2020-2022年HIV检测服务研究进展

HIV检测是艾滋病防治工作的关键环节,是诊断发现HIV感染者的必要手段。新型冠状病毒感染疫情（新冠疫情）期间,通过医疗卫生机构和社会组织等途径提供的HIV检测数量明显下降。HIV自我检测需求在新冠疫情期间快速上升,成为医疗机构等HIV检测途径的重要补充。HIV检测在新冠疫情期间主要受到医疗机构服务、新冠疫情防控措施、人群检测意愿、性伴数量等供需两端多种因素的影响。本文从新冠疫情对HIV检测数量的总体影响,对不同检测途径的影响、相关因素以及提高HIV检测的策略措施方面进行综述,为优化传染病流行时期的HIV检测服务提供依据。     

浅谈新型冠状病毒感染肺炎流行期间列车的消毒策略

铁路旅客列车作为我国人口出行的主要方式,有着人员密集、流动性大、运输距离远等特点,尤其在新型冠状病毒感染肺炎流行期间与春运相叠加,对于新型冠状病毒感染肺炎的传播有着巨大的潜在危险。针对新型冠状病毒感染肺炎流行期间防止疫情通过交通工具传播的要求,本文介绍了旅客列车较为全面的消毒策略。     

新型冠状病毒肺炎流行对HIV感染者卫生需求影响的快速评估

目的 了解新型冠状病毒肺炎暴发流行对HIV感染者卫生需求影响，为政府和感染者社区快速制定应对措施提供参考依据。方法 于2020年2月5-10日，通过网络招募年满18周岁并已开始服用抗反转录病毒药物（ARV）的HIV感染者参加网络匿名调查，了解新型冠状病毒肺炎流行期间，受访者在预防新型冠状病毒肺炎、获取HIV防治相关服务和心理支持需求等方面的信息。结果 调查共收集1 014份来自全国各省的HIV感染者的调查问卷，93.79%的调查对象表示自己所在的社区提供了新型冠状病毒肺炎的预防信息，同时更加关心HIV感染者相关的新型冠状病毒肺炎预防措施以及防护品短缺问题；32.64%的调查对象表示自己现有的ARV不足以满足交通和旅行管制期间的需求，其中部分感染者在未来1个月面临断药风险。湖北省需要补充药物的HIV感染者中，64.15%的人表示因为"封锁和行动受限"而难以获得HIV治疗药物。调查还发现，28.93%的调查对象希望获得社会心理支持；对政府的期待方面，85.31%的调查对象希望可以进一步完善HIV感染者异地取药流程。结论 HIV感染者希望了解该人群预防新型冠状病毒肺炎暴发的相关信息，部分返乡或居住在交通管制地区的感染者，仍存在定期领药等方面的困难。疫情形势下，HIV感染者获取药物面临困难，我们应当进一步开展系统调查了解新型冠状病毒肺炎流行对HIV感染的影响，并提高卫生系统应急储备和处置能力。     

新型冠状病毒肺炎暴发与大流行的流行病学调查及应对策略

目的探讨新型冠状病毒肺炎暴发与大流行的流行病学调查及应对策略。方法分析新型冠状病毒肺炎疫情暴发后流行病学调查实践工作经验,提出疫情国际大流行背景下的应对策略和方法。结果新型冠状病毒肺炎暴发的流行病学调查与控制工作的要点包括:流行病学证据及证据链,疫情事件传染源确定,传染源控制,传播途径切断,高危人群分类管理等。提出了加强国境卫生检疫,加强信息收集与信息分享,加强主动监测并开展以病例为核心的线索追踪,加快疫苗研发进度等新型冠状病毒肺炎大流行的应对策略。结论及时调整和完善应对策略,对进一步做好新型冠状病毒肺炎防控工作至关重要。     

关于印发不同人群预防新型冠状病毒感染口罩选择与使用技术指引的通知

肺炎机制发[2020]20号各省、自治区、直辖市及新疆生产建设兵团应对新型冠状病毒感染的肺炎疫情联防联控机制(领导小组、指挥部):在新型冠状病毒感染的肺炎流行期间,为指导不同人群科学合理地选择和使用口罩,严防新型冠状病毒感染的肺炎疫情蔓延和扩散,制定了《不同人群预防新型冠状病毒感染口罩选择和使用技术指引》。现印发给你们...     

