Background::HIV/AIDS has transformed into a chronic controllable but not yet curable infectious disease as other chronic diseases to some extent.The additional of so called fourth 90%that included the improved health-...Background::HIV/AIDS has transformed into a chronic controllable but not yet curable infectious disease as other chronic diseases to some extent.The additional of so called fourth 90%that included the improved health-related quality of life(HRQoL)for people living with HIV(PLWHIV)required solutions beyond antiretroviral therapy and viral load suppression.This study will explore the role of personality,social economic and prevention strategy effection on HRQoL among people living with HIV/AIDS.Methods::A cross-sectional study was conducted among PLWHIV aged more than 16 years old in the 10 municipalities in Yunnan Province,China from October 2019 to May 2020,enrolling total 1997 participants.Individual-level HRQoL data were measured by 12-item Short Form Health Survey(SF-12)and EuroQol Five Dimensions Questionnaire(EQ-5D-5L).We assembled municipal-level data about social economic from Yunnan Statistical Yearbook in 2020 and strategy practice information from the self-evaluation system.We used the principal component analysis to build the social economic and strategy effect on each area respectively and one-way ANOVA was used to perform univariate analysis to identify the predictors with significant differences.Finally we used multi-level model(MLM)to explore the personality,social economic and strategy effects in health-related quality of life among PLWHIV.Results::The global score for quality of life measured using EQ-5D-5L had an estimated mean score(standard deviation,SD)of 0.901±0.146.The HRQoL score measured using PCS-12 had an estimated mean score(SD)of 46.62±8.55.The mean MCS-12 score(SD)was estimated to be 47.80±9.71.The area-level predictors explained a proportion of 13.6-17.2%for the between-area variation of the HRQoL scores,regardless of the total HRQoL,physical component and mental component.The impacts of stigma(P<0.01),social support(P<0.001),anxiety(P<0.001),depression(P<0.05)and social economic status(P<0.05)on HRQoL at the individual-level were significantly different.The plots visualized the impact of individual-level factors on a respondent’s HRQoL was modified by the area-level characteristics.Conclusions::The study identified the possible strategy determinant of individual HRQoL of PLWHIV and also the area effect on HRQoL.Stigma,social support,anxiety,depression and social economic status were the individual-level determinants on HRQoL.These could be a valuable resource for evaluating the overall health of the areas and help improve local decision making.展开更多
Background: A high-risk prevention strategy is an effective way to fight against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The China AIDS Fund for Non-Governmental Organizations...Background: A high-risk prevention strategy is an effective way to fight against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The China AIDS Fund for Non-Governmental Organizations (CAFNGO) was established in 2015 to help social organizations intervene to protect high-risk populations in 176 cities. This study aimed to evaluate the role of social organizations in high-risk population interventions against HIV/AIDS.Methods: This study was based on the CAFNGO program from 2016 to 2020. The collected data included the number and types of social organizations participating in high-risk group interventions and the amount of funds obtained by these organizations each year. We explored the factors influencing the number of newly diagnosed AIDS cases using a spatial econometric model. Furthermore, we evaluated the effectiveness of intervention activities by comparing the percentages of the individuals who initially tested positive, and the individuals who took the confirmatory test, as well as those who retested positive and underwent the treatment.Results: Overall, from 2016 to 2020, the number of social organizations involved in interventions to protect HIV/AIDS high-risk populations increased from 441 to 532, and the invested fund increased from $3.98 to $10.58 million. The number of newly diagnosed cases decreased from 9128 to 8546 during the same period. Although the number of cities with overall spatial correlations decreased, the spatial agglomeration effect persisted in the large cities. Citywise, the number of social organizations (direct effect 19.13), the permanent resident population (direct effect 0.12), GDP per capita (direct effect 17.58;indirect effect -15.38), and passenger turnover volume (direct effect 5.50;indirect effect -8.64) were the major factors influencing new positive cases confirmed through the testing interventions performed by the social organizations. The initial positive test rates among high-risk populations were below 5.5%, the retesting rates among those who initially tested positive were above 60%, and the treatment rates among diagnosed cases were above 70%.Conclusions: The spatial effect of social organizations participating in interventions targeting high-risk populations funded by CAFNGO is statistically significant. Nevertheless, despite the achievements of these social organizations in tracking new cases and encouraging treatment, a series of measures should be taken to further optimize the use of CAFNGO. Working data should be updated from social organizations to CAFNGO more frequently by establishing a data monitoring system to help better track newly diagnosed AIDS cases. Multichannel financing should be expanded as well.展开更多
基金Our study was supported by National Nature Science Foundation of China(No.71904166)Yunnan high-level medical cultivation programme(No.H-2018103)13th Five-year National S&T Major Project for Comprehensive Pilots(No.2018ZX10715006).
