Epidemiological characteristics of infectious diseases havechanged dramatically requiring necessitate health care workers tounderstand the status of these diseases, especially for AIDS andother pandemics disease [8–10]. Efforts andinvestments have been made globally to strengthen countries’ HIVmonitoring and evaluation (M&E) capacity. Cross-border travelerswith an HIV infection may cause local HIV transmission and aredefined as a bridge population . Shanghai has the largestcross-border population entering China from countries around theworld. Cross-border travel is important for culture and commercebut also leads to the spread of infectious diseases. Therefore,it’s important to analyze HIV prevalence and demographiccharacteristics in this population. This was the first study whichdisplayed the HIV infection rate and their characteristics amongentry travelers over such a long time span, with such a large-scalepopulation in Shanghai.
From 2005 to 2016, there were 50830 international personsentering Shanghai who finished health examination in ShanghaiInternational Healthcare Center. In this crossing borderpopulation, a total of 245 (0.48%) travelers were determined as HIVpositive. Overall, we found that the HIV infection rate among entrytravelers in Shanghai did not show an increasing tendency overthese years, contributed by global HIV/AIDS prevention and controlefforts, such as promoting condoms in Southeast Asian countries andimplementing the Asian regional AIDS project, had receivedinternational attention and achieved good results.
After the HIV infected persons were found, the epidemicsituations were reported to the CDC epidemic reporting system, andthe related data were handed over to the local health department.In recent years, the Shanghai international travel healthcarecenter has strengthened the follow-up supervision of the entry ofAIDS patients, and established foreign liaison files for foreignHIV infected persons. Health education for the HIV infected personswas carried out to provide information about disease diagnosis andtreatment and conduct high risk behavior intervention. With thelocal disease control departments, medical institutions, foreignembassies and other information interoperability, jointcooperation, explore overseas HIV infection health counseling andtreatment measures. AIDS patients who do not want to return to thecountry need to be treated by providing health consultation anddesignated medical institutions to receive paid medical treatment.Using the existing conditions, according to local conditions, theentry-exit personnel health examination site could be settled as aconsulting base. We tried to make full use of newspapers,magazines, radio, television and other mass media to answer typicalquestions; to establish International Travel Health Advisorycontact, by using of websites, cellphone app and other ways toanswer questions raised by travelers on AIDS prevention and controlwork. With the local health administration, Family PlanningCommission, Red Cross and other departments, through public welfareperformances, on-site distribution brochures, free distribution ofcondoms and other means were undergoing.
In the last decade, we had seen a dramatic change in thedemographic structure of the population of people living with HIV(PLWH) . This study found that HIV infectionof entry travelers in Shanghai also had certain demographiccharacteristics. From the perspective of age-specific HIVprevalence, the major age population of HIV infected travelers was18–40 years (73.90%). Overall, an estimated of 5 millionyoung people aged 15–24 were living with HIV in 2009 and accountedfor 41% (about 890,000 cases) of new HIV infections globally.HIV is disproportionately afflicting young people worldwideglobally, especially in the developing countries. The similar trendpersisting was founded in our study. According to the diagnostictests, those with positive results was divided into three groups,(more than 40 years old, 31 to 40 years old, less than30 years old), working men aged 31 to 40 had the highestincidence whereas working women had a very low incidence (nearzero). The results are consistent with Wang’s research, they foundthat travelers aged 21–30 and 31–40 were the most commonly infectedindividuals among entry travelers in Yunnan Province.
In addition, HIV infection was more frequently detected amongindividuals with occupations such as businessman and entertainers.Furthermore, from a view of marriage, unmarried (single or othermarital status) applicants had higher proportion of infectioncompared to those married group (54.70%vs18.37%). In general,people with better education and better cognitive ability havehealthier behaviors and lower HIV infection rate.Nevertheless, our study found that most of the infected people werehighly educated. The entry travelers are divided into high-incomecountries, middle-income countries, and low-income countries basedon the host country . Our data showed that most of thepositive cases were from middle- and low-income countries.
From the view of transmission, our data implied that sexualcontact was the major high risk behavior,especially in those menhave sex with men (MSM). In the meantime, a study in the USreported the most common HIV transmission route had changed tohomosexual contact in men, while injection drug users were rankedthe third.We also deemed that the major HIVinfection route had been shifted from intravenous drug use tosexual contact in this study.
Monitoring of HIV infections in high-risk populations wasparticularly important for preventing the spread. This study foundthat those who did not use condom accounted for a large proportionin the positive cases. Inconsistent condom uses and severalrisk-taking behaviors were also reported among young people inUnited States (African-Americans aged 18–21) and Uganda.Insufficient HIV-related knowledge and low self-awareness of riskmight be associated with an increasing number of AIDS. Thus,promotion and acceptance of sex education, accurate andage-appropriate information on HIV appeared to be the needed inorder to interrupt the spread of HIV.