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ObjectiveTo analyze the failure of antiretroviral therapy (ART) and drug resistance characteristics among the newly reported HIV-infected patients in Taizhou City from 2020 to 2022.MethodsBlood samples, sociodemographic characteristics and ART information of the newly reported HIV-infected patients who received ART for ≥6 months in Taizhou City from 2020 to 2022 were collected for the detection of recent infections and HIV-1 genotypic drug resistance. Multivariate logistic regression analysis was used to analyze the influencing factors of treatment failure. The gene sequences of cases with failed ART were submitted to the HIV drug resistance database of Stanford University to determine the drug resistance mutation sites and drug resistance characteristics.ResultsAmong the 1 023 newly reported HIV-infected patients receiving ART, the median age (P25,P75) was 47 (33, 58) years, 81.4% were male, 66.4% (679/1 023) were infected through heterosexual transmission, 74.7% had a WHO clinical stage Ⅰ/Ⅱ, 62.2% had a baseline CD4 count of >200 cell·μL-1, 94.4% (966/1 023) received an immediate ART, and 78.7% were long-term infected. Among the 66 patients with treatment failure (6.5%), the likelihood of treatment failure was lower in those with homosexual transmission (OR=0.39, 95%CI: 0.17‒0.84) and without history of sexually transmitted disease (STD) (OR=0.45, 95%CI: 0.24‒0.92), but higher in those with a baseline CD4 count of ≤200 cell·μL-1, delayed ART (OR=3.19, 95%CI: 1.24‒7.52), and primary drug resistance (OR=4.69, 95%CI: 1.68‒11.89). Among the 36 HIV-infected patients with virological failure, 27 sequences were successfully amplified, with a successful amplification rate of 75.0% (27/36). The total drug resistance rate was 55.6% (15/27), of which the drug resistance rates of nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) were 37.0% (10/27), 51.9% (14/27) and 3.7% (1/27), respectively. Among the NNRTIs, the degree of resistance to efavirenz and nevirapine was consistent, with a majority (51.9%) of highly drug-resistant. K103N and M184V were the most common mutation sites, but PIs mutations occured less frequently. A total of 8 genotypes of HIV-1 were detected, in which subtype CRF01_AE accounted for 37.0% (10/27), followed by CRF07_BC [14.8% (4/27)], CRF08_BC [14.8% (4/27)] and subtype C [14.8% (4/27)].ConclusionDuring the period from 2020 to 2022, the newly reported HIV-infected individuals in Taizhou City were predominated by long-term infections. Immediate initiation of ART can reduce the risk of treatment failure in HIV-infected individuals. Virological treatment failures are primarily associated with resistance to NRTIs and NNRTIs. It is recommended to strengthen active detection and promptly initiate ART to minimize the occurrence of ART failure. Simultaneously, there is a need to intensify drug resistance detection targeted for those with treatment failure, so as to provide a scientific guidance for drug replacement.

ObjectivesTo determine the syphilis infection and risk factors among the male outpatients in sexually transmitted disease (STD) clinics in Taizhou, and to provide a scientific evidence for the development of comprehensive prevention and intervention strategies for syphilis.MethodsA questionnaire survey and serological testing were conducted among the male STD outpatients in the hospitals designated for STD treatment in Jiaojiang, Linhai, Luqiao and Sanmen in Taizhou. Logistic regression analysis was used to determine the risk factors associated with syphilis infection.ResultsA total of 16 400 male STD outpatients were investigated, with a syphilis infection rate of 2.10%. Multivariate analysis showed that aged over 60, non-local household registration, engaging in sexual activity with commercial sex workers in the past three months, having two or more sexual partners in the past three months, engaging in anal sex with heterosexual partners, co-infection with human immunodeficiency virus (HIV), and co-infection with hepatitis C virus (HCV) were significantly associated with a higher syphilis infection rate (all P

