Figure 1 graphically illustrates the trends of all relevant HIV prevalence indicators for this MSM subpopulation between 7/2005-11/2005 and 11/2006-2/2007, all of which except for the percentage of the HIV-infected MSMs remaining undetected show a substantial increase. The estimated number of the undetected HIV-infecteds exhibits the largest jump, indicating rapidly increasing HIV prevalence in this subpopulation.
The exact characteristics of this sampled MSM subpopulation is difficult to describe, since three recruitment methods were used in both samplings and it is likely that the participants recruited through these methods could actually have come from multiple overlapping MSM subgroups in Beijing. Hence our estimates of population size are for this sampled MSM subpopulation in Beijing only, which only provides a partial perspective on the overall HIV prevalence among MSMs in Beijing but, more importantly, sheds some lights on its temporal trend.
In any event, the increasing trend of HIV prevalence among the MSMs, as indicated by the increase in the number of HIV-infected MSMs (both known and undetected), and of the MSM population size between the two sampling periods indicate a strong case for future concern in terms of social and public health burden. However, the estimated percentage of the HIV-infected MSMs that remains undetected in our sampled MSM subpopulation decreases slightly from 66.7% (34/51) to 63.2% (72/97) despite the steady increases in HIV infections and in the MSM population size in Beijing. Whether this gives indication of reduced HIV underreporting, perhaps in parts due successful efforts of intervention measures by the government, is a subject for further studies.
There are, of course, limitations to our GERMO estimation procedure, as there are with any estimation methods. For example, the data were treated statistically as if they were randomly drawn from the sampled subpopulation, although in reality their recruitment (i.e., convenient/voluntary) inevitably introduced selection bias. Whether this bias contributes toward the finding of an increasing prevalence is difficult to determine. Relevant discussions on its
application in various scenarios of interest for estimating HIV-infected population size among at high risk, elusive population groups can be found in [11-15]. The small number of samplings also contributes to larger CI ranges in some of the estimates when compared with previous studies using the same methodology. It suffices to say that, although widely useful in many applications of epidemiological studies, one must exercise caution in determining how well the data corresponds to the assumptions made for the estimation procedure.
For the present work, inconsistencies in the estimates as a result of the restrictions imposed by the random sampling assumptions are very likely to occur, due to the use of data from convenient/voluntary sampling. Any improvement in this direction, however, is difficult since population-based data of this nature (i.e., consecutive random seroprevalence sampling data of effusive and hard-to-count populations) is difficult to obtain.
The mobility of individuals in the sampled population also plays a role, especially in our estimation of the sampled MSM subpopulation size which shows a slower increase than the number of the HIV-infected MSMs, either in total or undetected, in this subpopulation.
Moreover, GERMO assumes that the sampled population is “open”, where newly infected persons and those leaving the sampled population via the onset of AIDS-related symptoms are taken into account [8]. However, Ruan [2] reported high mobility among the MSMs sampled in 2005, which might have affected our estimation results. In fact, several surveys [1-3] on the MSM population in Beijing reported that roughly 2/3 of those MSMs sampled in these studies were not official Beijing residents but migrants to the city in recent years (62.4% in 2005 [2] and 65.8% in 2006-7 [6]), a reflection of the social reality that there are millions of nonresident labors working in Beijing, many of them for several years. Similarly, high proportions of non-official residents are also found in surveys of the MSM populations in Shanghai [18] and Guangzhou [19]. Of special concern are those who are male sex workers (MSW), or “money boys” [20], an MSM subpopulation consisting of typically young, heterosexual, and under-educated rural male migrants who provide sexual services solely for money. In the 2005 serosurvey, 8.6% of the 526 respondents had received money for sex with men in the past six months while 4.2% had given
money for sex with men in the past six months (Table 1 in [2]), indicating substantial male commercial sex activity among the MSM populations. Other surveys in recent years have found MSW to range between 4.9%-24% among all MSMs [21-24]. In a survey of 15 money boys in Shanghai in 2005 [25], 9 (60%) reported residing in other cities before coming to Shanghai and 3 (20%) had been in Shanghai for less than one year, further indicating the exceptionally high mobility of the money boys. Due to their reported high level of unprotected sex, their role as a mobile core group in spreading infections among the MSM populations in different geographical locations cannot be overlooked, and needs to be addressed n future studies.
