Associations of PNPLA3 and LEP genetic polymorphisms with metabolic-associated fatty liver disease in Thai people living with human immunodeficiency virus

BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.

Epidemiology of Lower Extremity Artery Disease in People Living with HIV Followed at the Departmental University Hospital Center Ouémé-Plateau in 2019

Introduction: Lower extremity artery disease (LEAD) is a serious cardiovascular disease. People living with the human immunodeficiency virus (HIV) are at risk. The aim of the study was to determine the prevalence of LEAD and identify the associated factors among people living with HIV who were followed at the departmental university hospital Ouémé-Plateau in Benin. Methods: This was a cross-sectional study. It included all HIV-infected people who were monitored at the department of medicine of the target hospital during the study period and met the inclusion criteria (followed for at least three months, aged at least 25 years, and having given their written consent to participate). Data were collected during an individual interview, followed by the measurement of parameters. The ankle brachial index ≤ 0.9 was used for the diagnosis of LEAD. Associated factors were searched through a multivariable logistic regression. Results: The prevalence of LEAD was 34.2% among 222 respondents having a mean age was 42.9 ± 10.8 years and a female predominance (77.5%). No significant association was found between the presence of LEAD and sociodemographic factors. The presence of LEAD was significantly associated with hypertension and antiretroviral therapy. Hypertensive patients had a higher risk of LEAD compared to non-hypertensive patients (OR = 1.98, 95% CI [1.04-3.83], p = 0.037). Those who were receiving second-line therapy also had a higher risk of LEAD compared to those on first-line therapy (OR = 2.95, 95% CI [1.14-7.60], p = 0.025). Conclusion: This study showed a high prevalence of LEAD especially among hypertensive patients and those who were receiving second-line antiretroviral therapy. LEAD diagnosis and management should be included in the routine care of people living with HIV in Benin.

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

Assessment of the Level of Knowledge, Attitude, and Practice with Regard to Care of People Living with HIV/AIDS among Nursing and Midwifery Students in Fako, Cameroon

Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.

Stigma and Discrimination against People Living with HIV and AIDS in Malawi

A study was conducted to explore stigma and discrimination among people living with HIV and AIDS who were on home based care in the Lilongwe district of Malawi. The study design was descriptive through sectional and utilized qualitative data collection and analysis method. Fifteen people living with HIV and AIDS, aged between 15 and 60 years were purposively sampled from three organizations, which were: Light House, National Association for people living with HIV and AIDS in Malawi and Lilongwe Diocese. Qualitative data were collected using an open ended interview guide during in-depth face to face interviews with the participants. The data were analysed using ATLAS. ti 5.0. Results show that all the participants were facing stigma and discrimination because they were living with HIV and AIDS. Distant relatives were the main source of stigma and discrimination followed by friends and church members. Most participants indicated that they felt they were discriminated because HIV infection is associated with bad behaviours such as prostitution or promiscuity. However some of them complained that they contracted the virus from their married partners and hence they did not deserve to be stigmatized or discriminated against. Results show that there is a need for creation of awareness among community members on the transmission of HIV and the need for home based care for the chronically ill people living with HIV and AIDS.

Evaluation of Quality of Healthcare Service Avaeilable to People Living with HIVIAIDS： Evidence from Enugu State

The study evaluated the quality of healthcare services given to PLWHA （people living with HIV/AIDS） in different communities of Enugu State of Nigeria. Descriptive cross sectional survey design was employed for the study. The participants were PLWHA attending health facilities in different communities in the state. A sample of 180 PLWHA who participated in the study were selected using a multi-stage sampling procedure and were interviewed at community level. The data were analyzed using descriptive statistics. The results showed that 82.2% of the respondents were cared for by government health facilities, 75% were of the opinion that the health workers in those places do not discriminate against them, 81.7% felt that they were being given high quality healthcare, 82.8% stated that their drugs were readily available, 75% were of the opinion that the physical facilities in their care centers were adequate, 84.4% felt that grievance redressing were good while 90% felt that their healthcare providers maintain confidentiality about their conditions. It was concluded from the findings that quality of care provided to PLWHA in communities was of good quality as perceived by PLWHA and that the national antiretroviral programmes are making drugs available and affordable in the state. It was then recommended that all levels of government in the nation should strengthen the programmes on HIV prevention and control to maintain the continuity of care to PLWHA.