ObjectiveTo analyze the changes in HIV， syphilis and hepatitis C prevalence among men who have sex with men （MSM） in Taizhou City， Zhejiang Province from 2017 to 2022， and the utilization of HIV intervention services and its influencing factors.MethodsMSM participants were recruited from HIV sentinel surveillance in Taizhou through snowball sampling method. Participants’ socio-demographic characteristics， sexual behavior characteristics， knowledge of HIV and utilization of HIV intervention services were collected and statistically described by questionnaire survey. Blood samples from MSM sentinel population were also collected for HIV， syphilis， and HCV antibody testing. Multivariate logistic regression analysis was used to analyze the influencing factors for utilizing HIV intervention services among MSM.ResultsA total of 2 499 MSM were included in the analysis from 2017 to 2022， with HIV prevalence of 5.8%， syphilis prevalence of 4.0%， and HCV prevalence of 0.6%. The infection rate， proportion of homosexual anal sex and heterosexual sex showed a decreasing trend， while the proportion of condom use during homosexual anal sex， condom publicity and distribution， AIDS consultation and testing， acceptance of peer education， and online temporary homosexual sex showed an increasing trend. All these differences were statistically significant. Multivariate logistic regression analysis showed that COVID-19 epidemic （aOR=1.66， 95%CI：1.04‒2.64） and HIV knowledge awareness （aOR=2.57， 95%CI：1.22‒5.40） were positively correlated with increased acceptance of condom publicity and distribution， and utilization of AIDS counseling and testing. Those who sought male sexual partners through offline route （aOR=3.44， 95%CI： 1.16‒10.21）， and had a history of sexually transmitted diseases within one year （aOR=5.47， 95%CI： 1.04‒28.76） were positively correlated with community-based methadone maintenance therapy， clean needle provision and exchange services， while COVID-19 epidemic （aOR=0.35， 95%CI： 0.14‒0.88） was negatively correlated with the utilization of these services. COVID-19 epidemic （aOR=2.11， 95%CI： 1.54‒2.89）， HIV knowledge awareness （aOR=2.09， 95%CI： 1.08‒4.02）， offline search for male sexual partners （aOR=1.47， 95%CI： 1.03‒2.11）， and awareness of HIV infection of sexual partners （aOR=2.09， 95%CI： 1.62‒2.69） were positively correlated with the increased use of peer education service， while married or cohabited （aOR=0.73， 95%CI： 0.55‒0.98） and VCT （aOR=0.61， 95%CI： 0.46‒0.82） were negatively correlated with utilization of peer education service.ConclusionHIV infection rate of sentinel MSM population in Taizhou decreases， while the utilization of HIV intervention services increases in general. Targeted measures should be developed according to the changes in sexual behavior and HIV intervention services among MSM populations in Taizhou to improve the HIV intervention services for the MSM population.

ObjectiveTo determine the prevalence of hepatitis C virus （HCV） infection and identify the underlying risk factors among drug users in Taizhou City of Zhejiang Province during 2009‒2020.MethodsA consecutive cross-sectional survey was conducted. A total of 400 drug users in correctional settings were randomly selected from April to August. The drug users were interviewed with a questionnaire to collect demographic characteristics， AIDS-related knowledge， detoxification service， drug use， and sexual behavior. Blood samples were then collected for anti-HCV antibody testing. Chi-square test and multivariate conditional logistic regression were used.ResultsA total of 5 042 drug users were included in this study. Seroprevalence of HCV was determined to be 22.7%. From 2009 to 2019， the seroprevalence showed a significant downward trend， from 34.9% to 8.8% （χ2=221.025， P

Background: COVID-19 threatened global health, however little is known about the long-term courses of loneliness and their effect on mental health in adolescents. This study aimed to explore the trajectories of loneliness among adolescents in Taizhou, Zhejiang Province, China, during the last phase of the pandemic. We also aimed to identify risk factors in each loneliness course and the impact of loneliness on emotional problems, peer problems, hyperactivity and conduct problems. Methods: The study employed multistage cluster sampling to collect four waves of data from 2347 Chinese adolescents (average baseline age of 14.7 years) covering a period of 20 months (October 2021 – May 2023). The UCLA 3-Item Loneliness Scale and the Strengths and Difficulties Questionnaire were utilized to assess loneliness and mental health problems, respectively. Growth mixture modelling was employed to identify latent classes of loneliness trajectories. Associated risk factors were investigated using multinomial logistic regression model. Mixed-effects logistic regression models were constructed to examine the long-term impact of loneliness classes on mental health outcomes. Results: The overall percentage of loneliness increased from 22.9% at baseline to 32.2% at the fourth wave in our sample. Three classes of loneliness were identified: Decreasing Low Loneliness (58.71%), Increasing Medium Loneliness (36.52%), and Increasing High Loneliness (4.77%). Risk factors for poorer loneliness trajectories included lack of physical exercise habits, poorer mental health literacy, medium or low perceived social support, having study difficulties, being female, higher grades, and lower economic status. Loneliness classes were associated with the severity and variability of emotional problems, peer problems, hyperactivity and conduct problems (ORs for the highest loneliness class: 10.24, 4.21, 3.87, 2.68, respectively). Individuals in the higher loneliness classes experienced a significant increase in these mental health problems over time (p < 0.05 for interactions between loneliness classes and time). Conclusion: During the last phase of the pandemic, a large proportion of adolescents in our study endured medium to high levels of loneliness with no signs of improvement. Both unfavorable loneliness trajectories adversely affected internalizing and externalizing problems and displayed an upward trend in these difficulties. Results highlight the importance of tackling loneliness and improving mental health in adolescents. [ABSTRACT FROM AUTHOR]

