematic analysis and NVivo10 qualitative software were used for data analysis. The nurses perceived HIVST as an acceptable option for HIV testing and most were willing to self-test. Self-testing will provide confidential and accessible HIV testing services, reduce the stigma associated with the condition, and increase partner testing and disclosure. HIVST is more likely to be practised if self-testing kits are easily accessible and affordable, and there are strategies to educate people before the adoption of HIVST. The lack of pre- and post-test counselling, the risk of inaccurate test results, and lack of strategies for the confirmation of self-testing results were the main arguments against HIVST. The high acceptance of HIVST among nurses suggests that HIVST is a feasible option to increase the uptake of HIV-testing among HCWs. However, pre- and post-test counselling should be considered important components in the implementation of self-testing services. Educational and awareness campaigns should precede the roll-out of the self-testing programs.展开更多
Summary What is already known about this topic?Human immunodeficiency virus(HIV)self-testing serves as a crucial strategy for overcoming testing barriers,with urine-based self-testing emerging as a potential novel app...Summary What is already known about this topic?Human immunodeficiency virus(HIV)self-testing serves as a crucial strategy for overcoming testing barriers,with urine-based self-testing emerging as a potential novel approach.What is added by this report?In a real-world setting,this study demonstrated that the urine rapid test exhibited lower diagnostic accuracy compared to the blood rapid test.Study participants expressed stronger preferences for HIV self-testing methods utilizing finger prick samples,accompanied by standard written instructions and lower costs.展开更多
Background:Human immunodefciency virus(HIV)self-testing may help improve test uptake among female sex workers.China has implemented many HIV self-testing programs among men who have sex with men,creating an opportunit...Background:Human immunodefciency virus(HIV)self-testing may help improve test uptake among female sex workers.China has implemented many HIV self-testing programs among men who have sex with men,creating an opportunity for promotion among female sex workers.However,there is a limited literature on examining HIV selftesting among female sex workers.This study aimed to examine HIV self-testing experiences and its determinants among female sex workers in China.Methods:A venue-based,cross-sectional study was conducted among Chinese female sex workers in 2019.Participants completed a survey including social-demographic characteristics,sexual behaviors,and HIV self-testing history,the distribution of which were analyzed using descriptive analysis.Multivariable logistic regression was conducted to identify associations with HIV self-testing.Results:Among 1287 Chinese female sex workers,1072(83.3%,95%confdence interval[CI]81.2-85.3%)had ever tested for HIV,and 103(8.0%,95%CI 6.6-9.6%)had ever used HIV self-testing.More than half reported that the selftest was their frst HIV test(59.2%,61/103),around one-ffth reported HIV self-testing results infuenced the price of sex(21.4%,22/103).A minority of individuals reported ever experiencing pressure to undertake HIV self-testing(6.8%,7/103).After adjusting for covariates,HIV self-testing was positively associated with receiving anal sex in the past month(adjusted odds ratio[aOR]=2.2,95%CI 1.4-3.5),using drugs before or during sex(aOR=2.8,95%CI 1.8-4.5),injecting drugs in the past 6 months(aOR=2.6,95%CI 1.2-6.0),being diagnosed with other