HIV In China Research Articles

Gender differences in the relationship of sexual partnership characteristics and inconsistent condom use among people living with HIV in China

ABSTRACT Few studies have examined the relationship between inconsistent condom use and sexual partnership characteristics among people living with HIV (PLWH). The current study focused on such association and its gender differences. The study was conducted in a large hospital in South China in 2013. A total of 320 dyads (PLWH indexes and their sexual partners) were recruited from an outpatient clinic using convenience sampling. The proportion of inconsistent condom use in the last six months among female indexes was higher than that among male indexes (52.4% vs. 43.6%). Of sexual partnership characteristics, HIV seropositive status was a risk factor for inconsistent condom use for both male and female indexes (aOR = 2.32, 95%CI = 1.15∼4.66, aOR = 3.09, 95%CI = 1.10∼8.67, respectively). For male indexes, lower educational level was also a risk factor (aOR = 2.39, 95%CI = 1.23∼4.67); while having had emotionally intimate relationships was a protective factor (aOR = 0.40, 95%CI = 0.21∼0.77). For female indexes, receiving material support was a risk factor (aOR = 10.17, 95%CI = 2.13∼48.61) and receiving health-related advice was a protective factor (aOR = 0.11, 95%CI = 0.02∼0.55). Future HIV interventions for PLWH need to be gender-sensitive and include their sexual partners.

Mapping Potential Pre-Exposure Prophylaxis Users onto a Motivational Cascade: Identifying Targets to Prepare for Implementation in China.

Purpose: China recently commenced several pre-exposure prophylaxis (PrEP) projects, but little work has characterized potential users. This study describes awareness of, intention to use, and uptake of PrEP in a sample of men who have sex with men (MSM), a key population experiencing high rates of HIV in China. Methods: Through a cross-sectional survey administered to 708 MSM in four cities, we mapped respondents onto a Motivational PrEP Cascade. We conducted bivariable and multivariable analysis to examine factors associated with progression through the Cascade. Results: Among 45.6% of MSM who were PrEP eligible, 36% were in Contemplation, 9% were in PrEParation, 2% were in PrEP Action and Initiation, and none reached Maintenance and Adherence. We found no association between individual risk factors and progression through the Cascade. In multivariable analysis, friends' positive attitudes toward PrEP, more frequent sexually transmitted infection testing, and higher scores on the perceived PrEP benefits scale were positively associated with entering PrEP Contemplation. Having higher condom use self-efficacy was associated with decreased odds of entering PrEP Contemplation. Having sex with men and women in the past 6 months, having heard of PrEP from medical providers, and knowing a PrEP user were positively associated with entering PrEParation. Conclusion: We found a high proportion of MSM who were PrEP eligible and identified several intervention targets to prepare for PrEP introduction in China: community education to increase accurate knowledge, gain-framed messaging for PrEP and sexual health, and provider trainings to build MSM-competent services that can support shared decision-making for PrEP initiation.

Psychosocial correlates of health-related quality of life among people living with HIV in China: the mediating role of resilience.

The current study aims to examine associations between psychosocial factors and health-related quality of life (HRQoL) and the role of psychological resilience in mediating the relationship between perceived social support (PSS) and HRQoL. A cross-sectional study was conducted among people living with HIV (PLHIV) in Guangxi, China. A sample of 2987 PLHIV (1876 men and 1111 women) was included in the current analysis. Hierarchical multiple regression models were employed to assess the association of HRQoL with stigma, three types of PSS (informational, emotional and tangible), and resilience as well as to identify the possible role of resilience in mediating the effect of PSS on HRQoL RESULTS:: HRQoL was negatively associated with stigma (β = -0.27, P < 0.001), but positively associated with emotional PSS (β = 0.13, P < 0.001). After resilience was added to the model, HRQoL remained negatively associated with stigma (β = -0.20, P < 0.001), but positively associated with resilience (β = 0.38, P < 0.001). A mediating effect of resilience was found between emotional PSS and HRQoL (Sobel's Z = 16.87, P < 0.001). Interventions that consider enhancing resilience through building social support, especially emotional social support, will likely improve HRQoL among PLHIV.