文摘Background::HIV/AIDS has transformed into a chronic controllable but not yet curable infectious disease as other chronic diseases to some extent.The additional of so called fourth 90%that included the improved health-related quality of life(HRQoL)for people living with HIV(PLWHIV)required solutions beyond antiretroviral therapy and viral load suppression.This study will explore the role of personality,social economic and prevention strategy effection on HRQoL among people living with HIV/AIDS.Methods::A cross-sectional study was conducted among PLWHIV aged more than 16 years old in the 10 municipalities in Yunnan Province,China from October 2019 to May 2020,enrolling total 1997 participants.Individual-level HRQoL data were measured by 12-item Short Form Health Survey(SF-12)and EuroQol Five Dimensions Questionnaire(EQ-5D-5L).We assembled municipal-level data about social economic from Yunnan Statistical Yearbook in 2020 and strategy practice information from the self-evaluation system.We used the principal component analysis to build the social economic and strategy effect on each area respectively and one-way ANOVA was used to perform univariate analysis to identify the predictors with significant differences.Finally we used multi-level model(MLM)to explore the personality,social economic and strategy effects in health-related quality of life among PLWHIV.Results::The global score for quality of life measured using EQ-5D-5L had an estimated mean score(standard deviation,SD)of 0.901±0.146.The HRQoL score measured using PCS-12 had an estimated mean score(SD)of 46.62±8.55.The mean MCS-12 score(SD)was estimated to be 47.80±9.71.The area-level predictors explained a proportion of 13.6-17.2%for the between-area variation of the HRQoL scores,regardless of the total HRQoL,physical component and mental component.The impacts of stigma(P<0.01),social support(P<0.001),anxiety(P<0.001),depression(P<0.05)and social economic status(P<0.05)on HRQoL at the individual-level were significantly different.The plots visualized the impact of individual-level factors on a respondent’s HRQoL was modified by the area-level characteristics.Conclusions::The study identified the possible strategy determinant of individual HRQoL of PLWHIV and also the area effect on HRQoL.Stigma,social support,anxiety,depression and social economic status were the individual-level determinants on HRQoL.These could be a valuable resource for evaluating the overall health of the areas and help improve local decision making.
基金Research on population medicine theory,XK-001-YWZChina AIDS Fund for Non-governmental Organizations,Disciplines construction project:Population medicine,Zhejiang Province soft science research program,2021C35013.
文摘Background: A high-risk prevention strategy is an effective way to fight against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The China AIDS Fund for Non-Governmental Organizations (CAFNGO) was established in 2015 to help social organizations intervene to protect high-risk populations in 176 cities. This study aimed to evaluate the role of social organizations in high-risk population interventions against HIV/AIDS.Methods: This study was based on the CAFNGO program from 2016 to 2020. The collected data included the number and types of social organizations participating in high-risk group interventions and the amount of funds obtained by these organizations each year. We explored the factors influencing the number of newly diagnosed AIDS cases using a spatial econometric model. Furthermore, we evaluated the effectiveness of intervention activities by comparing the percentages of the individuals who initially tested positive, and the individuals who took the confirmatory test, as well as those who retested positive and underwent the treatment.Results: Overall, from 2016 to 2020, the number of social organizations involved in interventions to protect HIV/AIDS high-risk populations increased from 441 to 532, and the invested fund increased from $3.98 to $10.58 million. The number of newly diagnosed cases decreased from 9128 to 8546 during the same period. Although the number of cities with overall spatial correlations decreased, the spatial agglomeration effect persisted in the large cities. Citywise, the number of social organizations (direct effect 19.13), the permanent resident population (direct effect 0.12), GDP per capita (direct effect 17.58;indirect effect -15.38), and passenger turnover volume (direct effect 5.50;indirect effect -8.64) were the major factors influencing new positive cases confirmed through the testing interventions performed by the social organizations. The initial positive test rates among high-risk populations were below 5.5%, the retesting rates among those who initially tested positive were above 60%, and the treatment rates among diagnosed cases were above 70%.Conclusions: The spatial effect of social organizations participating in interventions targeting high-risk populations funded by CAFNGO is statistically significant. Nevertheless, despite the achievements of these social organizations in tracking new cases and encouraging treatment, a series of measures should be taken to further optimize the use of CAFNGO. Working data should be updated from social organizations to CAFNGO more frequently by establishing a data monitoring system to help better track newly diagnosed AIDS cases. Multichannel financing should be expanded as well.