title: The impact of social factors on human immunodeficiency virus and hepatitis C virus co-infection in a minority region of Si-chuan, the People's Republic of China: a population-based survey and testing study.
abstract: BACKGROUND
  While many human immunodeficiency virus (HIV) studies have been performed in Liangshan, most were focused only on HIV infection and based on a sampling survey. In order to fully understand HIV and hepatitis C virus (HCV) prevalence and related risk factors in this region, this study implemented in 2009, included a survey, physical examination, HIV and HCV test in two towns.
  
  
  METHODS
  All residents in two towns of the Butuo county were provided a physical examination and blood tests for HIV and HCV, and then followed by an interview for questionnaire.
  
  
  RESULTS
  In total, 10,104 residents (92.4%) were enrolled and 9,179 blood samples were collected for HIV and HCV testing, 6,072 were from individuals >14 years old. The rates of HIV, HCV, and HIV/HCV co-infection were 11.4%, 14.0%, and 7.7%, respectively for >14-year-old residents. The 25-34 yr age group had the highest prevalence of HIV, HCV, and HIV/HCV co-infections, reaching 24.4%, 26.2% and 16.0%, respectively. Overall, males had a much higher prevalence of all infections than females (HIV: 16.3% vs. 6.8%, HCV: 24.6% vs. 3.9%, HIV/HCV co-infected: 14.7% vs. 1.1%, respectively; P = 0.000). Approximately half of intravenous drug users tested positive for HIV (48.7%) and 68.4% tested positive for HCV. Logistic regression analysis showed that five factors were significantly associated with HIV and HCV infection: gender (odds ratio [OR]  = 5.8), education (OR = 2.29); occupation (student as reference; farmer: OR = 5.02, migrant worker: OR = 6.12); drug abuse (OR = 18.0); and multiple sexual partners (OR = 2.92). Knowledge of HIV was not associated with infection.
  
  
  CONCLUSIONS
  HIV and HCV prevalence in the Liangshan region is very serious and drug use, multiple sexual partners, and low education levels were the three main risk factors. The government should focus on improving education and personal health awareness while enhancing drug control programs.
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Caiting
authors.initials: C
authors.lastname: Dong
authors.affiliation: Department of International Health, Georgetown University, Washington DC, United States of America.
authors.forename: Z Jennifer
authors.initials: ZJ
authors.lastname: Huang
authors.affiliation: Department of Pediatrics - Adolescent & Young Adult Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Martin
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Honglu
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Deng
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Wenhong
authors.initials: W
authors.lastname: Lai
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Yihui
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Guangming
authors.initials: G
authors.lastname: Qin
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Linglin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of HIV Control and Prevention, Liangshan Prefecture Health Bureau, Xichang, Si-chuan, China.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Song
authors.affiliation: Department of HIV Control and Prevention, Lianshan Center for Disease Control and Prevention, Xichang, Si-chuan, China.
authors.forename: Daying
authors.initials: D
authors.lastname: Wei
authors.affiliation: Department of HIV Control and Prevention, Lianshan Center for Disease Control and Prevention, Xichang, Si-chuan, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Nan
authors.affiliation: Department of HIV Control and Prevention, Lianshan Center for Disease Control and Prevention, Xichang, Si-chuan, China.
authors.forename: Qixing
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of HIV Control and Prevention, Butuo Health Bureau, Butuo, Si-chuan, China.
authors.forename: Hongxia
authors.initials: H
authors.lastname: Deng
authors.affiliation: Department of HIV Control and Prevention, Butuo Health Bureau, Butuo, Si-chuan, China.
authors.forename: Jianxun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia, United States of America.
authors.forename: Frank Y
authors.initials: FY
authors.lastname: Wong
authors.affiliation: Department of HIV Control and Prevention, Si-chuan Center for Disease Control and Prevention, Chengdu, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D060085:Coinfection / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D055030:Drug Users; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012747:Sexual Partners; D012959:Socioeconomic Factors; D055815:Young Adult