Intention to initiate antiretroviral therapy (ART) among people living with HIV in China under the scaling-up of ART: the role of healthcare workers\u2019 recommendations

BackgroundThe early initiation of antiretroviral therapy (ART) for people living with HIV (PLWH) benefits both individuals and societies. However, little is known about the intention to initiate ART among PLWH in China in the context of a scaling-up of treatment or how the recommendations of healthcare workers affect this intention.MethodsA total of 451 ART-naïve PLWH were recruited from communities in Guangzhou, China for this study. Data were collected by trained physicians via face-to-face interviews. Logistic regression models were fitted for the data analyses.ResultsOf the participants, 93.8% were male, 72.7% were infected via homosexual behaviour and 68.5% reported an intention to initiate ART. In the latter category, 77.8, 41.9 and 20.0% of respondents received strong recommendations to initiate ART from healthcare workers at the Centres for Disease Control and Prevention (CDC), community healthcare centres and non-governmental organisations (NGOs), respectively. After adjusting for potential confounders, depression, anxiety and strong recommendations from healthcare workers at the CDC and NGOs correlated significantly with ART intention. In the adjusted final hierarchical logistic regression model, the duration of infection [multivariate odds ratio (ORm) = 0.30, p < 0.001], route of HIV infection (ORm = 0.18, p < 0.01), infection status of the current spouse/regular sex partner (ORm = 0.21–0.23, p < 0.01), anxiety (ORm = 2.44–2.65, p < 0.05) and strong recommendations from CDC physicians (ORm = 3.67, p < 0.01) or NGOs workers (ORm = 3.67, p < 0.01) were independently associated with the ART intention, whereas a recommendation from a community healthcare centre physician was not.ConclusionsIn Guangzhou, the prevalence of ART intention was below the 90–90-90 targets. Further studies aimed at an in-depth understanding and encouragement of health care workers’ perceptions regarding early ART are warranted as a means of scaling up new ART strategies.

Validation of the Outcome Expectancy Scale for HIV Serostatus Disclosure to Female Sex Partners Among Men Who Have Sex with Men and Women Living with HIV in China

The study aimed to develop an instrument, Outcome Expectancy Scale (OES), to assess outcome expectancies regarding disclosing HIV-positive status to the regular female sex partner (i.e. girlfriend, wife) based on a cross-sectional survey among 217 men who have sex with men and women living with HIV. We developed the positive OES and negative OES, and five factors were identified for each of them by the Exploratory Factor Analysis, respectively. The psychometric properties were satisfactory. This 30-item OES was valid and reliable in assessing outcome expectancies, and it could be used to inform intervention design and theory development.

Perceived discrimination and cognitive function in middle-aged and older adults living with HIV in China

ABSTRACTMiddle-aged and older adults with HIV experience double discrimination and cognitive impairment due to both their HIV status and their age. However, the relationship between perceived discrimination and self-reported cognitive ability in middle-aged and older people living with HIV (PLWH) is less clear. We measured self-reported perceived discrimination and cognitive ability using the Expanded Everyday Discrimination Scale and the subscale of the AIDS Health Assessment Questionnaire (AIDS-HAQ). The study sample included 324 middle-aged and older PLWH (over 45 years old) from five designated HIV hospitals in three regions (east coast, middle, and southwest regions) of China. The descriptive analysis showed that 45.37% of the participants reported perceiving discrimination at least once in the past twelve months, and 47.22% reported having at least one type of cognitive impairment. Multiple linear regression results showed that higher levels of perceived discrimination (β = −0.121, P = 0.036) were significantly associated with lower levels of self-reported cognitive ability after controlling for several covariates, including sociodemographic variables, mental health status, health behaviors, and social support. A longer duration of HIV was also related to a lower level of self-reported cognitive ability. Our findings indicate that perceived discrimination is related to self-reported cognitive ability and suggest that counseling services and support systems should be developed to reduce age- and disease-associated discrimination. A reduction in perceived discrimination would improve not only overall wellbeing but also cognitive ability in later life.