sexually transmitted infections(aOR=1.6,95%CI 1.0-2.5),tested for other sexually transmitted infections in the past six months(aOR=3.4,95%CI 2.1-5.5),ever tested in the hospital(aOR=3.4,95%CI 2.0-5.6),and ever tested in the community(aOR=1.5,95%CI 1.2-1.9).Conclusions:Our fndings suggest that HIV self-testing could expand overall HIV testing uptake,increase HIV testing frequency,reach sub-groups of high-risk female sex workers and has limited potential harms among female sex workers.HIV self-testing should be incorporated among Chinese female sex workers as a complement to facility-based HIV testing services.展开更多
BACKGROUND In 2019,the Nigerian Ministry of Health published the first operational guidelines for human immunodeficiency virus self-testing(HIVST)to improve access to human immunodeficiency virus(HIV)testing services ...BACKGROUND In 2019,the Nigerian Ministry of Health published the first operational guidelines for human immunodeficiency virus self-testing(HIVST)to improve access to human immunodeficiency virus(HIV)testing services among undertested populations in the country.Also,as part of the campaign to increase HIV testing services in Nigeria,the Nigerian Ministry of Health developed standard operating procedures for using HIVST kits.AIM To systematically review the acceptability and strategies for enhancing the uptake of HIVST in Nigeria.METHODS The systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Different databases were searched to get the necessary materials needed for this review.Standardized forms developed by the authors were used for data extraction to minimize the risk of bias and ensure that the articles used for the study were properly screened.Identified articles were first screened using the titles and their abstracts.The full papers were screened,and the similarities of the documents were determined.Qualitative,quantitative,and mixed-method studies were evaluated using the Critical Appraisal Skills Programme and Critical Appraisal Framework criteria.RESULTS All the publications reviewed were published between 2015 and 2022,with 33.3%published in 2021.Most(77.8%)of the studies were cross-sectional,43.3%were conducted in Lagos State,and 26.3%were conducted among young people.The study revealed a high level of acceptability of HIVST.Certain factors,such as gender,sexual activity,and previous testing experience,influence the acceptability of HIV self-testing,with some individuals more likely to opt-out.The cost of the kit was reported as the strongest factor for choosing HIVST services,and this ranged from 200 to 4000 Naira(approximately United States Dollar 0.55-11.07),with the majority willing to pay 500 Naira(approximately United States Dollar 1.38).Privately-owned,registered pharmacies,youthfriendly centres,supermarkets,and online stores were the most cited access locations for HIVST.The least influential attribute was the type of specimen needed for HIVST.Strategies addressing cost and preferred access points and diverse needs for social media promotion,local translation of product use instructions,and HIVST distribution led by key opinion leaders for key populations were found to significantly enhance HIVST uptake and linkage to care.CONCLUSION HIVST acceptability is generally high from an intention-to-use perspective.Targeted strategies are required to improve the acceptability of HIV self-testing,especially among males,sexually active individuals,and first-time testers.Identified and proposed uptake-enhancing strategies need to be investigated in controlled settings and among different populations and distribution models in Nigeria.展开更多
