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This paper aimed to quantify and characterize the prevalence and associated factors for late diagnosis in older adults living with human immunodeficiency virus (HIV) in Liuzhou, China, from 2010 to 2020. The characteristics of older adults living with HIV were described separately in time, space and population. Multivariate logistic regression analysis evaluates the factors influencing late diagnosis in HIV‐positive adults ≥ 50 years of age. The majority of older adults living with HIV were over 60 years old, male, and with CD4 counts < 200 cells/μl at diagnosis, with most late diagnoses being more likely to report heterosexual transmission. These two factors may potentially provide a positive influence on late diagnosis: older and CD4 counts < 500 cells/μl. In contrast, females and those with homosexual or other transmission provide a negative. These results suggest that late diagnosis of HIV‐positive adults ≥ 50 years of age remains a severe and growing epidemiological issue. [ABSTRACT FROM AUTHOR]

In this paper, to investigate the synthetic effect of PrEP (pre‐exposure prophylaxis) and ART (antiretrovial therapy) on HIV transmission among MSM (men who have sex with men) in heterogenous environment, a realistic HIV epidemic model with spatial diffusion is established. Here, HIV infectious people are divided into three immunity based compartments, that is, CD4+ T cell count less than 350, between 350 and 500, and more than 500, respectively. The basic reproduction number R0 is established and proved as a threshold parameter: The global asymptotic stability of the disease‐free steady state holds for R0<1, and the disease will be present if R0>1. Considering the substantial advantages of PrEP and ART in controlling HIV transmissions among MSM, the optimal control problem is presented for the case of positive constant diffusion coefficients, which minimize the total population of susceptible individual and HIV infected individual, the cost of PrEP and ART therapy. As an illustration of our theoretical results, we conduct numerical simulations. We also conduct an optimal control case study where model parameters are estimated from the demographic and epidemiological data from China. This work suggests the following: (1) Spatial factors cannot be ignored during the HIV intervention; (2)taking the PrEP intervention measure for HIV transmissions among MSM as early as possible will help to improve the control efficiency and reduces its cost; (3) reducing the PrEP drug costs will promote the efficiency of PrEP treatment in preventing the spread of HIV among MSM. [ABSTRACT FROM AUTHOR]

This paper examines the social geography of sexually transmitted diseases (STDs) in China, focusing on the spread of HIV/AIDS, and the extent to which migration and urbanisation might be contributing to both the spread and the increasing prevalence of these diseases. The paper begins with a discussion of the early years of the epidemic (beginning in the mid-1980s), when the consensus view was that STDs and HIV were geographically marginal phenomena, occurring either on China's periphery, or in isolated parts of its rural interior. This characterisation seemed to be less appropriate in the latter part of the 1990s, when it became clear that temporary and circular migration had the potential to spread the diseases from one part of the country to another. The second part of the paper examines the connection between migration and the prevalence of STDs and HIV, reporting on some of the empirical evidence to support such a hypothesis, and speculating on the theoretical underpinnings of the migration/STD relationship. The third part of the paper considers what might lie in store for China in terms of its HIV epidemic. One distinct possibility is the spread of HIV to China's booming cities, and to explore this possibility in theoretical terms, a number of interrelated aspects of urbanisation that might be associated with higher rates of HIV-related risky behaviours are considered. It is suggested that these overlapping sets of forces could be related to the emergence of new behaviours and lifestyles that may be putting a growing number of Chinese people at risk in the new millennium. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study examining the effect of a multifaceted HIV/AIDS educational intervention on the knowledge, attitudes and willingness of Chinese nurses in caring for patients with human immunodeficiency virus. Background. The expanding HIV/AIDS epidemic challenges nurses to increase their knowledge about this devastating illness to provide effective HIV/AIDS prevention and care to their patients. HIV/AIDS educational interventions, which were developed for North American and European nurses, have not been studied among nurses in other societies. Methods. The study employed a pretest, post-test experimental design with 208 nurses from seven Chinese provinces. The intervention consisted of a 5-day workshop comprising didactic lectures interspersed with activities designed to elicit discussion of participants' values and personal feelings about HIV/AIDS. Bloom's Taxonomy and principles of good HIV/AIDS educational practice guided the educational intervention. Outcome variables were HIV/AIDS knowledge, attitude toward patients with HIV/AIDS (including empathy for and desire to avoid these patients) and willingness to provide nursing care to these patients. The data were collected in 2003. Findings. At baseline, HIV/AIDS knowledge was not high and attitudes and willingness to care were neutral. Knowledge, attitudes toward patients with HIV/AIDS and willingness to provide nursing care to these patients were each improved at the conclusion of the workshop (P < 0.001). Conclusions. As the HIV/AIDS epidemic expands, nurses will be called upon to deliver competent, compassionate and comprehensive care to patients and their significant others. Intensive, interactive HIV/AIDS professional workshops can contribute to the national effort by increasing knowledge and improving attitudes towards and willingness to provide nursing care for patients with HIV/AIDS. [ABSTRACT FROM AUTHOR]

