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Design and weighting methods for a nationally representative sample of HIV-infected adults receiving medical care in the united states-medical monitoring project

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Open aids Journal 2016年 10卷 164-181页

作者： Iachan, Ronaldo Johnson, Christopher H. Harding, Richard L. Kyle, Tonja Saavedra, Pedro Frazier, Emma L. Beer, Linda Mattson, Christine L. Skarbinski, Jacek ICF International Inc Calverton MD United States Division of HIV/AIDS Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA United States

Background: Health surveys of the general US population are inadequate for monitoring human immunodeficiency virus (HIV) infection because the relatively low prevalence of the disease (<0.5%) leads to small subpopulation sample sizes. Objective: To collect a nationally and locally representative probability sample of HIV-infected adults receiving medical care to monitor clinical and behavioral outcomes, supplementing the data in the National HIV Surveillance System. This paper describes the sample design and weighting methods for the Medical Monitoring Project (MMP) and provides estimates of the size and characteristics of this population. Methods: To develop a method for obtaining valid, representative estimates of the in-care population, we implemented a cross-sectional, threestage design that sampled 23 jurisdictions, then 691 facilities, then 9,344 HIV patients receiving medical care, using probabilityproportional-to-size methods. The data weighting process followed standard methods, accounting for the probabilities of selection at each stage and adjusting for nonresponse and multiplicity. Nonresponse adjustments accounted for differing response at both facility and patient levels. Multiplicity adjustments accounted for visits to more than one HIV care facility. Results: MMP used a multistage stratified probability sampling design that was approximately self-weighting in each of the 23 project areas and nationally. The probability sample represents the estimated 421,186 HIV-infected adults receiving medical care during January through April 2009. Methods were efficient (i.e., induced small, unequal weighting effects and small standard errors for a range of weighted estimates). Conclusion: The information collected through MMP allows monitoring trends in clinical and behavioral outcomes and informs resource allocation for treatment and prevention activities. © Iachan et al.

关键词： HIV infection Nonresponse Probability sampling Surveillance Survey methodology Weighting

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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

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International journal of pediatrics & adolescent medicine 2018年第1期5卷 5-12页

作者： Mary Bachman DeSilva Nicole Penwill Lora Sabin Allen L Gifford Zhong Li Zhang Fujie Mu Weiwei Li Yongzhen Lu Hongyan Zeng Xuemei Yiyao Barnoon Christopher J Gill Rachael Bonawitz Center for Global Health and Development Boston University School of Public Health Boston MA United States. Department of Global Health Boston University School of Public Health Boston MA United States. Westbrook College of Health Professions University of New England Portland ME United States. Departments of Health Policy and Management Boston University Schools of Public Health and Medicine Boston University Boston MA United States. Edith Nourse Rogers Memorial VA Hospital Bedford MA United States. FHI 360 Beijing China. Division of Infectious Diseases Beijing Ditan Hospital Capital Medical University Beijing China. Division of Treatment and Care National Center for AIDS/STD Control and Prevention (NCAIDS) China CDC Beijing China. AIDS Division Guangxi Centers for Disease Control and Prevention Guangxi China. Boston Children's Hospital 300 Longwood Ave. Boston MA United States.

BACKGROUND AND OBJECTIVES:With 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 SETTING:The 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 METHODS:We 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 NVivo software, we summarized major themes. RESULTS:Only 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. CONCLUSION:Disclosure 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.

关键词： Adolescent Caregiver China Disclosure HIV/aids Stigma

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HIV infection care and viral suppression among people who inject drugs, 28 U.S. jurisdictions, 2012-2013

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Open aids Journal 2016年 10卷 127-135页

作者： Karch, Debra L. Gray, Kristen Mahle Shi, Jing Hall, H. Irene Centers for Disease Control and Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Atlanta 30329 GA United States ICF International Inc Atlanta 30329 GA United States

Objectives: Assess outcomes along the care continuum for HIV-infected people who inject drugs (PWID), by type of facility and stage of infection at diagnosis. Methods: Data reported by 28 jurisdictions to the National HIV Surveillance System by December 2014 were used to identify PWID aged ≥13 years, diagnosed with HIV infection before December 31, 2013. Analyses used the CDC definition of linkage to care (LTC), retention in care (RIC), and viral suppression (VS), and are stratified by age, sex, race/ethnicity, and type of facility and stage of HIV infection at diagnosis. Results: Of 1,409 PWID diagnosed with HIV in 2013, 1,116 (79.2%) were LTC with the lowest percentages among males (78.4%);blacks (77.5%) ages 13-24 years (69.0%);those diagnosed in early stage infection (71.6%);and at screening, diagnostic, or referral agencies (60.0%). Of 80,958 PWID living with HIV in 2012, 40,234 (49.7%) were RIC and 34,665 (42.8%) achieved VS. The lowest percentages for RIC and VS were among males (47.1% and 41.3% respectively);those diagnosed with late stage disease (47.1% and 42.4%);and young people. Whites had the lowest RIC (47.0%) while blacks had the lowest VS (41.1%). Conclusion: Enhanced LTC activities are needed for PWID diagnosed at screening, diagnostic or referral agencies versus those diagnosed at inpatient or outpatient settings, especially among young people and blacks diagnosed in early stage infection. Less than half of PWID are retained in care or reach viral suppression indicating the need for continued engagement and return to care activities over the long term. © Karch et al.;Licensee Bentham Open.