目的分析2016—2022年云南省艾滋病自愿咨询检测(voluntary counselling and testing,VCT)和医疗机构医务人员主动提供人类免疫缺陷病毒(human immunodeficiency virus,HIV)检测咨询(provider initiated HIV testing and counselling,PI...目的分析2016—2022年云南省艾滋病自愿咨询检测(voluntary counselling and testing,VCT)和医疗机构医务人员主动提供人类免疫缺陷病毒(human immunodeficiency virus,HIV)检测咨询(provider initiated HIV testing and counselling,PITC)发现的HIV感染者和艾滋病患者(HIV感染者/艾滋病患者)特征的差异,为制定艾滋病检测策略提供依据。方法收集“中国疾病预防控制信息系统”中2016年1月1日—2022年12月31日通过VCT和PITC发现的新报告HIV感染者/艾滋病患者。利用非条件logistic回归分析比较不同途径发现的HIV感染者/艾滋病患者的特征、晚发现以及抗病毒治疗情况。结果2016—2022年云南省累计新报告VCT和PITC发现HIV感染者/艾滋病患者56378例,其中,VCT发现11750例(20.84%),PITC发现44628例(79.16%)。多因素logistic回归分析显示,女性(OR=0.84,95%CI:0.80~0.88)、配偶HIV阴性(OR=0.38,95%CI:0.35~0.41)及不清楚配偶HIV感染情况(OR=0.74,95%CI:0.61~0.89)者,通过PITC检测发现的可能性高。初中(OR=1.17,95%CI:1.11~1.24)、高中或中专(OR=1.31,95%CI:1.21~1.43)和大专及以上文化程度(OR=1.43,95%CI:1.30~1.57),通过男男同性性行为感染(OR=3.59,95%CI:3.29~3.92)、注射毒品感染(OR=1.63,95%CI:1.42~1.87)及配偶HIV阳性(OR=3.56,95%CI:3.38~3.75)者通过VCT门诊发现感染HIV的可能性高。与VCT相比,PITC中的其他就诊者检测(OR=1.41,95%CI:1.34~1.48)和术前/受血前检测(OR=1.20,95%CI:1.12~1.28)发现的HIV感染者/艾滋病患者晚发现的比例高,孕产期检测晚发现的比例低(OR=0.70,95%CI:0.60~0.81);与VCT相比,术前/受血(制品)前检测(OR=0.63,95%CI:0.57~0.70)、其他就诊者检测(OR=0.64,95%CI:0.59~0.69)发现的HIV感染者/艾滋病患者抗病毒治疗比例更低。结论VCT在早期发现病例、男男同性性行为筛查及抗病毒治疗促进方面有优势;PITC的推广有助于扩大普通人群的检测比例;可针对不同人群制定HIV感染者发现策略,促进早检测、早发现和早治疗。展开更多
目的 基于巨噬细胞自噬探讨参芩龙清肺培元颗粒的作用机制。方法 选择人类免疫缺陷病毒(HIV)/艾滋病(AIDS)合并肺部感染痰热壅肺证患者36例,应用流式细胞术检测治疗前后患者外周血T淋巴细胞亚群中CD4^(+)及CD8^(+)T淋巴细胞计数,巨噬细...目的 基于巨噬细胞自噬探讨参芩龙清肺培元颗粒的作用机制。方法 选择人类免疫缺陷病毒(HIV)/艾滋病(AIDS)合并肺部感染痰热壅肺证患者36例,应用流式细胞术检测治疗前后患者外周血T淋巴细胞亚群中CD4^(+)及CD8^(+)T淋巴细胞计数,巨噬细胞亚群CD11b、CD86、CD206的表达及巨噬细胞自噬探针CD11b+DALGreen、CD86+DALGreen、CD206+DALGreen的表达。ELISA法检测治疗前后血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、IL-10、转化生长因子(TGF)-β1等炎性因子的表达。采用荧光定量PCR法检测治疗前后患者外周血中组蛋白去乙酰化酶(HDAC)2 m RNA、Unc-51样激酶1(ULK1)m RNA的表达。结果 治疗后,患者CD11b、CD206、CD11b+DALGreen、CD206+DALGreen、ULK1 m RNA表达明显升高(P<0.05);CD86、TNF-α、IL-1β、HDAC2 m RNA的表达明显下降(P<0.05);CD4^(+)T淋巴细胞计数、IL-10、TGF-β1表达呈上升趋势(P>0.05)。结论 参芩龙清肺培元颗粒可能通过调节HDAC2/ULK1信号轴,促进巨噬细胞自噬,调节M1/M2的平衡,抑制炎症反应,从而发挥治疗HIV/AIDS患者合并肺部感染的作用。展开更多
基金funded by China-US Collaboration on HIV/AIDS(Grant#5U2GGH001153)China National Health&Family Planning Commission(131-16-000-105-02)
文摘Objective To examine HIV self-testing uptake and its determinates among men who have sex with men （MSM） in Beijing, China. Methods A cross-sectional online survey was conducted in Beijing, China in 2016. Participants were users of a popular Chinese gay networking application and had an unknown or negative HIV status. Univariate and multivariate logistic regression analyses were conducted to examine factors associated with HIV self-testing based on adjusted odds ratio （AOR） and 95% confidence interval （CI）. Results Among the 5,996 MSM included in the study, 2,383 （39.7%） reported to have used HIV self-testing kits. Willingness to use an HIV self-test kit in the future was expressed by 92% of the participants. High monthly income （AOR = 1.49; CI = 1.10-2.02; P = 0.010）, large number of male sex partners （≥2： AOR = 1.24; CI = 2.09-1.43; P = 0.002）, sexual activity with commercial male sex partners （〉 2： AOR = 1.94; CI = 1.34 -2.82; P = 0.001）, long-term drug use （AOR = 1.42; CI = 1.23-1.62; P 〈 0.001）, and long-term HIV voluntary counseling and testing （VCT） attendance （AOR = 3.62; CI = 3.11-4.22; P 〈 0.001） were all associated with increased odds of HIV self-testing uptake. Conclusion The nearly 40% rate of HIV self-testing uptake among MSM in our sample was high. In addition, an over 90% willingness to use kits in the future was encouraging. HIV self-testing could be an important solution to help China achieve the global target of having 90% of all people living with HIV diagnosed by 2020.
