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Facts about HIV/AIDS

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The human immunodeficiency virus (HIV) targets the immune system and weakens people's defence systems against infections and some types of cancer. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. Immune function is typically measured by CD4 cell count.

Immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off.

The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS), which can take from 2 to 15 years to develop if not treated, depending on the individual. AIDS is defined by the development of certain cancers, infections or other severe clinical manifestations.

Signs and symptoms

The symptoms of HIV vary depending on the stage of infection. Though people living with HIV tend to be most infectious in the first few months after being infected, many are unaware of their status until the later stages. In the first few weeks after initial infection people may experience no symptoms or an influenza-like illness including fever, headache, rash or sore throat.

As the infection progressively weakens the immune system, they can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough. Without treatment, they could also develop severe illnesses such as tuberculosis (TB), cryptococcal meningitis, severe bacterial infections, and cancers such as lymphomas and Kaposi's sarcoma.

Transmission

HIV can be transmitted via the exchange of a variety of body fluids from infected people, such as blood, breast milk, semen and vaginal secretions. HIV can also be transmitted from a mother to her child during pregnancy and delivery. Individuals cannot become infected through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water.

Risk factors

Behaviours and conditions that put individuals at greater risk of contracting HIV include:

having unprotected anal or vaginal sex;

having another sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhoea and bacterial vaginosis;

sharing contaminated needles, syringes and other injecting equipment and drug solutions when injecting drugs;

receiving unsafe injections, blood transfusions and tissue transplantation, and medical procedures that involve unsterile cutting or piercing; and

experiencing accidental needle stick injuries, including among health workers

HIV can be diagnosed through rapid diagnostic tests that provide same-day results. This greatly facilitates early diagnosis and linkage with treatment and care. People can also use HIV self-tests to test themselves. However, no single test can provide a full HIV diagnosis; a confirmatory test is required, conducted by a qualified and validated health worker at a community centre or clinic. HIV infection can be detected with great accuracy using WHO prequalified tests within a nationally approved testing strategy.

Most widely-used HIV diagnostic tests detect antibodies produced by the person as part of their immune response to fight HIV. In most cases, people develop antibodies to HIV within 28 days of infection. During this time, people experience the so-called "window" period - when HIV antibodies haven't been produced and when they may have had no signs of HIV infection, but also when they may transmit HIV to others. After infection, an individual may transmit HIV transmission to a sexual or drug-sharing partner.

Following a positive diagnosis, people should be retested before they are enrolled in treatment and care to rule out any potential testing or reporting error. Notably, once a person diagnosed with HIV and has started treatment they should not be retested.

While testing for adolescents and adults has been made simple and efficient, this is not the case for babies born to HIV-positive mothers. For children less than 18 months of age, serological testing is not sufficient to identify HIV infection - virological testing must be provided as early as birth or at 6 weeks of age). New technologies are now becoming available to perform this test at the point of care and enable same-day results, which will accelerate appropriate linkage with treatment and care.

HIV testing should be voluntary and the right to decline testing should be recognized. Mandatory or coerced testing by a health care provider or authority, or by a partner or family member is not acceptable as it undermines good public health practice and infringes on human rights.

New technologies to help people test themselves are being introduced, with many countries implementing self-testing as an additional option to encourage HIV diagnosis. HIV self-testing is a process whereby a person who wants to know his or her HIV status collects a specimen, performs a test, and interprets the test results in private or with someone they trust. HIV self-testing does not provide a definitive HIV-positive diagnosis, but it should be used as an initial test to be followed by confirmatory testing by a health worker.

The sexual partners and drug-injecting partners of people diagnosed with HIV infection have an increased probability of also being HIV-positive. WHO recommends assisted HIV partner notification services as a simple and effective way to reach these partners - many of whom are undiagnosed and unaware of their HIV exposure and may welcome support and an opportunity to test for HIV.

All HIV testing services must follow the WHO-recommended principles known as the "5 Cs":

informed Consent

Confidentiality

Counselling

Correct test results

Connection (linkage to care, treatment and other services).

Prevention

Individuals can reduce the risk of HIV infection by limiting exposure to risk factors. Key approaches for HIV prevention, which are often used in combination, are listed below.

Male and female condom use

Correct and consistent use of male and female condoms during vaginal or anal penetration can protect against the spread of STIs, including HIV. Evidence shows that male latex condoms have an 85% or greater protective effect against HIV and other STIs.

Testing and counselling for HIV and STIs

Testing for HIV and other STIs is strongly advised for all people exposed to any of the risk factors. This enables people to learn of their own HIV status and access necessary prevention and treatment services without delay. WHO also recommends offering testing for partners or couples. Additionally, WHO recommends assisted partner notification approaches, in which people with HIV receive support to inform their partners either on their own, or with the help of health care providers.