关键词： aids Care continuum Facility at diagnosis HIV Injection drug use Stage of infection

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A practical community-based response strategy to interrupt Ebola transmission in sierra Leone, 2014–2015

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Infectious Diseases of Poverty 2016年第1期5卷 670-679页

作者： Zhong-Jie Li Wen-Xiao Tu Xiao-Chun Wang Guo-Qing Shi Zun-Dong Yin Hai-Jun Su Tao Shen Da-Peng Zhang Jian-Dong Li Shan Lv Chun-Li Cao Rui-Qian Xie Hong-Zhou Lu Rong-Meng Jiang Zheng Cao Zhi-Jie An Lei-Lei Li Jie Xu Yan-Wen Xiong Wei Zang Wei Zhang Hong-Wei Zhang Wen-Sen Chen Hua Ling Wen Xu Jian Cai Huan-Jin Luo Xue-Sheng Xing Can-Jun Zheng Qiang Wei Xin-Xu Li Mei Li Hai Jiang Li-Quan Deng Ming-Quan Chen Xiang Huo Feng Xu Xue-Hui Lai Xi-Chen Bai Long-Jie Ye Jian-Yi Yao Wen-Wu Yin Jiao-Jin Sun Lin Xiao Fu-Qiang Liu Xiao-Qiang Liu Hong-Wei Fan Zeng-Qiang Kou Ji-Kun Zhou Hao Zhang Da-Xin Ni Thomas TSamba Qun Li Hong-Jie Yu Yu Wang Xiao-Feng Liang Division of Infectious Disease Key Laboratory of Surveillance and Early-warning on Infectious DiseaseChinese Center for Disease Control and PreventionBeijingChina Public Health Emergency Center Chinese Center for Disease Control and PreventionBeijingChina National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and PreventionBeijingChina Chinese Field Epidemiology Training Program Chinese Center for Disease Control and PreventionBeijingChina National Immunization Program Chinese Center for Disease Control and PreventionBeijingChina Bureau of Disease Prevention and Control National Health and Family Planning Commission of the People’s Republic of ChinaBeijingChina National Institute for Viral Disease Control and Prevention Chinese Center for Disease Control and PreventionBeijingChina National Institute of Parasitic Disease Chinese Center for Disease Control and PreventionShanghaiChina Chinese Center for Health Education BeijingChina Department of Infectious Diseases Shanghai Public Health Clinical CenterShanghaiChina Beijing Ditan Hospital Capital Medical UniversityBeijingChina Health News BeijingChina National Institute for Communicable Disease Control and Prevention Chinese Center for Disease Control and PreventionBeijingChina Department of Training Chinese Center for Health EducationBeijingChina Center for Infectious Diseases Beijing Youan HospitalCapital Medical UniversityBeijingChina Infection Management The First Affiliated Hospital of Nanjing Medical UniversityNanjingChina Chongqing Municipal Center for Disease Control and Prevention ChongqingChina Yunnan Provincial Center for Disease Control and Prevention KunmingChina Division of Infectious Disease Control and Prevention Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina Guangdong Provincial Center for Disease Control and Prevention GuangzhouChina Division of Acute Infectious Disease Control and Prevention Hubei Provincial Center for Disease Control and PreventionW

Background:The Ebola virus disease spread rapidly in West Africa in 2014,leading to the loss of thousands of *** engagement was one of the key strategies to interrupt Ebola transmission,and practical community level measures needed to be explored in the field and tailored to the specific context of ***:First,community-level education on Ebola virus disease(EVD)prevention was launched for the community’s social mobilizers in six districts in Sierra Leone beginning in November ***,from January to May of 2015,in three pilot communities,local trained community members were organized to engage in implementation of EVD prevention and transmission interruption measures,by involving them in alert case report,contact tracing,and social *** epidemiological indicators of transmission interruption in three study communities were ***:A total of 6016 community social mobilizers from 185 wards were trained by holding 279 workshops in the six districts,and EVD message reached an estimated 631680 *** three pilot communities,72 EVD alert cases were reported,with 70.8%of them detected by trained local community members,and 14 EVD cases were finally *** tracing detected 64.3%of EVD *** median duration of community infectivity for the cases was 1 *** secondary attack rate was 4.2%,and no third generation of infection was *** health worker was infected,and no unsafe burial and noncompliance to EVD control measures were *** community-based measures were modeled to reduce 77 EVD cases,and the EVD-free goal was achieved four months earlier in study communities than whole country of Sierra ***: The community-based strategy of social mobilization and community engagement was effective in casedetection and reducing the extent of Ebola transmission in a country with weak health system. The successfullypractical experience to reduce the risk of Ebola transmission in the