As a final note, an MSM population consists of many diverse subgroups. For example, male sex workers, gay men, bi-sexual men, or transgender are all very different in their social contact network. In recent years, studies on the MSMs in China have increasing rapidly in volume.
However, the issue of these sub-groups of MSMs and their relative risks of sexually transmitted infections is still understudied, and more detailed future studies with consideration of the sexual cultures among different sub-groups of MSM are needed to further elucidate this important aspect of sexually transmitted infections in the MSMs in China.
Acknowledments The funding was provided by National Science Council of Taiwan
(97-2314-B-039-013-MY3, 100-2115-M-039-002), the National Natural Science Foundation of China (81161120428), the International Development Research Center of Canada (#104519-010) and the Ministry of Science and Technology of China (2009ZX10004-903, 2012ZX10001-002).參考文獻 REFERENCE
1. Choi KH, Liu H, Guo Y, Han L, Mandel JS, Rutherford GW. Emerging HIV-1 epidemic in China in men who have sex with men. Lancet 2003; 361: 2125–6.
2. Ruan Y, Li D, Li X, et al. Relationship between syphilis and HIV infections among men who have sex with men in Beijing, China. Sex Transm Dis 2007; 34(8): 592–7.
3. Ma X, Zhang Q, He X, et al. Trends in prevalence of HIV, syphilis, hepatitis C, hepatitis B, and sexual risk behavior among men who have sex with men. Results of 3 consecutive respondent-driven sampling surveys in Beijing, 2004 through 2006. J Acquir Immune Defic
Syndr 2007; 45(5): 581–7.
4. Zhang X, Wang C, Hengwei W, et al. Risk factors of HIV infection and prevalence of
co-infections among men who have sex with men in Beijing, China. AIDS 2007; 21(Suppl 8):
S53–7.
5. Li S, Zhang XY, Li XX, et al. Detection of recent HIV-1 infections among men who have sex with men in Beijing during 2005–2006. Chinese Medical J 2008; 121(12): 1105–8.
6. Ruan Y, Luo F, Jia Y, et al. Risk factors for syphilis and prevalence of HIV, hepatitis B and C among men who have sex with men in Beijing, China: implications for HIV prevention.
AIDS Behav 2009; 13(4): 663–70.
7. Caceres CF, van Griensven GJ. Male homosexual transmission of HIV-1. AIDS 1994; 8(8):
1051–61.
8. Ruan Y, Jia Y, Zhang X, et al. Incidence of HIV-1, syphilis, hepatitis B and hepatitis C virus infections and predictors associated with retention in a 12-month follow-up study among men who have sex with men in Beijing, China. JAIDS 2009; 52(5):604-10.
9. Zippin C. An evaluation of the removal method of estimating animal populations. Biometrics 1956; 12: 163-9.
10. Zippin C. The removal method of population estimation. J Wildlife Management 1958; 22:
82-90.
11. Hsieh YH, Chen CWS, Lee SM. Empirical Bayes approach to estimating the number of HIV-infected individuals in hidden and elusive populations. Stat Med 2000; 19: 3095–108.
12. Chen CWS, Lee SM, Hsieh YH, Ungchusak K. A unified approach to estimating population size for births only models. Compu Stat Data Analysis 1999; 32: 29–46.
13. Hsieh YH, Lee, SM, Chen CWS, Arazoza H. On the recent sharp increase of HIV infections in Cuba. AIDS 2001; 13(3): 425–8.
14. Hsieh YH, Arazoza H, Lee SM, Chen,CWS. Estimating the number of Cubans infected by HIV using sexual contact data. Int J of Epidemiology 2002; 31: 679–83.
15. Hsieh YH, Lee SM, Chen CWS, et al. Estimating the number of HIV-infected gay sauna patrons in Taipei area. Physica A 2006; 362(2): 495–503.
