简介：ENSURINGINFORMEDCONSENTfrompatientsandexperimentalsubjectsistodayconsiderednormalclinicalpracticeandanessentialpartofbiomedicalresearchinvolvinghumansubjects.However,'informedconsent'isatechnicaltermfromthespheresofethicsandlawasdevelopedagainstaWesternculturalbackgroundand,asaconcept,isstillrelativelynewtoChina.

简介：SyphilisisafocalpointinpreventionandcontrolofSTDs.Syplhilisnowpresentsdifferentepidemiologicalandclinicalfeaturestothepast,andthesyphilisepidemicisnotseriousaspreviously-latesyphilisandcongenitalsyphilisbeingrelativelyrareinthewholecountry.Theclinicalfeaturesofskinlesionsinprimaryandsecondarysyphilishavenotchangedsubstantiallybuttheproportionofvarioustypesoflesionsisdifferenttothepast.AssyphilishasnotbeenpresentinChinaformorethan15years,someyoungmedicalworkershavenoexperienceinthediagnosisandtreatmentofthisdisease.Theyoftenmisdiagnoseormissdiagnosis.Thesemedicalworkersneedbetterknowledgeandtreatmentskills.Inordertocontrolsyphilisassoonaspossiblethroughearlydiagnosisandtreatment,thisarticlegivesanintroductiontothisissueforcolleaguesbywayofacomparisonofthepaststatusandthepresent.

简介：THEURGENCYOFtheHIVepidemicinChinahascreatedsubstantialinterestintheprevention,treatment,care,andadvocacyofHIVandAIDS.ChinahasinvestedlargeportionsofitspublichealthstructuretocurbthespreadoftheHIVepidemicwithinitsborders.however,trainingandeducationofphysicianshasbeentraditionallylessemphasized,stalledattheintersectionbetweenhealtheducation,clinicalscience,andpublichealth.^2TheemergingHIV/AIDScliniciantrainingneedsmustberevisitedinlightofthehistoricalandbiologicalcontextofHIVinChina.ThisbriefreviewofthecliniciantrainingneedsinChinawillexaminethehistoryofSTDsinChina,thebiologicalcorollariesimportanttotraining,andtheendpointsofrecentstudiesassessingChineseHIVandsexuallytransmitteddisease(STI)cliniciantraining.

简介：Objectives:TounderstandtrendsandepidemiologicalfeaturesofsyphilisovertherecentyearsinChinaandprovideascientificbasisfordevelopingpreventionstrategies.Methods:From1985to2000,syphiliscase-reportingdatacollectedfromallprovinces,autonomousregionsandmunicipalitieswereanalyzedbyapplyingepidemiologicalmethods.Results:(1)Epidemictrends:syphilisincidencehassteadilyriseninChinafrom1985to2000,especiallyafter1993,whenitassumedanexponentialgrowthpattern.80,406casesofsyphiliswerereportedinthecountryin1999,whichwasalmost40timesthenumberreportedin1993.Duringtheperiodof1993-1999,theannualaveragegrowthofthesyphilisincidenceratewas83.55%.Perhapsduetoarecentnationallawenforeementcampaign,thenumberofreportedsyphiliscasesdroppedslightlyin2000.(2)Geographicaldistribution:Syphilisspreadfromcoastal,""open""cities(especiallysomecitiesinFujianprovince)toinlandurbanareas,thentoruralareas.RegionswithahighincidencerateofsyphilisinChinaweretheMinjiang,Yangtze,andZhujiangRiverDeltas,BeijingandTianjinmunicipalities,andNortheastChina.Therewasasignificantdifferenceofsyphilisincidenceratesandgrowthratesbetweentheseareas.Aseriousepidemicoccurredinsomeareas,withanincidenceratereachingover200casesoutof100,000.(3)Populationdistribution:theratioofmaleandfemalecasesgraduallychangedfrom1.57:1in1993to1.02:1in2000.Theratewasthehighestinthe20-29agegroupandthelowestin10-14agegroup.Agreatdifferenceexistedinprevalencebetweendifferentpopulationgroupsanddifferentareas,andsomeareaswithseriousepidemicshadhighprevalenceratesevenamoungthegeneralpopulation.(4)Clinicalstageofsyphilis:Primaryandsecondarysyphiliscaseshavebeendominatingwithapercentageof90%ofallsyphiliscases.Primarysyphiliswasthemostcommoninmalesandsecondarysyphilisinfemales.Secondaryandlatentsyphilisc

