Evolution of HIV/AIDS Prevention and Control Policies in China:A Grounded Theory Approach

Objective:This study aims to provide a theoretical foundation for the development and practical application of human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)prevention and control policy systems in China by scrutinizing,analyzing,and synthesizing the evolution of Chinese policies in this domain.Methods:Utilizing grounded theory,we employed NVivo12 software to perform text content analysis,mining,and coding classification,along with visualization techniques,on policy texts sourced from Chinese government platforms,including the official website of China’s State Council.We considered four analytical dimensions—time,subject,type,and object.Results:The National Health Commission and the State Council emerged as the primary entities engaged in policymaking for HIV/AIDS in China.We identified four distinct stages in the evolution of these policies,culminating in a novel‘sun-shaped’HIV/AIDS prevention and control policy network model with an emphasis on‘knowledge,attitude,and practice’at its nucleus,which aligns with national conditions and societal progress.Furthermore,the focal groups of these policies have been dynamically refined and updated over time.Conclusions:Our findings introduce a‘sunshaped’HIV/AIDS prevention and control policy network model specific to China.We observed a conceptual policy shift towards prioritizing overall human health rather than confining the focus to disease treatment.Additionally,in light of China’s growing elderly population,the imperative to address HIV/AIDS prevention and control among older adults is an issue that warrants increased attention.

云南省大理州50岁及以上HIV/AIDS患者生存状况分析

背景云南省大理州1997年首次报告50岁及以上人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immunodeficiency syndrome,AIDS)患者(简称HIV/AIDS患者),2010年以后50岁及以上HIV/AIDS患者报告数呈现明显上升趋势。2017年公布的《中国遏制与防治艾滋病“十三五”行动计划》中,已正式将老年人作为艾滋病防治的重点人群之一。目的分析大理州50岁及以上HIV/AIDS患者的生存状况。方法对1997-2018年报告的50岁及以上HIV/AIDS患者,运用寿命表法计算生存率,运用Cox回归分析生存的影响因素。结果大理州2019例50岁及以上HIV/AIDS患者的中位生存时间为8.33年(95%CI:7.75~9.33)。寿命表法分析结果显示确诊后1年、5年、10年的生存率分别为74.76%、56.26%、40.29%。Cox回归分析结果显示50岁及以上HIV/AIDS患者男性死亡风险是女性的1.74倍(95%CI:1.43~2.12);未抗病毒治疗患者的死亡风险是抗病毒治疗患者的9.32倍(95%CI:7.86~11.05);2010年以后报告患者死亡风险是2010年及以前报告患者的0.62倍(95%CI:0.52~0.74)。结论应加强对50岁及以上中老年人群的艾滋病防治工作,早检测、早发现、早治疗是此类人群艾滋病防治的重点措施。

A Life-skills-based HIV/AIDS Prevention Education for Rural Students of Primary Schools in China:What Changed? What Have We Learned?

Objective To evaluate a four-hour life-skills-based HIV/AIDS prevention curriculum among 5th grade students in rural primary schools of Hainan province.Methods The study included two stages.Stage one （September 2006-May 2007） was a pre-post-quasi experimental design;a total of 2 413 students aged 9 to 14 years from fifth grade classes of nine primary schools completed a baseline survey （1 720 students were in the intervention group,693 in the control group）,and over 98% of them took part in a short survey.The experimental curriculum was provided to the intervention group.At stage two （September 2008）,a cross-sectional questionnaire was administered to 6 923 students in 7th grade classes of eight middle schools in the same study sites.There were 1 437 students in the intervention group when the curriculum was conducted.Results Students tended to score higher in areas of HIV/AIDS related knowledge and attitudes,if they were younger than average,lived in the county seat,had access to the internet,and their parents had completed higher levels of education.Path analysis showed that,after controlling for characteristics such as family and community factors,the total effects of curriculum on knowledge in the short-term model increased remarkably compared with the baseline,and maintained major contributions to knowledge in the mid-term model.The positive effect of knowledge on attitudes was significantly improved in the short-term model as well.Conclusion A life-skills based curriculum can improve HIV/AIDS related knowledge and self-perceived level of life-skills among primary school students in rural areas in a short time,and these positive effects can still be observed at least 2 years post participation in the curriculum.