关键词： Ebola virus disease Community engagement Health education Outbreak control

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Prescription of Pneumocystis Jiroveci Pneumonia Prophylaxis in HIV-Infected Patients

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Journal of the International Association of Providers of aids Care 2016年第6期15卷 455-458页

作者： Lin, Xia Garg, Shikha Mattson, Christine L. Luo, Qingwei Skarbinski, Jacek Epidemic Intelligence Service Centers for Disease Control and Prevention (CDC) Atlanta GA United States Division of HIV/AIDS Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention CDC 1600 Clifton Road NE Atlanta 30329 GA United States ICF International Atlanta GA United States

The US treatment guidelines recommend Pneumocystis jiroveci pneumonia (PCP) prophylaxis for all HIV-infected persons with a CD4 count 3 (ie, eligible for PCP prophylaxis). However, some studies suggest PCP prophylaxis... 详细信息

The US treatment guidelines recommend Pneumocystis jiroveci pneumonia (PCP) prophylaxis for all HIV-infected persons with a CD4 count <200 cells/mm³ (ie, eligible for PCP prophylaxis). However, some studies suggest PCP prophylaxis may be unnecessary in virally suppressed patients. Using national data of HIV-infected adults receiving medical care in the United States during 2009 to 2012, the authors assessed the weighted percentage of eligible patients who were prescribed PCP prophylaxis and the independent association between PCP prophylaxis prescription and viral suppression. Overall, 81% of eligible patients were prescribed PCP prophylaxis. Virally suppressed eligible patients were less likely to be prescribed PCP prophylaxis (prevalence ratio: 0.84;95% confidence interval: 0.80-0.89). Although guidelines recommend PCP prophylaxis for all eligible patients, some HIV care providers might not prescribe PCP prophylaxis to virally suppressed patients. Additional data on the risk for PCP among virally suppressed patients are needed to clarify this controversy. © The Author(s) 2015..

关键词： HIV Pneumocystis pneumonia prophylaxis viral suppression

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Distinctive Drug-resistant Mutation Profiles and Interpretations of HIV-1 Proviral DNA Revealed by Deep Sequencing in Reverse Transcriptase

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Biomedical and Environmental Sciences 2016年第4期29卷 239-247页

作者： YIN Qian Qian LI Zhen Peng ZHAO Hai PAN Dong WANG Yan XU Wei Si XING Hui FENG Yi JIANG Shi Bo SHAO Yi Ming MA Li Ying State Key Laboratory of Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention (NCAIDS) Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Chinese Center for Disease Control and Prevention State Key Laboratory of Infectious Disease Prevention and Control National Institute for Communicable Disease Control and Prevention Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Chinese Center for Disease Control and Prevention Key Laboratory of Medical Molecular Virology (Ministries of Education and Health) Shanghai Medical College and Institute of Medical Microbiology Fudan University

Objective To investigate distinctive features in drug-resistant mutations （DRMs） and interpretations for reverse transcriptase inhibitors （RTIs） between proviral DNA and paired viral RNA in HIV-l-infected patients. Methods Forty-three HIV-l-infected individuals receiving first-line antiretroviral therapy were recruited to participate in a multicenter aids Cohort Study in Anhui and Henan Provinces in China in 2004. Drug resistance genotyping was performed by bulk sequencing and deep sequencing on the plasma and whole blood of 77 samples, respectively. Drug-resistance interpretation was compared between viral RNA and paired proviral DNA. Results Compared with bulk sequencing, deep sequencing could detect more DRMs and samples with DRMs in both viral RNA and proviral DNA. The mutations M1841 and M2301 were more prevalent in proviral DNA than in viral RNA （Fisher＇s exact test, P〈0.05）. Considering ＇majority resistant variants＇, 15 samples （19.48%） showed differences in drug resistance interpretation between viral RNA and proviral DNA, and 5 of these samples with different DRMs between proviral DNA and paired viral RNA showed a higher level of drug resistance to the first-line drugs. Considering ＇minority resistant variants＇, 22 samples （28.57%） were associated with a higher level of drug resistance to the tested RTIs for proviral DNA when compared with paired viral RNA. Conclusion Compared with viral RNA, the distinctive information of DRMs and drug resistance interpretations for proviral DNA could be obtained by deep sequencing, which could provide more detailed and precise information for drug resistance monitoring and the rational design of optimal antiretroviral therapy regimens.