简介：Abstract:AcquiredImmuneDeficiencySyndrome(AIDS)isaninfectiousdiseasecausedbyHIV.Ithasbeenepidemicformorethan20years,butthereisnocureofit.HealtheducationandbehavioralinterventionsaresomeofthemosteffectiveapproachesinthecontrolandpreventionofAIDS.ChinaisoneofthecountrieswiththefastestgrowingHIVseroprevalencerate,andisfacingawidespreadepidemicofAIDS.Currently,high-riskpopulationssuchasindividualswithmultiplesexualpartnersandintravenousdrugusersarethemainfociofhealtheducationandbehavioralinterventionsinChina.Encouragingresultshavebeenobservedinmanyformsofhealtheducationandbehavioralintervention.Theapplicationofhealtheducationandbehavioralinterventionsmustemergefromscientificevidence,followaseriesofstrategies,becarriedoutfromvariousperspectives,andrequiretheparticipationofallsocietalcommunities.

简介：Objective:Tointroducethecurrentstatusofimplementingsexuallytransmittedinfection(STIs)syndromicmanagementinChina.Methods:Datawerecollectedandanalyzedfromtheliterature.Possiblesolutionsweresuggestedfortheobstaclesencounteredintheimplementationprocess.Results:Validationofrevisedflowchartsforthemanagementofthreesyndromes(urethritis,vaginaldischarge,andgenitalulcers)hasbeenconductedinChina.Thefeasibility,effectivenessandacceptanceofusingasyndromicSTIapproachwereinvestigatedinalargestudyinHainan,ZhejiangandHubeiProvinces.Chiefobstaclestoimplementationincludedthefollowing:lackofsupportfromgovernmentauthorities;negativereactionbyhospitals;lackofcriticalthinkingandinnovation;perceivedover-emphasisontreatmentattheexpenseofprevention;andlackofcoverageforseveralimportantpathogenswithintreatmentalgorithms.Possiblesolutionsmayincludepolicyadvocacy,adoptingsyndromicmanagementintoaChinesecontext,disseminationandpromotion,trainingofproviders,encouraginguseofsyndromicapproach,andconductingoperationalresearch.Conclusions:SyndromicSTImanagementprovidesafeasibleapproachforthediagnosisandtreatmentofSTIsinChina.Furthereffortsshouldbemadeforscalingupitsapplicationinclinicalsettings.

简介：Abstract5033farmerswereinterviewedtoparticipateinaclustersamplingsurveyonfactorsrelatedtotheHIV/AIDSepidemicinoneruralareainChina.Theresultsshowedthatfemalesattendedschoolforashortertimethanmales,maleshadahigherawarenessofHIV/AIDSandheldmorepositiveattitudestowardPLWHAs.Nearlyequalpercentagesofmenandwomenintheareasurveyed,soldblood.Elevenpercentmorementhanwomenhadahistoryofmigration.Condomusewasquitelowamongthesexuallyactivepopulationsurveyed.ResultsindicatedthataneducationcampaignonHIV/AIDSpreventioninruralareasshouldintegrategenderperspectivesandensurethattheinterventioncoverswomen.Futureinterventionsshouldbedesignedtotargetmaleandfemalemigration,andshouldfocusonmodifyingtheperceptionsofsocialnormsgoverninggenderrolesinadditiontoprovidingHIVpreventioninformationinordertocontaintheHIV/AIDSepidemicatitscurrentstageinChina.

简介：

简介：CHINABROKETHEsilencethisNovember,hostingtheFirstChinaAIDS/STDConferencefromNovember13-16inBeijing.Theeventdrewalmost2000attendeesfromeveryprovinceinChinaandseveralinternationallyrenownedscientists,physicians,andpublichealthpractitionersfromtheinternationalAIDScommunity.