AIDS Research and Its Role in China's AIDS Prevention and Control Policies

By the end of 2005,the estimated number of HIV infected people in China was 650,000. The seriousness of the epidemic calls for effective control measures to tackle the problems in order to avoid the tragedy in Africa from happening in China. "Prevention First" is the cornerstone of the country's health policy. On 2003 World AIDS Day,Premier Jiabao Wen announced a new national AIDS control policy,"Four Frees and One Care". This policy clearly shows that the Chinese government has once again taken full responsibility to solve public health problems and has profound impact far beyond the AIDS field. In early 2006,the central government put scientific and technology innovation as a national priority and set the target to build an innovative China by year 2020. Since then,the government has been increasing investment in science and technology with major emphasis on both infectious diseases control and new drug research and development. For the first time,development of 100 new drugs and control of major infectious diseases (AIDS,HBV,TB and other emerging infectious diseases) have been selected as national key scientific projects. China's best minds in related fields will be pooled to work together in order to remove the technical barriers blocking efficient control of the major infectious disease in China. Knowledge on molecular epidemiology,immunology,pathogenesis,HAART,as well as HIVDR strains will certainly provide urgently needed scientific information for China's AIDS control program. Only evidence-based strategy from good research will provide long-term effective control of AIDS.

Gender Sensitive STIs/HIV/AIDS Prevention Policies: A Qualitative Study

Background: The global incidence of STIs is rising. It is estimated that 499 million new cases of curable STIs occur every year. The existence of more than one million reported cases of STIs annually in Iran shows that addressing this issue must be a priority for Iranian health authorities. While recognition of the importance of gender issues to reproductive health (RH) programs has grown significantly in the past several years, major challenges remain in implementing gender-sensitive programs. Gender mainstreaming in Iranian reproductive health program is a relatively new issue, so this study aims to explore gender sensitive STIs/HIV/AIDS prevention policies. Method: This study employed a qualitative research design. Participants were health managers, health policy makers and reproductive health providers. They were selected purposefully and then continued by snowball sampling method. 43 semi-structured in-depth interviews with 37 key informants were done. All the interviews were recorded and transcribed. The data were analyzed by content analysis method. Trustworthiness of the data was achieved by using credibility, trans-ferability and conformability. Results: Key informants clearly explained the gender sensitive STIs/ HIV/AIDS prevention policies in three main categories: 1) advocacy, 2) collaboration between different sectors and 3) community empowerment to gender sensitive STIs/HIV/AIDS prevention programs. Conclusion: Changing gender neural STIs/HIV/AIDS prevention policy to more complete gender sensitive policy needs advocacy, collaboration of sectors and community empowerment.

Partnering with Batswana Youth and Families for HIV and AIDS Prevention

Introduction: This qualitative study triangulated data from adolescents, parents, and key informants in Gaborone, Botswana on adolescents’ risks for HIV infection, STIs and pregnancy, the types of relationships they get into, and preventive measures they use to protect themselves against HIV infection. The goal of this qualitative research is to inform adaptation of an intervention originally developed, implemented, and evaluated in the US that was effective in reducing the risk of HIV infection and early pregnancy by delaying initiation of sexual relationships of abstinent adolescents and lowering sexual risk behaviours of adolescents who were already sexually active. The objectives of this study were to conduct in-depth interviews with youth, key informants and parents;determine the behavioural risks that young people face;Assess youth and parents’ attitudes toward providing a risk reduction programme for adolescents and Use the data to adapt an evidence-based programme for Botswana. Methodology: In-depth qualitative interviews with 40 youth, 20 key informants and 40 parents elicited information on the risks and relationships that youth engaged in and their suggestions how their risky behaviours could be minimized or counteracted. Findings: Youth of both sexes engage in risky sexual behaviours that could predispose them to contracting HIV and STI infections or unplanned pregnancies. Risks were associated with use of alcohol and drugs: commonly marijuana, and engaging in unsafe sexual relations. Youth, key informants and parents showed a high level of acceptability for offering a primary prevention intervention program for adolescents. In addition, all groups of participants concurred on the importance of offering a separate program for parents to equip them with skills that can enable to them to guide their adolescents to safely transit into adulthood through education and family communication skills. Other risks confronting adolescents included sexual initiations from either older men or women (sugar daddy and mummy syndrome) in exchange for material and financial gains. Conclusion: Informants endorsed the need for primary prevention programs addressing adolescents and their families to reduce risk behaviours among Batswana youth to provide them with skills and minimise the risk of HIV infection among adolescents.

