Syphilis social epidemiology in the People's Republic of China

中华人民共和国梅毒社会流行病学

基本信息

批准号：
8101175
负责人：
Joseph David Tucker
金额：
$ 8万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2012-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8101175
关键词：
Anthropology Area Attitude Behavior Behavioral Biosocial Caring Characteristics China Chinese People Cities Clinic Communicable Diseases Communities Complex Congenital Syphilis Disclosure Early Diagnosis Enzyme-Linked Immunosorbent Assay Epidemic Epidemiology Faculty Far East Foundations Fright General Hospitals Goals HIV HIV Infections Health Priorities Health behavior Hour Human immunodeficiency virus test Income Individual Infection Knowledge Link Low income Massachusetts Mentors Methods Modeling Myron Patients Physicians Plague Positioning Attribute Prevention Principal Investigator Probability Public Health Qualitative Methods Qualitative Research Research Research Methodology Research Personnel Research Training Risk Screening procedure Services Sexual Health Sexually Transmitted Diseases Shapes Site Social Sciences Sociology Stigmata Syphilis Syphilis Serodiagnosis System Taiwan Testing Textiles Training Tuberculosis Twin Multiple Birth United States National Institutes of Health Work care systems clinical epidemiology effective intervention experience global health high risk improved international center novel programs public health relevance response scale up skills social social stigma transmission process uptake

项目摘要

DESCRIPTION (provided by applicant): Sexually transmitted infection (STI) patients co-infected with syphilis and HIV have some of the highest HIV transmission probabilities, yet many STI patients often never receive screening for either of these frequently asymptomatic STIs. This KOI application details a four year plan focused on implementing integrated syphilis/HIV services in South China, a region characterized by hyper endemic syphilis transmission and increasing sexual HIV transmission. Linking clinical epidemiology and social science methods, the research and training plan will be mentored by Dr. Myron S. Cohen (Infectious Diseases), Dr. Xiang-Sheng Chen (Epidemiology), and Dr. Martin K. Whyte (Sociology). The training component will include advanced coursework on clinical epidemiology, anthropology, and Mandarin Chinese to complete a Masters in Regional Studies East Asia (MRSEA) at Harvard. As an Infectious Disease Fellow at the Massachusetts General Hospital, I completed a preliminary study that found HIV to be independently associated with syphilis infection at STI clinics in South China. Syphilis test acceptance at STI clinics was greater than 90%, but HIV testing acceptance was poor. Responding to South China's expanding syphilis epidemic, the WHO has launched a pilot program in two cities providing free rapid syphilis testing at select STI clinics, introducing a special opportunity for parallel HIV operational research. Transitioning to the Massachusetts General Hospital faculty with my mentor's support, I will focus on the following three specific aims: 1) To analyze STI patient characteristics that correlate to accepting HIV testing at STI clinics; 2) To describe the social and cultural context of HIV testing STI patients using qualitative methods; 3) To assess STI physician characteristics that correlate to offering HIV testing. The proposed training and research program will provide a foundation to understand the complex biosocial fabric of rapidly evolving sexual health behaviors in China, uniquely positioning me as a junior investigator to implement novel behavioral responses to the twin epidemics of syphilis and HIV in China. PUBLIC HEALTH RELEVANCE: Scaling up integrated HIV services is a global health priority of the first order. Approximately 90% of new syphilis cases globally are in low income areas where sexually transmitted HIV is also a major public health problem, but there have been few studies systematically analyzing integration of syphilis and HIV testing. The ultimate goal of this research is to determine optimal systems for integrated syphilis/HIV testing at STI clinics in South China

描述（由申请人提供）：同时感染梅毒和 HIV 的性传播感染 (STI) 患者的 HIV 传播概率最高，但许多 STI 患者往往从未接受过对这些经常无症状的 STI 中的任何一种的筛查。该 KOI 申请详细介绍了一项四年计划，重点是在华南地区实施梅毒/艾滋病毒综合服务，该地区的特点是梅毒传播高度流行，艾滋病毒性传播不断增加。该研究和培训计划将临床流行病学和社会科学方法联系起来，将由 Myron S. Cohen 博士（传染病）、陈祥生博士（流行病学）和 Martin K. Whyte 博士（社会学）指导。培训内容将包括临床流行病学、人类学和普通话方面的高级课程，以完成哈佛大学东亚区域研究硕士学位（MRSEA）。作为马萨诸塞州总医院的传染病研究员，我完成了一项初步研究，发现艾滋病毒与华南性传播感染诊所的梅毒感染独立相关。性传播感染诊所的梅毒检测接受度超过 90%，但艾滋病毒检测接受度较差。为应对中国南方不断扩大的梅毒疫情，世界卫生组织在两个城市启动了一项试点计划，在选定的性传播感染诊所提供免费快速梅毒检测，为平行艾滋病毒业务研究提供了特殊机会。在导师的支持下，我将重点关注以下三个具体目标：1）分析与在 STI 诊所接受 HIV 检测相关的 STI 患者特征； 2) 使用定性方法描述 HIV 检测性传播感染患者的社会和文化背景； 3) 评估与提供 HIV 检测相关的 STI 医生特征。拟议的培训和研究计划将为了解中国快速发展的性健康行为的复杂生物社会结构奠定基础，使我成为一名初级研究员，对中国梅毒和艾滋病毒这两种流行病实施新颖的行为应对措施。公共卫生相关性：扩大艾滋病毒综合服务是全球卫生的首要任务。全球约 90% 的新梅毒病例发生在低收入地区，性传播艾滋病毒也是一个主要的公共卫生问题，但很少有研究系统分析梅毒和艾滋病毒检测的结合。这项研究的最终目标是确定华南地区性传播感染诊所梅毒/艾滋病毒综合检测的最佳系统