简介：AbstractBackground:TheNnewlyreportedcasesofcongenitalsyphilishavebeenincreasedingsubstantiallyoverthepastfewyears.Tocontroltheepidemic,amunicipalprogramaimedatpreventingmother-to-childtransmissionofsyphiliswasintroducedinJuly,2001,whichwasdesignedaimedtoscreenallpregnantwomenforsyphilisattheirfirstvisittoantenatalclinicsoratadmissiontohospitalsinShenzhen.Objectives:TheaimofthestudyistTodeterminetheprevalenceofsyphilisamongwomenattendingantenatalclinicsandothermedicalinstitutionsinShenzhenandidentifiesitspatternsofinfection.Methods:Upongivinginformedconsent,wWomenwhoattendedantenatalcarecentersinShenzhenfromJanuarytoDecember2003wereincludedinthisstudysubjecttoobtaininginformedconsent.AbloodsamplewasharvestedforsyphilisscreenedforsyphUisingbyusingrapidplasmareagenttest(RPR)andconfirmedbyTPHAforthosewhowereRPRpositive.Thewomenwithpregnantsyphilispositiveserologyweresystematicallyinterviewedtoobtain.Duringtheinterview,theirdemographicdetailsinformation,patternsofriskbehaviorsandotherdata.Datawerecollectedandwereanalyzedretrospectively.Results:AmongOf118,235pregnantwomensurveyed,555pregnantwomenwereconfirmedtohavesyphilis(prevalenceof4.69%),withaincidenceof4.69‰123womenwereexcludedfromtheanalysisbecauseofincompletemedicalrecords.Of432infectedsubjectswithcompletemedicalrecords,theaverageagewas26.8,witharangeof19to41.7.41%(32/432)ofthemsufferedfromprimarysyphilis,3.24%(14/432)wereofhadsecondarysyphilis,and89.35%(386/432)hadlatentsyphilis,withoutanyconspicuousclinicalsignsandsymptoms.Conclusions:Theprevalenceofsyphilisamongthepregnantwomeninourserieswashighandmostofthemwereasymptomatic.ScreeningforsyphilisamongpregnantwomeninShenzhenisofimportantceforthepreventionofmother-to-childtransmissionofsyphilis.

简介：

简介：Toinvestigatetheetiologyofgenitalulcerdisease(GUD)amongpatientsattendingsexuallytransmitteddisease(STD)clinicsinGuangzhou,China.BetweenSeptember8,1998,andAugust9,assessed.ClinicaletiologyofGUDwasdependentonincludingthefollowing:darkfieldmicroscopyandserologyforTreponemapallidum(TP),swabsofgenitalulcerforsimultaneousdetectionofHSV,TP,Haemophiusducreyi(HD),Humanpapillomavirus(HPV),andserologyforHIVinfection.Twohundredthirtymenandthirty-sevenwomenwithamedianageof33.4(range16-74years)wereanalyzed.TheetiologyofGUDwassyphilis(26.59%)(71/267),genitalherpes(17.60%)(47/267),condylomataacuminata(4.87%)(13/267),candidiasis(3.37%)(10/267),andmultipeinfection(6.74%)(18/267).TheseroprevalenceofHIVwas0.07%(2/267).Noetiologywasidentifiedin50.56%(135/267).TheetiologyofGUDamongSTDpatientsinourareawasmultifactorialwithapredominanceofsyphilisandgenitalherpes.BasedonthislimiteddataobtainedatSTDclinics,HIVinfectionwasnotcommon.

简介：Objectives:Todescribeandanalyzeriskfactorsassociatedwithdisuseofcondomsduringcommercialsexualintercourseamongclientsattendingsaunaandmassagecenters.Methods:Selectedfemalesexworkersfromsaunasandbeautyparlorsweretrainedasinterviewers.Theysurveyedclientsduringprovisionofsexualservices.Informationcollectedincludedcustomers’demographics,knowledgeofSTDs,rationaleforandhistoryofcondomuse.Riskfactorsforcondomusagewereasessedthoughlogisticalmodeling.Results:Atotalof50clientswereinterviewed.Theratesofcondomusageforlastsexualintercoursewithcommercialandnon-commercialpartnerswere57%and53%forclientsofrespectively.Thechoicetouseacomdomwasinfluencedbyclients60.8%ofthetime,sexworkers30.4%,andotherfactors8.8%.Thechoiceagainstusingacondomwasdecideduponbyclients69.7%,ogthetime,sexworkers9.1%,andotherfactors21.2%.Multivariateanalysisshowedthateducationallevelandperceptionofriskofinfectionwerefactorsforcondomuse.Clientswithahighschooleducationhadahighercondomuseratethanthosewithamiddleschooleducationorless.Furthermore,clientswhoperceivedriskofdiseaseusedcomdomsmorefrequentlythanthosewhodidnot.Conclusions:Clientsplayedasignificantroleindecidingwhetherornottouseacondomduringcommercialsex,Lackofperceptionofriskisamajorfactorfornotusingcondoms.Aprogramforpromotionofprophylacticstargetingbothcommercialsexworkersandtheirclientsisrecommended.

