We aimed to evaluate HIV prevalence among residents of Liangshan Prefecture through HIV sentinel surveillance (HSS) data over the period from 2010 to 2016, and investigate risk factors for HIV infection in this population and interactions among them.Two sites (Dechang and Ningnan counties) with majority-Han populations, and 1 site (Butuo) with a majority-Yi population were selected. We used questionnaires to investigate residents’ demographic and behavioral characteristics from 2010 to 2016, and performed HIV testing. Multivariate logistic regression and path analysis were undertaken to investigate the interactions and mediating effects among significant risk factors for HIV infection.A total of 5403 community residents in the Yi area and 10,897 community residents in the Han areas were enrolled. HIV prevalence in the Yi area was consistently high, ranging from 9.46% (63/666, 2011) to 2.88% (23/798, 2012) over the period from 2010 to 2016. HIV prevalence in the Han areas ranged from 0.15% (2/1333, 2010) to 0.44% (7/1604, 2011) over the same period. Multivariate logistic regression showed that unprotected casual sexual behavior, male gender, illiteracy, drug use, and injection drug use were positively associated with HIV infection risk in the Yi area. Path analysis of the risk factors revealed that casual sexual behavior (0.051) and injection drug use (0.161) were directly associated with HIV infection. However, marital status (0.004), ethnicity (0.017), education level (−0.004), HIV/AIDS-related prevention knowledge (−0.012), and drug use (0.11) had an indirect influence on HIV infection through casual sexual behavior and injection drug use.The prevalence of HIV is high among residents of majority-Yi areas, and injection drug use and casual sexual behavior are risk factors for infection.
Background: The outbreak of coronavirus disease 2019 (COVID-19) had spread worldwide. Although the world has intensively focused on the epidemic center during this period of time, it is imperative to emphasize that more attention should also be paid to some impoverished areas in China since they are more vulnerable to disease outbreak due to their weak health service capacities. Therefore, this study took Liangshan Yi Autonomous Prefecture as an example to analyze the COVID-19 epidemic in the impoverished area, evaluate the control effect and explore future control strategies. Methods: In this study, we collected information including age, gender, nationality, occupation, and address of all COVID-19 cases reported from 25 January 2020 to 23 April 2020 in Liangshan Prefecture from the Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), which were used under license and not publicly available. Additionally, we retrieved other information of cases through epidemiological investigation reports reviewing. Data were analyzed using the software Excel 2010 and SPSS 17.0. The geographic distribution of cases was mapped using ArcGIS10.2. Results: By 23 April 2020, a total of 13 COVID-19 cases and two asymptomatic SARS-CoV-2 carriers were reported in Liangshan, in three family clusters. Among the cases, eight cases had a history of sojourning in Hubei Province (61.54%), of which six were related to Wuhan. Cases aged under 44 years accounted for 61.54%, with no child case. The delay of patients' hospital visiting, and the low degree of cooperation in epidemiological investigation are problems. Conclusions: During the study period, Liangshan was well under control. This was mainly contributed to strict preventive strategies aimed at local culture, inter-sectoral coordination and highly degree of public cooperation. Besides, some possible environmentally and culturally preventive factors (e.g., rapid air flow and family concept) would affect disease prevention and control. In the next step, the health education about COVID-19 should be strengthened and carried out according to the special culture of ethnic minorities to enhance public awareness of timely medical treatment.
Background: Previous geographic studies of HIV infection have usually used prevalence data, which cannot indicate the hot-spot areas of current transmission. To develop quantitative analytic measures for accurately identifying hot-spot areas in growth of new HIV infection, we investigated the geographic distribution features of recent HIV infection and long-term HIV infection using data from a whole-population physical examination in four key counties in Liangshan prefecture, which are most severely affected by HIV in China.Methods: Through a whole-population physical examination during November 2017- June 2018 in the four key counties, a total of 5,555 HIV cases were diagnosed and 246 cases were classified as recently infected by laboratory HIV recency tests. The geospatial patterns of recent and long-term HIV infected cases were compared using ordinary least squares regression and Geodetector. Further, geospatial-heterogeneity was quantified and indicated using a residual map to visualize hot-spot areas where new infection is increasing.Results: The geographic location of HIV cases showed an uneven distribution along major roads and clustered at road intersections. The geographic mapping showed that several areas were clustered with more recently infected HIV cases than long-term infected cases. The quantitative analyses showed that the geospatial asymmetry between recent and long-term HIV infection was 0.30 and 0.31 in ordinary least squares regression and Geodetector analysis, respectively. The quantitative analyses found twenty-three townships showing an increase in the number of recent infections.Conclusions: Quantitative analysis of geospatial-heterogeneous areas by comparing between recent and long-term HIV infections allows accurate identification of hot-spot areas where new infections are expanding, which can be used as a potent methodological tool to guide targeted interventions and curb the spread of the epidemic.
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