China's Energy Diplomacy: Does Chinese Foreign Policy Favor Oil-Producing Countries?

AbstractDue to its rapid economic growth and increasing demand for energy, China has engaged in numerous efforts to sustain its energy supplies and enhance its energy security. While existing literature argues that access to energy is oftentimes the driving force behind Beijing's foreign policy behavior, little work has been done to systemically examine the bilateral relationship between China and energy-producing countries. This paper explores how China's foreign policy making is influenced by its energy security concern, focusing on three foreign policy instruments—partnerships, foreign aid, and leadership visits. Using a large-N, quantitative approach, this paper analyzes the effect of oil production on these three foreign policy indicators. The results show that Beijing is more likely to form partnerships with oil-producing countries. Top Chinese leaders are also more likely to travel to countries that produce a higher level of oil. China's aid allocation to Africa is driven by oil abundance as well, although the findings on aid are only valid in the cross-national analysis.

Human papillomavirus infection and associated factors for cervical intraepithelial neoplasia in women living with HIV in China: a cross-sectional study

ObjectiveWomen living with HIV (WLHIV) face disproportionately higher risks of acquiring human papillomavirus (HPV) compared with HIV negative counterparts. We aimed to investigate the prevalence of HPV in WLHIV in...

Sex differences in neurocognitive screening among adults living with HIV in China

HIV-infected (HIV+) women may be more vulnerable to neurocognitive impairment (NCI) due to psychological and physiological factors but previous studies show mixed findings. We investigated the neurocognitive performances in HIV+ versus HIV- women and men. This cross-sectional analysis included 669 HIV+ patients (223 women) and 1338 HIV-uninfected (HIV-) controls (446 women) which were frequency matched on sex, education, and 5-year age categories. NCI was screened using the Mini-mental State Examination. Psychomotor speed was assessed using timed alternating hand sequence test. Prevalence of NCI was higher among women versus men in the HIV+ group (16.1% vs 10.5%) but not the HIV- group (4.3% vs 3.5%). HIV+ women performed worse compared to men on psychomotor speed, orientation, attention, and calculation, whereas HIV- women performed worse compared to men on attention and calculation. Adjusted interaction effects of HIV status × sex (women vs men) were significant on orientation, attention, and calculation, and marginally significant on psychomotor speed (p = 0.053). In multivariable models, among both HIV+ women and men, less years of education and depressive symptoms were associated with NCI. Waist-to-hip ratio above the cut-off was strongly associated with NCI among HIV+ women. HIV+ women perform worse on cognitive measures compared to HIV+ men. The association of central obesity with NCI in HIV+ women should be noted.

Utility of Theory to Explain Village Doctors’ Willingness to Treat People Living with HIV in Rural China

Stigma against people living with HIV in China is common, not only among the general public but also among Chinese health-care providers, impacting their ability to provide quality HIV treatment and care. HIV stigma may be particularly common in rural areas of China, where village doctors (i.e., “barefoot doctors”) have limited medical training yet are charged with providing frontline care for much of China’s rural population. Therefore, the present study aims to use communication and behavioral theory to better understand Chinese village doctors’ beliefs about HIV, including their willingness to become involved in HIV treatment and care. In collaboration with the Behai Centers for Disease Control, we surveyed 228 village doctors in rural China to learn about their experiences in providing HIV treatment and care. We then applied a hybrid theoretical model, combining variables from the Situational Theory of Publics and the Theory of Reasoned Action, to explain providers’ communication, attitudes, and behaviors. Findings suggest that enhanced information activity about HIV may increase providers’ self-efficacy in caring for HIV patients and yield more positive attitudes towards caring for people living with HIV. Theoretical and practical implications are discussed.