通辽市364名性服务女性HIV监测分析

随着艾滋病疫情的流行蔓延，尤其是经性途径传播在快速上升，性服务小姐作为艾滋病传播的桥梁人群，了解掌握该人群人类免疫缺陷病毒（HIV）感染状况及与艾滋病感染相关的危险行为，采取相应的控制措施是预防艾滋病的关键。根据内蒙古中美全球艾滋病综合防治项目（GAP）监测计划，2005年8～9月对通辽市科尔沁区化娱乐场所的性服务小姐进行艾滋病监测。现将结果报告如下。     

我国老年人群艾滋病防控现状与挑战

近年来我国老年人群艾滋病疫情呈现快速上升趋势,老年人群艾滋病防治面临新的挑战。老年人群对HIV感染风险认知较低,发生无保护的临时性行为或商业性行为比例较高,HIV感染风险较高。老年HIV感染者和感染风险较高的老年人群文化程度和社会经济水平普遍偏低,获取艾滋病相关知识和检测服务机会较为有限,老年HIV感染者由于检测发现晚、合并慢性疾病等因素,死亡风险显著上升。需从行为特征、社会经济、文化、心理等方面多维度深入开展老年人艾滋病防治研究,探索和采取适合老年人群特点的防治艾滋病健康服务的策略措施,强化对老年感染者全流程综合管理模式的研究。     

西安市高危人群性传播疾病现状调查

目的：调查西安市性传播HIV／AIDS感染的流行情况，为艾滋病的预防和控制提供依据。方法：采取西安市美发、桑拿按摩人员、歌舞娱乐服务人员（96人），性病门诊病人（109人）血样进行酶联免疫吸附实验检测HIV。结果：调查人群HIV检出率为1．95％。结论：HIV已向性乱人群传播，应加强对该人群的疫情监测，并开展针对艾滋病的干预活动。     

新型冠状病毒肺炎疫情期间血液透析室防控管理实践

目前新型冠状病毒肺炎疫情严峻,人群普遍易感。疫情期间,肾功能不全患者对于透析的刚需仍在。由于其疾病本身因素和治疗特点,这些患者抵抗力低,加之血液透析室人员流动大、密度高,较易成为新型冠状病毒感染暴露风险极高的医疗场所。北京大学第三医院从院级统筹规划、应急预案制定、医务人员管理、诊疗流程优化、患者分层处置、防护物资合理配置等几方面制定新型冠状病毒肺炎疫情流行期间血液透析室综合防控措施,为新型冠状病毒肺炎等突发公共卫生事件期间血液透析室管理及应对策略提供参考。     

大理州艾滋病病毒感染现状分析

为了掌握我州艾滋病病毒(HIV)感染疫情态势及流行(?)(?),促进预防控制工作.于1990年～1996年对辖区12个县市实施了艾滋病高危人群血清流行病学调查工作,有关情况报告如下:1 材料与方法1.1 材料 对1990～1996年开展HIV血清学监测的目标人群,包括强制戒毒人员、拘留劳教管制吸毒者、性病患者、交通沿线性服务嫌疑人员,取静脉血3～5ml,分离血清冷藏待检.1.2 方法 血清由州卫生防疫站用ELISA法初筛,阳性血清送云南省艾滋病防治研究中心经WB法复判,重复阳性即诊断为HIV感染.     