16. Hsieh YH. The changing faces of commercial sex in Thailand: its implications for HIV transmission. JAIDS 2002; 30(5): 537–40.
17. Casella G, George EI. Explaining the Gibbs sampler. American Statistician 1992; 46:
167-74.
18. Choi KH, Ning Z, Gregorich SE, Pan QC. The influence of social and sexual networks in the spread of HIV and syphilis among men who have sex with men in Shanghai, China. J Acquir
Immune Defic Syndr 2007; 45(1): 77–84.
19. He Q, Wang Y, Lin P, et al. Potential bridges for HIV infection to men who have sex with men in Guangzhou, China. AIDS Behavior 2006; 10(Suppl 4): S17–23.
20. Kong TSK. Risk factors affecting condom use among male sex workers who serve men in China: a qualitative study. Sex Transm Infections 2008; 84: 444–8.
21. Zhang BC, Liu D, Li X, Hu T. A survey of men who have sex with men: mainland China.
Am J Public Health 2000; 90: 1949–50.
22. Liu H, Yang H, Li X, et al. Men who have sex with men and human immunodeficiency virus/sexually transmitted disease control in China. Sex Transm Dis 2006; 33: 68–76.
23. Choi KH, Gibson DR, Han L, Guo Y. High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing,
China. AIDS Educ Prev 2004; 16(1): 19–30.
24. Liu H, Liu H, Cai Y, Rhodes AG, Hong F. Money Boys, HIV Risks, and the Associations between Norms and Safer Sex: A Respondent-Driven Sampling Study in Shenzhen, China.
AIDS Behavior 2009; 13(4): 652–62.
25. He N, Wong FY, Huang ZJ, Thompson EE, Fu C. Substance use and HIV risks among male heterosexual and „money boy‟ migrants in Shanghai, China. AIDS Care 2007; 19: 109–15.
26. Metropolis N, Rosenbluth AW, Rosenbluth MN, Teller AH. Equations of state calculations by fast computing machines. Journal of Chemical Physics 1953; 21: 1087-91.
27. Hastings WK. Monte-Carlo sampling methods using Markov chains and their applications.
Biometrika 1970; 57: 97-109.
28. Chib S, Greenberg E. Explaining the Metropolis-Hastings Algorithm. The American
Statistician 1995; 49: 327-35.
29. Gelman A, Roberts GO, Gilks WR. Efficient Metropolis jumping rules, In: Bernardo JM, Berger JO, Dawid AP, Smith AFM, eds. Bayesian Statistics 5. Oxford: Oxford University Press, 1996, pp. 599-607.
Table 1. Summary of distribution of the participants of the two surveys by recruitment methods.
Recruitment method
Sampling 1 (July-Nov 2005)
Sampling 2 (Nov 2006- Feb 2007)
Number (%) Number (%)
Peer recruiter
8 (1.5) 29 (5.4)
Volunteer
1
308 (58.8) 272 (50.4)Partner 203 (38.7) 229 (42.4)
Others
2
7 (1.3) 10 (1.9)Total 524 (100) 540 (100)
1
Volunteers recruited via distribution of fliers, Web, and newspaper advertisement.2
Others include those with recruitment method unknown, and one by referral in each round.Table 2. HIV Seroprevalence Data for an MSM subpopulation in Beijing for the two sampling periods.
Sampling period
July 2005-Nov2005 Nov 2006-Feb 2007
N 526 540
HIV+ 17 25
+% 3.23 4.63
Change between samplings +43%
Table 3. Median estimates of the numbers of the HIV-infected MSMs, the undetected HIV-infected MSMs, the percentage of the HIV-infected undetected, and the total MSM subpopulation size for each sampling periods; with the corresponding 95% CIs in parentheses.