The Prevalence of Drug-Resistant Tuberculosis among People Living with HIV (PLHIV) in Abia State

Tuberculosis (TB) is a chronic disease caused by mycobacterium tuberculosis and transmitted from person to person, through inhalation of droplet nuclei aerosolized by coughing of an infected person. It reached epidemic proportions in Europe and North America during the 18th and 19th centuries. The incubation period is 2 - 6 weeks and the control has been complicated with emergence of HIV and drug-resistant TB. In 1993, World Health Organization (WHO) declared TB a global emergency. However, despite the concerted effort of National TB control programs, adoption and implementation of Stop TB strategy, TB has remained a major public health challenge with high mortality rate, especially in developing countries. Methodology: This is a descriptive study, evaluated using the positivist/quantitative approach. The study was conducted at FederalMedical Centre Umuahia, a tertiary specialist hospital with comprehensive TB/HIV treatment services. All the presumptive drug-resistant TB cases and symptomatic PLHIV were screened for HIV and their sputum specimens were tested for tuberculosis using the Gene xpert and the Ziehl- Neelsen technique for detecting Acid Fast bacilli. A pretested structured questionnaire was used tocollect the demographic data and other essential data from the presumptive TB and laboratory registers such as total number of TB presumptive cases registered HIV status, AFB status and rifampicin status within the study period. Result: A total of 493 presumptive TB cases were screened in the study, 49.9% were HIV positive while 50.05% were HIV negative. More so, 77.85% of thescreened cases were AFB negative and 22.15% were AFB positive. Moreover, 11% of the TB/HIV co-infected patients were rifampicin positive. Interestingly among the 493 cases screened with gene xpert machine, 3.6% were rifampicin positive. Furthermore, 3.6% of the HIV negative cases were rifampicin positive while 1.6% of the HIV positive cases were rifampicin positive. Discussion: The data depict lower rifampicin resistance among HIV positive cases than HIV negative cases. The implication for public health professionals is to intensify equitable and unbiased search for resistant TB cases among smear negative and positive cases.

Can People Living With HIVIAIDS Be Teachers?

HIV is still a sensitive topic in China,which was once again thrust into the spotlight in September when a young aspiring teacher launched a lawsuit against local authorities in southwest China’s Guizhou Province for employment discrimination. The candidate,who went by the alias Xiao Hai,tested positive for HIV during a mandatory employment medical examination

Living Conditions and Palliative Care Needs among End-of-Life Former Commercial Plasma Donors Affected with HIV/AIDS in Rural Henan of China

Objective China began providing antiretroviral therapy to people living with HIV/AIDS （PLWHA） in 2003. This study was to investigate the living conditions, including quality of life and happiness, and need for palliative care of end-of-life PLWHA in rural Henan. Methods One hundred end-of-life AIDS patients were selected from Weishi, Zhenping and Tanghe counties in Henan, using convenience sampling. The World Health Organization Quality of Life for HIV （WHOQOL-HIV） BREF Chinese Version was used to measure the quality of life and the Memorial University of Newfoundland Scale of Happiness （MUNSH） was employed to measure subjective welfare. Qualitative interviews and focus group discussions were undertaken to learn about the palliative care provided and the specific needs of the end-of-life patients. Results Patients’ overall quality of life was moderate （12.62±1.97）. Highest scores were in the spirituality/religion/personal beliefs, higher than the average scores in the Chinese population （P0.01）, while psychological （13.58±2.06） and environment （12.50±3.28） domain scores were similar to the latter （P0.05）. Both independence （12.15±2.15） and physiological （14.04±3.16） domain scores were lower than the average of the people living with HIV/AIDS in other studies （P0.01）; however, all were in the moderate range. The average MUNSH score was 21.00±6.20, which was also moderate. The in-depth interviews indicated that the Henan Provincial Government’s policy of treatment and care had a beneficial impact on end-of-life AIDS patients, although the care components could be improved. Conclusions Living conditions of the end-of-life AIDS patients were moderate, and the HIV/AIDS palliative care model used was beneficial to them. Care could be improved by assisting the family unit as a whole.

