High Prevalence of Sexually Transmitted Infections and Risk Factors Among HIV-Positive Individuals in Yunnan, China

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Other treatable sexually transmitted infections (STIs) are associated with accelerated HIV transmission and poor ART outcomes, but are only diagnosed by syndromic algorithms. Methods We recruited 406 HIV-positive participants for a cross-sectional study (204 ART-naive and 202 ART). Blood samples and first-voided urine samples were collected. Real-time polymerase chain reaction methods were used for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Mycoplasma genitalium (MG). Syphilis and HSV-2 tests were also performed. Results Among 406 participants, the overall prevalence of STI was 47.0% and 45.1% in ART-naive individuals and 49.0% in ART individuals, respectively. Testing frequency was 11.6% (11.8% vs 11.4%), 33.2% (29.4% vs 37.1%), 3.2% (3.4% vs 3.0%), 2.0% (3.4% vs 0.5%) and 4.7% (6.4% vs 3.0%) for active syphilis, HSV-2, chlamydia , gonorrhoeae and genitalium . Percentage of multiple infections in both groups was 10.8% (22/204) in ART-naive participants and 9.9% (20/202) in ART participants. Females, age between 18 to 35 years, ever injected drugs, homosexual or bisexual, HIV/HBV coinfection, and not receiving ART were identified as risk factors. Self-reported asymptom was not eliminating of having a laboratory-diagnosed STI. Conclusions STI prevalence was 47.0% (45.1% vs 49.0%), HSV-2, syphilis and MG were the most common STIs in HIV-infected individuals. We found high prevalence (6.4%) of Mycoplasma genitalium in ART-naive individuals. ART can reduce the diversity of STI-HIV coinfection but not the prevalence. HIV-positive individuals tend to neglect or maybe hide their genital tract discomfort, thus we suggest strengthening STI joint screening and treatment services among HIV-infected individuals whether they describe genital tract discomfort or not. Internal Medicine HIV syphilis Chlamydia trachomatis Neisseria gonorrhoeae Mycoplasma genitalium HSV-2 risk factor Figures Figure 1 Figure 2 Figure 3 Introduction Sexually transmitted infections (STI) present an ongoing and persistent global public health challenge. The latest World Health Organization (WHO) estimates that among people aged between 15 and 49 years there are 374.3 million new curable cases of STI every year of either Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), or syphilis [ 1 ]. This means STIs are responsible for more than one million new infections per day [ 1 ]. Evidence shows that genital ulcers caused by STI are an important clinical manifestation, which can increase the risk of human immunodeficiency virus type 1 (HIV-1) acquisition and replication [ 2 ]. The synergistic effect between STI and HIV can destroy the health of HIV-infected individuals in various ways. Firstly, some STIs generally destroy mucosal barriers, induce genital inflammation and ulceration, increase viral shedding of HIV in the genital tract, increase the scale of susceptible immune cells (e.g, CD4 + T cells, and dendritic cells (DCs)) in the genital tract, which may facilitate HIV transmission to the sex partners by the increase of HIV target cells [ 3 – 5 ]. Secondly, STIs also can restrain the immune responses of the skin-resident DCs and create a microenvironment conducive to HIV infection in the host; STI not only helps itself but creates a "yellow brick road" for HIV-1, which transmit mostly through the sexual route [ 6 , 7 ]. Thirdly, STI-HIV coinfection usually can reduce the CD4 + T cell count and enhance HIV viral load in blood plasma and genital secretions, which might decrease the effectiveness of antiretroviral therapy (ART) [ 8 , 9 ]. Finally, STI-HIV coinfection is significantly associated with persistent immune activation and poorer CD4 + T cell recovery [ 10 ]. HIV can also accelerate the progression of other STIs. When the immune function is compromised, STI-HIV coinfection is more difficult to treat and may prolong the course of the disease [ 11 ]. Yunnan province is the earliest epidemic of AIDS in China and the most heavily