In recent years, dramatically increasing numbers of mainland Chinese women have entered Hong Kong to engage in sexual labour. Public discourses on the threat of HIV/AIDS increasingly locate these women's bodies as sites of danger, colluding with pre-existing imaginations of mainland rural women as ignorant, desperate and deceptive in representing these women's penetration of Hong Kong's border as a primary means of infection of the Hong Kong body. Drawing on state, media and popular representations, and the narratives of female sex workers themselves, this paper examines the interwoven bio-medical, gendered, sexual and cross-border relationships that intersect in the experiences of mainland Chinese sex workers in Hong Kong. I argue that while images of disease and danger have been used to regulate these women's bodies, mainland female sex workers challenge these images by drawing on other popular stereotypes of mainland women as pure, feminine and traditional. Although images of the related but still‘other’ figure of the mainland Chinese woman are powerful mechanisms for the regulation of these women's bodies, mainland female sex workers skilfully use inherent tensions in those images in resisting that control and in struggling to achieve their own personal and economic goals. [ABSTRACT FROM AUTHOR]

This paper on drug use and HIV/AIDS in China follows on from the column's May 2005 article on the description of the first methadone maintenance clinic in Beijing. Methadone maintenance clinics and needle exchange programmes are now being implemented in China as a response to the rapid increase in prevalence of HIV/AIDS over the last 10 – 15 years. It is worth noting that in prior years methadone was available only as for short-term detoxification from opioids and for research purposes. Accordingly, the Department of Health Education and Behavioural Intervention at the National Center for AIDS Prevention and Control in China plans to establish 1000 methadone replacement clinics within the next 5 years to treat 200 000 heroin-dependent users who are at increased risk of HIV/AIDS. Robert Ali & Rachel Humeniuk Editors, Asia Pacific Column The cumulative number of registered drug users in mainland China increased from 70 000 in 1990 to 1.14 million in 2004. Heroin continues to be the most commonly used drug in China; however, polydrug use is popular among heroin users. Sedatives/hypnotics (e.g. triazolam) and other uncontrolled prescription opioids (e.g. pethidine and tramadol) are used commonly in combination with heroin. The majority of drug users (79%) are young people aged between 17 and 35 years and comprise predominantly farmers (30%) and unemployed people (45%). The HIV/AIDS epidemic in China has reached expansion phase (1995 – present). It is estimated that the actual number of HIV/AIDS cases reached 840 000, including 80 000 actual AIDS patients, in 2003, with injecting drug users (IDUs) making up the largest proportion of these cases. Although the prevalence rate of HIV/AIDS is only 0.065% in the Chinese population overall, there is potential for an explosive spread of HIV/AIDS if preventative measures are not employed. Supported by the Chinese government and other related international organisations, harm reduction strategies such as methadone maintenance treatment (MMT) and needle-syringe programmes (NSP) have commenced implementation to reduce the risk of HIV infection among heroin users. [Liu Z, Lian Z, Zhao C. Drug use and HIV/AIDS in China . Drug Alcohol Rev 2006;25:173 – 175] [ABSTRACT FROM AUTHOR]