文摘Background: Human Immuno-Deficiency Virus Self-Testing (HIVST) is a process where an individual who wants to know their HIV status collects a specimen, performs a test and interprets the result by themselves. HIVST data from the Zimbabwe AIDS and TB Program (ATP) directorate showed that between 2019-2020, only 31% of the target HIVST kits were distributed in the country. Mashonaland West Province was one of the least performing provinces in meeting targets for HIVST kits distribution. Gaps in the implementation of the HIVST in the province ultimately affect the nationwide scaleup of targeted testing, a key enabler in achieving HIV epidemic control. We analyzed HIVST trends in Mashonaland West Province to inform HIV testing services programming. Methods: We conducted a cross-sectional study using HIVST secondary data obtained from the District Health Information Software 2 (DHIS2) electronic database. We conducted regression analysis for trends using Epi Info 7.2 and tables, bar graphs, pie charts and linear graphs were used for data presentation. Results: A total of 31,070 clients accessed HIVST kits in Mashonaland West Province from 2019-2020. A slightly higher proportion (50.4% and 51.7%) of females as compared to males accessed HIVST kits in 2019 and 2020 respectively. Overall, an increase in the trend of HIVST kits uptake was recorded (males R<sup>2</sup> = 0.3945, p-value = 0.003 and females R<sup>2</sup> = 0.4739, p-value = 0.001). There was generally a decline in the trend of community-based distribution of HIVST kits from the third quarter of 2019 throughout 2020 (R<sup>2</sup> = 0.2441, p-value = 0.006). Primary distribution of HIVST kits remained the dominant method of distribution, constituting more than half of the kits distributed in both 2019 (67%) and 2020 (86%). Conclusion: Mashonaland West Province was mainly utilising facility-based distribution model for HIVST over the community-based distribution model. We recommended training more community-based distribution agents to increase community distribution of HIVST kits.
文摘Globally, there is increasing evidence that HIV self-testing (HIVST) is commonly practiced among health care workers (HCWs). Although HIVST kits are available in South Africa, their distribution and use remain unregulated and its acceptability, undocumented. The aim of the study was to explore the acceptability of HIV self-testing among student nurses, examine their willingness to use self-testing, and evaluate their views on the implementation of a regulated HIV self-testing programme. This was a qualitative explorative study, and six focus group discussions were conducted with 67 student nurses recruited from a private nursing college, in Pretoria, South Africa. Thematic analysis and NVivo10 qualitative software were used for data analysis. The nurses perceived HIVST as an acceptable option for HIV testing and most were willing to self-test. Self-testing will provide confidential and accessible HIV testing services, reduce the stigma associated with the condition, and increase partner testing and disclosure. HIVST is more likely to be practised if self-testing kits are easily accessible and affordable, and there are strategies to educate people before the adoption of HIVST. The lack of pre- and post-test counselling, the risk of inaccurate test results, and lack of strategies for the confirmation of self-testing results were the main arguments against HIVST. The high acceptance of HIVST among nurses suggests that HIVST is a feasible option to increase the uptake of HIV-testing among HCWs. However, pre- and post-test counselling should be considered important components in the implementation of self-testing services. Educational and awareness campaigns should precede the roll-out of the self-testing programs.
基金Supported by the National Natural Science Foundation of China(grant numbers#71974212,#71774178,#81803334,#72204059)the Guangdong Basic and Applied Basic Research Foundation(grant number#2020A1515010737)+1 种基金the Science and Technology Program of Guangzhou,China(grant number#202201010078)the Infectious Disease Prevention and Control of the National Science and Technology Major Project(grant number#2018ZX10715004).
文摘Summary What is already known about this topic?Human immunodeficiency virus(HIV)self-testing serves as a crucial strategy for overcoming testing barriers,with urine-based self-testing emerging as a potential novel approach.What is added by this report?In a real-world setting,this study demonstrated that the urine rapid test exhibited lower diagnostic accuracy compared to the blood rapid test.Study participants expressed stronger preferences for HIV self-testing methods utilizing finger prick samples,accompanied by standard written instructions and lower costs.
