Characteristics of the HIV/AIDS Epidemic among People Aged≥50 Years in China during 2018–2021

Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.

Stability Analysis of a Delayed HIV/AIDS Epidemic Model with Treatment and Vertical Transmission

A delayed HIV/AIDS epidemic model with treatment and vertical transmission is investigated. The model allows some infected individuals to move from the symptomatic phase to the asymptomatic phase;next generation of infected individuals may be infected and it will take them some time to get maturity and infect others. Mathematical analysis shows that the global dynamics of the spread of the HIV/AIDS are completely determined by the basic reproduction number R0 for our model. If R0 R0 > 1.

Modelling the Spread of HIV/AIDS Epidemic

In this paper, a deterministic mathematical model for the spread of HIV/AIDS in a variable size population through horizontal transmission is considered. The existence of a threshold parameter, the basic reproduction number, is established, and the stability of both the disease-free equilibrium and the endemic equilibrium is discussed in terms of R0 .

Optimal Control of an HIV/AIDS Epidemic Model with Infective Immigration and Behavioral Change

In order to find out the effect of human (sexual) behavior change and immigration in spreading the HIV/AIDS, a deterministic model of HIV/AIDS with infective immigration is formulated. First, basic properties of the model, including non-negativity and boundedness of the solutions, existence of the endemic equilibrium and the basic reproduction number, R0 are analyzed. The geometrical approach is used to obtain the global asymptotic stability of endemic equilibrium. Then the basic model is extended to include several control efforts aimed at reducing infection and changing behavior. Pontryagin’s maximum principle is used to derive the optimality system and solve the system numerically. Our numerical findings are illustrated through simulations using MATLAB, which shows reliability of our model from the practical point of view.

Control Model of the HIV/AIDS Epidemic Based on Kinetic Equation

The corresponding dynamics equation model of HIV/AIDS was given based on the popular situation of HIV/AIDS in recent years. We studied the stability of the equilibrium point, discussed the threshold of epidemic, and carried on the numerical simulation based on the different persuade rate P, the different disease mortality α and the different infection rate β. The HIV/AIDS epidemic disease can pop in city at R0 > 1. We suggested that more persuade should be increased in addition to strengthening routine work according to the characteristics of R0 in the prevented and the controlled work of HIV/AIDS, which could more effectively reduce the number of HIV/AIDS patients. It provided the theoretical guidance, the beneficial reference on the prevented and the controlled work of HIV/AIDS.

Analysis on the Trends of HIV/AIDS Epidemic in Shenzhen

Objective:To make a summary of the trends of HIV/AIDS epidemic and route of transmission in Shenzhen from 1992 to 2000 to provide scientific evidence for the policy-maker to formulate strategies of HIV/AIDS prevention and control in Shenzhen.Method:To analyze HIV/AIDS surveillance data in Shenzhen from 1992 to 2000 by software Epi-Info. Results: One hundred and two HIV positive cases including 18 AIDS cases (three cases deceased) were identified in Shenzhen from 1992 to 2000. Among the 102 cases, those infected via sex were 46.0%, intravenous drug use 42.9%.Blood donation 7.8%, blood transfusion recipient 3.9%, and indeterminate 2%. Conclusion: In Shenzhen, HIV/AIDS infection is spreading and increasing rapidly. Effective prevention measures must be taken to reduce the HIV prevalence as soon as possible.

The Changing Trends of HIV/AIDS in An Ethnic Minority Region of China: Modeling the Epidemic in Liangshan Prefecture, Sichuan Province

Objective This study was to investigate the HIV current situation in Liangshan prefecture, in order to predict prevalence and transmission trends. Methods Region-specific population, behavior, serosurveillence, and policy/program data （from 1995 to 2020） were gathered from various local and national organizations and applied to the Asian Epidemic Model （AEM） and used to derive estimates of future HIV prevalence, epidemic trends, and outcomes of intervention strategies. Results The AEM projections for 2020 included increased number of people living with HIV （PLHIV; to 136 617）, increased HIV prevalence （2.51%）, and 8037 deaths from acquired immunodeficiency syndrome （AIDS） in this region. However, the overall HIV incidence rate （per 10 000） was projected to decline from 27 in 2015 to 22 in 2020, largely due to a predicted decrease in HIV infection rate （per 10 000） from 658 in 2013 to 621 in 2020 among intravenous drug users. In contrast, the cases of HIV infection per i0 000 was projected to increase from 420 in 2010 to 503 in 2020 among men who have sex with men, and from 8 in 2010 to 15 in 2020 among the general population. The predominant risk factor for HIV transmission over the next decade in Liangshan was casual sex. Community-based outreach strategies to reduce injected drug use and casual sex, and to promote condom use, were predicted as effective interventions to decrease HIV transmission. Conclusion Implementation of a comprehensive public health program, with targeting to the region-specific at-risk populations, will help to mitigate HIV/AIDS spread in Liangshan.