affected area, there exists the largest number of HIV-Positive Individuals. Along with the rapid development of the economy, HIV has developed from high-risk groups to the general population, sexual transmission has now replaced unsafe intravenous drug use (IDU) as the dominant route of HIV transmission in China [ 12 ]. Epidemiological studies show that STIs are a public health problem in this area. Among miners in Yunnan province, the prevalence of CT, NG, syphilis and HSV-2 has been reported to be 4.8%, 0.8%, 1.8% and 9.6%, respectively [ 13 ]. Whereas among female sex workers involved in high-risk sexual behavior the prevalence of CT, NG, syphilis, HSV-2 and TV was 25.9%, 8.3%, 7.5%, 68.1% and 10.6%, respectively [ 14 ]. STIs such as CT, MG, syphilis and TV cause asymptomatic disease [ 15 – 18 ]. Hence, it is difficult to screening and treats asymptomatic STIs, which also can induce genital inflammation and facilitate HIV transmission. Since HIV and STIs own almost the same routes of transmission and risk behaviors, we should make a strategy to control the spread of these infections combining with HIV. However, limited researches have been managed to determine the prevalence and risk factors of STI-HIV coinfection among HIV-positive participants in Yunnan, China. This study aimed to evaluate the prevalence of coinfection of STIs (syphilis, herpes progenitalis, chlamydia , gonorrhea and genitalium ) and the risk factors of coinfection among HIV-positive participants in Yunnan province. Our research results might be helpful to improve STIs screening and treatment services and reduce the risk of HIV acquisition and transmission. Methods Study population The cross-sectional study was conducted from September 2020 to June 2021 and included ART-naive and ART HIV-Positive participants living in Yunnan, China. A total of 406 HIV-positive participants (204 cases of ART-naive group and 202 cases of ART group) were recruited. Demographic data including age, sex, nation, occupation, region, current marital status, education status, ever injected drugs, sexual orientation, number of sexual partners, condom use, HBV, HCV, blood routine, blood biochemistry, latest CD4 + T cell count and ART were collected from the database of outpatient service system and questionnaire survey in Yunnan AIDS Care Center. Data Collection and STI detection Trained interviewers managed a face-to-face interview with each participant using a structured questionnaire. Measures included demographic characteristics, drugs use, sexual behaviors, and so on. Laboratory technicians collected approximately 5 ml of venous blood using an anticoagulant tube, which was centrifuged immediately for 15 minutes to separate the serum. Finally, participants provided a first-void urine specimen for the examination of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG). Serum samples were tested for syphilis using the Treponema pallidum particle agglutination (TPPA, FUJIREBIO Inc, Japan) and the toluidine red unheated serum test (TRUST, Shanghai Rongsheng Biotech Co. Ltd, China). Active syphilis-positive individuals were defined as those who were positive for both TPPA and TRUST. Serum samples were tested for herpes simplex virus type 2 (HSV-2) immunoglobulin (IgG) antibodies using the HSV-2 IgG enzyme-linked immunoassay kit HerpesSelect 2 ELISA IgG (ACON Biotech Co. Ltd, China). First-void urine was collected from the participants for the detection of CT, NG and MG by polymerase chain reaction (PCR) using CT RNA PCR kit, NG RNA PCR kit, and MG RNA PCR kit (Shanghai Rendu Biotech Co. Ltd, China). If any test appeared positive, the participants would be notified and received treatment. Statistical analyses The chi-squared test or Fisher’s exact test for categorical variables and t test for continuous variables were used to analyze differences of demographic characteristics and selected variables between the ART-naive group and ART group. Odds ratio (OR) and their 95% confidence intervals (CI) were calculated by using logistic regression analyses to evaluate the association between STI-HIV coinfection and its related factors