HIV/AIDS患者ART过程中高三酰甘油血症、高胆固醇血症、高血糖发生情况及其影响因素

目的探讨艾滋病病毒感染(HIV/AIDS)者在抗逆转录病毒治疗(antiretroviral therapy,ART)过程中高三酰甘油血症(三酰甘油≥2.3 mmol/L)、高胆固醇血症(总胆固醇≥6.2 mmol/L)、高血糖(空腹血糖≥6.10 mmol/L)的发生情况及其可能影响因素。方法采用回顾性队列研究,收集广州市某传染病专科医院2004-2019年期间首次接受ART的HIV/AIDS患者基线和随访数据。采用多因素Cox比例风险回归模型分析高三酰甘油血症、高胆固醇血症、高血糖发生的可能影响因素。结果HIV/AIDS患者8839例。在ART过程中,新发高三酰甘油血症4255例(48.14%),高胆固醇症1234例(13.96%),高血糖2647名(29.95%),总发病密度分别为28.12/100人年、5.11/100人年和14.22/100人年。多因素Cox比例风险回归模型结果显示,基线BMI、开始ART年份、基线WHO临床分期、基线机会性感染、临床症状种类数、初始ART方案、基线CD4细胞计数与高三酰甘油血症的发生有关;性别、年龄、基线BMI、开始ART年份、基线WHO临床分期、基线机会性感染、初始ART方案、基线CD4细胞计数与高胆固醇症的发生有关;性别、年龄、基线BMI、开始ART年份、感染途径、基线机会性感染、基线CD4细胞计数与高血糖的发生有关。结论HIV/AIDS患者ART过程中易发生高三酰甘油血症、高胆固醇血症、高血糖,应动态监测患者的血脂、血糖情况,尤其是对采用含克力芝方案治疗的患者,以期对高风险患者及时进行早期干预,调整治疗方案,预防心血管疾病等慢性非传染性疾病的发生,提高患者生命质量。

Acceptance and Factors Associated With Participation in Functional Cure–Related Trials Among People Living With HIV: A Cross-sectional Study in Southern China

HIV remains a global health challenge,and research efforts directed towards a functional cure require people living with HIV(PLHIV)in-volvement in clinical trials.Our study assessed willingness to participate in HIV functional cure–related clinical trials and associated factors among PLHIV in Guangzhou,China,using a questionnaire survey approach.We analyzed responses from 718 questionnaires,finding that 71.2%were willing to participate in Phase Ⅲtrials,while 51.7%were willing to participate in Phase I trials and 42.9%expressed acceptability for analytic treatment interruption.Multivariate logistic regression demonstrated that male PLHIV,those with awareness of functional cure,and PLHIV,who had been on antiretroviral therapy(ART)for less than 1 year,were more willing to partic-ipate in Phase Ⅲtrials.Those with a body mass index greater than 24,and those without resistance to ART drug were more willing to participate in Phase I trials.The major motivations for participation in Phase Ⅲtrials were access to cutting-edge treatments(62.6%)and supporting research(55.3%).Safety was the main concern contributing to hesitancy.Our study revealed a high willingness to participate in HIV functional cure–related trials among PLHIV in Guangzhou,China,and willingness varied across different trial phases and was influenced by multiple factors.This study provides valuable references for future clinical trial recruitment strategies and public health policy formulation.

Socio-Demographic and Occupational Aspects of HIV-HBV Co-Infection in Bangui, Central African Republic (CAR): Hospital-Based Cross-Sectional Study

Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.