HIV/AIDS肺脾气虚证相关心脑血管疾病风险因素探析

目的通过检测血脂四项、血管内皮损伤因子、炎症相关因子,并结合前期的基因芯片结果,初步探讨人类免疫缺陷病毒(HIV)/艾滋病(AIDS)肺脾气虚证相关心脑血管疾病风险因素及机制,为中医药早期干预心脑血管疾病提供依据。方法2020年9月—2020年11月选取河南省某地区确诊的20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例HIV抗体阴性作为健康对照组。检测CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)计数,并计算CD_(4)^(+)/CD_(8)^(+)比值;检测血脂四项甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);检测氧化低密度脂蛋白(Ox-LDL)、载脂蛋白A-I(ApoAⅠ)、载脂蛋白A-Ⅱ(ApoAⅡ)、载脂蛋白B(ApoB)、锌-α2-糖蛋白1(AZGP1)、可溶性血栓调节蛋白(sTM)、血管性血友病因子(vWF)、脂联素、瘦素(LEP)、超敏C反应蛋白(Hs-CRP)、单核细胞趋化因子1(MCP-1)、肿瘤坏死因子α(TNF-α)。结果HIV/AIDS肺脾气虚证患者与健康对照组比较CD_(4)^(+)降低,CD_(4)^(+)/CD_(8)^(+)比值倒置,TC降低,sTM、AZGP1、Ox-LDL、Hs-CRP升高。结论HIV/AIDS肺脾气虚证患者存在炎性反应、血脂异常的表现,罹患心脑血管疾病风险增加。为中医药早期干预心脑血管疾病的发生提供新思路。

A Collocation Technique via Pell-Lucas Polynomials to Solve Fractional Differential EquationModel for HIV/AIDS with Treatment Compartment

In this study,a numerical method based on the Pell-Lucas polynomials(PLPs)is developed to solve the fractional order HIV/AIDS epidemic model with a treatment compartment.The HIV/AIDS mathematical model with a treatment compartment is divided into five classes,namely,susceptible patients(S),HIV-positive individuals(I),individuals with full-blown AIDS but not receiving ARV treatment(A),individuals being treated(T),and individuals who have changed their sexual habits sufficiently(R).According to the method,by utilizing the PLPs and the collocation points,we convert the fractional order HIV/AIDS epidemic model with a treatment compartment into a nonlinear system of the algebraic equations.Also,the error analysis is presented for the Pell-Lucas approximation method.The aim of this study is to observe the behavior of five populations after 200 days when drug treatment is applied to HIV-infectious and full-blown AIDS people.To demonstrate the usefulness of this method,the applications are made on the numerical example with the help of MATLAB.In addition,four cases of the fractional order derivative(p=1,p=0.95,p=0.9,p=0.85)are examined in the range[0,200].Owing to applications,we figured out that the outcomes have quite decent errors.Also,we understand that the errors decrease when the value of N increases.The figures in this study are created in MATLAB.The outcomes indicate that the presented method is reasonably sufficient and correct.

HIV/AIDS合并肝损伤患者的临床特点

目的总结HIV/AIDS合并肝损伤患者的临床特点。方法选取53例HIV抗体阳性合并肝损伤患者作为研究对象,根据肝脏组织病理结果分为病毒性肝炎组(n=27)、肝细胞肝癌组(n=15)和肝脏弥漫大B细胞淋巴瘤组(n=11)。比较三组患者的临床症状和腹部CT影像学特征,以及肝脏组织病理学和免疫表型。结果三组在消瘦、发热、上腹痛、浅表淋巴结肿大、丙氨酸转氨酶升高、碱性磷酸酶升高、甲胎蛋白升高方面差异均有统计学意义;三组在多发结节、单发结节、病灶不均匀强化、病灶轻度强化、病灶重度强化方面差异均有统计学意义(均P<0.05)。病毒性肝炎组镜下见肝小叶结构破坏,肝细胞肝癌组镜下见凝固性坏死组织,弥漫大B细胞淋巴瘤组镜下见肝小叶结构广泛破坏和星空现象。结论不同类型HIV/AIDS合并肝损伤患者临床症状、实验室检查结果、腹部CT影像学特征有一定差异,但其较难区分肝细胞癌和弥漫大B细胞淋巴瘤,两者鉴别诊断需借助肝脏组织病理学和免疫表型方法。