Need for Intervention Services for Promotion of Condom Use by Female Sex Workers to Consider Size of Entertainment Venues: A Cross-Sectional Study.

BackgroundConsistent condom use among female sex workers (FSWs) is a key intervention in China’s AIDS Control Program. Female sex workers (FSWs) in China are at increased risk for acquiring HIV/AIDS because of low knowledge about HIV transmission and inconsistent use of condoms, the grade of venues may play a role in HIV/AIDS-related knowledge and consistent condom use of female sex workers.Material/MethodsA cross-sectional study was conducted among 802 FSWs in 2016 in Fuyang, China. A self-administered questionnaire was used to assess whether there is a need of different intervention services promotion of consistent condom use among FSWs in different-grade entertainment venues.ResultsMultivariate logistic regression analysis indicated that knowledge scores of HIV transmission routes and peer education were associated with consistent condom use in large-size venues, while peer education was associated with consistent condom use in mid-size venues. Knowledge scores of HIV non-transmission routes, knowledge scores of AIDS prevention/control, and peer education were associated with consistent condom use in small venues.ConclusionsOur data suggested that the strategies for strengthen interventions on health benefits of consistent condom use of FSWs should differ by size of venue.

HIV screening among patients seeking care at Xuanwu Hospital: A cross-sectional study in Beijing, China, 2011-2016.

ObjectivesOne-third of people living with HIV in China are still unaware of their status, so we sought to better understand HIV testing in the general hospital setting in China.MethodsA cross-sectional study was conducted using the electronic medical records of all patients who attended Xuanwu Hospital in Beijing, January 1, 2011 to December 31, 2016. HIV screening and detection rates and characteristics of patients diagnosed with HIV were assessed.ResultsOverall, 235,961 patients were screened, for a screening rate of 1.4%. Although most were outpatients (98.4%), screening rate was higher among inpatients (70.0% versus 0.4%), and highest in internal medicine (36.1%) and surgery (33.3%) departments. A total of 140 patients were diagnosed with HIV, for a detection rate of 5.93 per 10,000. Detection rates were highest among outpatients (9.34 per 10,000), and patients attending the dermatology and sexually transmitted infection (STI) department (153.85 per 10,000). Most diagnoses were made among males (91.4%), aged 20–39 (67.1%), who reported becoming infected through homosexual contact (70.0%).ConclusionsHIV screening in China’s general hospitals needs to be improved. More focus should be placed on screening outpatients, especially in the dermatology and STI department, and young men.

HIV-1 Genotypes and Disease Progression Among Chinese Men Who Have Sex with Men: An Observational Cohort Study

Background HIV-1 genetic diversity is increasing among MSM living with HIV in China, but it is not known whether disease progression and response to antiretroviral therapy (ART) vary with different HIV-1 genotypes. Methods In an observational cohort of 860 HIV-1-infected MSM in Guangzhou, China between January 2008 and December 2012, Kaplan-Meier curve analysis and the Cox proportional hazard model were used to predict the median time between HIV-1 diagnosis and progression of AIDS-defining illness as well as the adjusted hazard ratio (aHR). A generalized estimating equation (GEE) model was adapted to evaluate the effect of HIV-1 genotypes on the response to ART. Findings The four major HIV-1 genotypes CRF01_AE, CRF07_BC, CRF55_01B, and subtype B accounted for 37·0%, 37·0%, 15·3%, and 8·0% of the total, respectively. The median time and risk from HIV diagnosis to progression to AIDS was different among HIV-1 genotypes, ranked in descending order: CRF07_BC (7·03y) > CRF55_01B (5·71y, p = 0·014; aHR=2·29, p = 0·137) > CRF01_AE (5·18y, p subtype B (3·96y, p 350 cell/mm3 was statistically different between CRF07_BC and CRF01_AE (1·04 vs 1·95 years, p=0·002), but similar between CRF07_BC and subtype B (1·04 vs 1·07 years, p=0·292). After adjustment for baseline CD4 cell counts, no significant differences were observed in the rates of CD4 increases by HIV-1 genotype. Interpretation Differential rates of disease progression were observed as a function of HIV-1 genotype with HIV-1B and CRF01_AE being the most virulent, followed by CRF55_01B, with CRF07_BC, being the least pathogenic. Individuals infected with CRF07_BC had an improved virological but similar immunological response to ART compared to those infected with subtype B or CRF01_AE. Funding Bureau of Science and Information Technology of Guangzhou Municipality (Project No. 201704020219, and 201707010184). Declaration of Interest: All authors declare that they have no conflicts of interest. Ethical Approval: This study was approved by the Institutional Review Board of the Guangzhou CDC. It was performed in accordance with relevant local laws and the ethical requirements of the Helsinki Declaration.