Human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and syphilis are the most common sexually transmitted diseases (STDs) worldwide, as well as in China. The objective of this study is to describe the trend of spatial and temporal variation of HIV/AIDS and syphilis in mainland China from 2007 to 2017. Stratified analysis was conducted according to age and the GDP per capita. Estimated Annual Percentage Change (EAPC) was calculated and spatial autocorrelation analysis was used to evaluate the epidemiology and identify clusters. The morbidity of new HIV infection increased from 2.5034/100 000 in 2007 to 6.9247/100 000 in 2017, with an EAPC of 9.84 (95% confidence interval [CI]: 9.07–10.60). From 2007 to 2017, the morbidity of syphilis presented a significant upward trend from 15.8834/100 000 to 34.4867/100 000 (EAPC = 6.48, 95% CI: 4.23–8.73). The number of new HIV infections (205 084) and syphilis (921 279) were highest in the 20–30 years old group, where the incidence decreased with age over 20 years. In general, HIV and syphilis infection had the same incidence trend according to age and time stratification. The morbidity of new HIV infection was mainly reported from Xinjiang and southwestern China. As for syphilis, the highest was found in Zhejiang in Xinjiang and southeast coastal areas. Both HIV and syphilis infection showed a nonrandom positive correlation by Moran's I value. The High‐High cluster areas of HIV infection were concentrated in southwestern and eastern China due to syphilis. A highly significant positive correlation was found between gross domestic product per capita and syphilis infection (p < 0.05) but was not associated with HIV infection. The incidence of AIDS/HIV and syphilis is increasing year by year, and a higher prevalence is found in younger individuals. More attention should be paid to HIV infection in the southwest, syphilis in southeast coastal areas, and both the two diseases in Xinjiang. [ABSTRACT FROM AUTHOR]

This paper presents a successful social model in China for HIV/AIDS care. Shuizhou, a medium-sized city in China, has developed a “Government lead, social support and mutual help among patients” social model, which has achieved valuable results. The model comprises four networks focusing respectively on management, health promotion, funding, and care centre and home care. The model brings together a wide range of organizations, government entities, and (some) enterprises, contributing to a variety of tasks, from leadership to finance. Meanwhile, neighbourhood support for HIV/AIDS patients ensures personal care, family support, and health promotion. Over its four-year operation, the model has achieved improving social and financial results. It deserves interest beyond China. [ABSTRACT FROM AUTHOR]

Background: Talaromyces marneffei, formerly known as Penicillium marneffei, is a significant emerging pathogenic fungus in Southeast Asia which can generate life‐threatening systemic infections. Human immunodeficiency virus (HIV) infection is considered as the most underlying disease among systemic infections. However, infections due to T. marneffei without HIV are increasing in recent years. Objectives: Research the characteristics of T. marneffei infection in non‐HIV individuals in mainland China. Methods: In this study, we searched Pubmed, China National Knowledge Infrastructure (CNKI) and WanFang from inception to 31 December 2019 for studies reporting T. marneffei infection. Our research concentrates on non–HIV‐infected cases and their epidemiology, clinical manifestations, laboratory findings, treatment methods and prognosis. Results: T. marneffei infections in non‐HIV individuals are increasing. Due to frequent present with atypical symptoms, these non–HIV‐infected cases were usually misdiagnosed as other diseases, containing tuberculosis (80.7%), bacterial pneumonia (20.5%), lung cancer (5.1%) or other diseases (5.1%). Conclusions: T. marneffei infection in non‐HIV individuals should be taken seriously. Their symptoms and signs are not typical. Accurate diagnosis and timely antifungal agent treatment is the key to the treatment for the disease. [ABSTRACT FROM AUTHOR]

