Heterosexual Behaviors Before And After Diagnosis Among Newly Reported Hiv/aids Cases With Heterosexual Mode Of Transmission In Six Districts Of Chongqing City

Objective To understand the sources of newly reported HIV/AIDS cases with heterosexual mode of transmission in six districts of Chongqing city;to understand the psychological changes,spouse notification,ART-related knowledge scores and ART acceptability after diagnosis among HIV/AIDS with heterosexual mode of transmission;to understand heterosexual behaviors before and after diagnosis among newly reported HIV/AIDS with heterosexual mode of transmission in Chongqing,and to evaluate the risk of secondary transmission.Methods Cohort study was conducted among newly reported HIV/AIDS with heterosexual mode of transmission in six districts of Chongqing city from July to October 2019,and a self-designed questionnaire was used in this face-to-face survey to collect sociodemographic characteristics,ART-related knowledge,and heterosexual behaviors before and after diagnosis,spouse notification and ART acceptability.Logistic regression model was used to analyze the influencing factors of HIV infection mode,and logistic regression model was also used to analyze the influencing factors of HIV/AIDS whom were not yet receiving ART.Some HIV/AIDS were selected for qualitative survey which was performed through face to face in-depth interview,to know their infection status,spouse notification and ART acceptability.Results A total of 312 HIV/AIDS cases with heterosexual mode of transmission were recruited.Most of them were males(207,66.3%),aged 50 years and over(210,67.3%),having junior high school or lower education level(252,80.8%),married or cohabitating(200,64.1%).48.7%(152/312)of them were infected through commercial sexual contact while 40.4%(126/312)of them were infected by spouses or fixed partners.10.9%(34/312)of them were infected by non-marital and non-commercial sexual contacts.Significant differences were noticed on the infection mode of heterosexual transmission in gender,age,occupation(P<0.05).Results from the multivariate logistic regression analysis revealed that male(OR=822.34,95% CI: 103.99?6503.10),junior high school or lower education level(OR=3.02,95% CI: 1.05?8.66),household chores and underemployed(OR=0.23,95% CI: 0.07?0.76)were influencing factors on HIV infection that were through commercial sexual contacts.Male(OR=29.20,95%CI: 9.40?90.75),junior high school and lower education level(OR=4.28,95% CI:1.24?14.81)were influencing factors on HIV infection,through non-marital and non-commercial sexual contacts.In addition to meeting sexual partners in offline places,some HIV/AIDS patients with heterosexual mode of transmission had developed sexual partnerships through online dating,and with low-grade venue as the main place for sex engagement.89.1%(156/175)reported that having informed their spouse of their infection.92.3%(253/274)HIV/AIDS received ART,7.7%(21/274)did not received ART,and HIV/AIDS who did not receive ART were significantly correlated with their age,education level,marital status,occupation,ART-related knowledge scores and other characteristics(P<0.05).According to the results of multivariate logistic regression analysis,HIV/AIDS who were aged between 30 to 50 years(OR=4.52,95% CI:1.31?15.65)were more likely to refuse ART than those were 50 years old and over.Compared with those with low ART-related knowledge scores,those with highART-related knowledge scores(OR=0.03,95% CI: 0.01?0.23;OR=0.18,95% CI:0.05?0.65)were more likely to receive ART.21.9%(60/274)had spouse or fixed partners,commercial sexual contacts or non-marital and non-commercial sexual contacts within three months after diagnosis,leading to risk of secondary transmission.6.2%(17/274)had heterosexual contacts,and condoms were not consistently used,leading to high risk of secondary transmission.Conclusions Newly reported HIV/AIDS cases under heterosexual mode of transmission in Chongqing were mainly infected from offline low-grade venue,and caused by commercial sexual engagement.Some HIV/AIDS patients have not received ART,and some HIV/AIDS still have heterosexual contacts after diagnosis,and do not adhere to use condoms,which increases the risk of secondary transmission.