The Utility of a National Surveillance Network to Estimate CKD Prevalence and Identify High-Risk Populations in Primary Care

UNSTRUCTURED The HIV epidemic poses a heavy burden on societal development. Presently, the protection of susceptible populations is the most feasible method for eliminating the spread of HIV. The government and other relevant industries always attempt at solving the problem, in view of the unavailability of biological vaccines, no better measures can take except identify HIV-infected persons, provide treatment and behavioral intervention. This study proposes a HIV digital vaccine strategy. Based on blockchain technology, a decentralized surveillance network has been jointly constructed using HIV high-risk individuals as application nodes and accredited testing agencies as authentication nodes. When testing accomplished at authentication nodes, the results uploaded to the blockchain, thus HIV high-risk populations can determine the HIV infection status of one another in a convenient, anonymous, and credible manner, thereby reducing the occurrences of high-risk sexual behavior and effectively protecting susceptible populations. This is a promising solution to prevent the spread of HIV. The performance of decentralized surveillance network may lead to the restructuring of current government-funded infectious disease prevention and control modes that are centered on centers for disease control and prevention and hospitals to introduce revolutionary changes in public health systems globally.

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Opportunities and barriers for providing HIV testing through community health centers in mainland China: a nationwide cross-sectional survey

BMC Infectious Diseases ◽

10.1186/s12879-019-4673-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Jason J. Ong ◽

Ming Hui Peng ◽

William W. Wong ◽

Ying-Ru Lo ◽

Michael R. Kidd ◽

...

Keyword(s):

Primary Care ◽

High Risk ◽

Hiv Testing ◽

Community Health ◽

Community Health Centers ◽

Mainland China ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Major Barrier ◽

High Risk Populations

Abstract Background Primary care may be an avenue to increase coverage of HIV testing but it is unclear what challenges primary healthcare professionals in low- and middle-income countries face. We describe the HIV testing practices in community health centres (CHCs) and explore the staff’s attitude towards further development of HIV testing services at the primary care level in China. Methods We conducted a national, cross-sectional survey using a stratified random sample of CHCs in 20 cities in 2015. Questionnaires were completed by primary care doctors and nurses in CHCs, and included questions regarding their demographics, clinical experience and their views on the facilitators and barriers to offering HIV testing in their CHC. Multivariate logistic regression was conducted to examine the association between staff who would offer HIV testing and their sociodemographic characteristics. Results A total of 3580 staff from 158 CHCs participated. Despite the majority (81%) agreeing that HIV testing was an important part of healthcare, only 25% would provide HIV testing when requested by a patient. The majority (71%) were concerned about reimbursement, and half (47%) cited lack of training as a major barrier. Almost half (44%) believed that treating people belonging to high-risk populations would scare other patients away, and 6% openly expressed their dislike of people belonging to high-risk populations. Staff who would offer HIV testing were younger (adjusted odds ratio (aOR) 0.97 per year increase in age, 95% confidence interval (CI):0.97–0.98); trained as a doctor compared to a nurse (aOR 1.79, 95%CI:1.46–2.15); held a bachelor degree or above (aOR 1.34, 95%CI:1.11–1.62); and had previous HIV training (aOR 1.55, 95%CI:1.27–1.89). Conclusions Improving HIV training of CHC staff, including addressing stigmatizing attitudes, and improving financial reimbursement may help increase HIV testing coverage in China.

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