The Process of Policy Implementation： The Policy of HIV/AIDS Prevention in Youth Groups in Thailand

Thailand was implementing the policy of HIV/A1DS prevention in risky group, The youth is one of groups with sexual risk behaviors to HIV/AIDS. This research aims to elucidate the process of policy implementation at the national and regional levels, and to explain the obstacles of policy implementation. The method was qualitative study. The stakeholders were 88 people. The data were collected by in-depth interview and coded by a computer program. The policy was transferred from the national AIDS committee to the Department of Disease Control （DDC） and provincial level. This process was lacking budget support. The provincial AIDS committee was monitored by the provincial health office, cooperating with the central level. The major role was to transfer the policy to the school, Local Administration Organization （LAO） and associated organization. The activity was funded by provincial, global funds, and outside sources. In the community, the core activities were AIDS knowledge, establishing core youth groups, and building the network of AIDS. The obstacle at the national level was changing the policy process from one with a budget to one without budget. In the area of practice, the AIDS problem and the effects of the risk behavior in youth groups were slightly concerned.

艾滋病(AIDS)预防宣讲对AIDS预防控制中基础知识、传播途径及预防措施知晓情况的影响

目的 探索分析艾滋病(acquired immunodeficiency syndrome,AIDS)预防宣教对AIDS预防控制中基础知识、传播途径以及预防措施知晓情况的影响。方法 选取2022年1月至2023年1月于本院咨询AIDS健康知识的80例高危群体视为观察对象,采取随机数表分组方法将其均分为对照组(常规AIDS宣讲,n=40例)、观察组(AIDS预防宣讲,n=40例),比较分析两组干预效果。结果观察组干预后AIDS基础知识知晓评分、传播渠道知晓评分、预防措施知晓评分、对AIDS正向态度率均高于对照组(P<0.05);观察组干预后AIDS患病率低于对照组(P<0.05)。结论 AIDS预防宣讲能提高AIDS高危群体对基础知识、传播途径、预防措施等知识的知晓率,降低AIDS患病率,改变其对AIDS的态度。

Depression and Suicidal Ideations among Older Persons Living with HIV/AIDS in Mbarara City, Southwest Uganda

Background: Due to the increase in longevity and use of antiretroviral treatment, Uganda has had a growing population of older persons living with HIV/AIDS. However, there is a paucity of information on the mental health of the elderly living with HIV/AIDS. In this cross-sectional study, we determined the prevalence of, and associated factors for depression and suicidal ideation among older persons living with HIV/AIDS in Mbarara city, southwest Uganda. Methods: Older persons (150 females, 115 males), with mean age = 64.2 (±5.1) years, accessing health services from three purposively selected HIV/AIDS care centers in Mbarara city, southwest Uganda were recruited. Data on depression and suicidal ideation were collected using a Patient Health Questionnaire (PHQ-9) validated in Uganda, and a structured questionnaire was used to collect data on clinical and socio-demographic characteristics. Data were analysed using logistic regression. Results: Approximately 8.3% and 12.1% had depression and suicidal ideation, respectively. The factors associated with lowering the likelihood of depression were: an increase in the number of family members they stayed with and having no having any problems with their ARVs. On the other hand, earning more than 100,000 Uganda shillings was associated with reducing the risk of suicidal ideations among the participants. Conclusion: Approximately 8 to 12 in 100 older persons living with HIV/AIDS in Uganda have experienced depression or suicidal ideation. Family support and financial control were instrumental factors associated with depression and suicidal ideations, respectively. We recommended strengthening family structures and creating more avenues for financial independence among older persons living with HIV/AIDS to reduce the burden of depression, and suicidal behaviours among this vulnerable population.

Control of HIV/AIDS can be achieved with multi-strategies

Over past three decades,many prevention strategies have been proven effective in reducing human immunodeficiency virus (HIV) transmission.However,none of these strategies alone are effective to stop the spread of HIV.This review discusses a few key prevention strategies,including testing,harm reduction,prevention,prophylaxis,and modern communication strategies.We argue that although there are great challenges remaining to stop HIV transmission via sexual contact and injecting drug use routes,the combination of these effective strategies,control HIV epidemic can be achieved.

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.

Strategy for AIDS Prevention and Treatment

HIV/AIDS has been circulating in China for over 25 year. While making achievements on HIV/AIDS prevention, there still are great challenge and difficulties epidemic controlling and vaccine research .