自噬相关基因在HIV/AIDS肺脾气虚证中的表达及意义

目的探讨自噬相关基因在人类免疫缺陷病毒(human immunodeficiency virus,HIV)/艾滋病(acquired immune deficiency syndrome,AIDS)肺脾气虚证中的表达及意义。方法选取河南驻马店市20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例健康人为对照,HIV/AIDS肺脾气虚证患者用益艾康胶囊进行干预治疗。采用基因芯片技术,检测分析两组人群外周血单个核细胞(peripheral blood mononuclear cell,PBMC)中自噬相关基因的表达。结果HIV/AIDS肺脾气虚证组患者中DDIT4、IRS2、CXCR4表达下调,PDPK1表达上调,经益艾康治疗后差异基因发生转归,差异有统计学意义(P<0.05)。应用KEGG分析发现DDIT4、CXCR4、PDPK1、IRS2与磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白(phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin,PI3K/PKB,又称Akt/mTOR)信号通路相关。结论HIV/AIDS肺脾气虚证人群中自噬相关基因差异表达,益艾康可能通过调节DDIT4、CXCR4、IRS2的表达影响HIV/AIDS肺脾气虚证患者的自噬过程。

武汉市1994~2022年HIV感染者/AIDS患者的生存时间及其影响因素

目的分析武汉市1994~2022年HIV感染者/AIDS患者(HIV/AIDS)生存时间及其影响因素,为进一步制定防治策略提供依据。方法收集国家艾滋病综合防治信息系统中武汉市1994~2022年直报的常住HIV/AIDS流行病学调查和抗病毒治疗数据,采用寿命表法、Cox比例风险回归模型对生存时间及其影响因素进行分析。结果纳入研究的8954例HIV/AIDS共随访47245.4人年,全死因死亡1078例,中位生存时间22.3年;第1、5、10、15、20年生存率分别为92.9%、88.5%、83.5%、78.7%、73.8%;Cox比例风险回归模型分析结果显示,未治疗、男性、较大年龄、无职业、低文化程度、本地户籍、异性性行为传播及注射吸毒传播、医疗机构检测发现及较低CD4基线水平是影响HIV/AIDS生存时间的危险因素,未治疗患者死亡风险为已治疗患者的13.979倍(95%CI:11.883~16.446),无职业患者死亡风险为有职业患者的1.140倍(95%CI:1.004~1.295),本地患者死亡风险是流动人口1.682倍(95%CI:1.415~2.000),医疗机构检测发现的患者死亡风险是自愿咨询检测患者的1.823倍(95%CI:1.421~2.339)。结论应针对50岁及以上、无职业、低文化程度、医疗机构检测发现及低CD4基线水平等危险因素,开展宣传教育提升大众对艾滋病的科学认识,并通过医防协同、社会组织参与等方式促进早检测、早治疗;充分利用HIV/AIDS人群健康大数据,形成多维度全生命周期健康档案,针对不同个体提供包括心理干预在内的精准医疗,延长生存时间和提高生活质量是今后努力的方向。