Object: Revealed the spatial‐temporal patterns of acquired immune deficiency syndrome (AIDS) incidences in Mainland China. Methods: Empirical orthogonal function (EOF) technique was applied to analyze the major spatial distribution modes and the temporal changes of AIDS incidences in Mainland China during 2002‐2017. Results: The annual average AIDS incidences increased from 0.06 per 100 000 in 2002 to 4.15 per 100 000 in 2017, with an annual average increase of 0.31 per 100 000. The southwest regions were high‐incidence areas, as well as Xinjiang province in the northwest. There were two typical spatial modes. EOF 1 represented an isodirectional spatial pattern that the incidences were relatively high in general, and the fluctuation ranges were relatively high in the southwest and northeast. EOF 2 represented a reverse spatial pattern that the incidences were relatively high (or low) in Guangxi, Yunnan, Xinjiang, Shanghai, and Henan, yet were relatively low (or high) in the remaining regions. Conclusion: The AIDS incidences in Mainland China were relatively low during 2002‐2010, yet were kept in a relatively high level since 2012. The prevention and control of AIDS need further development, especially in the southwest regions. [ABSTRACT FROM AUTHOR]

Objectives: HIV‐1 genetic diversity is increasing among men who have sex with men (MSM) in China, but the association of HIV‐1 genotype with disease progression remains to be elucidated. Methods: We collected data in an observational longitudinal cohort study of 860 HIV‐1‐infected MSM in Guangzhou, China between January 2008 and March 2017. Kaplan‐Meier analysis and Cox proportional hazard model were used to predict the time from HIV‐1 diagnosis to immunodeficiency progression (CD4 cell count < 200 cells/μl) as well as adjusted hazard ratio (aHR). Results: CRF01_AE and HIV‐1 subtype B infection were associated with higher percentage of patients progressed to immunodeficiency and higher incidence of immunodeficiency than infection with CRF07_BC or CRF55_01B. Compared with CRF07_BC, the time from HIV‐1 diagnosis to immunodeficiency were different among the major HIV‐1 genotypes, which ranked as follows, in descending order: CRF07_BC (7.03 years) > CRF55_01B (5.71 years, P = 0.014; aHR 3.752, P = 0.0923) > CRF01_AE (5.18 years, P < 0.001; aHR 4.733, P = 0.0152). HIV‐1 genotype, viral load and baseline CD4 T‐cell count were three independent variables associated with disease progression. Conclusions: Our results confirm differential rates of immunodeficiency progression as a function of HIV‐1 genotype. The impact of HIV‐1 genotype on HIV epidemics, patient management and prevention should be further investigated. [ABSTRACT FROM AUTHOR]

Objectives: To observe relationships between oral Candida status and salivary human beta‐defensin 2 and 3 (hBD‐2 and hBD‐3) levels in HIV/AIDS patients of Guangxi, China during the first year of antiretroviral therapy (ART) dynamically, and to understand the influence of ART on oral Candida status and salivary hBDs expressions. Methods: A prospective self‐controlled study was carried to observe the dynamic changes of CD4+ T cell counts, oral Candida carriages and salivary hBD‐2,3 expressions in HIV/AIDS patients during the first year of ART. A total of 90 HIV/AIDS patients were enrolled and were examined at the baseline, 3rd, 6th, 12th month of ART. Thirty healthy individuals were enrolled as control. Peripheral blood, oral rinse sample, and unstimulated whole saliva were collected to test CD4+ T cell counts, oral Candida carriages, and hBD‐2,3 expressions. Results: In the first year of ART, CD4+ T cell counts increased significantly. However, oral Candida carriages and oral candidiasis decreased significantly, and salivary hBD‐2 expressions in HIV/AIDS patients decreased gradually, salivary hBD‐3 levels were highly variable. Salivary hBD‐2 concentrations were positively related to oral Candida carriages. Conclusions: The incidence of oral candidiasis among HIV/AIDS patients gradually decreased due to the immune reconstruction of ART. Salivary defensins might play an important role in Candida‐host interaction in HIV/AIDS patients. [ABSTRACT FROM AUTHOR]