COVID-19疫情给其它传染病防治带来的挑战与机遇

COVID-19大流行对人类健康造成巨大威胁的同时也给全世界公共卫生系统带来前所未有的挑战和机遇。为迅速控制疫情,世界各国采取保持社交距离、重新分配医疗资源、调整医疗策略等应急措施,原有医疗服务秩序遭到破坏,有限医疗资源受到再挤压,其它传染病防治最佳时机被错过,导致结核病、肝炎、麻疹、艾滋病等多种传染病发病率和死亡率快速上升,给人类健康和社会经济都造成严重损害。但是也有一些意外收获,如改变了人们对旅行安全常态的定义、完善了中低收入国家被忽视的传染病防控关键内容、暴露出医疗体系中传染病医生匮乏问题、降低严重复杂性流感和侵袭性肺炎球菌等疾病发病率等。年初,COVID-19大流行给全世界敲响了警钟,让各国看清自身公共卫生系统在应对传染病暴发上的不足。年末,COVID-19和其它传染病或将同时暴发,各国公共卫生系统将面临更为严峻的大考,亟待各国政府高度重视并做好充分准备。     

COVID-19-Related Disruptions to HIV Testing and Prevention Among Young Sexual Minority Men 17–24 Years Old: A Qualitative Study Using Synchronous Online Focus Groups,April–September 2020

Prior research has highlighted the impact of the COVID-19 pandemic on HIV prevention services within the U.S., but few studies have explored this impact through an exploratory, qualitative lens. In this study, we sought to highlight the voices of young sexual minority men (YSMM) 17–24 years old and explored the perceived impact of the pandemic on HIV prevention among a diverse, nationwide sample of YSMM who participated in synchronous online focus group discussions between April and September 2020. Forty-one YSMM described the negative effects of the COVID-19 pandemic on HIV testing and prevention services, including limited and disrupted access to HIV testing, HIV pre-exposure prophylaxis (PrEP), and HIV post-exposure prophylaxis. COVID-19-related challenges were compounded by ongoing, pre-COVID-19 barriers experienced by YSMM in the U.S. For instance, many YSMM relocated back home with family, causing men to avoid HIV prevention services for fear of outing themselves to relatives. YSMM also worried about placing their family at increased risk of COVID-19 by attending clinical appointments. YSMM who did seek HIV prevention services, including access to PrEP, experienced significant barriers, including limited appointment availability and services not tailored to YSMM. Further efforts are needed to support YSMM re-engaging in HIV prevention during and after the COVID-19 era.

     

新冠疫情期间保障急诊医疗服务质量的探究

目的基于公众对疫情期间急诊延误事故的反应,分析疫情期间如何保障急诊医疗服务质量。 方法采用Python网络爬虫抓取知乎平台下公众对某一疫情期间急诊延误事故相关问题的回答,采用词云图可视化展现回答内容,并统计公众关注的导致疫情期间急诊服务质量下降的原因、公众对法规改进和社区医疗的建议。 结果公众普遍认为,此次急诊事故的发生与疫情防控密切相关。公众关注的因素主要包括私立医院的营业性质、法规不合理、行政管理者、医院基层和社区的过失。通过进一步分析讨论可知,疫情对急诊就诊的影响主要在于急诊就诊资源减少、急诊流程延长和交叉感染风险增加等。私立医院存在大量监管漏洞,监管机构可以从检查方式和准入标准等方面强化监督。卫生行政管理部门应当合理统筹医疗资源,建设实时应急管理信息发布通道并严惩急诊拒诊。医院应当优化医院结构,设置不同等级的院感风险区,并设立专门值班室。社区卫生服务中心应当做好预检分流工作,落实双向转诊并优化医疗配置。 结论从政府、医院、社区多角度协同保障疫情期间的急诊医疗质量,可改善现有卫生管理的不足。     

COVID-19疫情对北京市公立医院住院服务量的影响及其恢复情况分析

目的：了解COVID-19疫情对北京市公立医院住院服务的影响,为卫生健康管理决策提供参考。方法：采用描述性方法分析2020年上半年北京市公立医院出院量的变化情况,并利用ARIMA乘积季节模型假设未发生COVID-19情况下对2020—2021年的出院量进行预测,通过比较其与实际状态下出院量的差异,评估COVID-19疫情对住院服务的潜在影响。结果：2020年1—6月出院总量较2019年同期减少69.1万人次（48.0%）;外地患者出院量较去年同期下降28.2万人次（65.5%）,其中循环系统疾病与恶性肿瘤患者出院人次数下降最多。ARIMA模型结果显示,2020年1—6月实际出院总量与外地患者出院量较预测值分别减少77.3万人次（50.8%）与33.2万人次（69.1%）,住院服务的恢复压力不断增加。结论：疫情后期北京市住院医疗服务秩序的恢复将面临更为复杂的挑战,建议卫生健康部门充分利用互联网与现代化信息技术手段,在做好常态化防控的同时,重点做好外地患者与重点专科医院的住院需求应对。     