Sampling period
July 2005-Nov 2005 Nov 2006-Feb 2007 HIV-infected MSMs
% Change between samplings +90%
Undetected HIV-infected MSMs
% Change between samplings +112%
% HIV-infected MSMs undetected
% Change between samplings -6.7%
Sampled MSM subpopulation size
% Change between samplings +34%
計畫成果自評
1. 研究內容與原計畫相符程度: 非常相符 2. 達成預期目標情況: 達成預期目標
3. 研究成果之學術或應用價值: 有學術發表或公衛應用參考價值
4. 是 否 適 合 在 學 術 期 刊 發 表 或 申 請 專 利 : 研 究 成 果 在 學 術 期 刊 發 表 : Ying-Hen Hsieh*, Yuhua Ruan, Cathy W. S. Chen, Wei Shi, Dongliang Li, Fengji Luo, and Yiming Shao. (2012) HIV prevalence and underreporting of men who have sex with men in Beijing. Int J STD AIDS August 2012 23:606-607.
5. 主要發現或其他有關價值: 本研究成果顯示在2005-2007年兩次血清採樣
期(sampling period)之間，所有可估計的北京男同性戀族群的愛滋病病毒
(HIV)流行指標的上升趨勢是值得引貣人們的關注，尤其是未來愛滋病病
毒感染者所需要的長期醫療負擔。對中國大陸愛滋病疫情，乃至其對台灣
未來愛滋病防治規劃的影響，有指標性的貢獻。
國科會補助專題研究計畫出席國際學術會議心得報告
日期：101 年 9 月 17 日
一、參加會議經過
本人於 2011 年 12 月 1 日至 12 月 3 日前往北京市參加 BIT’s 2nd Annual World AIDS Day(HIV-2011)會議，並發表邀請論文: HIV/AIDS Epidemiology in Cuba, 1986-2008:
Modeling the Impact of Changes in Detection Measures。會議地點在北京國際會議中 心。參加學者眾多約有美、古巴、南非等近 100 位學者、研究人員，共有約 60 幾場 論文發表。本人的邀請演講(invited talk)，共有約 40 人出席。本人並擔任 HIV Epidemiology 組的 session co-chairman.
二、與會心得
本人在會議期間中有很多機會和舊識及新交的各國學者密集討論雙方有興趣的傳染 病流行病學建模分析的最近研究方向，頗有助於未來研究。最值得一題的是認識了 古巴疾病防治中心(Cuban CDC)的愛滋病專家團，其中包括古巴疾病防治中心性病及
計畫編號 NSC 100－2115－M－039－002－
計畫名稱 愛滋病數學建模分析研究
出國人員
姓名 謝英恒 服務機構
及職稱 中國醫藥大學公共衛生學系教授
會議時間 100 年 12 月 1 日至
100 年 12 月 3 日 會議地點 北京
會議名稱 BIT’s 2nd Annual World AIDS Day (HIV-2011) Conference
發表題目 HIV/AIDS Epidemiology in Cuba, 1986-2008: Modeling the Impact of Changes in Detection Measures
附件五
對我在古巴愛滋病的建模分析研究極感興趣，並提出與我合作研究的建議。我和 Dr.
Ochoa 並深入討論未來合作研究的方向及機制。
五、攜回資料名稱及內容：會議 program 及摘要集
六、最後感謝國科會補助機票及生活費，使本人得以成行並對本人執行國科會專題
研究計劃之進行受益良多。
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BIT's Upcoming Events
Full Program
BIT’s 2 nd Annual World AIDS Day
Time: December 1-3, 2011 Venue: Beijing, China
Preliminary Program
HIV 100: AIDS Global Plan Cooperation HIV 101: Basic Science of AIDS
HIV 102: HIV Diagnostics and Biotherapy and Management of HIV-associated Diseases HIV 103: Community Engagement in AIDS Control
HIV 104: HIV, Epidemiology & Prevention
HIV 105: HIV Drug Discovery and Clinical Sciences of HIV
Registration
Time: 09:00-18:00, November 30, 2011 (Wednesday)
Opening Ceremony
Time: 09:00-09:10, December 1, 2011 (Thursday)
Welcome Banquet
Time: 18:30-20:30, December 1, 2011 (Thursday)
HIV Keynote Forum
Time: 9:10-11:10, December 1, 2011 (Thursday)
Moderator Dr. Shibo Jiang, Professor, Fudan University, China
09:10-09:40
Title: A Novel DNA Technology Applied in the Development of a Therapeutic HIV Vaccine Dr. Kalevi Reijonen, CEO, FIT Biotech Ltd., Finland
09:40-10:10
Title: A Novel Chimeric Protein-based HIV-1 Fusion Inhibitor: Potential for Developing Anti-HIV Therapeutics or Microbicides
Dr. Shibo Jiang, Professor, Fudan University, China
10:10:10:40
Title:Overcoming Stigma with a Collaborative, Comprehensive Community Approach: Fostering Public and Private Engagement for Preventing HIV/AIDS and Promoting Lifelong Wellness
Dr. Carol A. Poore, CEO, Southwest Center for HIV/AIDS,USA
10:40-11:10
Title: HIV- serodiscordant Couples: Psycho Social Characteristics - A Study at Center for AIDS Treatment (CAT) Dr.