Background Highly active antiretroviral therapy ( HAART) as an effective therapy for immune reconstruction among patients with HIV/ AIDS might have influence on oral Candida status. We investigated oral Candida carriage, distribution, and antifungal susceptibility dynamically during the first year of HAART among adult HIV-infected patients in Guangxi, China. Methods Forty-five adult HIV-infected patients who received their first year HAART in the AIDS clinic of the Guangxi Center for Disease Control ( CDC) and 31 healthy individuals were recruited. Clinical information and oral examinations were obtained. Oral rinses taken from patients at baseline, 3, 6, 12 months during HAART, respectively, were cultured, and Candida species were identified following standard microbiological techniques. In vitro antifungal susceptibilities were tested by the broth microdilution method. Results The oral Candida load decreased gradually in the 45 patients with HIV/ AIDS during the first year of HAART ( P < 0.050). Among 176 Candida isolates, Candida albicans (114/176) was the predominant species, and Candida parapsilosis (23/62) was the most common non- albicans species. We found the frequency of resistance to fluconazole and itraconazole of Candida isolated from our samples increased ( P < 0.05) after 12 months of HAART. In addition, the frequency of C. albicans isolates resistant to fluconazole and itraconazole was on the rise ( P < 0.05). Conclusions The Candida load decreased with increased CD4+ T cell counts, and C. albicans was still the prevailing species. Further, a trend toward more frequent in vitro resistance to fluconazole and itraconazole was observed. Our results provide reference for treatment and prevention of oral candidiasis among this population. [ABSTRACT FROM AUTHOR]

An editorial is presented on HIV Medicine highlighting the current progress in the management of and clinical research on HIV/AIDS in China. Topics include Chinese authorities making several efforts regarding the prevention and treatment of AIDS; HIV infections transmitted by illegal blood transfusions being eradicated; and reducing due to the implementation of a needle and syringe exchange programme.

China's HIV/AIDS policy progress displays a long-term stagnancy followed by a sudden revolution. This article utilizes multiple theoretical tools to interpret this policy progress. It identifies four phases of China's HIV/AIDS policy process: (1) institutional endurance interpreted by path dependence from historical institutionalism; (2) deinstitutionalization explained by Oliver's antecedents of deinstitutionalization; (3) the radical shift interpreted by Kingdon's agenda-setting theory; and (4) reinstitutionalization and diffusion of institutional theory. This study demonstrates the utility of 'creative borrowing'-employing multiple theoretical tools to harness the strengths of each. Doing so reveals that a country's past experience with similar policy issues, the perceived political and moral legitimacy of existing policies, and a country's existing political interests can exert resistance to change. In the presence of multiple pressures for change, policy entrepreneurs who can identify policy windows and couple multiple streams may achieve radical policy shifts. El progreso legislativo relacionado al VIH/SIDA en China muestra un estancamiento a largo plazo seguido de una revolución repentina. El objetivo de este estudio es utilizar múltiples herramientas teoréticas para interpretar este progreso legislativo. Se identifican cuatro fases en el progreso de la legislación china sobre el VIH/SIDA: (1) Resistencia Institucional, interpretada por la dependencia al modelo del institucionalismo histórico; (2) Desinstitucionalización, explicada por los antecedentes de desinstitucionalización de Oliver; (3) el Cambio Radical, interpretado por la teoría del establecimiento de agendas políticas de Kingdon, y (4) Reinstitucionalización y Difusión de la teoría institucional. Este estudio muestra la utilidad del 'préstamos creativo'-el empleo de múltiples herramientas teóricas para aprovechar las fortalezas de cada una. Este estudio revela que experiencias pasadas con temas legislativos similares, la percepción de legitimidad política y moral de las políticas existentes, y los intereses políticos existentes en el país pueden ejercer una resistencia al cambio Dada la presencia de múltiples presiones para el cambio, emprendedores políticos que identifiquen oportunidades en las políticas y combinen múltiples enfoques pueden lograr cambios políticos radicales. Related Articles:'Civil Society and Immigrant Health Policy Convergence,' (2011): 'The State, the Market, Economic Growth, and Poverty in China,' (2007): 'The Search for Legitimacy in Asia,' (2010): [ABSTRACT FROM AUTHOR]

