Background:By September 2016,approximately 653,865 people in China were living with HIV/AIDS(PLWHA)and 492,725 people were receiving antiretroviral therapy(ART).PLWHA frequently experience discrimination in all domain...Background:By September 2016,approximately 653,865 people in China were living with HIV/AIDS(PLWHA)and 492,725 people were receiving antiretroviral therapy(ART).PLWHA frequently experience discrimination in all domains of their personal and social lives.The World Health Organization includes discrimination in its list of social determinants of health factors that have been linked to poor physical and psychological health.This paper identifies the family support enjoyed and discrimination faced by people infected with HIV and examines the effect they have on patients’quality of life(QOL)as they undergo ART in China.Methods:We conducted this observational cohort study of ART-treated patients with HIV in Guangxi Province using a questionnaire survey at baseline,6,12,and 24 months,starting in 2010.Descriptive analysis was used to describe the demographic characteristics(e.g.,age,sex,educational level,marital status,and employment status)of participants.Generalized estimating equations(GEE)were employed to examine the relationships between family support,discrimination,and QOL.Results:In the study,90.4%(n=281)of patients received family support at baseline,here defined as the initiation of ART,91.8%(n=244)received family support 6 months into ART,95.5%(n=220)at 12 months,and 94.3%(n=230)at 24 months.The proportion of patients who did not feel discriminated against by their families was 87.2%(n=274)at baseline,90.4%(n=229)6 months into ART,90.0%(n=210)at 12 months,and 94.5%(n=219)at 24 months.Patients’overall QOL scores were positively associated with having received family support(OR=2.74,P=0.040,95%CI:1.68-4.47),not feeling discriminated against by their families(OR=1.3,P=0.041,95%CI:1.07-1.59)or discrimination from patients themselves,including never experiencing fear of abandonment by family(OR=2.05,P=0.025,95%CI:1.49-2.82).Conclusions:Family support along with no or minimal discrimination was found to contribute to QOL among people infected with HIV.Their overall QOL tended to improve significantly as ART continued.This suggests that strategies meant to improve and strengthen family support,care for PLWHA,and promote HIV screening among high-risk populations should be explored by both policy makers and researchers.展开更多
目的了解云南省德宏州HIV单阳家庭合并HCV感染人群HCV基因型分布特征。方法截至2015年12月,德宏州芒市、梁河、陇川三县市共有HIV单阳家庭1151对,选取夫妻双方均有血浆样本且信息完整的582对夫妻纳入研究对象。采用问卷调查获取研究对...目的了解云南省德宏州HIV单阳家庭合并HCV感染人群HCV基因型分布特征。方法截至2015年12月,德宏州芒市、梁河、陇川三县市共有HIV单阳家庭1151对,选取夫妻双方均有血浆样本且信息完整的582对夫妻纳入研究对象。采用问卷调查获取研究对象基本信息,采集夫妻血浆样本进行HCV抗体检测,采用巢式PCR对HCV的核心蛋白结合包膜蛋白(Core/E1)与非结构蛋白(NS5B)两个基因区进行扩增并测序,用Chromas Pro 1.5软件和MEGA 6.06软件构建分子系统进化树确定基因亚型,χ^2检验和Fisher精确检验比较不同特征人群的基因型分布差异。结果162例阳性样本中共有135例成功扩增HCV基因片段并分型(扩增成功率83.33%,135/162),基因型以3b(52.59%,71/135)居多。其中,HIV合并HCV感染样本112例,HCV基因型以3b和6u为主,占53.57%和23.21%,6n、1a、3a、疑似重组/混合感染和1b型分别占10.72%、5.36%、3.57%、2.68%和0.89%。HCV单纯感染者23例,占17.04%(23/135)。合并感染与单纯感染者HCV基因型分布差异有统计学意义(χ^2=11.429,P=0.045)。112例合并感染者中,以男性(92.85%)、35~45岁(58.04%)、景颇族(56.25%)、文化程度小学(52.68%)、注射吸毒(67.86%)、中国籍(90.18%)、农民(91.96%)为主,分析表明,除民族(χ^2=15.699,P=0.006)、感染途径(χ^2=9.106,P=0.018)在HCV基因型分布上差异有统计学意义外,其他特征差异无统计学意义(P>0.05)。结论德宏州HIV单阳家庭合并HCV感染人群中HCV基因亚型至少6种,同时还发现疑似重组或混合感染的基因型。HCV基因型分布与感染途径、HIV感染情况密切相关,应当加强HIV单阳家夫妻HCV的干预。展开更多
基金The study was supported in part by grants from the Program of 15 Years China AIDS Antiretroviral Treatment of Economic Evaluation and Medicare Payment Mode Studies(project no.20163000254).