Impact of COVID-19 on people with physical disabilities: A rapid review

BackgroundThe COVID-19 pandemic caused drastic changes in the lives of the general population. People with physical disabilities, who commonly encounter daily challenges such as barriers to community mobility, reduced access to healthcare services and higher risk of suffering from depression, may face additional challenges in the context of the pandemic.ObjectiveThis study aims to review the impact of the COVID-19 pandemic, and associated isolation and protective measures, among people with physical disabilities.MethodsA rapid review of the published literature was conducted on August 10, 2020 through a search in six online databases to synthesize results from original studies regarding the impact of the COVID-19 pandemic on people with physical disabilities. The International Classification of Functioning, Disability and Health was used to describe the population and the personal and environmental factors with a unified and standard health language.ResultsEleven records were extracted from 1621 individual papers retrieved from the search strategy. Various impacts on daily functioning such as a decrease in access to healthcare have been noted during the pandemic. Changes in social and lifestyle habits, mood changes and decreased levels of physical activity were also noted.ConclusionsOur results highlighted the lack of early research about the impacts of COVID-19 experienced by people with physical disabilities. Future studies should focus on specific consequences and needs of this vulnerable population to ensure their inclusion in public health recommendations and consideration by policy makers.     

The Anticipated Future of Public Health Services Post COVID-19: Viewpoint

In March 2020, the World Health Organization declared COVID-19 as a global pandemic. The COVID-19 pandemic has affected various public health functions and essential services in different ways and magnitudes. Although all countries have witnessed the effect of COVID-19, the impact differed based on many factors including the integrity and resiliency of the countries’ health systems. This paper presents opinions and expectations of the authors about the anticipated changes in the future of public health at the global, regional, and national levels. The viewpoint is based on the current efforts and challenges that various stakeholders have carried out to control COVID-19 and the contribution from the literature on the future of public health. Numerous agencies and actors are involved in the fight against COVID-19 with variations in their effectiveness. The public health services showed weaknesses in most of the countries, in addition to the lack of adequate curative medicine settings. The pandemic highlighted the need for better governance and stronger and more resilient health systems and capacities. The COVID-19 experience has also emphasized the importance of coordination and collaboration among the countries and stakeholders. The COVID-19 pandemic might lead to a wide discussion to improve international and national approaches to prepare for and respond to similar events in terms of preparedness and response mechanisms and tools. Public health will not be the same as before COVID-19. New health priorities, approaches, and new agendas will be on the table of the global platforms and initiatives. More investment in research and technology to meet the demand for new vaccines and medicines, innovative methods like distance learning and working, more respect and remuneration to health professionals, and normalization of the public health and social measures that were induced during the COVID-19 pandemic are expected to be seen in future.     

Eviction,Health Inequity,and the Spread of COVID-19: Housing Policy as a Primary Pandemic Mitigation Strategy

The COVID-19 pandemic precipitated catastrophic job loss, unprecedented unemployment rates, and severe economic hardship in renter households. As a result, housing precarity and the risk of eviction increased and worsened during the pandemic, especially among people of color and low-income populations. This paper considers the implications of this eviction crisis for health and health inequity, and the need for eviction prevention policies during the pandemic. Eviction and housing displacement are particularly threatening to individual and public health during a pandemic. Eviction is likely to increase COVID-19 infection rates because it results in overcrowded living environments, doubling up, transiency, limited access to healthcare, and a decreased ability to comply with pandemic mitigation strategies (e.g., social distancing, self-quarantine, and hygiene practices). Indeed, recent studies suggest that eviction may increase the spread of COVID-19 and that the absence or lifting of eviction moratoria may be associated with an increased rate of COVID-19 infection and death. Eviction is also a driver of health inequity as historic trends, and recent data demonstrate that people of color are more likely to face eviction and associated comorbidities. Black people have had less confidence in their ability to pay rent and are dying at 2.1 times the rate of non-Hispanic Whites. Indigenous Americans and Hispanic/Latinx people face an infection rate almost 3 times the rate of non-Hispanic whites. Disproportionate rates of both COVID-19 and eviction in communities of color compound negative health effects make eviction prevention a critical intervention to address racial health inequity. In light of the undisputed connection between eviction and health outcomes, eviction prevention, through moratoria and other supportive measures, is a key component of pandemic control strategies to mitigate COVID-19 spread and death.     