HIV感染者/AIDS患者衰弱状况及影响因素分析

目的了解人类免疫缺陷病毒(HIV)感染/艾滋病(AIDS)患者(PLWHA)衰弱现状及其影响因素。方法选取2019年6—8月长沙市某医院≥18岁的PLWHA作为研究对象,采用自行编制的问卷以及蒂尔堡衰弱量表分别评估研究对象的基本情况以及衰弱情况。结果PLWHA衰弱发生率为26.4%,logistics回归分析显示,感染年限>5年的患者发生衰弱的风险为感染年限≤5年患者的2.33倍(95%CI:1.24~4.37,P=0.009);最高HIV载量≥10万拷贝/mL患者发生衰弱的风险为最高HIV载量<10万拷贝/mL患者的1.40倍(95%CI:1.05~1.85,P=0.022);CD4^(+)T淋巴细胞计数<200个/mm 3的患者发生衰弱的风险为CD4^(+)T淋巴细胞计数≥200个/mm 3患者的3.60倍(95%CI:1.96~6.62,P<0.001)。结论HIV感染年限越长、当前CD4^(+)T淋巴细胞计数越低、HIV载量越高的PLWHA更容易发生衰弱。

HIV感染者生命质量影响因素研究进展

在人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者预期寿命不断延长的过程中,其生理、心理、社会环境等方面受到不同程度的侵害,HIV感染者的生命质量普遍低于一般人群。影响HIV感染者生命质量的因素包括地区差异、人口学、临床与疾病、心理、社会等因素。本文通过检索公开发表的国内外关于HIV感染者生命质量相关的文献,对HIV感染者生命质量现状及影响因素进行总结,为后期开展HIV感染者生命质量研究提供参考。

People With HIV Now Live a Better Life

As a UN Volunteer, working with UNAIDS China, I have the opportunity to get involved in a wide range of areas. From working with community-based organizations, set up by people living with HIV to interacting with the media on topics related to HIV/AIDS to sup- porting campaigns to fight HIV/AIDS- related discrimination in the workplace, I get to do it all.

HIV Hospital Admissions Attributable to Specific Opportunistic Infections and Factors Associated with Them at a Botswana Referral Hospital

Hospital admissions among people living with HIV (PLWH) in Botswana are high. Opportunistic infections (OIs) are responsible for most of these admissions. Although leading OIs causing these admissions have been identified in the region, their correlates are poorly understood. This study aimed to: 1) evaluate major OIs responsible for admissions among HIV patients at Princess Marina Hospital (PMH) in Botswana;2) estimate the proportion and identify the most frequent admissions attributable to specific OIs;3) characterize major correlates of admissions attributable to each specific OIs and identify populations most at risk as a base for effective policy and resource orientation. HIV infected patients were randomly selected from hospital record lists. Biomedical, sociodemographic and economic data were collected from the records and from face-to-face patient interviews and analyzed. Tuberculosis was the most important OI responsible for 234.6 per 1000 HIV admissions. Cryptococcal meningitis accounted for 162.0 per 1000 admissions. Patients with a CD4-cell count < 350/μL and males were more likely to be admitted for both tuberculosis and cryptococcal meningitis compared to those with a CD4-cell count > 350/μL and females. The risk of admission due to cryptococcal meningitis was also high among patients with low socioeconomic status (SES). Females were more at risk for Cryptosporidium, Bacterial pneumonia (BP), Pneumocystis Carinii Pneumonia (PCP), Herpes and candidiasis-specific admissions than male and, patients not on co-trimoxazole were more likely to be admitted than those on co-trimoxazole. Comprehensive implementation strategies to address OIs among PLWH are needed. To be effective, such strategies should address not only biomedical factors but should also focus on PLWH’s SES.

HIV感染者遭受医务人员歧视的经历和体验的文献研究

通过Meta整合方法系统梳理关于艾滋病病毒(human immunodeficiency virus,HIV)感染者遭受医务人员歧视的经历和体验的质性研究,为提高HIV感染者就医体验提供参考依据。经过文献筛选和质量评价后共纳入19篇文献,通过Meta整合共得出27个研究结果,其中相近结果可归类为7个新类别,最终归纳出3个整合结果:(1)医务人员歧视产生的原因;(2)医务人员歧视的表现形式;(3)遭受医务人员歧视的危害。提示医务人员对HIV感染者具有多种歧视,并会严重影响患者的治疗行为和心理健康,未来有必要采取干预措施,减轻甚至消除医务人员对HIV感染者的歧视现象。