with age, sex, nation, occupation, region, current marital status, education status, sexual orientation, ever injected drugs, number of sexual partners, condom use, HBV, HCV, CD4 latest and ART. All the statistics were performed by SPSS 19 software (IBM Company, New York, USA). Results Characteristics of participants A total of 406 HIV-infected participants agreed to participate in the study, among which, 204 cases (50.25%) were ART-naive participants and 202 cases (49.75%) were ART participants. The characteristics between ART-naive participants and ART participants were summarized in Table 1. Compared to ART participants, ART-naive participants had a significantly higher unemployment rate (16.2% versus 4%) and were more likely to be unmarried or single (68.1% versus 51%). A higher proportion of ever-injected drugs in ART participants (14.9%) than ART-naive participants (5.9%). Regarding sexual behaviors, a total of 63 (30.9%) ART-naive participants with multiple sexual partners compared to 2 (1%) ART participants in the past year. The mean of sexual partners in the former were 3.2 (± 0.2) compared to the latter 1 (± 0.3). A higher proportion of never-used condoms in ART participants (12.7%) than ART-naive participants (0%). The average count of CD4 + T cells in ART-naive participants was significantly lower than ART participants (mean: 321 cells/µl versus 807 cells/µl). Similarly, the average count of Total T lymphocytes was lower on ART-naive participants compared with ART participants (mean: 1464 cells/µl versus 1890 cells/µl). Therefore, CD4/CD8 also became lower on ART-naive participants (0.4 versus 0.9). Compared with ART-naive participants, ART participants had a higher average count of white cells, percentage of lymphocytes, lymphocyte count, platelet and triglyceride, but a lower average count of erythrocyte and trioxypurine (Fig 1). In addition, the age, sex, nation, region, education, sexual orientation and other data between ART-naive and ART groups had no statistical difference ( p > 0.05). Coinfections and multiple infections in ART-naive and ART participants The prevalence of syphilis, herpes progenitalis, chlamydia , gonorrhea and genitalium among the participants was 19.9% (ART-naive: 19.6% and ART: 20.3%), 33.2% (ART-naive: 29.4% and ART: 37.1%), 3.2% (ART-naive: 3.4% and ART: 3.0%), 2.0% (ART-naive: 3.4% and ART: 0.5%), 4.7% (ART-naive: 6.4% and ART: 3.0%) (Table 2). Percentage of coinfections and multiple infections in both groups was 10.8% (22/204) in ART-naive participants and 9.9% (20/202) in ART participants. For the ART-naive participants, the coinfection rate by decreasing order of prevalence was 54.5% (12/22) for TP-HSV-2, 9.1% (2/22) for CT-HSV-2 and 9.1% (2/22) for TP-MG-HSV-2, and 4.5% (1/22) for MG-HSV-2, TP-NG, CT-NG, MG-NG, MG-TP, and for CT-NG-MG-HSV-2. The group of ART participants had a lower diversity of STIs. Coinfections by decreasing order of prevalence were 75.0% (15/20) for TP-HSV-2, 10.0% (2/20) for MG-HSV-2, 5% (1/20) for TP-NG, TP-NG-MG and TP-MG-HSV-2 (Fig 2). Factors associated with STI-HIV coinfection All of the items between STI-HIV coinfection groups were included in the logistic regression model (Table 3). For all participants, logistic regression analyses revealed that females were significantly associated with STI-HIV coinfection risk (OR = 3.46, 95%CI: 1.95-6.15, p < 0.001). In further stratification analysis of ART-naive and ART groups, Female also showed consistent significant associations with STI-HIV coinfection risk (OR = 3.89, 95% CI: 1.59-9.50, p = 0.003 versus OR = 4.21, 95% CI: 1.84-9.61, p = 0.001). The identification of risk factors for each STI was determined by logistic regression model. In the logistic regression analysis, all variables were adjusted, the following variables remained in the model as risk factors: age > 36 years (OR = 0.33, 95% CI: 0.13-0.87, p = 0.024) reduced the risk of TP-HIV coinfection. Age > 36 years (OR = 2.24, 95%CI: 1.20-4.20, P = 0.012) and female (OR = 3.47, 95% CI: 1.95-6.16, p < 0.001) significantly increased the risk of HIV-HSV-2 coinfection. Ever injected drugs (OR = 