文摘Background:Human immunodefciency virus(HIV)self-testing may help improve test uptake among female sex workers.China has implemented many HIV self-testing programs among men who have sex with men,creating an opportunity for promotion among female sex workers.However,there is a limited literature on examining HIV selftesting among female sex workers.This study aimed to examine HIV self-testing experiences and its determinants among female sex workers in China.Methods:A venue-based,cross-sectional study was conducted among Chinese female sex workers in 2019.Participants completed a survey including social-demographic characteristics,sexual behaviors,and HIV self-testing history,the distribution of which were analyzed using descriptive analysis.Multivariable logistic regression was conducted to identify associations with HIV self-testing.Results:Among 1287 Chinese female sex workers,1072(83.3%,95%confdence interval[CI]81.2-85.3%)had ever tested for HIV,and 103(8.0%,95%CI 6.6-9.6%)had ever used HIV self-testing.More than half reported that the selftest was their frst HIV test(59.2%,61/103),around one-ffth reported HIV self-testing results infuenced the price of sex(21.4%,22/103).A minority of individuals reported ever experiencing pressure to undertake HIV self-testing(6.8%,7/103).After adjusting for covariates,HIV self-testing was positively associated with receiving anal sex in the past month(adjusted odds ratio[aOR]=2.2,95%CI 1.4-3.5),using drugs before or during sex(aOR=2.8,95%CI 1.8-4.5),injecting drugs in the past 6 months(aOR=2.6,95%CI 1.2-6.0),being diagnosed with other sexually transmitted infections(aOR=1.6,95%CI 1.0-2.5),tested for other sexually transmitted infections in the past six months(aOR=3.4,95%CI 2.1-5.5),ever tested in the hospital(aOR=3.4,95%CI 2.0-5.6),and ever tested in the community(aOR=1.5,95%CI 1.2-1.9).Conclusions:Our fndings suggest that HIV self-testing could expand overall HIV testing uptake,increase HIV testing frequency,reach sub-groups of high-risk female sex workers and has limited potential harms among female sex workers.HIV self-testing should be incorporated among Chinese female sex workers as a complement to facility-based HIV testing services.
文摘BACKGROUND In 2019,the Nigerian Ministry of Health published the first operational guidelines for human immunodeficiency virus self-testing(HIVST)to improve access to human immunodeficiency virus(HIV)testing services among undertested populations in the country.Also,as part of the campaign to increase HIV testing services in Nigeria,the Nigerian Ministry of Health developed standard operating procedures for using HIVST kits.AIM To systematically review the acceptability and strategies for enhancing the uptake of HIVST in Nigeria.METHODS The systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Different databases were searched to get the necessary materials needed for this review.Standardized forms developed by the authors were used for data extraction to minimize the risk of bias and ensure that the articles used for the study were properly screened.Identified articles were first screened using the titles and their abstracts.The full papers were screened,and the similarities of the documents were determined.Qualitative,quantitative,and mixed-method studies were evaluated using the Critical Appraisal Skills Programme and Critical Appraisal Framework criteria.RESULTS All the publications reviewed were published between 2015 and 2022,with 33.3%published in 2021.Most(77.8%)of the studies were cross-sectional,43.3%were conducted in Lagos State,and 26.3%were conducted among young people.The study revealed a high level of acceptability of HIVST.Certain factors,such as gender,sexual activity,and previous testing experience,influence the acceptability of HIV self-testing,with some individuals more likely to opt-out.The cost of the kit was reported as the strongest factor for choosing HIVST services,and this ranged from 200 to 4000 Naira(approximately United States Dollar 0.55-11.07),with the majority willing to pay 500 Naira(approximately United States Dollar 1.38).Privately-owned,registered pharmacies,youthfriendly centres,supermarkets,and online stores were the most cited access locations for HIVST.The least influential attribute was the type of specimen needed for HIVST.Strategies addressing cost and preferred access points and diverse needs for social media promotion,local translation of product use instructions,and HIVST distribution led by key opinion leaders for key populations were found to significantly enhance HIVST uptake and linkage to care.CONCLUSION HIVST acceptability is generally high from an intention-to-use perspective.Targeted strategies are required to improve the acceptability of HIV self-testing,especially among males,sexually active individuals,and first-time testers.Identified and proposed uptake-enhancing strategies need to be investigated in controlled settings and among different populations and distribution models in Nigeria.