Kutikuppala Surya Rao Hospital, Visakhapatnam, India
Dr. Kutikuppala Surya Rao, Head, Dr.Kutikuppala Surya Rao Hospital, India
HIV 100: AIDS Global Plan Cooperation Time: 13:30-15:35, December 1, 2011 (Thursday)
Chair: Dr. Neora Pick, Medical Director, Oak Tree Tree Clinic (Children’s and Women’s Health Centre of BC), Canada
Page 1 of 3 BIT's 2nd World AIDS Day
Title: Initiation of an Outreach Program to Alouette Correctional Centre for Women: An Inter-professional Collaborative Approach to HIV Care
Dr. Neora Pick, Medical Director, Oak Tree Clinic (Children’s and Women’s Health Centre of BC), Alouette Correctional Centre for Women, Canada
13:55-14:20
Title: Knowledge, Attitudes, Beliefs, and Decision-making of Pregnant and Parenting Women of African Heritage at Risk for or Living with HIV/AIDS: A Cross National Study
Dr. Gloria B. Callwood, Associate Professor, University of the Virgin Islands, USA
14:20-14:45
Title: Indirect Injection Equipment Reuse: Historic Epidemic Blood Borne Virus Transmission and Continuing Unsafe Practices
Dr. Savanna Reid, WHO Consultant, University of Nevada School of Community Health Sciences, USA
14:45-15:10
Title: Process of Establishment of a Military Network in the Fight against HIV: Case of REMAFOC/AIDS (West and Central Africa Military Network against AIDS), Acquires and Challenges
Dr. Guehi Andre, Director, Health Service of the Armed Forces & Ministry of Defense,C?te d'Ivoire, African
15:10-15:35
Title: Tracking HIV Expenditures on Prevention Interventions Targeting Populations at Higher Risk for HIV in the Caribbean
Dr. Nyla Lyons, Program Specialist-HIV Surveillance,Centers for Disease Control and Prevention Global AIDS Program,Trinidad and Tobago
15:35-15:55 Coffee Break
HIV 101: Basic Science of AIDS
Time: 15:55-17:35, December 1, 2011 (Thursday) .
Chair: Dr. Mario Clerici, Professor, University of Milano, Italy
15:55-16:45 Title: Immunologic and Genetic Correlates of Resistance to HIV Infection Dr. Mario Clerici, Professor, University of Milano, Italy
16:45-17:10
Title:HIV Suppression by Host Restriction Factors and Viral Countermeasures Dr. Yong Xiong, AssociateProfessor, Yale University, USA
17:10-17:35
Title: The Evolutionary Significance of Certain Amino Acid Substitutions and Their Consequences for Immunogenicity Toward HLA’s A*0201 and B*27
Dr. Anton Dormer,Associate Professor, Washington Adventist University, USA
HIV 102: HIV Diagnostics and Biotherapy and Management of HIV-associated Diseases Time: 8:30-09:20, December 2, 2011 (Friday)
Chair: Dr. Kutikuppala Surya Rao, Head, Dr.Kutikuppala Surya Rao Hospital, India
08:30-08:55 Title: Dermatologic Manifestations of HIV
Dr. Ronald M. Harris, Professor, Irvine Medical Center, University of California, Irvine, USA
08:55-09:20 Title: Eradication of HIV-infection by Treatment with Gc Protein-derived Macrophage Activating Factor (GcMAF) Dr. Nobuto Yamamoto, Director & Professor, Socrates Institute for Therapeutic Immunolog, USA
09:20-09:40 Coffee Break
HIV 103: Community Engagement in AIDS Control Time:09:40-10:55, December 2, 2011 (Friday)
Chair: Dr. Gil H Odendaal, Director, HIV/AIDS Initiative at the Saddleback Church, USA
9:40-10:05 Title: Pedagogical Theories and Practices in Mobilizing Civil Society for Effective Community Engagement in AIDS Control
Dr. Gil H Odendaal, Director, HIV/AIDS Initiative at the Saddleback Church, USA
10:05-13:30 Title: Study on Relationship between HIV Prevention and RH Advocacy
Dr. Junqing Wu,Professor, Shanghai Institute of Planned Parenthood Research, China
10:.30-10:55 Title: Caring for People Living with HIV/AIDS and Their Families through Community Engagement in Malaysia Dr. Ismail Baba,Dean, University Sains Malaysia, Malaysia
HIV 104: HIV, Epidemiology & Prevention
Time: 13:30-17:30, December 2, 2011 (Friday) Place: Room No.