171.00, 95%CI: 13.80-2133.40, P < 0.001) and female (OR = 9.60, 95%CI: 1.46-63.06, P = 0.019) were much associated with CT-HIV coinfection risk. Coinfection with HBV (OR = 100.50, 95% CI: 4.70-2168.70, p = 0.003) increased the risk of NG-HIV coinfection, however, received antiretroviral therapy (OR = 0.03, 95% CI: 0.001 - 0.75, p = 0.032) became a protective factor of NG-HIV coinfection. We also found Homosexual or Bisexual (OR = 5.12, 95% CI: 1.13-23.26, p = 0.034) was significantly associated with an increase of MG-HIV coinfection. The logistic regression analysis showed the following variables as risk factors for each STI coinfection among participants with ART-naive status: homosexual or bisexual (OR = 3.99, 95%CI:1.02-15.61, p = 0.047) for TP-HIV coinfection, female (OR = 3.03, 95% CI: 1.26-7.26, p = 0.013) for HIV-HSV-2 coinfection, ever-injected drugs (OR = 68.60, 95% CI: 1.60-2880.00, p = 0.027) and female (OR = 22.69, 95% CI: 1.10-448.20, p = 0.040) for CT-HIV coinfection, age > 36 years (OR = 0.05, 95% CI: 0.003-0.77, p = 0.032) and coinfection with HBV (OR = 81.84, 95% CI: 5.80-1159.50, p = 0.001) for NG-HIV (Fig 3). Discussion This is the first research of STI prevalence included large amounts of new HIV-infected people and detected by blood samples and first-voided urine samples in Yunnan, China. In the present study, a rather high STI prevalence among HIV-positive individuals was confirmed, namely, 47.0% (191/406) in total,45.1% (91/204) in ART-naive individuals and 49.0% (99/202) in ART individuals. This prevalence is much higher than the 5.3% observed in the HIV-positive individuals in Nepal [19], the 11.1% detected in the women living with HIV/AIDS (WLHA) in Uganda [20] and the 23.5% of HIV-infected MSM in China [21], but the prevalence was less than the 60.6% of female sex workers in Peru [22] and the 60.5% of HIV-infected Women in Zimbabwe [23]. The prevalence of genital tract discomfort was 0.5% (2/406),which was rather lower than the STI prevalence. It was interesting to find that HIV-positive individuals tend to neglect or maybe hide their genital tract discomfort. However, our health policy was that no symptom means no screening, those reason may contribute to the high prevalence of STIs. In this study, We found that the overall prevalence of STIs among ART individuals was slightly higher than among ART-naive individuals, although the difference was not statistically significant. This may be associated with the high prevalence of HSV-2/HIV coinfection, 29.4% (60/204) in the ART-naive group versus 37.1% (75/202) in the ART group. In HIV-positive individuals, genital herpes tends to recurrently attack, some individuals even show asymptomatic [24], without intervention, HSV-2 infection will be persisted, accumulated, and transmitted in the people living with HIV/AIDS. However, the ART-naive group had a higher diversity of STIs, coinfections and more sexual partners, and the prevalence of CT, NG and MG was also higher in this study, we believe that ART-naive individuals may face greater threats of STIs and keep in a more dangerous situation. HSV-2 was the most common STI detected, with an overall prevalence of 33.2% (135/406 ) for HIV-positive individuals in this study. The prevalence of HSV-2/HIV coinfection was much higher than the 6%-13% observed in non-injecting drug users [25], but the prevalence was less than the 48.6% of HIV-positive men who have sex with men (MSM) in Shenyang [26]. Active syphilis was also the familiar STI observed, with the prevalence of 11.8% (24/204) for the ART-naive group and 11.4% (23/202) for the ART group. The result is similar to the 11.3% detected in HIV-positive MSM in Zhejiang province [27], however, the prevalence of active syphilis detected in our study was lesser than the 34.3% of HIV-Positive MSM in Shenyang and 82.9% of HIV-Positive MSM in the United States [26, 28]. HSV-2 and TP can induce genital ulceration, which plays an important role in facilitating the acquisition and transmission of HIV and other STIs.Evidence shows that 60.7% of HSV-2, 3.9% of TP could be detected in ulcer specimens, and 68% of HSV-positive