Primary Effusion Lymphoma in a HIV-1/2-Infected Patient

Background: Primary effusion lymphoma (PEL) is a lymphoid proliferation related to Kaposi sarcoma herpesvirus 8/human herpesvirus 8 (KSHV/HHV8) that affects mainly human immunodeficiency virus (HIV) infected individuals but can also occur in other immunodeficiency settings. It is characterized by lymphomatous effusions in different serous body cavities without the presence of a detectable tumor mass. The diagnosis is challenging and the clinical outcomes are poor. Aim: The aim of this paper is to report a rare case of PEL in a man who have sex with women (MSW) with HIV-1/2 infection, history of visceral Kaposi sarcoma (KS) and the development of a seronegative arthritis previous to the lymphoproliferative disease diagnosis. PEL presented with ascites, was treated with high-dose chemotherapy and autologous stem cell transplantation, with a good clinical outcome. Case Presentation: We describe a case of a 48-year-old HIV-1/2-infected patient from a high HHV8 seroprevalent country, hospitalized following a three-month history of increased abdominal volume and general constitutional symptoms. Laboratory data revealed normocytic normochromic anemia and a high level of lactate dehydrogenase. A diagnostic paracentesis was performed with cytology compatible with high-grade B-cell lymphoma. Peritoneal fluid cytology showed large lymphoid cells expressing leucocyte-common antigen CD45 without expression of the CD20 antigen (B-lymphocytes) and positivity for HHV8 by immunocytochemical staining, compatible with the diagnosis of PEL.

童年创伤与HIV感染者/AIDS患者焦虑抑郁及自杀倾向相关性研究

目的探讨HIV感染者/AIDS患者(PLWHA)的儿童期创伤经历与焦虑、抑郁及自杀风险间关系,为早期识别PLWHA心理问题风险与干预提供循证证据支持与流行病学依据。方法选取于西安市某医院艾滋病专科门诊接受治疗的患者为研究对象,采用广泛性焦虑症量表(GAD-7)评估患者焦虑水平,抑郁自评量表(PHQ-9)评定患者抑郁情绪,简明国际神经精神访谈自杀问卷部分(MINI)评估自杀风险,童年创伤问卷(CTQ)评估儿童期创伤;以频数和构成比描述定性资料,采用卡方检验进行各组间比较,通过优势比(OR)及其95%置信区间(CI)表示关联强度。结果在470例患者中,64.7%的PLWHA有过童年创伤经历,其中童年受情感虐待、躯体虐待的发生率均高于无焦虑症状者(P<0.05)。54.5%的PLWHA患有抑郁症状。童年受到情感虐待、躯体虐待者具有自杀倾向的风险分别是未受到的4.792倍(OR=4.792,95%CI:1.896~12.110)、3.130倍(OR=3.130,95%CI:1.430~6.851)。结论儿童期创伤经历的PLWHA更容易发展为焦虑抑郁,并增加自杀风险。应特别关注PLWHA的心理健康状况,尤其是有童年期情感虐待与躯体虐待经历者,尽早设计相应心理干预措施,预防自杀和其他不良事件的发生。

HIV感染者相关知识与行为及生活现状调查

[目的]了解安徽省艾滋病综合防治示范区艾滋病感染者/病人的知识与行为以及他们的生活现状。[方法]采用封闭式问卷,由当地卫生专业人员担当访问员,使用无记名问卷方式,对558名HIV感染者和艾滋病病人进行单独面访。[结果]示范区HIV感染者主要是已婚青壮年,其中30～50岁者占总调查人数的75.27%,艾滋病相关知识总体知晓率为88.21%,男性高于女性(89.7%对86.9%,P﹤0.01)。仅有28.2%的人每次过性生活时都使用安全套,双方都是HIV感染者的安全套使用率为33.8%,双方感染状况不一致的安全套使用率为19.8%。几乎所有的感染者都受到不同形式的关怀与帮助,但有69.6%艾滋病感染者不能继续工作学习,其12.9%的感染者子女不能上学。[结论]安徽省示范区工作取得了较大的成效,艾滋病感染者/病人的艾滋病相关知识知晓率相当高,但安全套使用率偏低。安全套的推广使用应该成为今后干预工作的重点,政府及卫生部门对感染者的关怀除了继续提供暂时性的帮助以外,重点要从根本上解决感染者及其家人的失业、辍学和生活困难等问题。