Chair: Dr. Reza Nassiri, Professor, Michigan State University, USA
Co-Chair Dr. Ying-Hen Hsieh, Professor, Department of Public Health and Center for Infectious Disease Education and Research, China Medical University Taichung, Taiwan
13:30-13:50 Title:HIV Prevention Measures in the Island of Hispaniola: Perspective on Capacity-Building Dr. Reza Nassiri,Professor & Dean, Michigan State University, USA
13:50-14:10 Title: HIV/AIDS Epidemiology in Cuba, 1986-2008: Modeling the Impact of Changes in Detection Measures
Page 2 of 3 BIT's 2nd World AIDS Day
Dr. Ying-Hen Hsieh, Professor, Department of Public Health and Center for Infectious Disease Education and Research, China Medical University Taichung, Taiwan
14:10-14:30 Title: Epidemiology of HIV in Australia’s Aboriginal and Torres Strait Islander Population: A Review Dr. Saifur Rahman, Epidemiologist & Post Doctoral Research Fellow, University of New England, Australia
14:30-14:50 Title: Reconstructing the Epidemic History of HIV-1 Expansion in Asia: Understanding the Genesis of Asia's AIDS Epidemic
Dr. Yutaka Takebe, Chief (retired), National Institute of Infectious Diseases, Japan
14:50-15:10 Title: Study on Urban Community AIDS Network Management
Dr. Guohua Qi, Director, Changchun Municipal Health Bureau, Changchun People’s Municipal Government, China
15:10-15:30 Coffee Break
15:30-15:50 Title: Maternal and Child Survival in Families Living with HIV/AIDS
Dr. Karen P. Beckerman, Associate Professor, Albert Einstein College of Medicine, USA
15:50-16:10 Title: HIV- serodiscordant Couples: Psycho Social Characteristics – A Study at Center for AIDS Treatment (CAT) Dr.