Introduction In December 2019, reports on cases of pneumonia of unknown etiology emerged from Wuhan, China. Subsequently, researchers identified the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the [...], Problem On 21 January 2020, the city of Taizhou, China, reported its first imported coronavirus disease 2019 (COVID-19) case and subsequently the number of cases rapidly increased. Approach To organize the emergency responses, the government of Taizhou established on 23 January 2020 novel headquarters for prevention and control of the COVID-19 outbreak, by coordinating different governmental agencies. People at high risk of acquiring COVID-19, as well as probable and confirmed cases, were identified and quarantined. The government closed public venues and limited gatherings. The Taizhou Health Commission shared information about identified COVID-19 patients and probable cases with affected agencies. To timely track and manage close contacts of confirmed cases, Taizhou Center for Disease Control and Prevention did epidemiological investigations. Medical institutions or local centers for disease control and prevention reported confirmed cases to the national Center for Disease Control and Prevention. Local setting Taizhou, a city in Zhejiang province with about 6 million residents, reported 18 confirmed COVID-2019 cases by 23 January 2020, which ranked it third globally in number of cases after Wuhan and Xiaogan cities in the Hubei province. Relevant changes In total, 146 confirmed cases (85 cases imported and 61 cases through community transmission) and no deaths due to COVID-19 had been reported in Taizhou by 1 June 2020. Between 16 February and 1 June 2020, no confirmed case had been reported. Lesson learnt Identifying and managing imported cases and people at risk for infection, timely information sharing, limiting gatherings and ensuring collaborations between different agencies were important in controlling COVID-19. [phrase omitted] [phrase omitted] Probleme Le 21 janvier 2020, la ville de Taizhou, en Chine, a signale son premier cas importe de maladie a coronavirus 2019 (COVID-19). Le nombre de cas a ensuite rapidement augmente. Approche Afin d'organiser les interventions d'urgence, les autorites de Taizhou ontetabli le 23 janvier 2020 un nouveau guartier general charge de la prevention et du controle de l'epidemie de COVID-19, fruit de la coordination entre differents organismes gouvernementaux. Les personnes presentant un risgue eleve de contracter la COVID-19, ainsi gue les cas probables et confirmes, ont ete identifies et mis en guarantaine. Les autorites ont ferme les lieux publics et limite les rassemblements. La Commission de la sante de Taizhou a partage des informations relatives aux patients COVID-19 identifies et aux cas probables avec les agences concernees. Pour retracer et gerer sans delai les contacts rapproches des cas confirmes, le Centre de prevention et de controle des maladies de Taizhou a mene des investigations epidemiologigues. De leurcote, les etablissements medicauxou centres locaux de prevention et de controle des maladies ont notifie les cas confirmes au Centre national de prevention et de controle des maladies. Environnement localTaizhou est une ville de la province du Zhejiang et compte environ 6 millions d'habitants. Elle avait denombre 18 cas de COVID-2019 confirmes au 23 janvier 2020, ce gui la classait au troisieme rang mondial en nombre de cas apres Wuhan et Xiaogan, dans la province du Hubei. Changements significatifs Taizhou a enregistre un total de 146 cas confirmes (85 cas importes et 61 cas de transmission communautaire) etaucun decesdu a la COVID-19au 1erjuin 2020. Entre le 16 fevrier et le 1erjuin 2020, aucun cas confirme n'a ete signale. Lemons tirees Identifier et gerer les cas importes ainsi gue les personnes a haut risgue d'infection, partager les informations au moment opportun, limiter les rassemblements et assurer une bonnecollaboration entre les differents organismes sont autant de mesures gui jouent un role essentiel dans le controle de la COVID-19. [phrase omitted] Situacion El 21 de enero de 2020, la ciudad de Taizhou (China) comunico su primer caso importado de la enfermedad del coronavirus 2019 (COVID-19) y posteriormente el numero de casos se incremento rapidamente. Enfoque El 23 de enero de 2020, el gobierno de Taizhou establecio una nueva sede para la prevencion y el control del brote de la COVID-19, a traves de la coordinacion de distintos organismos gubernamentales para organizar las respuestas de emergencia. Se identificaron y entraron en cuarentena las personas con alto riesgo de padecer la COVID-19, asi como los casos probables y confirmados. El gobierno cerro los lugares publicos y restringio las reuniones. La Comision de Salud de Taizhou compartio informacion sobre los pacientes identificados con la COVID-19 y los casos probables con los organismos afectados. El Centro para el Control y la Prevencion de Enfermedades de Taizhou realizo investigaciones epidemiologicas para hacer un seguimiento oportuno y manejar los contactos cercanos de los casos confirmados. Las instituciones medicas o los centros locales para el control y la prevencion de enfermedades reportaron los casos confirmados al Centro Nacional para el Control y la Prevencion de Enfermedades. Marco regional Taizhou, una ciudad de la provincia de Zhejiang que tiene unos 6 millones de habitantes, comunico 18 casos confirmados de la COVID-2019 al 23 de enero de 2020, lo que la situo en el tercer lugar mundial en numero de casos despues de las ciudades de Wuhan y Xiaogan en la provincia de Hubei. Cambios importantes En total, para el 1. de junio de 2020 se confirmaron 146 casos (85 casos importados y 61 casos por transmision comunitaria) y no se notificaron muertes por causa de la COVID-19 en Taizhou. Tampoco se notificaron casos confirmados entre el 16 de febrero y el 1. de junio de 2020. Lecciones aprendidas La identificacion y la gestion de los casos importados y de las personas en riesgo de infeccion, el intercambio oportuno de informacion, la restriccion de las reuniones y la garantia de la colaboracion entre los distintos organismos fueron importantes para controlar la COVID-19.

