Treatment Adherence and Health Outcomes in MSM with HIV/AIDS: Patients Enrolled in “One-Stop” and Standard Care Clinics in Wuhan China

Wang, Zhou; Zhao, Min; Wang, Xia; Schilling, Robert F.; Zhou, Sheng; Qiu, Hua‐Ji; Xie, Na; Liu, Man‐Qing; Dong, Han-Sheng; Zhang, Yao; Cai, Thomas

doi:10.1371/journal.pone.0113736

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…This finding highlights an important health service gap in this population, particularly in light of the country's free national ART program which provides free drugs and treatment for opportunistic infections for all people living with HIV. Though the rate of uptake in our sample is slightly lower than those reported by past analyses of ART initiation in China whether in a national cohort (48.9%) or in convenience samples of HIV‐positive MSM (54.3% to 75.2%) . However, direct comparisons are challenging given the fact that past studies were restricted to persons already engaged in care or to those under a certain CD4 cell count.…”

Section: Discussioncontrasting

confidence: 61%

Transplantation or rurality? Migration and HIV risk among Chinese men who have sex with men in the urban areas

Liu

Tang

et al. 2018

J Intern AIDS Soc

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IntroductionMigration of men who have sex with men (MSM) from rural to urban areas is common across low‐ and middle‐income countries and is widely believed to contribute to elevated HIV risk among migrant MSM in urban areas. Little consensus exists on whether their risk is due to their transplantation or their being from resource‐constrained rural areas. This study seeks to clarify the relationship between migration and HIV risks by comparing differences in HIV‐related risky sexual behaviours and healthcare utilization across competing conceptualizations of migratory statuses.MethodsIn July 2016, MSM ≥16 years old currently residing in one of eight urban cities in China were recruited for an online cross‐sectional survey, which collected information on socio‐demographics, sexual behaviours, HIV care‐seeking behaviours, and healthcare utilization. Based on a question about residency status, each participant was classified as an urban local resident, urban transplant, or rural transplant. Multivariable multinomial logistic regression was used to examine the associations between risky behaviours and healthcare utilization among these three groups.ResultsAmong 2007 MSM, the proportion of local, urban transplant and rural transplant were 32% (648/2007), 24% (478/2007), and 44% (881/2007), respectively. Compared with urban local resident MSM, urban transplant MSM were more likely to have ever tested for HIV (adjusted odds ratio (aOR) = 1.39, 95% confidence interval (CI): 1.08 to 1.80). Compared with urban transplant MSM, rural transplant MSM were less likely to have utilized any governmental sexual health services in the past three months (aOR = 0.75, 95% CI: 0.60 to 0.93), ever tested for HIV (aOR = 0.77, 95% CI: 0.61 to 0.96), ever initiated antiretroviral therapy (ART) (aOR = 0.16, 95% CI: 0.05 to 0.52), and ever purchased sex (aOR = 0.57, 95% CI: 0.38 to 0.85). No other significant differences were found in sexual behaviours among three groups.ConclusionsThe widely used local/migrant categorization obscures important differences in HIV risk present between urban/rural subgroups among them. Previous studies of HIV risks in Chinese “migrant” may have failed to consider the role of structural factors such as discrimination or barriers to healthcare when interpreting their findings of higher HIV prevalence in this population. Low ART uptake among rural transplant MSM in this study is particularly concerning and underscore the need for HIV‐related interventions tailored for this group.

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Section: Discussioncontrasting

confidence: 61%

Transplantation or rurality? Migration and HIV risk among Chinese men who have sex with men in the urban areas

Liu

Tang

et al. 2018

J Intern AIDS Soc

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“…A study conducted in 2014 indicated that many HIV-infected individuals are receiving ART that is sub-optimal, even after they receive definite diagnosed [ 44 ]. Among MSM patients with CD4 cell count ≤ 350 cells//mm3, only around 60 % received ART [ 44 , 45 ].…”

Section: Resultsmentioning

confidence: 99%

HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review

et al. 2016

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BackgroundDespite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM) and transgender (TG) individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China.MethodsWe searched MEDLINE, EMBASE and the Cochrane Library for recent studies on MSM/TG HIV epidemiology and responses. We also included supplemental articles, grey literature, government reports, policy documents, and best practice guidelines.ResultsOverall, HIV prevalence among Chinese MSM was approximately 8 % in 2015 with a higher prevalence observed in Southwest China. TG are not captured in national HIV, STD, or other sexual health surveillance systems. There is limited data sharing between the public health authorities and community-based organizations (CBOs). Like other low and middle income countries, China is challenged by low rates of HIV testing, linkage, and retention. Several pilot interventions have been shown to be effective to increase HIV testing among MSM and TG individuals, but have not been widely scaled up. Data from two randomized controlled trials suggests that crowdsourcing contests can increase HIV testing, creating demand for services while engaging communities.ConclusionImproving HIV surveillance and expanding HIV interventions for Chinese MSM and TG individuals are essential. Further implementation research is needed to ensure high-quality HIV services for MSM and TG individuals in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1904-5) contains supplementary material, which is available to authorized users.

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“…40 Previous studies have shown that a “one-stop” model might achieve better retention in care, CD4 recovery and viral load suppression. 41 A CDC-based drug delivery model was found to have lower rate of retention in care despite the extensive network. 42 …”

Section: Discussionmentioning

confidence: 99%

HIV Linkage to Care and Retention in Care Rate Among MSM in Guangzhou, China

et al. 2017

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Quantifying HIV service provision along the HIV care continuum is increasingly important for monitoring and evaluating HIV interventions. We examined factors associated with linkage and retention in care longitudinally among MSM (n = 1974, 4933 person-years) diagnosed and living in Guangzhou, China, in 2008-2014. We measured longitudinal change of retention in care (≥2 CD4 tests per year) from linkage and antiretroviral therapy initiation (ART). We examined factors associated with linkage using logistic regression and with retention using generalized estimating equations. The rate of linkage to care was 89% in 2014. ART retention rate dropped from 71% (year 1) to 46% (year 2), suggesting that first-year retention measures likely overestimate retention over longer periods. Lower CD4 levels and older age predicted retention in ART care. These data can inform interventions to improve retention about some subgroups.

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Treatment Adherence and Health Outcomes in MSM with HIV/AIDS: Patients Enrolled in “One-Stop” and Standard Care Clinics in Wuhan China

Cited by 9 publications

References 29 publications

Transplantation or rurality? Migration and HIV risk among Chinese men who have sex with men in the urban areas

Transplantation or rurality? Migration and HIV risk among Chinese men who have sex with men in the urban areas

HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review

HIV Linkage to Care and Retention in Care Rate Among MSM in Guangzhou, China

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