简介：Objectives:Todeterminetheaetiologiesofvaginaldischargesyndromes,tocalculatetheperformanceofdifferentmanagementalgorithms,andvalidatethesealgorithmsinSTDclinicsinChina.ThesealgorithmswereadoptedfromthoseproposedbytheWorldHealthOrganization.Methods:Atotalof315consecutivepatientswithvaginaldischargewereenrolledatthreeSTDclinics.CervicalinfectionwasdefinedaspresenceofNeisseriagonorrhoeaeoncultureand/orChlamydiatrachomatisbypolymerasechainreaction.OtherlaboratorytestsincludedwetmountmicroscopyandpHtestingofvaginalfluid.Sensitivity,specificity,andpositivepredictivevalueofdifferentalgorithmsweredeterminedusingstandardmethods.Results:Cervicalinfectionwasidentifiedin37.8%ofpatients(20.6%gonorrhea,12.7%chlamydialinfection,4.4%gonorrheaincombinationwithchlamydialinfection).Thesensitivity,specificity,andpositivepredictivevalueofalgorithmsAandBfortheidentificationofNeisseriagonorrhoeaeand/orChlamydiatrachomatiswererespectively71.4%and90.8%,65.3%and46.9%,55.6%and50.9%.Conclusions:Thevaginaldischargealgorithmscouldbeappliedforclinicalmanagement.Theirsensitivitiesareacceptable.However,thereisaneedtofurtherimprovetheirspecificityandpositivepredictivevalue.Thetwoalgorithmscouldbeusedinclinicalsettingswithdifferentfacilities.Thesealgorithmsshouldalsobevalidatedinpopulationswithlowerdiseaseprevalence.

简介：Objectives:TodevelopamethodofsimultaneousPCRdetectionofHaemophilusducreyi,Treponemapallidum,andHerpesSimplexVirusTypes1and2fromgenitalulcersamongpatientsattendingSTDclinicsinGuangzhou,China;andevaluatetheclinicalapplicationofmultiplexPCR(M-PCR)assayfordiagnosingtheetiologyofgenitalulcerdiseases(GUD).Methods:244patientswithagenitalulcerwereevaluated.ClinicaletiologyofGUDwasbasedonphysicalappearanceandmicrobiologicevaluationsthatincludeddarkfieldmicroscopyexamination(D-F)andserologytestforsyphilis(STS).SwabsofeachgenitalulcerweretestedforHSVantigenbyenzymeimmunoassay(EIA)andprocessedinanM-PCRassayforsimultaneousdetectionofT.pallidum,HSVandH.ducreyi.Results:ThestandardstrainsofT.pallidum,HSVandH.ducreyiwereamplifiedbyM-PCR,producingamplifiedproductsof260bp,432bp,170bp,respectively.ThesensitivityofM-PCRis102pgDNA.M-PCRassayforT.pallidum,HSVandH.ducreyishowedgoodagreementwhencomparedwithD-FdetectionforT.pallidum,STS,H.ducreyicultureandEIAforHSVantigen(Kappascoresare0.774,0.704,0.793,0.756,respectively).Conclusions:TheM-PCRisaconvenient,accurateandreliableassayforthedetectionofT.pallidum,HSVandH.ducreyifromgenitalulcers,andcanbeusedasamethodofdiagnosingtheetiologyofGUD.

简介：Objectives:TodescribeandanalyzeHIV/AIDS/STD-relatedhighriskbehaviorsandaffectingfactorsofmenwhohavesexwithmen(MSM)inmainlandChina~Methods:426self-administeredorinterview-basedquestionnairescollectedfromMSMwereanalyzedwithSPSSorSASSystems.Results:OftheMSM,four-fifthshadengagedinoral-genitalintercourse,abouthalfhadengagedinanalintercourse,andinthepastyearmorethantwo-fifthshadcasualsexualpartner(s).Veryfewmaintainedmonogamoussexualrelationships,andnearlyhalfalsohadintercoursewithwomen.Onefourthhadpreviouslybeendiagnosedwithavenerealdiseases.OneHIV+individualwasfoundamongthe40whoreportedhavingbeentestedforHIV.Onlytwomenconsistentlyusedcondomsamongtheone-thirdwhohadeverusedcondoms,despitealmostuniversalknowledgeofHIVanditstransmission.Conclusions:MSMinmainlandChinaareverysexuallyactive,highlightingthepossibilityofaseriousHIVepidemicthatmaybedirectlyspreadtothefemalepopulation.However,AIDSinterventionstargetingMSMfacesevereobstructionsresultingfromculturalbiasandotherfactors.