文摘目的分析2016—2022年云南省艾滋病自愿咨询检测(voluntary counselling and testing,VCT)和医疗机构医务人员主动提供人类免疫缺陷病毒(human immunodeficiency virus,HIV)检测咨询(provider initiated HIV testing and counselling,PITC)发现的HIV感染者和艾滋病患者(HIV感染者/艾滋病患者)特征的差异,为制定艾滋病检测策略提供依据。方法收集“中国疾病预防控制信息系统”中2016年1月1日—2022年12月31日通过VCT和PITC发现的新报告HIV感染者/艾滋病患者。利用非条件logistic回归分析比较不同途径发现的HIV感染者/艾滋病患者的特征、晚发现以及抗病毒治疗情况。结果2016—2022年云南省累计新报告VCT和PITC发现HIV感染者/艾滋病患者56378例,其中,VCT发现11750例(20.84%),PITC发现44628例(79.16%)。多因素logistic回归分析显示,女性(OR=0.84,95%CI:0.80~0.88)、配偶HIV阴性(OR=0.38,95%CI:0.35~0.41)及不清楚配偶HIV感染情况(OR=0.74,95%CI:0.61~0.89)者,通过PITC检测发现的可能性高。初中(OR=1.17,95%CI:1.11~1.24)、高中或中专(OR=1.31,95%CI:1.21~1.43)和大专及以上文化程度(OR=1.43,95%CI:1.30~1.57),通过男男同性性行为感染(OR=3.59,95%CI:3.29~3.92)、注射毒品感染(OR=1.63,95%CI:1.42~1.87)及配偶HIV阳性(OR=3.56,95%CI:3.38~3.75)者通过VCT门诊发现感染HIV的可能性高。与VCT相比,PITC中的其他就诊者检测(OR=1.41,95%CI:1.34~1.48)和术前/受血前检测(OR=1.20,95%CI:1.12~1.28)发现的HIV感染者/艾滋病患者晚发现的比例高,孕产期检测晚发现的比例低(OR=0.70,95%CI:0.60~0.81);与VCT相比,术前/受血(制品)前检测(OR=0.63,95%CI:0.57~0.70)、其他就诊者检测(OR=0.64,95%CI:0.59~0.69)发现的HIV感染者/艾滋病患者抗病毒治疗比例更低。结论VCT在早期发现病例、男男同性性行为筛查及抗病毒治疗促进方面有优势;PITC的推广有助于扩大普通人群的检测比例;可针对不同人群制定HIV感染者发现策略,促进早检测、早发现和早治疗。
文摘目的 基于巨噬细胞自噬探讨参芩龙清肺培元颗粒的作用机制。方法 选择人类免疫缺陷病毒(HIV)/艾滋病(AIDS)合并肺部感染痰热壅肺证患者36例,应用流式细胞术检测治疗前后患者外周血T淋巴细胞亚群中CD4^(+)及CD8^(+)T淋巴细胞计数,巨噬细胞亚群CD11b、CD86、CD206的表达及巨噬细胞自噬探针CD11b+DALGreen、CD86+DALGreen、CD206+DALGreen的表达。ELISA法检测治疗前后血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、IL-10、转化生长因子(TGF)-β1等炎性因子的表达。采用荧光定量PCR法检测治疗前后患者外周血中组蛋白去乙酰化酶(HDAC)2 m RNA、Unc-51样激酶1(ULK1)m RNA的表达。结果 治疗后,患者CD11b、CD206、CD11b+DALGreen、CD206+DALGreen、ULK1 m RNA表达明显升高(P<0.05);CD86、TNF-α、IL-1β、HDAC2 m RNA的表达明显下降(P<0.05);CD4^(+)T淋巴细胞计数、IL-10、TGF-β1表达呈上升趋势(P>0.05)。结论 参芩龙清肺培元颗粒可能通过调节HDAC2/ULK1信号轴,促进巨噬细胞自噬,调节M1/M2的平衡,抑制炎症反应,从而发挥治疗HIV/AIDS患者合并肺部感染的作用。