participants were coinfected with HIV in South Africa [29]. Moreover,among genital ulcer disease people, the positivity rate of HSV,TP and HIV was 38.5%,16.0% and 52.2% in Zimbabwe [30]. The prevalence of CT detected in the two groups of participants (3.4% vs 3.0%) was larger than the 0.9% identified in WLHA [20], while it was smaller than the 11.1% of MSM in Port-au-Prince [31]. The prevalence of NG identified in our study (3.4% vs 0.5%) was lower than the 5.4% observed in WLHA [20] and the 7.2% of HIV-positive MSM in Birmingham [32]. Very few researches of M. genitalium prevalence are assessed and generally associated with specific groups of women [33]. Our study provides the first report of MG prevalence among ART-naive individuals in Yunnan. We identified a prevalence of 6.4% (13/204) of MG infection in ART-naive participants. This prevalence was higher than the 2.4% detected in the HIV-infected women in Brazil [34], but the prevalence was lower than the 10.5% of HIV-Positive women in Zimbabwean [35]. However, more and more evidence shows an association between MG and HIV infection. The report shows that the prevalence of MG was comparable to that for CT, NG and HSV among HIV-positive men and MG infection may associate with HIV shedding in the genital tract [35]. MG infection was 21.4% among HIV-infected pregnant women and was associated with higher plasma HIV levels [36]. This finding was notable that the prevalence of MG infection in ART-naive participants was 6.4%, which was higher than CT or NG infection in the two groups. Therefore, we need further researches to understand MG infection in the HIV-positive population in Yunnan province. We found that ART-naive individuals had a higher unemployment rate, unmarried rate, more sexual partners per year and less use of condoms compared to ART individuals. Unemployment and low income make marry become impractical in China and individuals are more likely to proceed with unprotected sexual behavior for economic gains. However, ART individuals had recognized their condition and more convenient to access STI preventative information. Our result shows that the proportion of ever-injected drugs in the ART-naive group was lower than in another group because the sexual transmission has become the dominant route of HIV transmission, with the government's strict control of drugs, intravenous drug users will be rare. The average count of CD4 + T cells, total T lymphocytes, CD4/CD8, lymphocyte count and percentage of lymphocytes in ART-naive participants were significantly lower than ART participants. In China, the enrolment criteria for ART changed that individuals should receive ART once diagnosed as HIV-positive from 2015. ART can restrain the replication of HIV-1 and gradual recovery of CD4 + T-cell counts [37]. We found the significant promotion of CD4 + T cells and lymphocytes in the ART group. ART participants had a higher average count of white cell, platelet and triglyceride, but a lower average count of erythrocyte and trioxypurine. Lipid abnormalities and metabolic complications associated with ART maybe can explain it [38, 39]. Our findings revealed that females were more likely to have one of the curable STIs (CT, NG, MG, HSV-2 or active syphilis), no matter in the ART-naive group or ART group. Two variables of female and ever-injected drugs showed a significant association with CT-HIV coinfection. Similarly, females and ages >36 years showed association with HSV-2/HIV coinfection. Homosexual or bisexual was associated with a significantly increased MG-HIV coinfection risk. However, age between 18 to 35 years becomes a risk factor in TP-HIV or NG-HIV coinfection. Other risk factors of TP-HIV coinfection were Homosexual or bisexual and NG-HIV coinfection was HIV/HBV coinfection. Participants receiving ART were less likely to have NG-HIV coinfection compared with those not receiving ART. In conclusion, risk factors associated with sexually transmitted infections among HIV-positive individuals were female, age between 18 to 35 years, ever-injected drugs, homosexual or bisexual, HIV/HBV coinfection, and not receiving