A Systematic Review Study on Prevalence, Determinants, and Risk Factors of HIV/AIDS among Pacific Countries

Introduction: The Human Immunodeficiency Virus (HIV) is known as the biggest public health challenge in both developed and developing countries. This systematic review study is carried out to assess the prevalence, determinants, and risk factors of HIV/AIDS in Pacific countries. Methods: This systematic review study applied Cochrane Library Guideline to search, review, apprise, and analyze the articles related to HIV/AIDS. Both qualitative and quantitative articles were published between 2000 to 2016, in English language and were published in databases such as MEDLINE/PubMed, CINAHL, ISI Web of Science, EBSCO, ProQuest, Springer and PyschInfo. A data extraction sheet was made and a descriptive statistic was applied to analyze the data. Results: Fifty-one studies met the study inclusion and exclusion criteria. The United States had the highest frequency of studies on HIV/AIDS (30 studies). The overall prevalence of HIV/AIDS among Pacific islanders was between 1 to 14 percent. The most common determinants of community-based studies were ethnicity and gender, while they were age and ethnicity in the school-based studies and age in the hospital-based studies. The highest risk factors for HIV were substance abuse, number of sexual partners and unprotected sex. Conclusion:The results of the study highlighted the main determinants and risk factors, which provide a framework for public health experts and program planners to focus on different aspects of HIV/AIDS. As HIV/AIDS is a culturally sensitive health issue, developing preventive strategies considering the factors determined in this study will be strongly advised.

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.

Depression and Suicidal Risk in HIV-Infected Adults at Brazzaville University Hospital: Prevalence and Associated Factors

Introduction: Highly active antiretroviral tritherapies have improved the quality of life of people living with HIV (PVVIH) and extended their life expectancy. However, the nervous system is faced with a neurotropic virus that evolves chronically, sometimes creating neurological disorders directly or indirectly linked to stigmatization or therapeutic effects. Objective: to determine the prevalence of depression associated with suicidal risk (SR) and identify associated factors. Patients and method: This was a prospective descriptive and analytical study from January 1 to November 30, 2022, including all HIV-positive patients receiving or not receiving antiretroviral therapy. The study took place in the infectious diseases department of Brazzaville University Hospital. This department has an inpatient capacity of 36 beds, and an outpatient capacity of 25 patients per day, three times a week. This is the largest center for PVVIH in Brazzaville. The Patient Heath Questionnaire 9 (PHQ-9) was used to assess the degree of depression and suicidal risk. Therapeutic adherence was assessed using the Morisky questionnaire. Data were analyzed using SPSS version 23 software. Qualitative variables were expressed as numbers and percentages, and quantitative variables as means and standard deviations. Statistical tests were used according to their applicability criteria. For all tests, the significance threshold was set at 0.05. Results: A total of 150 patients were consulted, constituting the sample size. The prevalence of depression and suicidal risk was 32%. These patients had an average age of 42.83 ± 10.24 years, were female (n = 101;67.3%), Christian (n = 97;64%), single (n = 68;45.3%). Stigmatization (n = 75;50%) was the reason for attempted suicide. HIV was perceived as treatable (n = 103;68.7%), unlucky (n = 62;41.3%). Patients were WHO stage 1 (n = 105;70%). RS was present in 47 cases (31.3%). Factors associated with depression and suicidal risk were age (p = 0.000), residence (p = 0.028), suicide attempt (p = 0.000), desire to procreate (p = 0.000) and ARV (antiretrovirals) side effects (p Conclusion: The prevalence of depression and suicidal risk was high, in line with stigma and socio-economic conditions. The associated factors were in line with those identified in the literature. Mental health needs to be integrated into the overall care of people living with HIV.