Testing and counselling, linkages to tuberculosis (TB) care

TB is the most common illness among people living with HIV. Fatal if undetected or untreated, TB is the leading cause of death among people with HIV, responsible for nearly 1 in 3 HIV-associated deaths.

Early detection of TB and prompt linkage to TB treatment and ART can prevent these deaths. TB screening should be offered routinely at HIV care services, and routine HIV testing should be offered to all patients with presumptive and diagnosed TB. TB preventive therapy should be offered to all people living with HIV who do not have active TB. Individuals who are diagnosed with HIV and active TB should urgently start effective TB treatment (including for multidrug-resistant TB) and ART.

Voluntary medical male circumcision (VMMC)

Medical male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. Since 2007, WHO recommends VMMC as an additional prevention strategy. This is a key prevention intervention supported in 15 countries in eastern and southern Africa with high HIV prevalence and low male circumcision rates. VMMC is also regarded as a good approach to reach men and adolescent boys who do not often seek health care services. At the end of 2018, 23 million adolescent boys and men in eastern and southern Africa had been provided with a package of services, including VMMC, HIV testing, and education on safer sex and condom use.

Use of ARVs for prevention

Prevention benefits of ART

A scientific trial confirmed that if an HIV-positive person adheres to an effective ART, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96% in 2011. Following the results, WHO recommended that all people living with HIV should be offered ART with the aim of saving lives and significantly reducing HIV transmission. A 2019 study showed that HIV transmission risk through sex without condoms in serodiscordant men in same sex couples who were virally suppressed and on ART was effectively zero.

Pre-exposure prophylaxis (PrEP) for HIV-negative partner

Oral PrEP of HIV is the daily use of ARVs by HIV-negative people to block the acquisition of HIV. More than 10 randomized controlled studies have demonstrated the effectiveness of PrEP in reducing HIV transmission among a range of populations, including serodiscordant heterosexual couples (where one partner is infected and the other is not), men who have sex with men, transgender women, high-risk heterosexual couples, and people who inject drugs.

WHO recommends PrEP as a prevention choice for people at substantial risk of HIV infection as part of a combination of prevention approaches. WHO has also expanded these recommendations to HIV-negative women who are pregnant or breastfeeding.

Post-exposure prophylaxis for HIV (PEP)

PEP is the use of ARVs within 72 hours of exposure to HIV to prevent infection. PEP includes counselling, first aid care, HIV testing, and administration of a 28-day course of ARV drugs with follow-up care. WHO recommends PEP use for both occupational and non-occupational exposures, and for adults and children.

Harm reduction for people who inject and use drugs

People who inject drugs can take precautions against becoming infected with HIV by using sterile injecting equipment (including needles and syringes) for each injection, and not sharing drug-using equipment and drug solutions. Treatment of drug dependence, in particular, opioid substitution therapy for people dependent on opioids, also helps to reduce the risk of HIV transmission and supports adherence to HIV treatment. A comprehensive package of HIV prevention and treatment interventions for people who inject drugs includes:

needle and syringe programmes;

opioid substitution therapy for people dependent on opioids, and other evidence-based drug dependence treatment;

HIV testing and counselling;

HIV treatment and care;

risk-reduction information and education, and provision of naloxone to prevent opioid overdose;

access to condoms; and

management of STIs, TB and viral hepatitis.

Elimination of mother-to-child transmission of HIV

The transmission of HIV from an HIV-positive mother to her child during pregnancy, labour, delivery or breastfeeding is called vertical or mother-to-child transmission (MTCT). In the absence of any interventions during these stages, rates of HIV transmission from mother-to-child can be between 15% and 45%. The risk of MTCT can almost be eliminated if both the mother and her baby are provided with ARV drugs as early as possible in pregnancy and during the period of breastfeeding.

WHO recommends lifelong ART for all people living with HIV, regardless of their CD4 count and the clinical stage of disease; this includes pregnant and breastfeeding women. In 2018, 82% of the estimated 1.3 million pregnant women living with HIV globally received ARV drugs to prevent transmission to their children. A growing number of countries and territories are achieving very low rates of MTCT, with some formally validated for elimination of MTCT of HIV as a public health problem (Anguilla, Antigua and Barbuda, Armenia, Belarus, Bermuda, Cayman Islands, Cuba, Malaysia, Maldives, Montserrat, Saint Kitts and Nevis, and Thailand). Several countries with a high burden of HIV infection are also progressing along the path to elimination.