简介：

简介：Objective:Todescribethedifferentcharacteristicsbetweenfull-timesexworkers(FTSW)andpart-timesexworkers(PTSW)inGuangzhou,China,andtode-terminetheriskfactorswhichleadtothesignificantlyhigherprevalenceofgonorrheaandtrichomoniasisamongFTSW.Methods:FromMarch1998toOctober1999femalesexworkerswererecruitedthroughvariousoutreachmethods,andwereinterviewedandtestedforthepres-enceofsexuallytransmitteddiseases(STDs).IntermsofadditionalregularsalaryfemalesexworkersweredividedintoFTSWwhodidn'thaveadditionalregularsalaryandPTSWwhohadadditionalregularsalary.Univariateandmultivariatelogisticregressionanaly-seswereusedtoidentifyriskfactorsforgonorrhea/trichomoniasisandtodeterminetheconfoundersintherelationshipbetweennoregularsalaryandgonor-rhea/trichomoniasis.Results:Atotalof442FTSWand524PTSWen-teredthisstudy.Prevalenceofgonorrheaandtri-chomoniasiswassignificantlyhigherinFTSWcomparedtoPTSW.FTSWweremorelikelytohavealowereducationlevel,haveahistoryofinject-ingdrugsusesince1990,torecruitclientsinamas-sage/sauna,havebusinessmenastheirclientsandnothaveasteadypartnercomparedtoPTSW.Inbivariateanalysesmodels,ageleavingeducation,maintypesofclientsandrecruitmentlocationsappearedtobethestrongestlinksbetweennoregularsalariedpositionandgonorrhea.Ahistoryofinjectingdrugsandhay-ingnosteadypartner(past12months)appearedtobethestrongestlinksintherelationshipbetweennoregu-larsalariedpositionandtrichomoniasis.Conclusion:Differenteducationlevels,clients,andrecruitmentlocationsbetweenFTSWandPTSWmayaccountforthedifferentgonorrheaprevalenceamongsexworkers.Thehigherprevalenceoftrichomonia-sisamongFTSWmayberelatedtothelargerpropor-tionofwomenhavingnosteadypartnerorahistoryofinjectingdrugs.TheresultssuggeststrategiestopreventHIV/STDsamongfemalesexworkersshoul

简介：Objective:Theaiminthisstudywastoidentifytheallelicfrequenciesofthechemokine(SDF1-3'A)andchemokinereceptor(CCR5△32,CCR5m303andCCR2-64I)genesresistanttoHIV-1infectionand/ordiseaseprogressioninindigenousChinesepopulations.Methods:ByusingQIAampDNABloodMiniKit,thegenomicDNAsampleswerepurifiedfromwholeperipheralbloodofhealthyindividuals(n=2067)fromHan,Uygur,MongolianandTibetanethnicgroups,aswellasHanpatientsincludingHIV-1carriers(n=330),patientswithothersexuallytransmitteddiseases(STDs,n=259)andintravenousdrugusers(IVDUs,n=125).TheallelicpolymorphismswereidentifiedbymeansofPCRorPCR-RFLPanalyses.ThesequencesofrandomlyselectedamplifiedPCRproductswerefurtherconfirmedbydirectDNAsequencing.Results:Themutantfrequencieswereidentifiedtobe0%-3.48%forCCR5△32,0%forCCR5m303,19.15%-28.79%forCCR2-64and19.10%-28.73%forSDF1-3'Aalleles,respectively,inChinesehealthyindividualsfromfourethnicgroups.Ourfindingsindicatedtheallelicfrequenciesvaryamongthedifferentethnicgroups.Furthermore,theHIV-1carriers,STDcasesandIVDUs(allofHanethnicity)werefoundtohavetheallelicfrequenciesof0%-0.19%(CCR5A32),0%(CCR5m303),19.31%-20.45%(CCR2-64)and25.61%-26.83%(SDF1-3'A)withminorvariationsintheirfrequenciesbetweenthepatientsandhealthyHangroups.TherewasnoCCR5-m303mutationfoundinanysubjectinthisstudy.Conclusion:TheexaminedsubjectsoffourChineseethnicoriginsshowedlowerfrequenciesofCCR5A32andCCR5m303alleles,buthigherfrequenciesofmutantCCR264IandSDF1-3'Aallelescomparedtothoseidentifiedinnorthern-EuropeanandAmericanCaucasians.ThesignificanceofthedifferentfrequenciesandpolymorphismsoftheaboveallelesinChinesepopulationsneedstobefurtherexaminedinHIV-1/AIDSdiseases.