Regional differences in HIV prevalence among drug users in China: potential for future spread of HIV?

Kretzschmar M, Zhang W, Mikolajczyk RT, et al. Regional differences in HIV prevalence among drug users in China: potential for future spread of HIV? BMC Infectious Diseases. 2008;8(1):108.Background: Drug use and in particular injecting drug use has been at the forefront of the explosive spread of HIV in general populations in many countries in Asia. There is concern that also in China increased HIV incidence in drug users might spark off a generalized epidemic in the wider population. Close monitoring of HIV incidence and risk factors in drug users is therefore important to be able to target interventions effectively. Second generation surveillance was launched to assess HIV prevalence and risk behaviours jointly with the purpose of describing trends and predicting future developments. To assess whether these goals were fulfilled among drug users in China we provide an analysis of risk factors for HIV infection and of regional differences in HIV prevalence. Methods: We analysed data collected in 2005 in 21 drug user second generation surveillance sentinel sites from 14 provinces in China. We used random effects logistic regression to test for risk factors for HIV infection and regional differences. Results: The overall HIV-1 antibody prevalence was 5.4% (279/5128); 4.9% among injecting drug users (IDU) not sharing needles and 3.7% among non-injecting drug users. We found substantial heterogeneity among the surveillance sites with prevalence rates ranging between 0% and 54%. HIV status was strongly affected by the regional prevalence of HIV. Risk behaviours were highly prevalent in regions where HIV prevalence is still low. The distribution of duration of drug use in different sites indicated different stages of the drug use epidemics. Conclusion: ]Regional differences in HIV prevalence in China reflect different stages of the drug use and HIV epidemics rather than differences in risk behaviours. Therefore, outbreaks of HIV among drug users in regions where prevalence is still low can be expected in the future. However, methodological limitations of surveillance embedded into routine systems limit the usability of existing data. More standardized approaches to data collection in secondary generation HIV surveillance are necessary to better understand regional differences in risk behaviour and prevalence and to design targeted intervention for those regions at risk of experiencing outbreaks

Revisão sistemática da produção acadêmica brasileira sobre causas externas e violências contra a pessoa idosa Systematic review of the Brazilian academic production about external causes and violence against the elderly

Apresenta-se revisão sistemática sobre violência contra a pessoa idosa no período de 2000 a 2009. A base de dados para a pesquisa é o acervo de artigos, livros, capítulos de livros, manuais e planos de ação da Biblioteca Virtual em Violência e Saúde. Foram categorizados e analisados 115 documentos segundo os subtemas: quedas; causas externas e violência em geral; estudos epidemiológicos e socioepidemiológicos; prevenção da violência; violência e acidentes no contexto familiar; revisão conceitual e metodológica; ordem legal e denúncias; violência sob o olhar de quem a vivencia; serviços de saúde, profissionais e cuidadores; e construção e revalidação de instrumentos de pesquisa. Os resultados mostram relevante aumento da produção e aprimoramento metodológico nas áreas de saúde pública, serviço social, direito, fisioterapia, enfermagem, psicologia, otorrinolaringologia e na formulação de políticas e planos de ação. No entanto, há temas pouco aprofundados como acidentes de trânsito, homicídios, suicídios, afogamentos e sufocações.<br>This article presents a review about violence against the elderly, covering the period of 2000 to 2009. The database used in this research was the collection of articles, books, book chapters, manuals and plans of action of the Virtual Library on Violence and Health. We analyzed 115 documents divided into the following categories: falls; external causes and violence in general; epidemiological and socio-epidemiological studies; prevention of violence; violence and accidents in the family; conceptual and methodological review; legal order and denunciation; violence from the elderly's point of view; health services, professionals and caretakers; and construction and validation of research instruments. The results show a relevant increase in production and methodological improvement in public health, social work, law, physiotherapy, nursing, psychology and otorhinolaryngology. However, there are issues that have not been sufficiently approached such as traffic accidents, homicides, suicides, drowning and suffocation