Changes and determinants of health-related quality of life among people newly diagnosed with HIV in China: a 1-year follow-up study

PurposeThis study aimed to investigate changes in health-related quality of life (HRQoL) among people newly diagnosed with HIV and to identify factors associated with HRQoL.MethodsNewly diagnosed HIV-positive individuals were consecutively recruited and assessed at baseline and 1-year follow-up after diagnosis. HRQoL was measured through the physical health summary score (PHS) and mental health summary score (MHS) derived from the Medical Outcomes Study HIV Health Survey. Socio-demographic, clinical, and psychological information was also collected at both times. Generalized estimating equations were applied to explore factors associated with HRQoL in 1 year.ResultsA total of 410 participants were included. After 1 year, significant increases were observed for both the mean PHS score (53.5–55.0; p = 0.009) and the mean MHS score (44.2–49.0; p < 0.001). Older age (p = 0.024), rural household registration (p = 0.031), HIV-related symptoms (p < 0.001), and depression (p = 0.014) were negatively associated with PHS. Additionally, the negative association between stress and PHS increased over time (β = − 0.07 for the baseline; β = − 0.18 for the 12-month follow-up; p < 0.001). HIV-related symptoms, depression, lower social support, and higher levels of stress (all p < 0.001) were negatively associated with MHS. Additionally, the negative relationship between stress and MHS was stronger among participants who were asymptomatic (p = 0.015).ConclusionA relatively lower HRQoL among HIV-infected people shortly after HIV diagnosis and an increase in HRQoL among people 1 year after HIV diagnosis were observed. Additional attention should be paid to individuals of older age, from rural areas, with HIV-related symptoms, with depression, with high levels of stress, and with a lack of social support.

Development and Feasibility Testing of an mHealth (Text Message and WeChat) Intervention to Improve the Medication Adherence and Quality of Life of People Living with HIV in China: Pilot Randomized Controlled Trial.

BackgroundMost people living with HIV (PLWH) reside in middle- and low-income countries with limited access to health services. Thus, cost-effective interventions that can reach a large number of PLWH are urgently needed.ObjectiveThe objective of our study was to assess the feasibility and acceptability of an mHealth intervention among PLWH in China.MethodsBased on previous formative research, we designed an mHealth intervention program that included sending weekly reminders to participants via text messages (short message service, SMS) and articles on HIV self-management three times a week via a popular social media app WeChat. A total of 62 PLWH recruited from an HIV outpatient clinic were randomly assigned to intervention or control group. The intervention lasted for 3 months, and all participants were assessed for their medication adherence, presence of depression, quality of life (QoL), and CD4 (cluster of differentiation 4) counts. Upon completing the intervention, we interviewed 31 participants to further assess the feasibility and acceptability of the study.ResultsAt baseline, the intervention and control groups did not differ in terms of demographic characteristics or any of the major outcome measures. About 85% (53/62) of the participants completed the intervention, and they provided valuable feedback on the design and content of the intervention. Participants preferred WeChat as the platform for receiving information and interactive communication for ease of access. Furthermore, they made specific recommendations about building trust, interactive features, and personalized feedback. In the follow-up assessment, the intervention and control groups did not differ in terms of major outcome measures.ConclusionsThis pilot study represents one of the first efforts to develop a text messaging (SMS)- and WeChat-based intervention that focused on improving the medication adherence and QoL of PLWH in China. Our data indicates that an mHealth intervention is feasible and acceptable to this population. The data collected through this pilot study will inform the future designs and implementations of mHealth interventions in this vulnerable population. We recommend more innovative mHealth interventions with rigorous designs for the PLWH in middle- and low-income countries.Trial RegistrationChinese Clinical Trial Registry ChiCTR1800017987; http://www.chictr.org.cn/showprojen.aspx?proj=30448 (Archived by WebCite at http://www.webcitation.org/71zC7Pdzs)Registered Report IentifierRR1-10.2196/