ART. Our results on STI-HIV coinfection have important implications for improving STIs screening and treatment services among HIV-positive individuals. Evidence shows that many STIs were asymptomatic.The prevalence of syphilis was 13.5%, among them, 91.3% were asymptomatic among women in China. Most of the anorectal (93.3%) and urethral (79.2%) MG infections were asymptomatic among MSM in western Sydney [15]. A Nigerian study shows that over 95% of STI cases were asymptomatic among MSM [40]. In Yunnan, we found that some hospitals and clinics may not screen other STIs when found a new HIV-positive case, especially in resource-poor settings and rural areas, unless having obvious symptoms. Therefore, strategies to screening all HIV-positive individuals for HSV-2, syphilis, and MG, and so on would be necessary. Untreated STIs may facilitate HIV acquisition and transmission and reduce the effectiveness of antiviral therapy. There are several limitations to the research. This was a cross-sectional study and the participants were not random. Our collected information might have been compromised by recall bias and social desirability bias as sexual behavior is private information to participants. Conclusions In conclusion, we identified a high prevalence of STIs among ART-naive and ART HIV-positive individuals in Yunnan. HSV-2, syphilis and MG were the most common STIs in HIV-positive individuals.HSV-2 infection will be recurred, persisted and accumulated that cannot be stoped by ART. The prevalence of MG was high in ART-naive participant and the further researches are needed to understand this association. We suggest strengthening STIs joint screening and treatment services among every HIV-positive individual whether experienced ART or not, especially in resource-poor settings and rural areas. Females, age between 18 to 35 years, ever-injected drugs, homosexual or bisexual, HIV/HBV coinfection and not receiving ART were identified as risk factors. Younger patients, women, ever-injected drugs, homosexual or bisexual, coinfection with HBV and not receiving ART should be a focus for interventions to decrease STIs. Declarations Ethics approval and consent to participate This study was approved by the review board of Yunnan Provincial Hospital of Infectious Diseases, and written informed consent was obtained from the study participants. All experiments were performed in accordance with the approved guidelines and regulations according to the principles expressed in the Declaration of Helsinki, and the experimental protocols were approved by the institutional review board. Consent for publication N/A Availability of data and materials The majority of datasets used and/or analyzed during the current study are available from the indicated published resources. The remaining data, including model code, are available from the corresponding author on reasonable request. Competing interests The authors declare no conflict of interest. Funding The work was supported by the Project of AIDS Bureau of Yunnan Province, the grant from National Natural Science Foundation of China (81860553 and 32060177), the "Ten-thousand Talents Program" of Yunnan Province (YNWR-MY-2018-039), the Medical Leadership Foundation of Health and Family Planning Commission of Yunnan Province, China (L-201613), Yunnan Province Clinical Research Center for Skin Immune Diseases (2019ZF012), and Yunnan Province Clinical Center for Skin Immune Diseases (ZX2019-03-02). Authors' contributions L.L., Y.Y.L. and Y.Q.K. conceived and designed the study. W.T., R.H.X., X.Q.D. and D.Z. contributed to experiment conduction and data acquisition. W.T., Y.L.M., W.Y.Z. and Y.Q.K. analyzed and interpreted the data. W.T. and Y.Q.K. drafted the manuscript. L.L., Y.Y.L. and Y.Q.K. contributed to the critical revision of the manuscript for important intellectual content. Y.Y.L. and L.L. obtained funding. All authors read and approved the final version of the manuscript for publication. Acknowledgements The authors would like to thank all the participants in this study, the staff of Biomedical Laboratory of Dermatology in the First affiliated Hospital of Kunming Medical University and Yunnan Provincial Infectious Disease Hospital for their assistance in this study. Provenance and peer review Not commissioned; externally peer reviewed. ORCID iD Wei Tu https://orcid.org/0000-0003-1795-2262 References Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021 [Available from: https://www.who.int/publications/i/item/9789240027077. Accessed 10 September 2021. Torrone EA, Morrison CS, Chen PL, Kwok C, Francis SC, Hayes RJ, et al. Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. PLoS Med. 2018;15(2):e1002511. 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Risk factors associated with sexually transmitted infections among HIV infected men who have sex with men. PLoS One. 2017;12(2):e0170635. Carcamo CP, Campos PE, Garcia PJ, Hughes JP, Garnett GP, Holmes KK, et al. Prevalences of sexually transmitted infections in young adults and female sex workers in Peru: a national population-based survey. Lancet Infect Dis. 2012;12(10):765-73. Lowe S, Mudzviti T, Mandiriri A, Shamu T, Mudhokwani P, Chimbetete C, et al. Sexually transmitted infections, the silent partner in HIV-infected women in Zimbabwe. South Afr J HIV Med. 2019;20(1):849. Garland SM, Steben M Genital herpes. Best Pract Res Clin Obstet Gynaecol. 2014;28(7):1098-110. Des Jarlais DC, Arasteh K, Feelemyer J, McKnight C, Tross S, Perlman DC, et al. Decline in Herpes Simplex Virus Type 2 Among Non-Injecting Heroin and Cocaine Users in New York City, 2005 to 2014: Prospects for Avoiding a Resurgence of Human Immunodeficiency Virus. Sex Transm Dis. 2017;44(2):85-90. Hu QH, Xu JJ, Chu ZX, Zhang J, Yu YQ, Yu H, et al. Prevalence and Determinants of Herpes Simplex Virus Type 2 (HSV-2)/Syphilis Co-Infection and HSV-2 Mono-Infection among Human Immunodeficiency Virus Positive Men Who Have Sex with Men: a Cross-Sectional Study in Northeast China. Jpn J Infect Dis. 2017;70(3):284-9. Chen L, Yang J, Ma Q, Pan X Prevalence of Active Syphilis Infection and Risk Factors among HIV-Positive MSM in Zhejiang, China in 2015: A Cross-Sectional Study. Int J Environ Res Public Health. 2019;16(9). Dean BB, Scott M, Hart R, Battalora L, Novak RM, Durham MD, et al. Sexually Transmitted Disease Testing of Human Immunodeficiency Virus-Infected Men Who Have Sex With Men: Room for Improvement. Sex Transm Dis. 2017;44(11):678-84. Kularatne RS, Muller EE, Maseko DV, Kufa-Chakezha T, Lewis DA Trends in the relative prevalence of genital ulcer disease pathogens and association with HIV infection in Johannesburg, South Africa, 2007-2015. PLoS One. 2018;13(4):e0194125. Mungati M, Machiha A, Mugurungi O, Tshimanga M, Kilmarx PH, Nyakura J, et al. The Etiology of Genital Ulcer Disease and Coinfections With Chlamydia trachomatis and Neisseria gonorrhoeae in Zimbabwe: Results From the Zimbabwe STI Etiology Study. Sex Transm Dis. 2018;45(1):61-8. Jean Louis F, Galbaud G, Leonard M, Pericles E, Journel I, Buteau J, et al. Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis in men having sex with men in Port-au-Prince, Haiti: a cross-sectional study. BMJ Open. 2020;10(3):e033976. Footman A, Dionne-Odom J, Aaron KJ, Raper JL, Van Der Pol B Performance of 4 Molecular Assays for Detection of Chlamydia and Gonorrhea in a Sample of Human Immunodeficiency Virus-Positive Men Who Have Sex With Men. Sex Transm Dis. 2020;47(3):158-61. Daley GM, Russell DB, Tabrizi SN, McBride J Mycoplasma genitalium: a review. Int J STD AIDS. 2014;25(7):475-87. Rodrigues LLS, Hardick J, Nicol AF, Morgado MG, Martinelli KG, de Paula VS, et al. Sexually transmitted infections among HIV-infected and HIV-uninfected women in the Tapajos region, Amazon, Brazil: Self-collected vs. clinician-collected samples. PLoS One. 2019;14(4):e0215001. Napierala Mavedzenge S, Muller EE, Lewis DA, Chipato T, Morrison CS, Weiss HA Mycoplasma genitalium is associated with increased genital HIV type 1 RNA in Zimbabwean women. J Infect Dis. 2015;211(9):1388-98. Roxby AC, Yuhas K, Farquhar C, Bosire R, Mbori-Ngacha D, Richardson BA, et al. Mycoplasma genitalium infection among HIV-infected pregnant African women and implications for mother-to-child transmission of HIV. AIDS. 2019;33(14):2211-7. Yang X, Su B, Zhang X, Liu Y, Wu H, Zhang T Incomplete immune reconstitution in HIV/AIDS patients on antiretroviral therapy: Challenges of immunological non-responders. J Leukoc Biol. 2020;107(4):597-612. Lagathu C, Bereziat V, Gorwood J, Fellahi S, Bastard JP, Vigouroux C, et al. Metabolic complications affecting adipose tissue, lipid and glucose metabolism associated with HIV antiretroviral treatment. Expert Opin Drug Saf. 2019;18(9):829-40. Waters DD, Hsue PY Lipid Abnormalities in Persons Living With HIV Infection. Can J Cardiol. 