HIV can be suppressed by combination ART consisting of 3 or more ARV drugs. ART does not cure HIV infection but suppresses viral replication within a person's body and allows an individual's immune system to strengthen and regain the capacity to fight off infections.

In 2016, WHO recommended that all people living with HIV be provided with lifelong ART, including children, adolescents and adults, and pregnant and breastfeeding women, regardless of clinical status or CD4 cell count. By mid-2019, 182 countries had already adopted this recommendation, covering 99% of all people living with HIV globally.

The HIV treatment guidelines include new alternative ARV options with better tolerability, higher efficacy, and lower rates of treatment discontinuation when compared with previous recommended medicines. WHO recommends the use of dolutegravir-based or low-dose efavirenz for first-line therapy, and raltegravir and darunavir/ritonavir for second-line therapy.

Transition to dolutegravir has already started in 82 low- and middle-income countries and is expected to improve the durability of the treatment and the quality of care for people living with HIV. Despite improvements, limited options remain for infants and young children. For this reason, WHO and partners are coordinating efforts to enable a faster and more effective development and introduction of age-appropriate paediatric formulations of ARV drugs.

In addition, 1 in 3 people living with HIV present to care with advanced disease, at low CD4 counts, and at high risk of serious illness and death. To reduce this risk, WHO recommends that these individuals receive a "package of care" that includes testing for and prevention of the most common serious infections that can cause death, such as TB and cryptococcal meningitis, in addition to ART.

Globally, 23.3 million people living with HIV were receiving ART in 2018. This equates to a global ART coverage rate of 62%. However, more efforts are needed to scale up treatment, particularly for children and adolescents. Only 54% of children and adolescents were receiving ART at the end of 2018.

Expanding access to treatment is at the heart of a set of targets for 2020, which aim to bring the world back on track to end the AIDS epidemic by 2030.

WHO response

The Sixty-Ninth World Health Assembly endorsed a new "Global health sector strategy on HIV for 2016-2021". The strategy includes five strategic directions that guide priority actions by countries and by WHO over six years.

The strategic directions are:

Information for focused action (know your epidemic and response)

Interventions for impact (covering the range of services needed)

Delivering for equity (covering the populations in need of services)

Financing for sustainability (covering the costs of services)

Innovation for acceleration (looking towards the future).

WHO is a cosponsor of the Joint United Nations Programme on AIDS (UNAIDS). Within UNAIDS, WHO leads activities on HIV treatment and care, and HIV and TB coinfection, and jointly coordinates the work on elimination of MTCT of HIV with UNICEF.

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The human immunodeficiency virus (HIV) targets the immune system and weakens people's defence systems against infections and some types of cancer. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. Immune function is typically measured by CD4 cell count.

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PEP means taking medicines after you may have been exposed to HIV to prevent becoming infected. Learn more.

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This dossier provides figures and statistics on demographics, personal and work environment, and consumer behavior, including travel behavior, of LGBT citizens in China.

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Discover all statistics and data on LGBT in China now on statista.com!

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Basic questions and answers on HIV post-exposure prophylaxis or PEP.

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Two sentences, one night stand, 28 days  course

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Two sentences, one night stand, 28 days  course

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浙江日报报业集团所属浙江日报、钱江晚报、今日早报、美术报、浙江老年报、浙江法制报等16张系列报刊和其16张数字报纸同步报道浙江潮、中国风。数字报的推出使读者可提前在网上阅读当天的报纸，同时数字报版面可以随意翻阅，图文可通过网页清晰阅读，见诸报端的新闻还可以转化成语音收听。

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Block AIDS - a six-year anti-aids sample from the border of Yunnan

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Block AIDS - a six-year anti-aids sample from the border of Yunnan

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南方周末报 南方周末网站 南方周末官方网站 南方周末电子版 论坛 社区 在线阅读 新闻线索 读者 艾滋病 教育

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南方周末 - 阻断艾滋--云南边陲的六年防艾样本

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此前防艾工作，主要是由卫生部门承担。现在，教育部门和公益组织开始发挥越来越重要的作用。

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UN Cares video on HIV Post-Exposure Prophylaxis (PEP) Kit

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UN Cares video on HIV Post-Exposure Prophylaxis (PEP) Kit

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AIDS in China: A third of those infected remain undetected

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AIDS in China: A third of those infected remain undetected