Kutikuppala Surya Rao Hospital, Visakhapatnam, India
Dr. Kutikuppala Surya Rao, Head, Dr.Kutikuppala Surya Rao Hospital, India
16:10-16:30 Title:The Impact of Provider-initiated Routine HIV Counseling and Testing during Outpatient Care on Promoting Safer Sexual Behaviors in Uganda
Dr. Susan M. Kiene, Assistant Professor, Alpert Medical School of Brown University, USA
16:30-16:50 Title: Review of the Impact of HIV on the African-American Population of the US：With 3- minute “Safer Sex”
Intervention for Primary and Secondary Prevention of HIV in Medical Offices Dr. Karen W. Krigger,Associate Professor, University of Louisville, USA
16:50-17:10 Title: The Translation of HIV Prevention Research into Policy and Practice in Africa Dr. Geoffrey Setswe, Professor, Monash University, South Africa
17:10-17:30 Title: Addressing the HIV/AIDS Epidemic Drivers- The Challenges that Face the Higher Education Sector in South Africa. Are We Turning the Tide within Higher Education Sector
Dr. Ramneek Ahluwalia,Head, Higher Education HIV/AIDS Programme (HEAIDS), South Africa
HIV 105: HIV Drug Discovery and Clinical Sciences of HIV Time: 8:30-11:20,December 3, 2011（Saturday）
Chair Dr. Carol A. Harris, Professor, Albert Einstein College of Medicine, USA Co-Chair Dr. Guohua Qi , Director, Changchun People’s Municipal Government, China
08:30-08:55 Title: HIV and TB-entwined Epidemics
Dr. Carol A. Harris, Professor, Albert Einstein College of Medicine, USA
08:55-09:20 Title: Nanoscale Drug Targeting for Eradicating HIV Infection
Dr. Patrick J Sinko, Profesor & Associate Vice President, Rutgers – The State University of New Jersey, USA
09:20-09:45 Title: Management of Lipoatrophy in HIV Patients with Facial Fillers
Dr. Gerald Pierone Jr, Executive Director , AIDS Research and Treatment Center of the Treasure Coast , USA
09:45-10:10 Title: Topical Microbicides for HIV Prevention: Current Development and Challenges Dr. Haitao Yang,Senior Research Investigator, Population Council, USA
10:10-10:30 Coffee Break
10:30-10:55 Title:Treatment of Lipid Disorders in HIV Infected Patients Receiving Anti-retroviral Therapy Dr. Joseph Cadden, Assistant Professor, University of Southern California, USA
10:55-11:20 Title:The Potential Use of Topical Estrogen to Reduce the Risk of HIV Infection in Men Dr. Andrew J. Pask, Associate Professor, University of Connecticut, USA
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Paper Presented
Title: HIV/AIDS Epidemiology in Cuba, 1986-2008: Modeling the Impact of Changes in Detection
MeasuresAbstract.
A nonlinear compartmental model is developed for the HIV detection system in Cuba with
different types of detections. We analyze the dynamics of this system and compute the
reproduction numbers. We obtain estimates for the detection related parameters during two
separate time periods to reflect the timeline of the implementation of various types of
searches. We also estimate the magnitude of Cuban HIV epidemic and the mean time for
detecting a person infected with HIV. The reproduction numbers for each time period are
also computed from the sets of values of the parameters. We found that random screening is
most important as a mean of surveillance, since there will always be an epidemic if the
averaged total number of infections by an infective detected through random screening
exceeds one. Moreover, local asymptotic stability for DFE can be achieved if (i) random
screening is sufficiently effective and (ii) infection by detected HIV-positive individuals is
minimal. Our results highlight the importance of education of known infectives to prevent
further infections. If the average number of infections by a known infective exceeds unity
(due to inefficient detection by random screening or lack of behavior change by the known
infectious), the endemic equilibrium is always unstable and it is possible for the total
number of infectious would increase without bound, provided that the initial infective
population sizes are large and outside the domain of attraction of the disease-free
equilibrium (DFE). On the other hand, if it is less than one, then either the DFE or the
endemic equilibrium is globally asymptotically stable, leading to a more manageable
epidemic, even if the disease is not eradicated. Fitting the 1986-2008 HIV data to obtain the
model parameter estimates indicates that the HIV epidemic in Cuba is currently
approaching an endemic equilibrium.