基于Bayes时空模型分析HIV/AIDS晚发现的时空分布特征及其影响因素

【目的】旨在分析兰州市HIV/AIDS晚发现的时空聚集性特征及相关影响因素,明确兰州市HIV/AIDS晚发现高风险地区和时间趋势,为兰州市因地制宜地制定HIV/AIDS防治策略措施提供参考依据。【方法】选择兰州市2011-2018年间新报告的成年HIV/AIDS病例作为研究对象,研究中所需的数据资料来自兰州市疾病预防控制中心和兰州市统计年鉴。采用Bayes时空模型分析HIV/AIDS晚发现相对风险(RR)的时空分布特征及其影响因素。【结果】2011-2018年间兰州市新报告的HIV/AIDS病例共计1984例,其中HIV/AIDS晚发现者有982例(49.5%),平均年龄为39.67岁,男性占90.9%。老年人和女性HIV/AIDS病例中晚发现的比例更高;城关区(51.1%)、安宁区(50.3%)和榆中县(51.9%)具有高于平均水平的HIV/AIDS晚发现比例;2011-2018年间兰州市总体的晚发现比例呈波动上升趋势。Bayes时空模型分析结果显示,兰州市HIV/AIDS晚发现风险在2011-2015年间波动变化,而在2015年后迅速上升,其RR(95%CI)从1.01(0.84,1.23)上升到1.11(0.77,1.97);红古区和三个县的晚发现风险变化趋势与兰州市的总体变化趋势相似,而城关区和七里河区的晚发现风险呈下降趋势;晚发现相对风险大于1的区县包括:永登县(RR=1.07,95%CI:0.55,1.96)、西固区(RR=1.04,95%CI:0.67,1.49)、城关区(RR=2.41,95%CI:0.85,6.16)和七里河区(RR=2.03,95%CI:1.10,3.27)。冷热点分析结果显示城关区和七里河区为热点区。影响因素分析结果显示,随着人均GDP(RR=0.65,95%CI:0.35,0.90)和HIV/AIDS病例中的男性比例(RR=0.53,95%CI:0.19,0.92)的增高,HIV/AIDS晚发现的相对风险越低;而人口密度(RR=1.35,95%CI:1.01,1.81)越大,晚发现风险越高。【结论】兰州市的HIV/AIDS晚发现风险呈上升趋势,并且存在明显的地区差异特征;人均GDP、HIV/AIDS中男性比例和人口密度是HIV/AIDS晚发现的影响因素。因此,对于晚发现风险高和存在相关风险因素的区县,应重视并制定有针对性的HIV筛查和防治服务,降低HIV/AIDS晚发现比例和风险。

宁夏50岁及以上HIV/AIDS患者流行病学特征分析

目的分析宁夏50岁及以上HIV/AIDS患者的相关特征,为艾滋病防控政策制定提供依据。方法数据来源于中国疾病预防控制信息系统,选取2015-2022年报告中年龄≥50岁的病例,应用SPSS 21.0软件进行统计分析。结果宁夏报告HIV/AIDS患者中≥50岁所占比例从2015年的14.8%上升至2022年31.3%(P<0.05)。2015-2022年共报告≥50岁HIV/AIDS患者643例,其中男性494例(76.8%)、农民296例(46.0%)、已婚456例(70.9%)、小学及以下文化程度314例(48.8%),本省582例(90.5%);传播途径以异性传播为主(79.8%);发现方式以医疗机构检测为主(75.3%);首次CD4细胞计数<350个/μl占33.4%。男性以商业异性性传播为主(46.8%),同性传播占一定比例(18.8%);随着年龄增加离异或丧偶者占比增加,商业异性性传播占比也增加。女性以配偶阳性传播(46.0%)和非婚非商业异性性行为(44.6%)为主;已婚有配偶者配偶阳性传播占比较高(54.7%),离异或丧偶者非婚非商业传播占比较高(65.6%)。全死因报告死亡比例为5.1%,晚发现比例为30.5%。结论2015-2022年宁夏报告50岁及以上HIV/AIDS患者占比逐年增加,人群艾滋病传播方式多样,感染风险持续存在,应加强艾滋病防治知识宣传教育和配偶告知,加大主动检测力度,减少新发感染和二代传播。

广州市海珠区HIV/AIDS患者抑郁、焦虑和社会支持状况相关分析

目的了解广州市海珠区人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)患者(简称HIV/AIDS)抑郁、焦虑和社会支持现状及相关因素,为群体AIDS的防治工作提供参考。方法采用横断面研究方法,选取2019年10月至2022年6月广州市海珠区HIV/AIDS患者363例为研究对象进行问卷调查。使用自行设计的问卷,收集其人口学、抑郁、焦虑、社会支持、性行为等信息,分析HIV/AIDS患者抑郁、焦虑和社会支持状况。采用独立样本t检验、方差分析、秩和检验。结果本研究共调查HIV/AIDS患者363例,年龄(39.38±11.94)岁,男性占70.25%(255/363)、已婚占46.83%(170/363)、初中文化程度占36.91%(134/363)、工人占30.03%(109/363)。HIV/AIDS患者抑郁自评总分为(52.67±7.84)分,45.07%(160/355)的患者存在抑郁情绪,其中轻度居多[37.18%(132/355)];焦虑自评总分为(51.84±6.64)分,主要为轻度焦虑[47.92%(173/361)]。HIV/AIDS患者社会支持总分为(22.87±7.79)分,其中客观支持得分为(6.45±3.00)分,主观支持得分为(16.42±4.79)分,对支持的利用度得分为(5.74±1.84)分。结论广州市海珠区HIV/AIDS患者存在部分心理健康问题,社会支持普遍较低,应加强该人群的心理健康辅导,增加对该人群的社会支持,尤其是客观支持和主观支持。