AbstractBackgroundContact tracing is especially useful for identifying an infection with few cases in the population, such as HIV in China. Little such research is available in China.MethodsEvery newly diagnosed HIV case from 2008–2010 in Taizhou Prefecture, Zhejiang Province in China, was invited to participate as an “index case” in a contact tracing survey by providing contact information for up to eight sexual contacts who themselves were approached for voluntary HIV counseling and testing (VCT). Those who tested HIV-positive were then subjected to another contact tracing survey. This process was repeated until no more sexual contacts were reported or tested positive.ResultsA total of 463 HIV-infected individuals were newly identified during the study period, including 338 cases who were identified from routine surveillance programs and 125 cases who were identified from the present contact tracing survey. Among these 463 cases, 398 (86.0%) served as ‘index cases’ in the survey, including 290 (85.8%) out of the 338 cases identified from routine surveillance programs and 108 (86.4%) out of the 125 cases identified from the present survey. These 398 ‘index cases’ reported a total of 1,403 contactable sexual contacts, of whom 320 (22.8%) received HIV testing and 125 (39.1%) tested positive for HIV. Willingness to receive HIV testing was high among spouses and long term heterosexual or homosexual partners but extremely low among casual and commercial sex partners of ‘index cases’. Consistent condom use was rare for all participants. A total of 290 independent sexual network components were constructed, with high complexity.ConclusionContact tracing is useful for identifying new HIV infections from spouses or long term sexual partners of HIV-infected individuals. The complicated sexual networks existing between and beyond HIV-infected persons provide opportunities for rapid spread of HIV in such areas.

Background Frailty is one of the major concerns among aging people with HIV (PWH). Evidence regarding the association between sleep disorders and physical frailty in PWH is limited. Methods PWH and HIV-negative individuals aged ≥40 years were included and frequency-matched in a 1:2 ratio by sex and age. Logistic regression models were used to estimate the odds ratios (ORs) and 95% CIs of the association between sleep disorders and physical frailty, and restricted cubic splines were used to describe the dose–response association. The contribution of depression to the association was estimated by mediation analysis. Results A total of 1526 PWH and 3052 HIV-negative individuals were included. Logistic regression indicated that insomnia (OR, 3.05; 95% CI, 1.63–5.72) and poor sleep quality (OR, 2.32; 95% CI, 1.21–4.45) were significantly associated with physical frailty in middle-aged and older PWH, especially in those with current CD4+ T-cell counts <350 cells/µL, but not in HIV-negative participants. A U-shaped and J-shaped dose–response relation between sleep duration and physical frailty was observed in PWH and HIV-negative participants, respectively. Shorter and longer sleep duration was associated with an increased risk of physical frailty in PWH. However, in HIV-negative participants, only longer sleep duration was associated with physical frailty. Mediation analysis revealed that depression mediated the relation between sleep disorders and frailty among PWH. Conclusions Sleep disorders including insomnia, poor sleep quality, and short and long sleep duration were significantly associated with physical frailty among middle-aged and older PWH. Depression may play a mediating role in the sleep–frailty association. [ABSTRACT FROM AUTHOR]

Health-related quality of life (HRQOL) has become a concept commonly used in the related research. Using the World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF), this study evaluated the Quality of Life (QOL) of people living with HIV/AIDS (PLWHA) in Zhejiang province, China, and assessed the influences of demographic, laboratory and disease-related variables on QOL. This cross-sectional study was conducted among PLWHA aged ≥ 18 years in Taizhou municipality, Zhejiang province, China, between August 1 and October 31, 2014. A multiple linear regression model was used to analyze the influential factors. Of 403 subjects, 72.48% were male, 72.46% had received a high- school or above education, 94.79% were of Han ethnicity, and 65.51% were non farmers. The total score of QOL was 15.99±1.99. The scores of QOL in physiological, psychological, social relation, and environmental domains were 14.99 ±2.25, 14.25 ±2.12, 13.22 ±2.37, and 13.31 ±1.99 respectively. Except the total score of QOL and the score of environmental domain (p