淄博市2000—2021年HIV/AIDS患者生存时间及影响因素分析

目的探究淄博市2000年1月—2021年12月艾滋病病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immune deficiency syndrome,AIDS)患者生存时间及影响因素。方法采用回顾性分析对2000年1月—2021年12月淄博市HIV/AIDS患者的临床资料进行研究统计其生存情况,绘制生存曲线,并分析患者生存时间的影响因素。结果1203例HIV/AIDS患者纳入队列,全死因死亡147例(12.22%),平均生存时间(168.48±5.82)个月,第1、3、5、10年累计生存率分别为90.42%、88.01%、85.94%、80.58%。单因素分析结果显示,患者不同民族、婚姻状况、确定感染时的年龄、职业、文化程度、感染途径、样本来源、首次检测CD4^(+)T淋巴细胞计数、是否接受抗病毒治疗与生存时间有关(P<0.05);多因素分析结果显示,婚姻状况离异或丧偶[β=0.515,HR=1.673,95%CI 1.129~2.479]、未接受抗病毒治疗[β=2.088,HR=8.067,95%CI 4.176~15.582]是影响淄博市HIV/AIDS患者生存时间的独立危险因素(P<0.05),文化程度大专及以上[(β=-1.168,HR=0.311,95%CI 0.146~0.663)、文化程度不详(β=-2.417,HR=0.089,95%CI 0.012~0.686)、样本来源检测咨询(β=-0.946,HR=0.388,95%CI 0.242~0.624)、首次检测CD4^(+)T]淋巴细胞计数351~<500个/μL(β=-0.856,HR=0.425,95%CI 0.211~0.854)、首次检测CD4^(+)T淋巴细胞计数≥500个/μL(β=-0.948,HR=0.387,95%CI 0.173~0.865)是影响淄博市HIV/AIDS患者生存时间的保护性因素(P<0.05)。结论淄博市HIV/AIDS患者的生存率较高,HIV/AIDS患者生存时间受多种因素影响,应加强早发现和早治疗工作,延长HIV感染/AIDS患者生存时间,体现了《HIV/AIDS诊断标准和处理原则》的执行标准。

不同样本来源的中老年HIV/AIDS死亡率及其影响因素分析

目的了解云南省部分地区不同样本来源的〉150岁中老年艾滋病感染者／病人（HIV／AIDS）的病死率及其影响因素。方法收集来自云南省的临沧市、保山市、玉溪市、德宏州盈江县和瑞丽市、红河州开远市及昆明市五华区1989—2012年累计报告的≥50岁2244例中老年HIV／AIDS信息，计算病死率，并采用多因素非条件Logistic回归分析其影响因素。结果2244例I〉50岁中老年HIV／AIDS中，1989—2003年占5．40％，2004—2007年占30．20％，2008—2012年占64．40％；主要的样本来源为临床医疗机构，占36．30％，自愿咨询机构（VCT）占29．40％，其中2008—2012年占总数的构成比分别为81．90％和72．80％；以艾滋病死亡为结局的病死率为22．80％（95％CI：21．1％～24．6％），标准化后以来源于临床医疗机构的病死率最高（8．90％），后续依次分别为VCT（6．10％）、羁押场所（2．70％）、性病门诊（1．30％）、阳性配偶检测（0．60％）、专题调查（0．30％）。Logistic多因素回归分析显示，在控制潜在的多种混杂因素影响后，性别、年龄、职业、样本来源成为影响中老年HIV／AIDS死亡的主要因素。结论1989—2012年云南部分地区中老年HIV／AIDS主要来源于临床医疗机构和VCT点，且这两种来源的病死率较高。

重庆市2006-2012年艾滋病高危人群HIV/AIDS流行情况分析

目的分析重庆市2006-2012年艾滋病高危人群HIV/AIDS流行情况,为艾滋病高危人群的干预提供科学依据。方法从重庆市传染病上报系统和艾滋病监测哨点收集时间序列数据,评价指标为HIV新发病例数、HIV感染率和安全套使用率,利用泊松分布估计总体率的95%可信区间,采用时间序列相关性分析方法进行时间序列趋势性检验。结果 2006-2012年艾滋病感染的主要途径为异性性途径、同性性途径和静脉注射吸毒。暗娼（female sex worker,FSW）、静脉注射吸毒者（injecting drug use,IDU）、男男性行为人群（men who have sex with men,MSM）和性病门诊患者（people with sexually transmitted diseases,STDs）的HIV年平均感染率分别为0.18%（95%CI：0.10%～0.25%）、8.42%（95%CI：7.82%～9.03%）、15.62%（95%CI：14.41%～16.86%）和1.58%（95%CI：1.25%～1.91%）。FSW和MSM平均安全套使用比例分别为74.01%（95%CI：73.21%～74.82%）和62.30%（95%CI：60.67%～63.92%）。结论重庆市必须加强针对男男性行为人群、暗娼和性病门诊患者的干预工作,并在男男性行为人群和暗娼人群中加强安全套使用重要性的宣传力度。