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Background The growing global epidemic of HIV/AIDS has a significant impact on the lives of both people living with HIV/AIDS and their family members including children. Children of parents with HIV/AIDS may experience an increased responsibility of caregiving in family. However, limited data are available regarding the caregiving experience and its impact on psychosocial well-being among these children. This study was designed to address these issues by using qualitative data collected from children affected by HIV/AIDS in China. Methods The qualitative data were collected in 2006 in rural central China, where many residents were infected with HIV/AIDS through unhygienic blood collection procedures. In-depth individual interviews were conducted by trained interviewers with 47 children between 8 and 17 years of age who had lost one or both parents to AIDS. Results Findings of this study suggest that many children affected by AIDS had experienced increased responsibilities in housework and caregiving for family members. Such caregiving included caring for self and younger siblings, caring for parents with illness and caring for elderly grandparents. Positive impacts from children's participation in family caregiving included personal growth and emotional maturity. Negative consequences included physical fatigue, psychological fear and anxiety and suboptimal schooling (dropping out from school, repeated absence from school and unable to concentrate in class). Conclusion While the increased caregiving responsibilities among children reflected some cultural beliefs and had some positive effect on personal growth, the caregiving experience generally negatively effected the children's physical and mental health and schooling. The findings in the current study suggest that community-based caregiving support is necessary in areas with high prevalence of HIV and limited resources, especially for the families lacking adult caregivers. In addition, social and psychological support should be made available for children participating in family caregiving. [ABSTRACT FROM AUTHOR]

Objective We investigated the psychological impact of sibling separation among children who lost both of their parents to AIDS and were placed in group care or kinship care settings in rural China. Methods Comparative analysis of cross-sectional survey data among 155 children among whom 96 experienced sibling separation. Trauma symptoms (Anxiety, Depression, Anger, Post-traumatic stress, Dissociation, Sexual concerns) were compared between the AIDS orphans who experienced sibling separation and those who did not using analysis of variance and multivariate analysis of covariance. Results Among the participants (47.7% girls) with an average age of 12.4 years, univariate and multivariate analyses showed that separation from siblings was associated with significantly higher scores in anxiety, depression, anger and dissociation before or after controlling for gender, age, care arrangement, number of household replacement, trusting relationship with the current caregivers and perceived quality of current living condition. Sibling separation among orphans was not associated with level of post-traumatic stress and sexual concerns. Conclusion AIDS orphans separated from their siblings suffered from increased psychological distress compared with those who remained with their siblings. The data in the current study suggest that care arrangement for AIDS orphan should include accommodating the siblings together or providing them with opportunities for frequent contact and/or communication with each other. Appropriate psychological counselling should be given to those orphans experiencing sibling separation. [ABSTRACT FROM AUTHOR]

Laws in China relating to HIV disclosure are inconsistent. After a patient has tested HIV-positive, service providers struggle to decide who should be informed first: patients, family members, or both. To understand service providers' attitudes and practices regarding the HIV notification process in China, 1101 service providers from a southwestern province of China were surveyed. Opinions were gathered from providers at five different levels of health care facilities (provincial, city, county, township and village). A mixed methods approach was used to analyze perceptions of informing family members of a patient's HIV status. Quantitative analysis was used to examine whether providers held a favorable attitude toward notifying family members first and qualitative analysis was used to explore the reasons and consequences of notifying family members first. Nearly half of service providers felt family members should be informed of a patient's HIV status first. Providers who were older, had contact with HIV patients, or had less medical education were more likely to agree with a family-first notification practice. Psychological pressure, concern about protecting family members, the need for family support, and consideration for local regulations were cited as the main reasons for this practice. There is an immediate need to re-examine HIV notification policies so that there are consistent guidelines and procedures for providers throughout China. [ABSTRACT FROM AUTHOR]