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今年是艾滋病传入中国的第33个年头。中国总体感染率不足0.1%，远低于国际0.8%的平均水平。但近年来，有关青年学生、男同群体的艾滋感染成了社会关注的新问题。本刊记者专访了联合国艾滋病规划署专家委员会委员、中国疾病预防控制中心首席流行病学家吴尊友研究员。他介绍，目前青年学生的感染仍未能控制，男男性传播感染达历史最高点。如果按照联合国艾滋病规划署到2020年诊断90%、治疗90%、治疗有效90%的目标，中国在诊断和治疗覆盖上还有差距，有约三分之一的感染者未被发现，防艾工作依然任重道远。

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艾滋病在中国：仍有三分之一的感染者未被发现

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今年是艾滋病传入中国的第33个年头。中国总体感染率不足0.1%，远低于国际0.8%的平均水平。但近年来，有关青年学生、男同群体的艾滋感染成了社会关注的新问题。本刊记者专访了联合国艾滋病规划署专家委员会委员、中国疾病预防控制中心首席流行病学家吴尊友研究员。他介绍，目前青年学生的感染仍未能控制，男男性传播感染达历史最高点。如果按照联合国艾滋病规划署到2020年诊断90%、治疗90%、治疗有效90...

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Emergency HIV Treatment in China Still Hard to Come By

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Emergency HIV Treatment in China Still Hard to Come By

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A university sophomore in eastern China's Zhejiang province was horrified when he realized that his sex partner had covertly slipped off the condom. Fearing HIV, he tested the man with a home screening kit, and sure enough, the result was positive. Fortunately, he immediately went to nearby Shanghai, and received a checkup and emergency treatment.

The anonymous poster shared his story on microblog platform Weibo, saying that after 28 days of medication, he remained HIV-negative.

For people who are accidentally exposed to HIV, post-exposure prophylaxis (PEP) is a four-week course of medication that can reduce the likelihood of infection by more than 80 percent if taken daily from within 72 hours of exposure, according to the World Health Organization.

Yet in China, timely access to PEP is not available to most people.

Though the formulation uses the same antiretroviral drugs that people living with HIV in the country take as treatment, according to national guidelines, local centers for disease control only provide PEP free of charge to health workers and police officers who have been exposed to HIV through occupational injuries.

For people who have been accidentally exposed through unprotected sex, there are limited official channels to obtain PEP. The few approved providers are big-city hospitals like Beijing Ditan Hospital and Shanghai Public Health Clinical Center. Treatment typically costs around 5,000 yuan ($750) - or about twice as much as Shanghai's minimum monthly wage - including physical checkups as well as the four-week course.

But HIV seems to be increasing among sexually active young people. Party newspaper People's Daily reported in 2015 that between 2011 and 2015, HIV rates among students aged 15 to 24 increased by 35 percent.

Zhang Jianpu, senior project manager at Shanghai Qing'ai Health Center, an HIV prevention organization, told Sixth Tone that the center has callers seeking advice about PEP every couple of weeks, including some from outside the city, though they only began promoting the medication in the last six months. Previously, the center was solely focused on encouraging condom use and HIV testing, but now they have come to see PEP as part of a holistic prevention strategy.

"We realized that this is actually a way to help people avoid getting HIV infections," Zhang said.

Despite scant public promotion, there is a growing demand for PEP, according to Ma Tiecheng, the director of an HIV prevention organization based in Shenyang, the capital of northeastern China's Liaoning province. He said his organization is receiving an increasing number of calls about the treatment. But with nowhere to obtain PEP in Shenyang after-hours - unlike in Shanghai, where the treatment is available 24/7 - some people turn to unofficial channels.

Ma said that some people purchase the drugs through their personal networks or through web forums such as Baidu Tieba, while others ask for a few pills from HIV-positive friends until they can find somewhere to prescribe a full course of medication. However, Ma said, he has also heard of counterfeit drugs circulating online.

Apart from the dangers of gray-market pharmaceuticals, taking even genuine medication without a prescription is not recommended, as patients have not been screened for additional risk factors or contraindications. Liver and kidney function tests in particular are necessary before being prescribed PEP, Zhang said.

Meanwhile, China has yet to publicize pre-exposure prophylaxis (PrEP), a daily treatment to reduce the risk of acquiring HIV for people who are at high risk for the virus - for example, those whose long-term partners are HIV-positive.

The drug used for PrEP, Truvada, was approved by the U.S. Food and Drug Administration in 2004 for use in treating people living with HIV, but it was not until 2012 that the administration approved the drug as a preventative treatment.

In China, PrEP has an even shorter history - and remains steeped in doubt and controversy.

Lu Hongzhou, a doctor at the Shanghai Public Health Clinical Center who specializes in HIV, told Sixth Tone that Truvada has been on the domestic market for four years, though it is only available in limited clinical settings. His colleague, Qi Tangkai, added that getting the medication is "very inconvenient."