HIV/AIDS家庭社会心理状况调查

目的了解我国艾滋病高发区人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)病人家庭的社会心理状况及社会支持情况,为评估救助效果提供参考。方法在某艾滋病高发区,随机采访了155户有HIV/AIDS家庭并进行问卷调查,包括HIV/AIDS 256人。调查内容包括社会人口学特征、感染/发病状况、社会心理及社会支持现状。结果HIV/AIDS以有偿献血为主(96.5%),其中55.9%的人认为自己半年来心情不好,83.2%的人回答患病对夫妻感情无影响,有60%以上的人感觉患病前后家人和周围的人对待自己和以前一样。政府和社会在近几年的救助力度在逐年加大。结论政府的相关政策和社会的救助措施在减少艾滋病对农村高发地区家庭的社会心理影响方面已经起到了积极作用。

河南省艾滋病高发区HIV/AIDS人群安全套使用情况和影响因素

目的:了解河南省AIDS高发区人类免疫缺陷病毒感染者/艾滋病患者(HIV/AIDS)安全套的使用情况和影响因素。方法:采用分级整群抽样的方法抽取3个项目县中9个自然村的HIV/AIDS人群进行问卷调查,包括一般人口学特征、AIDS基本知识及安全套使用情况等,采用logistic回归模型进行统计学分析。结果:HIV/AIDS人群中,每次或经常使用安全套的人数占49.5%。年龄越大,安全套使用率越低,其OR值为0.941(95%CI为0.921～0.961);AIDS基本知识得分越高,安全套使用率越高,其OR值为1.620(95%CI为1.080～2.432);高中及高中以上文化程度者安全套使用率高于文盲,其OR值为5.289(95%CI为1.876～14.911)。结论:河南省AIDS高发区部分HIV/AIDS安全套使用意识较为淡薄。AIDS基本知识、文化程度及年龄是安全套使用率的主要影响因素。

艾滋病生存质量量表(HIV/AIDSQOL-46)的研制

目的:研制具有中国文化背景的艾滋病生存质量量表。方法:成立由多学科专家组成的量表研制工作组,严格按照国际通行的量表研制程序,先后形成条目池、预量表、初步量表,最终形成正式量表。结论:以中国文化为背景的HIV/AIDS生存质量量表(HIV/AIDSQOL-46)初步研制成功。

深圳市HIV/AIDS流行状况分析

目的分析深圳市近年来HIV／AIDS流行情况,为艾滋病控制策略提供依据。方法对1992～2005年深圳市HIV／AIDS常规监测资料进行描述性分析。结果 1992～2005年深圳市共发现HIV／AIDS感染者1287例,HIV／AIDS感染总检出率,1996年为30．5／10万,2001年急升至76．1／10万,2002年93／10万；2003年81．7／10万,2004年143／10万,2005年206．8／10万。结论深圳艾滋病流行已进入快速增长期,并将呈现出从高危人群向一般人群扩散的趋势。

艾滋病高发区HIV/AIDS患者的艾滋病相关知识和影响因素分析

目的:了解河南省艾滋病高发区HIV/AIDS患者的艾滋病相关知识知晓情况和影响因素。方法:采用整群随机抽样的方法,对当地HIV/AIDS患者进行问卷调查,采用单因素和多因素Logistic回归进行统计学分析。结果:艾滋病相关知识知晓率为79.5%;多因素非条件Logistic回归显示,年龄、文化程度是艾滋病相关知识知晓情况的主要影响因素。结论:河南省艾滋病高发区HIV/AIDS患者艾滋病相关知识的知晓率较高,年龄较高者和文化程度较低者是艾滋病相关知识宣传的重点对象。

HIV/AIDS患者医院内信息化转介运行效果评价

目的探讨HIV/AIDS患者医院内信息化转介的效果,为完善医院内转介工作提供参考依据。方法以2017年1月—2019年12月在就诊的HIV初筛阳性、确诊阳性和ART停药、失访HIV/AIDS患者为转介对象,利用医院HIS信息系统建立的医院内信息化转介模式进行转介,对比HIV/AIDS患者转介成功和未转介成功在地区、CD4^(+)、转介时间以及各年度之间的差异,评价HIV/AIDS患者医院内信息化转介的效果。结果3770例患者转介成功率为79.68%,84.54%~85.45%转介成功发生6 h内。HIV/AIDS患者转介成功率从2017年的67.50%上升到2019年的92.30%,2017、2018年南宁市转介成功率低于南宁市以外地区(P<0.05),各年度的CD4^(+)<200个/毫米^(3)患者转介成功率大于CD4^(+)≥200个/毫米3患者转介成功率(P<0.05)。结论HIV/AIDS患者转介成功率逐年提升,转介医嘱开出后6 h未到艾滋病门诊的,门诊护士可通知开嘱医师做好督促工作。转介开嘱医师和转介接收护士应关注南宁市和CD4^(+)≥200个/毫米^(3)患者转介工作,做好追踪落实工作,尽可能地避免转介不成功导致的HIV/AIDS患者流失。