To investigate psychological status, coping, social support, and psychosocial factors associated with people living with HIV/AIDS in a highly HIV-infected area of central China. Design: Cross-sectional descriptive correlation study. Sample: Of 200 individuals with HIV/AIDS registered at the “Warm Homestead” health care center (central China), all who met the eligibility criteria ( n=103) were recruited; 94 of these completed questionnaires. Measurements: Four anonymous self-administered questionnaires were used: (a) demographic data questionnaire, (b) Symptom Checklist–90 (SCL–90), (c) Medical Coping Modes Questionnaire, and (d) Perceived Social Support Scale questionnaire. Results: Participants had low education levels and family incomes. The majority ( n=87, 92.6%) had become infected due to improper procedures during plasma donations. Participants reported moderately high levels of perceived social support, but their high SCL–90 scores indicated high levels of psychological distress. The most frequently used coping style was confrontation. Both acceptance-resignation and avoidance coping styles were significantly correlated with high distress (high SCL–90 total and subscale scores). Conclusion: Public health personnel and AIDS professionals may consider further interventions to promote psychological health in HIV/AIDS-positive individuals in highly HIV-infected areas of China, as the available social support did not seem to be effective in decreasing psychological pathology or mobilizing their coping strategies. [ABSTRACT FROM AUTHOR]

Aims To determine the HIV-1 seroprevalence, risk behaviors and demographic characteristics associated with HIV-1 infection among injection drug users (IDU) in rural Guangxi, China. Design and setting Between July and November 2002, 702 IDU were screened for HIV-1 antibody through community outreach in rural Guangxi, China for enrollment in an HIV sero-incidence study. Participants A total of 702 active high-risk IDU were screened. High-risk injection was defined as anyone who reported injecting drugs at least three times per week in the last month or injected drugs with shared equipment on at least three occasions in the last 3 months. Measurements HIV-1 antibody testing with confirmation by Western blot was performed on all subjects. Demographic and risk assessment survey data were collected at screening from everyone whose baseline HIV antibody status was known. Findings HIV-1 antibody prevalence among 702 IDU at baseline was 25% with a median age of 26.7 years (18.2–43.2). Based on a multivariate logistic regression model using risk factors identified in univariate analyses, the following risk factors were associated significantly with an increase in risk for HIV seropositivity: age > 26 years (OR 1.50; 95% CI 1.04, 2.17), sharing of rinse water (OR = 1.24; 95% CI 1.09, 1.40), not having sex in the last 6 months (OR = 1.62; 95% CI 1.08, 2.43). Conclusions HIV infection among IDU in Guangxi, one of China’s major HIV epidemic regions, is high and the infection occurs predominantly among older IDU males who share rinse water. [ABSTRACT FROM AUTHOR]

The market for blood thrived in China for more than a decade, preying on rural villagers desperate for cash. Profit motives and unhygienic collection created an AIDS epidemic, where now up to 80 percent of adults in some villages are HIV infected. Today, illegal blood banks continue to operate in some areas. Moreover, better screening and blood testing do little to address the underlying cultural reluctance to give blood. This article examines what is at stake for blood donors in the circulation of blood through both the physical and the social bodies in China today. I argue that public health and social policy solutions require consideration of the symbolic meanings of blood and the body, kin relations, and gift exchange. China's HIV-contaminated blood procurement crisis demands a critical reexamination of the hidden processes embedded in a "circulatory system" that has inseparably bound the "gift of life" and a "commodity of death". [ABSTRACT FROM AUTHOR]