Barriers and Strategies to Prevent HIV/AIDS among Pacific Countries: A Systematic Review Study

Introduction: While the prevalence of HIV/AIDS is shown to be decreasing in the last few decades, it still remains a serious public health issue in Pacific countries. This study is aimed to review the common barriers and also preventive strategies for HIV/AIDS among Pacific Islanders. Methodology: This systematic review study on HIV/AIDS was developed based on the Cochrane Library Guideline. Seven online databases which were more frequently used in finding relevant studies were used to search literatures. Using relevant key words, all studies found in the search were reviewed by two independent reviewers and their quality and relevance were assessed. All previous qualitative and quantitative published articles included in the study were published from 2000 to 2016 and in the English language. A data extraction sheet was developed and a descriptive statistic was used to analyze the data. Results: Twenty-two studies met the study inclusion and exclusion criteria. Many of the studies were conducted in American Pacific countries (50%). Community-based studies were the most common type of studies (72.7%). In quantitative studies, the most common barriers were lack of accessibility to health services and lack of knowledge, while in the qualitative studies they were cultural barriers and access to health services. Educational trainings on sexual health topics were identified as the main preventive strategy. Conclusion: This study highlights the main barriers of HIV/AIDS among Pacific Islanders. It also provides a guide for decision makers to develop and implement new strategies which are sensitive and based on Pacific cultures and beliefs.

Imperatives of Health Psychologist in the Control and Management of HIV/AIDS in Sub-Saharan Africa

The paper studied the imperatives of health psychologists in the control and management of HIV/ AIDS. HIV/AIDS is a relatively new disease, but has caused more deaths than any other disease in human history, and there is no known cure yet. Even though, HIV/AIDS is a death sentence, experts agreed that early detection, and early commencement of treatment may prolong the life of the patients, and that early detection may prevent or reduce the transmission of the virus. Early detection, commencement of treatment, and compliance with medical advice are the responsibilities of the health psychologist. This paper therefore, concludes that health psychologist is indispensable in effective control, and management of HIV/AIDS, and so recommends that awareness be created on the roles of health psychologists in this regard, through health education.

四川省凉山艾滋病高发地区育龄妇女和妇幼工作者AIDs／HIV相关知识知晓情况和态度调查

目的了解四川省凉山艾滋病高发地区育龄妇女和妇幼工作者对艾滋病相关知识的知晓情况和态度意识,并为制定有效的艾滋病母婴传播阻断的干预模式提供科学有效的依据。方法在凉山彝族自治州昭觉县选择2个乡共13个村的82名育龄妇女村民和44名各级妇幼工作者共126人,进行一对一双语(彝语或汉语)不记名问卷调查。结果全部调查对象对HIV所有传播途径回答正确的比例为84.9%,但所有非传播途径回答正确的比例仅为38.9%。AIDs知识得分(满分12分),妇幼工作者平均得分9.0±2.4,育龄妇女平均得分8.5±1.7,按3个等级计,可认为育龄妇女知识的掌握与妇幼工作者无明显差异(Z=-1.507,P=0.132)。除县(乡)级妇幼工作者以外,村级妇幼工作者和全部育龄妇女村民对HIV的3种非传播途径、定期服用抗生素不能预防以及目前无有效疫苗或药物预防的知晓率都很低,且对AIDs/HIV感染者歧视现象较严重。结论村级妇幼工作者和全部育龄妇女村民对除传播途径外的艾滋病其他知识相当匮乏,对HIV感染者的歧视、恐惧及过度排斥态度较严重。应加强对该地区基层妇幼工作者和育龄妇女艾滋病知识的培训和教育。

中国HIV+/AIDS患者神经心理学初步研究

目的:探讨中国HIV+/AIDS 患者神经心理功能特点及情绪状态。方法:选取年龄、性别和受教育年限方面均匹配的28例HIM+和23例HIV-被试。对被试进行包含七个认知领域(如词语流畅、抽象/执行功能、信息处理速度、工作记忆、学习、延迟回忆和运动功能)的神经心理成套测验,共18个分测验。同时选用贝克抑郁问卷(BDI)让患者进行情绪自评。结果:单个测验粗分比较,HIV+/AIDS 被试比HIV-被试在范畴流畅测验、词语发音流畅测验、连线测验A、颜色连线测验Ⅱ及霍普金斯词语学习测验显著较差(P<0.05)。基于美国常模校正的标准分(T 分)显示,HIV+/AIDS 被试比HIV-被试在整套测验、词语流畅、抽象/执行功能和学习领域神经心理操作显著较差(P<0.05)。中国HIV-被试的平均T 分与美国常模50相近,总的平均T 分为48,各认知领域的平均T 分范围46-51。BDI 自评分提示中国HIV+/AIDS 被试比HIV-被试显示出更严重的抑郁情绪(P<0.001),且与躯体状况无关。HIV+/AIDS 被试BDI 得分与总的平均T 分无显著相关(r=0.22,p=0.27)。结论: 1.本研究所选用的神经心理成套测验有较为理想的跨文化效能。2.中国HIV/AIDS 被试在词语流畅、抽象/执行功能、学习认知领域和总的神经心理功能上比HIV--试显著较差,抑郁情绪更为严重,但抑郁情绪与HIV 造成的各领域认知功能损害无显著相关,提示HIV 可能对大脑的认知功能有一定影响。