HIV/AIDS患者肠内营养治疗喂养不耐受发生风险预测模型的构建与验证

目的调查HIV/AIDS患者肠内营养治疗喂养不耐受的影响因素,建立列线图预测模型并进行验证。方法回顾性分析2015年1月1日至2021年9月30日南宁市第四人民医院收治的HIV/AIDS住院患者临床资料,通过二分类Logistic回归模型,探索HIV/AIDS患者肠内营养治疗喂养不耐受的危险因素,构建列线图预测模型并验证评价。结果共纳入174例HIV/AIDS患者,其中76例HIV/AIDS患者发生早期肠内营养喂养不耐受(43.68%)。多因素分析显示,平均动脉压≤80 mmHg[OR=2.822,95%CI(1.267,6.287)]、急性生理学与慢性健康状况评分Ⅱ>15分[OR=5.625,95%CI(1.435,22.048)]、机械通气应用[OR=5.459,95%CI(2.046,14.564)]、高效抗反转录病毒治疗[OR=2.428,95%CI(1.118,5.275)]、肌松剂应用[OR=3.833,95%CI(1.758,8.357)]、CD4^(+)T细胞计数≤200个·μL^(-1)[OR=3.785,95%CI(1.126,12.724)]、抗生素使用数量>2种[OR=2.365,95%CI(1.039,5.384)]是HIV/AIDS患者肠内营养治疗发生喂养不耐受的影响因素。列线图预测模型AUC值为0.849[95%CI(0.794,0.905)],最大约登指数为0.555时,最佳临界值为0.331,灵敏度为88.16%,特异度为67.35%;校准曲线、决策曲线评价模型具有较好的一致性及获益性。结论本研究构建的HIV/AIDS患者肠内营养治疗喂养不耐受风险预测模型可为医护人员快速识别HIV/AIDS患者喂养不耐受发生风险、及时采取预防性护理措施提供参考依据。

2023年肇庆市现存HIV/AIDS患者随访检测现状统计分析

目的了解肇庆市现存艾滋病病毒感染及艾滋病(human immunodeficiency virus/acquired immune deficiency syndrome,HIV/AIDS)患者随访检测现状的流行病学特征。方法肇庆市疾病预防控制中心对肇庆市2023年1—12月现存的HIV/AIDS患者开展描述性流行病学分析,比较不同流行病学特征随访检测比例。结果截至2023年底现住址为肇庆的现存患者有1745例,男女比例为2.9∶1(1300/445);年龄以20~59岁为主,占77.0%;传播途径以异性传播为主,占73.2%;以医疗机构就诊发现为主,占57.3%。按年份统计,2021—2023年肇庆市每年现存HIV/AIDS患者随访检测比例呈逐年上升的趋势[88.3%(1402/1588)vs 89.6%(1507/1682)vs 95.7%(1670/1745)],差异有统计意义(χ^(2)=66.910,P<0.05);按现住址统计,2023年各县(市、区)现存的HIV/AIDS患者随访检测比例比较,差异有统计学意义(P<0.05);按人群特征统计,疾病名称、治疗状态随访检测比例比较,差异有统计学意义(P均<0.05)。结论2021—2023年肇庆市每年现存HIV/AIDS患者随访检测比例呈逐年上升趋势,2023年各县(市、区)随访检测比例有差异。在日后随访检测工作中针对随访检测现况的相关流行病学特征,采取各项干预措施,增加病人随访检测的依从性,能有效提高现存患者随访检测比例。