Reducing distress and promoting resilience: a preliminary trial of a CBT skills intervention among recently HIV-diagnosed MSM in China

ABSTRACTPeople living with HIV/AIDS (PLWHA) in China experience significant psychological distress, due to high rates of stigma and low availability of mental health resources. Recently diagnosed Chinese PLWHA who are men who have sex with men (MSM) are particularly vulnerable to distress, facing both HIV and sexual orientation stigma. Reducing distress and enhancing psychological resilience is critical in promoting wellbeing. However, no research to date has examined evidence-based interventions to reduce psychological symptoms and improve resilience in this population. Based on qualitative research on their mental health needs, we developed a culturally tailored, brief 3-session CBT skills-based intervention for integration into primary care [Yang, J. P., Simoni, J., Cheryan, S., Shiu, C., Chen, W., Zhao, H., & Lu, H. (2018). The development of a brief distress reduction intervention for individuals recently diagnosed with HIV in China. Cognitive Behavioral Practice, 25(2), 319–334. doi:10.1016/j.cbpra.2017.08.002]. The intervention includes cognitive restructuring to address depressive thought patterns, behavioral activation to decrease isolation, and paced breathing to reduce anxiety. We conducted a pilot Type 1 hybrid effectiveness-implementation trial assessing pre–post mental health outcomes as well as feasibility, acceptability, and appropriateness information. Ten recently diagnosed MSM completed the research protocol of three individual weekly sessions. Paired-samples t tests demonstrated significant reduction in HIV-related distress, depression, problems with adjustment, as well as improvements in resilience, and perceived social support. Participants and community advisory board members found the intervention highly acceptable, appropriate, and feasible. Preliminary data from the first known study examining a psychological intervention with evidence-based components for recently diagnosed Chinese MSM suggests that this brief intervention may be useful for reducing distress and promoting resilience.

A machine learning method to monitor China's AIDS epidemics with data from Baidu trends.

BackgroundAIDS is a worrying public health issue in China and lacks timely and effective surveillance. With the diffusion and adoption of the Internet, the ‘big data’ aggregated from Internet search engines, which contain users’ information on the concern or reality of their health status, provide a new opportunity for AIDS surveillance. This paper uses search engine data to monitor and forecast AIDS in China.MethodsA machine learning method, artificial neural networks (ANNs), is used to forecast AIDS incidences and deaths. Search trend data related to AIDS from the largest Chinese search engine, Baidu.com, are collected and selected as the input variables of ANNs, and officially reported actual AIDS incidences and deaths are used as the output variable. Three criteria, the mean absolute percentage error, the root mean squared percentage error, and the index of agreement, are used to test the forecasting performance of the ANN method.ResultsBased on the monthly time series data from January 2011 to June 2017, this article finds that, under the three criteria, the ANN method can lead to satisfactory forecasting of AIDS incidences and deaths, regardless of the change in the number of search queries.ConclusionsDespite the inability to self-detect HIV/AIDS through online searching, Internet-based data should be adopted as a timely, cost-effective complement to a traditional AIDS surveillance system.