116例HIV/AIDS病例5年随访期生存情况调查

目的了解HIV/AIDS病例生存状况,为开展艾滋病自愿咨询及关怀服务提供依据。方法收集116例HIV/AIDS病例相关资料,并开展为期60个月的随访,采用生存分析方法,分析病例的生存情况。结果 60个月的随访期内死亡25例,累积生存率为78.4%,平均生存时间为(50.2±1.9)月;其中12个月随访期内累计死亡14例,累积生存率为87.9%。接受抗病毒治疗组累积生存率为92.6%,未接受治疗组累积生存率为66.1%,差异有统计学意义(χ2=14.752,P=0.000)。主要死因为艾滋病相关疾病和吸毒过量。结论确诊为HIV阳性后12个月内病例死亡风险较高,接受抗病毒治疗者可能更易存活。应通过宣传、转介等手段积极引导需要治疗的病人接受抗病毒治疗。

深圳市老年HIV/AIDS人群流行现状及CD4+T淋巴细胞基线计数的影响因素分析

[目的]了解深圳市老年人类免疫缺陷病毒(HIV)/艾滋病(AIDS)人群流行现状及CD4^+T淋巴细胞基线计数情况,分析其分布特征及影响因素。[方法]采集2006年6月─2018年6月深圳市的50岁以上老年HIV/AIDS人群的疫情信息和CD4^+T淋巴细胞基线计数,对其流行现状、疫情状况等进行描述性分析,采用多元线性回归分析老年HIV/AIDS人群CD4^+T淋巴细胞基线计数的影响因素。[结果]研究纳入687例老年HIV/AIDS病人,CD4^+T淋巴细胞基线计数绝对值为2~828(207.3±146.4)个/μL。多元线性回归分析发现,年龄、吸烟、性别是CD4^+T淋巴细胞基线计数的影响因素。[结论]深圳市老年HIV/AIDS人群CD4^+T淋巴细胞基线计数普遍偏低,特别是老年女性和吸烟者,且使用安全套意识薄弱,阳性配偶检测率低,应早期检测CD4^+T淋巴细胞计数,并在高CD4^+T淋巴细胞计数下就开始接受抗病毒治疗,以提高病人的生活质量。

盈江县HIV/AIDS高流行区感染者关怀和吸毒行为社区综合干预

[目的]解决农村家庭如何应对艾滋病预防、治疗和护理问题。[方法]为感染者及家属提供关怀服务,发放艾滋病宣传册、安全套,为感染者提供体检及抗机会性感染治疗;利用同伴的影响进行针具交换。[结果]许多家庭有了接受过培训的护理员,从而提高了HIV感染者/病人及其家属的艾滋病防护知识,使他们的生活质量得到了一定改善;吸毒者的相关知识增长,危险行为降低。[结论]干预促进了吸毒者的行为改变。

HIV prevalence in suspects attending Sir Sunder Lal Hospital

Objective:To assess the sero-positivity rate of HIV infection among clinically suspected subjects of reproductive age group(15-49 years),biological and behavioral characteristics of the subjects gender specific variation of sero-positivity rale,and the differentials of the sero-positivity rate for the history of blood transfusion or blood products or other organs,history of needle exposure and symptoms of morbidity.Methods:Study is based on the retrospective data of the calendar year 2005 obtained from Voluntary Counseling and Testing Centre(VCTC)(now renamed as ICTC),Department of Microbiology,I.M.S.,B.H.U..Varanasi.These cases were either referred by the consultants of different OPD'S of Sir Sunderlal Hospital or came voluntarily for knowing their HIV status.About 2-3 mL of blood samples were collected in a plain vial and tested for HIV status by strategy Ⅱ/Ⅲ as per WHO/NACO guidelines.Results:Overall sero-positivity of HIV was 15.3%(18.1%in males and 12.2%in females) which increased 6-7 folds in the age group 35-49 years as compared to 15-24 years in both the sexes.Sero-positivity rate in male migrants was 43.1%,while in female migrants it was 18.7%.The history of multiple sexual contacts was about 3 times higher in males as compared to females;predominantly it was very high in male migrants(67.7%) as compared to male non-migrants(15.8%).History of multiple sexual contacts was not uncommon in females and it was 25.0%in female migrants and 9.7%in non-migrant females.The sero-positivity rate with the history of multiple sexual contacts was 45.4%in males and 60.3%in females,while without history of multiple sexual contacts these were only 2.8%and 5.3%respectively.Sero-positive cases had on an average 3.6±1.7 various morbidity symptoms as compared to 0.7±1.1 in sero-negatives.It is to be noted that sero-positivity rate was more in those females who seemed apparently healthy compared to those presenting with some of the symptoms;vice versa,in males presenting with some symptoms HIV infection was 7 times higher than those without symptoms.Conclusions:The findings indicate a high sero-positivity among both the genders.Multiple heterosexual contacts,especially,in migrants are the main root of transmission of HIV.These are causing spread of HIV to their spouses.The multiple sexual contacts in the society,especially,among non migrant females of this region are indicating the distortion of traditions and cultures which are a serious concern and may lead to HTV infection on the rise.Awareness program to the susceptible group is the need to reduce further spread of HIV.