國科會補助專題研究計畫出席國際學術會議心得報告
日期：101 年 9 月 17 日
一、參加會議經過
本人於 201272 月 12 日至 7 月 15 日前往北京市參加第六屆地壇國際感染病會議，並 發表邀請論文: Evaluating the transmissibility of 2009 pH1N1 during Summer and
Fall/Winter Waves。會議地點在北京國際會議中心。參加學者眾多約有美、菲律賓、
義大利、新加坡等百餘位學者、研究人員，包括中研院陳建仁副院長等數位國內研 究學者。共有約 60 幾個邀請論文、40 幾個 free papers、百餘個 poster 發表，及幾個 satellite symposiums 與 panel discussions。本人的邀請演講(invited talk)，共有約 20 人 出席。
二、與會心得
本人在會議期間中有很多機會和舊識及新交的各國學者密集討論雙方有興趣的世界 各國愛滋病流行病學的最近趨勢及利用建模分析進行研究的可行性，頗有助於本人 未來研究。另外本人並自費在北京多停留兩天前往中國疾病防治中心(China CDC)討
計畫編號 NSC 100－2115－M－039－002－
計畫名稱 愛滋病數學建模分析研究
出國人員
姓名 謝英恒 服務機構
及職稱 中國醫藥大學公共衛生學系教授
會議時間 101 年 7 月 12 日至
101 年 7 月 15 日 會議地點 北京
會議名稱 第六屆地壇國際感染病會議
發表題目 Evaluating the transmissibility of 2009 pH1N1 during Summer and
Fall/Winter Waves
及機制。
五、攜回資料名稱及內容：會議 program 及摘要集
六、最後感謝國科會補助機票及生活費，使本人得以成行並對本人執行國科會專題
研究計劃之進行受益良多。
6th Ditan International Conference on Infectious Diseases
第六屆地站固你感染病金缺
lS JULY 2012 ， SUNDAY
Meeting ..
Room 309
Moderators:Wing-Cheong Yam.Hong Kong Hong-Xin Zha口'.Beijing
Meeting Room310
Moderators
﹒
Siqi Lu. Beijing Ih-Jen SuoTainanMeeting Moderators:Wing-Hong Seto.Hong Kong Room 309 ViJaykrishna Dhanasekaran.Singapore 09:15-09:35 Coronavirus diversi旬，phylogeny andinterspecies jumping
Patrick
c.Y.
Woo.Hong Kong09:35-09:55 Long-term evolution and transmission dynamics of swine influenza A virus
Vijaykrishna Dhanasekaran. Singapore
09:55-10:15 Emergence and transmission pathways of human enterovirus 71 Wenbo Xu，beij的g
10:15-10:35 Evaluating the transmissibility of 2009 pH1 N1 during Summer and Falll Winter Waves
Ying-H凹的ieh Taipei 10:35-10:45 Discussion
6th Ditan International Conference on Infectious Diseases
第六屆地站固
F
示感染病金挫Oral Sessions
Paper Presented
Title: Evaluating the transmissibility of 2009 pH1N1 during Summer and Fall/Winter Waves Abstract.
Background In order to compare the transmissibility of the 2009 pH1N1 pandemic during successive waves of infections in summer and fall/winter in the Northern Hemisphere, and to assess the temporal changes during the course of the outbreak in relation to the intervention measures implemented, we analyse the epidemiological patterns of the epidemic in Taiwan during July 2009-March 2010.
Methods We utilize the multi-phase Richards model to fit the weekly cumulative pH1N1 epidemiological data (numbers of confirmed cases and hospitalizations) as well as the daily number of classes suspended under a unique "325" partial school closing policy in Taiwan, in order to pinpoint the turning points of the summer and fall/winter waves, and to estimate the reproduction numbers R for each wave.
Results Our analysis indicates that the summer wave had slowed down by early September when schools reopened for fall. However, a second fall/winter wave began in late September, approximately 4 weeks after the school reopened, peaking at about 2-3 weeks after the start of the mass immunization campaign in November. R is estimated to be in the range of 1.04-1.27 for the first wave, and between 1.01-1.05 for the second wave.
Conclusions Transmissibility of the summer wave in Taiwan during July-early September,
as measured by R, was lower than that of the earlier spring outbreak in North America and
Europe, as well as that of the winter outbreak in Southern Hemisphere. Furthermore,
transmissibility during fall/winter in Taiwan was noticeably lower than that of the summer,
which is attributable to population-level immunity acquired from the earlier summer wave
and also to the intervention measures that were implemented prior to and during the
fall/winter wave.
國科會補助計畫衍生研發成果推廣資料表
日期:2012/09/17
國科會補助計畫
計畫名稱: 愛滋病數學建模分析研究 計畫主持人: 謝英恆
計畫編號: 100-2115-M-039-002- 學門領域: 常微分方程
無研發成果推廣資料
100 年度專題研究計畫研究成果彙整表
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