Unfolding of HIV Epidemic and Spectrum of AIDS in North India

The review traces the unfolding of HIV epidemic in North India. The first few cases were reported in 1989 in Indians returning from African countries like Uganda, Zambia and a trickle from USA. Subsequently the cases started pouring from coastal areas of Mumbai, Chennai and finally the virus spread all over through rail and road. In the North eastern region or the golden triangle, IV drug users formed a major group. Using a simple peptide ELISA, it was documented that the virus belonged to the NOF strain. This was much before clades were identified using molecular analysis. It appears that the HIV virus followed the drug (mandrax) route between Mumbai and South Africa. An alarming rise was observed among truck drivers fuelling HIV in Punjab villages who indulged in promiscuous behavior in road side making shift brothels near eating kiosks. Special customs in the state also flared the spread. During the early epidemic a very high prevalence was shown in blood transfused individuals (12.5%) which dropped to 2% -3% after aggressive measures taken by the NACO. While HIV positivity rates plateaued in some states by 2004, infection in Punjab continued to rise even after 2005. Kaposi sarcoma is almost unknown in Indian patients while TB and candida formed major co-infections. In one study, subtype V3 -V5 region chimeras of Indian clade C and clade B replicated freely in peripheral blood mononuclear cells (PBMC) and macrophages and showed higher HIV replication. Opt-out screening was started in an emergency setting in a tertiary care hospital. The positivity rate was 20/per thousand. Thus a large number of patients would have been missed if opt-out screening was not resorted to.

Optimal control of a fractional-order model for the HIV/AIDS epidemic

In this paper,we present a general formulation for a fractional optimal control problem (FOCP),in which the state and co-state equations are given in terms of the left fractional derivatives.We develop the forward-backward sweep method (FBSM)using the Adamstype predictor-corrector method to solve the FOCP.We present a fractional model for transmission dynamics of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)with treatment and incorporate three control efforts (effective use of condoms,ART treatment and behavioral change control)into the model aimed at controlling the spread of HIV/AIDS epidemic.The necessary conditions for fractional optimal control of the disease are derived and analyzed.The numerical results show that implementing all the control efforts increases the life time and the quality of life those living with HIV and decreases significantly the number of HIV-infected and AIDS people.Also,the maximum levels of the controls and the value of objective functional decrease when the derivative order a limits to 1(0.7≤a <1).In addition,the effect of the fractional derivative order a (0.7≤a <1)on the spread of HIV/AIDS epidemic and the treatment of HIV-infected population is investigated.The results show that the derivative order a can play the role of using ART treatment in the model.

The evaluation of global epidemic of HIV/AIDS with a novel approach using country-specific counts of HIV infections and three rates controlled for population and geographic area

Background:The human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)epidemic is a typical global health concern.The impact of HIV/AIDS is global,and we cannot effectively solve the problem without a global effort.In this study,we report our research on global HIV/AIDS control with an innovative fourdimensional approach.Methods:Countries(n=148)with data available on area size,total population,and the total number of persons living with HIV(PLWH)were included.The HIV epidemic across the globe was described using 4 indicators,including the total count,population-based P rate,geographic area-based G rate,and population and geographic area-based PG rate.Results:A total of 35,426,911 PLWH were included,with a global prevalence rate of 0.51 per 1,000 population.The total PLWH count provided data on resource allocation in individual countries to improve HIV/AIDS care;and the top five countries with the highest PLWH counts were South Africa(7,000),Nigeria(3,500),India(2,100),Kenya(1,500),and Mozambique(1,500).The other three indicators provide a measure to assess the global risk profile of HIV transmission and to provide information on HIV/AIDS prevention strategies.The top five countries with the highest P rates(per 1,000 persons)were Swaziland(170.9),Botswana(154.7),Lesotho(145.2),South Africa(127.4),and Zimbabwe(89.7);the top five countries with the highest G rates(per 100 km2)were Swaziland(1,279.1),Malawi(1,039.5),Lesotho(1,021.1),Rwanda(810.7),and Uganda(748.1);and the top five countries with highest PG rates(per 1,000,000 persons per 100 km2)were Barbados(2,127.9),Swaziland(993.8),Lesotho(478.3),Malta(375.0),and Mauritius(319.7).With PG rate,we detected countries in two hotspots(south and middle Africa and the Caribbean region)and one belt across the Euro-Asian region with high risks of HIV transmission.Conclusions:This study expanded the conventional measures by adding two new indicators,thus forming a new four-dimensional framework to quantify the global HIV epidemic.In addition to gaining a better insight into the epidemic than before,study findings provide new data on country-level and global efforts to end the AIDS epidemic by 2030.