We don't dare to tell her … we don't know where to begin: Disclosure experiences and challenges among adolescents living with HIV and their caregivers in China.

Background and ObjectivesWith increasing access to antiretroviral therapy, HIV-infected youth are living longer, but are vulnerable as they navigate the transition to adulthood while managing a highly stigmatized condition. Knowing one's HIV status is critical to assuming responsibility for one's health. The process of disclosure to adolescents living with HIV is not well understood globally, even less so in China. To help address this gap, we explored practices for disclosure to adolescents living with HIV (ALHIV) among Chinese caregivers and clinicians, and the disclosure experiences of the adolescents themselves using qualitative methods.Design and SettingThe study was conducted in 2014 at the Guangxi Center for Disease Control and Prevention ART (CDC-ART) clinic in Nanning, China. We used a qualitative design, incorporating in-depth interviews (IDIs) and focus group discussions (FGDs).Patients and MethodsWe conducted IDIs with 19 adolescent/caregiver dyads and five FGDs with adolescents and clinicians. Adolescent participants were aged 10–15 years, and had contracted HIV perinatally. Using NVivoTM software, we summarized major themes.ResultsOnly 6/19 caregivers reported disclosing to their child; matched adolescents' statements indicate that 9/19 children knew their HIV status. Caregivers planned to disclose when children were 14 years or older. Concerns about stigma toward children and families were associated with reluctance to disclose.ConclusionDisclosure to adolescents living with HIV in China was delayed compared with recommended guidelines. Culturally appropriate disclosure strategies should be developed, focused on supporting caregivers and de-stigmatizing HIV.

Self-reported changes in alcohol use behavior among people living with HIV in China after receiving HIV positive diagnosis.

Background:Alcohol use remains a significant challenge for treating people living with HIV (people living with HIV). We aimed to examine current use and retrospective self-reported changes in drinking behavior after HIV+ diagnosis in people living with HIV.Method:Survey data were collected from a large random sample of people living with HIV (N = 2964, mean age = 42.5, standard deviation = 12.8) in Guangxi, China.Results:The estimated prevalence rate of current alcohol use was 42.8%. Among current drinkers, 41.7% reported binge drinking and 10.4% reported hazardous drinking. Among the ever drinkers, 45.4% reported reductions in drinking and 19.5% reported quitting after HIV+ diagnosis. Older age, female gender, higher income, being employed, if currently on antiretroviral therapy, and having received an HIV+ diagnosis within a year were positively associated with quitting; and more education, lower income, currently on antiretroviral therapy, and having received an HIV+ diagnosis more than one year were associated with reduced drinking.Conclusion:The time period immediately following receiving an HIV+ diagnosis may represent a window of opportunity for alcohol use intervention in people living with HIV.

The advance of detection technology of HIV self-testing

At present, China's AIDS testing increased rapidly, but there are still many people living with HIV do not recognize their status, thus postponing the antiviral treatment time. HIV self-testing (HST) is an effective method to expand the testing, not only simple operation, easy to get a result, effectively protect the detection privacy, expand the selection of testers, suit to the entire population, but also the premise and basis of other AIDS comprehensive prevention measures, all over the world are promoting it. Because the HST has controversies in the window period, price and before and after controversial, and our country is in the initial stage of HST, so it is not to develop related policies, but more and more countries are in accordance with their own situations are modified or developed to allow to use rapid detection of AIDS policy to regulate the field. This paper analyzed and summarized the advantage and influence factors of HST promotion, HST believes that in the long term, the advantages outweigh the disadvantages, we need to formulate relevant policies, and improve the sensitivity of the kit, shorten the window period of time, production and promotion of operation standard of video, specification and testing the operating practices, preventing and reporting the possible social harm, investigation and understanding of the needs of the people of the crowd, to maximize the advantages of HST, find more infection, so as to curb the epidemic of AIDS.