"We shouldn't use it just because it exists; we have to see whether it's any good," said Zhang, the project manager from Qing'ai. "There is a possibility that heavily promoting it could lead to more unsafe sex."

In 2012, Qing'ai assisted Shanghai's Fudan University with a study on PrEP, but they were only able to find a handful of recruits willing to take the medication. "Some would argue, 'I'm not sick, so why should I be medicated?' or 'If I adhere to using condoms, what's the point of taking the drug?'" Zhang explained.

Ma, the director of the Shenyang-based NGO, added that for most, the cost is prohibitive for long-term use: A month's course costs around 2,000 yuan. He said he hasn't seen any government promotion for PrEP in northeastern China, and only a little for PEP - which "at most gets a passing mention," he said.

Discrimination against gay people is an underlying factor that makes HIV prevention efforts more difficult, according to Lu Lu and Jiang Shibo, two medical professors at Fudan University. They said that efforts to popularize PEP and PrEP use among men who have sex with men, a group that is considered high-risk for HIV infection, are hampered by a lack of public support.

"[Without help or supervision,] it's very easy to feel hesitant about getting treatment or forget to take the drug," the pair told Sixth Tone via email.

For Ma, who has been in the HIV prevention field for 16 years, advocacy work is becoming more difficult, as recent laws governing foreign NGOs have restricted his organization's access to funds from overseas foundations.

When it comes to running a civil society organization, Ma mused, "there are many uncertainties in China."
Contributions: Qian Jinghua; editor: Qian Jinghua. (Header image: A health care professional draws blood from a gay patient in Yuncheng, Shanxi province, Dec. 17, 2014. Chen Wei/VCG)

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Emergency HIV Treatment in China Still Hard to Come By

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A university sophomore in eastern China's Zhejiang province was horrified when he realized that his sex partner had covertly slipped off the condom. Fearing HIV, he tested the man with a home screening kit, and sure enough, the result was positive. Fortunately, he immediately went to nearby Shanghai, and received a checkup and emergency treatment.

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The story about buying AIDS lifesaving drug for others from Thailand

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The story about buying AIDS lifesaving drug for others from Thailand

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虎嗅注：《我不是药神》这部电影的剧情，其实是基于真实故事改编的，而且我们发现这样的故事并不是孤例。今天这篇文章的主人公，从20岁就开始帮国内患者从国外代购药品，这活儿一直做到他成家立室。他身上又有着什么

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红枫湾发布：这里可以购买艾滋阻断药！

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全程正确使用安全套、定期检测等行为来预防艾滋病，但XX时难免脑袋短路，不说洁身自好，能想到戴套套就不错了。天亮了、脑袋清醒了......后悔了。 2017年5月的某天，一位帅气的中国小伙在泰国被一名感染艾滋病毒的人妖

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Interview with Haiqiang - employee of Sanya CDC

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Interview with Haiqiang - employee of Sanya CDC

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16th July 2018

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Interview an employee of a pharmaceutical company which could approach high level official in Beijing.

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Interview an employee of a pharmaceutical company which could approach high level official in Beijing.

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19th July 2018

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Try to approach and interview some people who used to take the HIV Pep-medication or some peope who is seeking the HIV Pep-medication.

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Try to approach and interview some people who used to take the HIV Pep-medication or some peope who is seeking the HIV Pep-medication.

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16th July 2018 - 25th July 2018.

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UN officials hail China's progress on HIV/AIDS prevention

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UN officials hail China's progress on HIV/AIDS prevention

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UN officials hail China's progress on HIV/AIDS prevention - Xinhua | English.news.cn

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As an advocate of the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths, Sidibe hailed China's efforts in boosting the accessibility of anti-AIDS drugs and medical treatment in recent years at his meeting with China's UNAIDS branch and partners Wednesday.

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The estimation about China's LGBT population, same sex behavior population and the relevant female population.

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The estimation about China's LGBT population, same sex behavior population and the relevant female population.

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刘明华 于增照 张北川 史同新 李秀芳 李洋 王燕飞 朱明泉 同性爱 同性性行为 人口数量  中国同性爱者、同性性行为者和相关女性群体人口数值估测 在线阅读

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中国同性爱者、同性性行为者和相关女性群体人口数值估测-【维普网】-仓储式在线作品出版平台-www.cqvip.com

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目的：在新的社会人口学和医学背景下,估测中国同性爱者、同性性行为者和相关女性群体人口数量,为当今中国的相关研究提供科学依据。方法：主要根据《2013年中国统计年鉴》提供的人口基数和潘绥铭2010年对中国成年人口的...