“三位一体”个案干预模式对北京地区HIV/AIDS患者ART启动时间和治疗依从性影响

目的本研究探讨了一种由医生、护士和非政府组织共同参与的“三位一体”个案干预模式,用以缩短从确诊HIV感染到开始抗反转录病毒治疗(antiretroviral therapy,ART)的时间,提高患者的依从性,改善ART效果。方法将2012年1月—2013年12月在北京佑安医院确诊的HIV/AIDS患者作为对照组,接受常规诊疗程序。2015年1月—2016年12月确诊的HIV/AIDS患者作为干预组,接受“三位一体”个案干预模式。比较2组ART启动时间及治疗依从性的差别及可能的影响因素。结果共纳入患者4906例,对照组1549例,干预组3357例。干预组从确诊到接受ART的中位时间为35 d,远少于对照组的56 d(Z=-10.087,P=0.001)。与对照组相比,干预组患者有更好的治疗依从性(89.2%vs.95.3%,P=0.000)。ART启动时间与个案干预模式的实施存在线性关系,且呈负相关。结论接受“三位一体”个案干预模式的HIV/AIDS患者能更快的启动ART,有更好的治疗依从性和队列保持率,可以在全国实施HIV个案干预模式,减轻AIDS负担。

一类具有意识分类的HIV/AIDS传染病模型的动力学研究

研究一类具有非线性发生率和意识分类的HIV/AIDS传染病模型,对其全局动力学进行了分析。证明了当基本再生数R_(0)<1时,无病平衡解全局渐近稳定;当R_(0)>1时,唯一的地方病平衡解全局渐近稳定。通过数值模拟验证解析结论。

2015—2019年洛江区HIV/AIDS流行病学分析

目的分析2015—2019年洛江区HIV/AIDS流行病学特征,为艾滋病防治提供科学依据。方法根据中国疾病预防控制信息系统中报告的洛江区2015—2019年HIV/AIDS病例信息,采用经典的描述统计法对收集的数据进行统计,分析其在不同年龄、不同性别、不同人群之间的发病情况。结果2015—2019年洛江区HIV/AIDS发病总人数78例,HIV/AIDS的发病率及死亡率呈不规律性增加或减少,总体较为平稳。男性发病率高于女性发病率,差异有统计学意义(P<0.05)。结论针对洛江区男性发病率高于女性发病率的特征,制定有效的防控措施,加强男性人群及20~60岁年龄组的艾滋病宣传及防控工作,实现对HIV感染的有效控制,降低HIV/AIDS社会传播概率。

不同肾小球滤过率评估方程在HIV/AIDS患者早期肾损害中的应用

目的探讨3种肾小球滤过率(GFR)评估方程(CKD-EPI2009 Scr、CKD-EPl2012 Cys C、CKD-EPI2012 Scr-Cys C)评价HIV/AIDS患者肾功能的应用。方法选取2018年7月至2021年8月定期检测的HIV/AIDS患者144例,检测血肌酐(Scr)及胱抑素C(Cys C),用3种不同方程估算肾小球滤过率(eGFR),并进行比较。结果方程CKD-EPI2009 Scr结果明显高于CKD-EPl2012 Cys C及CKD-EPI2012 Scr-Cys C的结果,差异有统计学意义(P<0.05),而CKD-EPl2012 Cys C与CKD-EPI2012 Scr-Cys C结果一致,差异无统计学意义(P>0.05)。结论方程CKD-EPI2009 Scr有可能存在高估HIV/AIDS患者的GFR,建议使用CKD-EPl2012 Cys C或CKD-EPI2012 Scr-Cys C方程评估HIV/AIDS患者的肾小球滤过率。