Indian-origin rhesus macaques (Macaca mulatta) have long served as an animal model for the study of human disease and behavior. Given the current shortage of Indian-origin rhesus, many researchers have turned to rhesus macaques from China as a substitute. However, a number of studies have identified marked genetic differences between the Chinese and Indian animals. We investigated the genetic characteristics of a third rhesus population, the rhesus macaques of Nepal. Twenty-one rhesus macaques at the Swoyambhu Temple in Kathmandu, Nepal, were compared with more than 300 Indian- and Chinese-origin rhesus macaques. The sequence analyses of two mitochondrial DNA (mtDNA) loci, from the HVS I and 12 S rRNA regions, showed that the Nepali animals were more similar to Indian-origin than to Chinese-origin animals. The distribution of alleles at 24 short tandem repeat (STR) loci distributed across 17 chromosomes also showed greater similarity between the Nepali and Indian-origin animals. Finally, an analysis of seven major histocompatibility complex (MHC) alleles showed that the Nepali animals expressed Class I alleles that are common to Indian-origin animals, including Mamu-A*01. All of these analyses also revealed a low level of genetic diversity within this Nepali rhesus sample. We conclude that the rhesus macaques of Nepal more closely resemble rhesus macaques of Indian origin than those of Chinese origin. As such, the Nepali rhesus may offer an additional resource option for researchers who wish to maintain research protocols with animals that possess key genetic features characteristic of Indian-origin rhesus macaques. Am. J. Primatol. 68:1–11, 2006. © 2005 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

The drug problem in China reappeared in the late 1980s. At that time, most drug abusers used opium only, with heroin accounting for a very small proportion and its use being limited to border areas in the southwest and rural areas in the northwest. Beginning in the early 1990s, drug abuse spread quickly. The number of registered drug addicts increased from 70,000 in 1990 to one million by the end of 2002. Besides opioids, some "new" kinds of drugs including amphetamines and ketamine have penetrated the country through various channels since 1997. Drug abuse has caused severe problems for both the abusers and society. Three types of treatment settings for detoxification and rehabilitation are available: compulsory detoxification institutions, rehabilitation units through labor, and voluntary detoxification institutions run by sections of public security, justice, and health, respectively. Medical treatment is often combined with psychological counseling and physical training. Pharmaceutical therapy, traditional Chinese medicine, and nonpharmaceutical therapy are utilized for opioid addiction. Drug prevention, especially for young people, is emphasized. NGOs at different levels have all joined in this work. Intervention work was also started in regions where drug abuse and HIV/AIDS problems are serious. Drug abusers are helped to keep drug free after being released from detoxification settings by their communities. Different levels of institutions engaged in research on drug abuse are found in all parts of China. [ABSTRACT FROM AUTHOR]

Background. With the increase in HIV infection among childbearing aged women in Hong Kong, health department policy-makers are considering the implementation of antenatal HIV screening to identify infected mothers. However, little is known about women's understanding of HIV/AIDS, and their attitudes towards HIV screening. Aim. The aim of this study was to explore pregnant women's knowledge about HIV/AIDS, their perceptions of risk, risk behaviour and management, and their attitudes towards HIV screening. Methods. A cross-sectional study was carried out, and all Chinese pregnant women who attended an antenatal clinic of a regional hospital in Hong Kong in the month of December 2000 were invited to complete a questionnaire. Findings. Hong Kong pregnant women had fairly good general knowledge of HIV/AIDS (mean score = 4·8/6), but were less knowledgeable on specific mother-to-child HIV transmission (mean score = 3·6/6). There were statistically significant differences between those with different levels of education (χ2 = 19·81; P < 0·001) and between Hong Kong born residents and immigrants from the Chinese mainland (z = -4·03; P < 0·001). Over a third (36·7%) of all pregnant women perceived a risk of contracting HIV. If HIV infection were suspected, over 70% would have HIV screening together with their spouse. If HIV was confirmed, 24% would terminate the pregnancy. As many as 78·5% and 72·8% of women believed that HIV screening should be carried out before marriage and pregnancy respectively. Only 4·7% would choose universal opt-out antenatal HIV testing. Recommendations. Health educators should provide tailored-made education programmes for women at risk, particularly those at lower education levels and those who have come from the Chinese mainland, to enhance their knowledge about mother-to-child HIV transmission, and to promote awareness of safe sex. Health policy-makers should consider the... [ABSTRACT FROM AUTHOR]