New obstacles and widening gaps: A qualitative study of the effects of the COVID-19 pandemic on U.S. adults with disabilities

BackgroundPrior research has demonstrated that the needs of the disability community have not been met during public health emergencies. The COVID-19 pandemic has exacerbated existing inequities for many populations including people with disabilities, and data is needed to develop inclusive public health response policies.ObjectiveTo identify how COVID-19 has uniquely impacted the lives of adults with disabilities.Methods38 participants were recruited through disability advocacy groups and social media. Semi-structured virtual focus groups were conducted with adults (≥18 years) who self-identified as having a disability. Focus groups were conducted for each of six disability sub-groups: vision, hearing, mobility and physical, mental health, cognitive, intellectual, and developmental, and chronic illness. Using inductive coding, major themes were identified and compared across the disability sub-groups.ResultsThree major themes and thirteen sub-themes were identified from the focus groups. The three major themes comprised: new problems created by the pandemic, obstacles in daily life that were exacerbated by the pandemic, and broader changes to accessibility and disability identity. Sub-themes such as difficulty with COVID-19 testing and regular medical care were reported by participants of all disability sub-groups, while other sub-themes like direct care needs and medical rationing were reported by participants from a subset of the disability sub-groups.ConclusionsThese results indicate how the COVID-19 pandemic unequally impacts disabled people. The participants indicated that to fully address their needs, disability perspectives must be included in the public health pandemic response. As new research shows that COVID-19 can cause long-term disability, the urgency to ensure the disability community is part of public health policies will increase.     

Sex in the Era of COVID-19 in a U.S. National Cohort of Cisgender Men,Transgender Women,and Transgender Men Who Have Sex with Men: April–May 2020

Since the emergence of the COVID-19 pandemic, there has been an increasing body of research focused on the effects that measures like stay-at-home orders and social distancing are having on other aspects of health, including mental health and sexual health. Currently, there are limited extant data on the effects of the pandemic on sexual and gender minorities. Between April 15, 2020, and May 15, 2020, we invited participants in an ongoing U.S. national cohort study (Together 5000) to complete a cross-sectional online survey about the pandemic, and its effects on mental and sexual health and well-being (n?=?3991). Nearly all (97.7%) were living in an area where they were told they should only leave their homes for essentials. Most (70.1%) reported reducing their number of sex partners as a result of the pandemic. Among the 789 participants prescribed HIV pre-exposure prophylaxis (PrEP), 29.9% said they stopped taking their PrEP entirely, and 14.2% started selectively skipping doses. For those who had been taking PrEP, discontinuing PrEP was associated with having no new sex partners (β?=?0.90, 95% CI 0.40–1.40). Among the 152 HIV-positive participants, 30.9% said they were unable to maintain an HIV-related medical appointment because of the pandemic and 13.8% said they had been unable to retrieve HIV medications. Additionally, 35.3% of participants were experiencing moderate to severe anxiety because of the pandemic and 36.7% reported symptoms of depression. In a multivariable logistic regression, reporting a new sex partner in the prior 30 days was significantly associated with being aged 30 or older (vs. not, AOR?=?1.21), being Black (AOR?=?1.79) or Latinx (AOR?=?1.40, vs. white), and being unsure if they had been in close contact with someone diagnosed with COVID-19 (AOR?=?1.32, vs. no contact). It was unassociated with COVID-19-induced anxiety, depression, or knowing someone hospitalized with COVID-19. The pandemic has caused disruptions in sexual behavior (partner reduction) as well as difficulties navigating PrEP and HIV care continua. Findings will guide more comprehensive public health responses to optimize HIV prevention and treatment in the era of COVID-19.