文摘Background:By September 2016,approximately 653,865 people in China were living with HIV/AIDS(PLWHA)and 492,725 people were receiving antiretroviral therapy(ART).PLWHA frequently experience discrimination in all domains of their personal and social lives.The World Health Organization includes discrimination in its list of social determinants of health factors that have been linked to poor physical and psychological health.This paper identifies the family support enjoyed and discrimination faced by people infected with HIV and examines the effect they have on patients’quality of life(QOL)as they undergo ART in China.Methods:We conducted this observational cohort study of ART-treated patients with HIV in Guangxi Province using a questionnaire survey at baseline,6,12,and 24 months,starting in 2010.Descriptive analysis was used to describe the demographic characteristics(e.g.,age,sex,educational level,marital status,and employment status)of participants.Generalized estimating equations(GEE)were employed to examine the relationships between family support,discrimination,and QOL.Results:In the study,90.4%(n=281)of patients received family support at baseline,here defined as the initiation of ART,91.8%(n=244)received family support 6 months into ART,95.5%(n=220)at 12 months,and 94.3%(n=230)at 24 months.The proportion of patients who did not feel discriminated against by their families was 87.2%(n=274)at baseline,90.4%(n=229)6 months into ART,90.0%(n=210)at 12 months,and 94.5%(n=219)at 24 months.Patients’overall QOL scores were positively associated with having received family support(OR=2.74,P=0.040,95%CI:1.68-4.47),not feeling discriminated against by their families(OR=1.3,P=0.041,95%CI:1.07-1.59)or discrimination from patients themselves,including never experiencing fear of abandonment by family(OR=2.05,P=0.025,95%CI:1.49-2.82).Conclusions:Family support along with no or minimal discrimination was found to contribute to QOL among people infected with HIV.Their overall QOL tended to improve significantly as ART continued.This suggests that strategies meant to improve and strengthen family support,care for PLWHA,and promote HIV screening among high-risk populations should be explored by both policy makers and researchers.
文摘目的了解云南省德宏州HIV单阳家庭合并HCV感染人群HCV基因型分布特征。方法截至2015年12月,德宏州芒市、梁河、陇川三县市共有HIV单阳家庭1151对,选取夫妻双方均有血浆样本且信息完整的582对夫妻纳入研究对象。采用问卷调查获取研究对象基本信息,采集夫妻血浆样本进行HCV抗体检测,采用巢式PCR对HCV的核心蛋白结合包膜蛋白(Core/E1)与非结构蛋白(NS5B)两个基因区进行扩增并测序,用Chromas Pro 1.5软件和MEGA 6.06软件构建分子系统进化树确定基因亚型,χ^2检验和Fisher精确检验比较不同特征人群的基因型分布差异。结果162例阳性样本中共有135例成功扩增HCV基因片段并分型(扩增成功率83.33%,135/162),基因型以3b(52.59%,71/135)居多。其中,HIV合并HCV感染样本112例,HCV基因型以3b和6u为主,占53.57%和23.21%,6n、1a、3a、疑似重组/混合感染和1b型分别占10.72%、5.36%、3.57%、2.68%和0.89%。HCV单纯感染者23例,占17.04%(23/135)。合并感染与单纯感染者HCV基因型分布差异有统计学意义(χ^2=11.429,P=0.045)。112例合并感染者中,以男性(92.85%)、35~45岁(58.04%)、景颇族(56.25%)、文化程度小学(52.68%)、注射吸毒(67.86%)、中国籍(90.18%)、农民(91.96%)为主,分析表明,除民族(χ^2=15.699,P=0.006)、感染途径(χ^2=9.106,P=0.018)在HCV基因型分布上差异有统计学意义外,其他特征差异无统计学意义(P>0.05)。结论德宏州HIV单阳家庭合并HCV感染人群中HCV基因亚型至少6种,同时还发现疑似重组或混合感染的基因型。HCV基因型分布与感染途径、HIV感染情况密切相关,应当加强HIV单阳家夫妻HCV的干预。