凉山州HIV／AIDS流行特点与对策分析

[目的]了解凉山州艾滋病流行情况,为制定防治策略提供依据。[方法]分析凉山州1995～2007年6月艾滋病疫情、监测和流行病学资料。[结果]自1995年以来凉山州累计发现艾滋病病毒感染者5995例。近3年来艾滋病感染数量分别以48.8%、12.4%、72.6%速度递增;2003～2007年6月共报告病例5275例,占总累计报告人数的87.99%;通过人口金字塔来描述感染人群的性别、年龄分布:感染者以20～30岁组为主,占总发现数的78%。感染者中彝族占40.95%;经静脉吸毒途径感染者占总数的46.34%,感染者中男性是女性的9.27倍。[结论]凉山州正面临防制艾滋病(AIDS)的关键时期,应立即采取有效的防制措施。

山西省HIV/AIDS流行状况分析及防治对策

目的 掌握山西省艾滋病 (AIDS)流行状况和特征 ,明确防治工作重点 ,为决策者提供科学依据。方法 收集和整理山西省 1995～ 2 0 0 3年艾滋病病毒 (HIV) /AIDS病例报告和个案流行病学调查表 ,进行统计分析。结果 山西省 1995～ 2 0 0 3年累计报告HIV/AIDS 6 4 4例 ,平均每年以 2 0 2 %的速度增长 ,其中病人 334例 ,占 5 1 8%(334/ 6 4 4 ) ;死亡 15 2例 ,占 4 5 5 % (15 2 / 334)。HIV感染人群以既往有偿供血员为主 ,因不规范的采供血造成经血液传播的占 76 1% (4 90 / 6 4 4 ) ;主要分布在晋南、晋东南地区 ,占 84 9% (5 4 7/ 6 4 4 )。男女比例为 2 1∶1。不安全性行为占 6 8% (4 4 / 6 4 4 ) ,吸毒占 2 3% (15 / 6 4 4 ) ,母婴传播 3 6 % (2 3/ 6 4 4 ) ,是潜在的危险因素。结论 山西省艾滋病流行快速增长 ,且已进入发病和死亡高峰 ,存在多种潜在危险因素。各级领导应提高认识 ,针对各种危险因素 ,采取积极的有效措施 ,控制艾滋病的进一步流行。同时 ,要开展医疗救治 ,提高HIV感染者和AIDS病人的生命质量 ,降低死亡率。

昆明市一所大学预防药物滥用及HIV/AIDS研究

在云南省财贸学院开展为期半年的预防药物滥用及感染性免疫缺陷病毒／艾滋病（ＨＩＶ／ＡＩＤＳ）活动。５３名自愿参加预防活动的大学生作为预防对象。预防方法以个人和社会技能训练为主，辅予信息传播方法和拒绝技能训练。训练课程分为８次，每次９０分钟。活动前后进行自身对照比较。结果显示，预防活动能提高预防对象相关知识的水平。预防对象的个人和社会技能比参加活动前有显著的提高。不足的是这种预防活动没有能改变预防对象对药物滥用及ＨＩＶ／ＡＩＤＳ的负性态度。研究对今后以学校为基础的预防方法提出了建议。

四川省HIV/AIDS流行趋势及防制对策研究

为了使四川省的艾滋病防制对策及措施更有针对性和实用性，本文采用描述、理论流行病学的方法，对四川省的ＨＩＶ／ＡＩＤＳ流行现状及特征、危险因素、流行趋势、防制对策及措施进行了调查和研究。结果显示，四川省目前尚属低流行区，但已处于快速增长时期，在今后一个不长的时间内，ＨＩＶ仍以较快速度在静脉吸毒人群中扩散，性传播的浪潮在不久的将来就会出现。需政府高度重视和全民参与。加强监测，掌握疫情动态，采取广泛的健康教育，针对吸毒者、暗娼等重点人群的行为干预和预防医源性感染等标本兼治的措施，遏制ＨＩＶ／ＡＩＤＳ迅速上升的势头。本文提示，四川省正处在ＨＩＶ／ＡＩＤＳ防制的关键时期，如不把握住这为时不长的关键时期，抓早抓小。