关键词： HIV-1 drug-resistant mutation Drug-resistance interpretation Proviral DNA Viral RNA Deep sequencing

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Reply to Alffenaar et al

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Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2017年第1期64卷 105-106页

作者： Charles A Peloquin Susan E Dorman Andrew Vernon Giovanni Battista Migliori Payam Nahid University of Florida Gainesville. Johns Hopkins University Baltimore Maryland. Division of Tuberculosis Elimination National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta Georgia. World Health Organization Collaborating Centre for TB and Lung Diseases Fondazione S. Maugeri Care and Research Institute Tradate Italy. University of California San Francisco.

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Tuberculosis screening at a diabetes clinic in the Republic of the Marshall Islands

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Journal of Clinical Tuberculosis and Other Mycobacterial Diseases 2016年 5卷 4-7页

作者： Trinidad, R.M. Brostrom, R. Morello, M.I. Montgomery, D. Thein, C.C. Gajitos, M.L. Heetderks, A. Chorba, T. Ministry of Health Ebeye Marshall Islands Centers for Disease Control and Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Division of Tuberculosis Elimination Atlanta GA United States Centers for Disease Control and Prevention Office of Surveillance Epidemiology and Laboratory Services Atlanta GA United States Kwajalein Atoll Healthcare Bureau Kwajalein Marshall Islands

Setting Tuberculosis (TB) and diabetes mellitus (DM) are prominent public health problems in the Republic of the Marshall Islands, a small island nation with high rates of tuberculosis and diabetes. Objective Evaluate the rate of active and latent TB in a Pacific Island DM clinic. Design In one DM clinic on the island of Ebeye, 213 adult patients aged 27–86 years completed tuberculin skin testing and TB work-up between April 2010 and March 2012. Results Screening for TB led to the diagnosis of 77 patients with TB infection and 11 patients with TB disease. From these data, the prevalence of TB disease among DM patients in the clinic exceeded 5% (95% CI 2.2%–8.1%). All patients who completed TB screening were at high risk of TB disease, and those with DM aged ≤ 50 years had a higher risk of TB disease than those with DM over age 50 (RR 3.1, C.I. 1.0–9.7, p = 0.05). Conclusion The experience at the Ebeye Diabetes Clinic demonstrates that screening DM patients for TB can identify significant rates of TB infection and TB disease, and should be considered for other settings with a high background TB incidence. Further assessment of TB risks should explore age, gender, and level of diabetes control. © 2016

关键词： Bi-directional screening Diabetes Pacific Islands Tuberculosis

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Prevalence and risk factors of HIV and syphilis,and knowledge and risk behaviors related to HIV/aids among men who have sex with men in Chongqing,China

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The Journal of Biomedical Research 2016年第2期30卷 101-111页

作者： Wenzhe Ma Guohui Wu Hui Zheng Wenjuan Zhang Zhihang Peng Rongbin Yu NingWang Department of Epidemiology and Biostatistics School of Public Health Nanjing Medical University Nanjing Jiangsu 211166 China Chongqing Center for Disease Control and Prevention Chongqing China National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China

High HIV prevalence and incidence burdens have been reported in men who have sex with men（MSM）in Chongqing,*** aimed to estimate the prevalence of HIV and other sexually transmitted infections（STIs）,to appraise the knowledge and risk behaviors related to HIV/aids among MSM,and to analyze the possible causes of deviation between behavior and knowledge to make better *** recruited 617 MSM from February to July in 2008 by using a respondent-driven sampling（RDS） method in Chongqing,*** the collection of questionnaire-based data and biological testing results from all objects,we launched a crosssectional ***/SE was used for data analysis by frequency,ANOVA,rank sum test and logistic regression *** with syphilis（OR=4.16,95%CI：2.35-7.33,P〈0.0001） were more likely to be HIV *** a company employee（OR=3.64,95%CI：1.22-10.08,P〈0.0001） and having bought male for sex（OR=3.52,95%CI：1.10-11.32,P〈0.034） were associated with a higher probability of *** with younger age,higher education and greater monthly income had a higher mean knowledge *** who had HIV testing had a higher mean knowledge score than those who never ***,venues for finding sex partners by Internet and homosexuals in MSM had a higher mean knowledge score compared to other occupations,venues for finding sex partners and sexual *** is an urgent need for delivery of barrier and biomedical interventions with coordinated behavioral and structural strategies to improve the effect of HIV interventions among MSM.

关键词： HIV/aids men who have sex with men Chongqing China

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Reply

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Hepatology (Baltimore, Md.) 2016年第6期64卷 2276-2277页

作者： Chong-Gee Teo Ajay Yesupriya Man-Huei Chang Lyna Zhang Division of Viral Hepatitis National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention. Research Data Center National Center for Health Statistics. Office of Directors National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA.

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