2019;35(3):249-59. Keshinro B, Crowell TA, Nowak RG, Adebajo S, Peel S, Gaydos CA, et al. High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria. J Int AIDS Soc. 2016;19(1):21270. Tables Table 1. Characteristics of ART-naive and ART HIV + participants Characteristics ART-naive (n = 204) ART (n = 202) p v alue n (%) n (%) General Age, years, median (range) 37 (18-86) 39.5 (23-69) 18-35 93 (45.6) 74 (36.6) ≥36 111 (54.4) 128 (63.4) 0.067 Sex Male 167 (81.9) 158 (78.2) Female 37 (18.1) 44 (21.8) 0.358 Nation Ethnic Han 171 (83.8) 179 (88.6) Other 33 (16.2) 23 (11.4) 0.162 Occupation Employee 121 (59.3) 115 (56.9) None 33 (16.2) 8 (4.0) Unknown 50 (24.5) 79 (39.1) 0.001 Region Yunnan 192 (94.1) 194 (96.0) Other province 12 (5.9) 8 (4.0) 0.371 Current marital status Married 65 (31.9) 99 (49.0) Unmarried or single 139 (68.1) 103 (51.0) <0.001 Education Up to primary 120 (58.8) 114 (56.4) Above primary 84 (41.2) 88 (43.6) 0.626 Sexual orientation Heterosexual 125 (61.3) 135 (66.8) Homosexual/Bisexual 79 (38.7) 67 (33.2) 0.243 Ever injected drugs Yes 12 (5.9) 30 (14.9) No 192 (94.1) 172 (85.1) 0.003 No.of sexual partners Single 58 (28.4) 53 (26.2) Multiple 63 (30.9) 2 (1.0) Unknown 83 (40.7) 147 (72.8) <0.001 Condom use Consistent/Casual 121 (59.3) 79 (39.1) Never 26 (12.7) 0 (0.0) Unknown 57 (28.0) 123 (60.9) <0.001 Genital tract discomfort Yes 2 (1.0) 0 (0) No or unanswered 202 (99.0) 202 (100.0) 0.483 CD4, median (range) 273 (1-1148) 731 (551-2200) Normal 28 (13.7) 202 (100.0) Down 176 (86.3) 0 (0.0) <0.001 CD4/CD8, median (range) 0.25 (0.02-3.19) 0.88 (0.30-6.75) Normal 16 (7.8) 135 (66.8) Down 160 (78.4) 65 (32.2) <0.001 total T lymphocytes, median (range) 1314 (112-5416) 1815 (923-3840) Normal 111 (54.4) 180 (89.1) Down 39 (19.1) 1 (0.5) <0.001 P values were based on the chi-square test (or Fisher exact test) for categorical variables. The statistical significance was indicated as *p < 0.05, and **p < 0.001. Created by the authors Table 2. Prevalence of Sexually Transmitted Infections among HIV + Participants. Variable Total (n = 406) ART-naïve (n = 204) ART (n = 202) Case number (%) Case number (%) Case number (%) Syphilis TPPA + 81 (19.9) 40 (19.6) 41 (20.3) TPPA + TRUST + 47 (11.6) 24 (11.8) 23 (11.4) HSV-2 IgG + 135 (33.2) 60 (29.4) 75 (37.1) Neisseria gonorrhoeae 8 (2.0) 7 (3.4) 1 (0.5) Chlamydia trachomatis 13 (3.2) 7 (3.4) 6 (3.0) Mycoplasma genitalium 19 (4.7) 13 (6.4) 6 (3.0) STI 191 (47.0) 92 (45.1) 99 (49.0) Created by the authors Table 3. Logistic regression analyses of related factors Associated with Curable STI-HIV coinfection among HIV + participants. Variable STI-HIV co-infection rate, (N = 406),n (%) STI-HIV co-infection rate on ART-naive, (N = 204),n (%) STI-HIV co-infection rate on ART,(N = 202),n (%) n/N (%) OR (95% CI) P value n/N (%) OR (95% CI) P value n/N (%) OR (95%CI) P value Age,years 18-35 72/167 (43.1) ref 37/93 (39.8) ref 35/74 (47.3) ref ≥36 119/239 (49.8) 1.24 (0.70-2.19) 0.461 55/111 (49.5) 1.12 (0.48-2.60) 0.791 64/128 (50.0) 1.08 (0.45-2.62) 0.858 Sex Male 136/325 (41.8) ref 66/167 (39.5) ref 70/158 (44.3) ref Female 55/81 (67.9) 3.46 (1.95-6.15) <0.001 26/37 (70.3) 3.89 (1.59-9.50) 0.003 29/44 (65.9) 4.21 (1.84-9.61) 0.001 Nation Ethnic Han 168/350 (48.0) ref 79/171 (46.2) ref 89/179 (49.7) ref Other 23/56 (41.1) 0.66 (0.36-1.22) 0.186 13/33 (39.4) 0.60 (0.25-1.42) 0.245 10/23 (43.5) 0.61 (0.23-1.62) 0.324 Occupation Employee 110/236 (46.6) ref 52/121 (42.9) ref 58/115 (50.4) ref None 21/41 (51.2) 1.26 (0.61-2.59) 0.528 16/33 (48.5) 1.06 (0.44-2.54) 0.896 5/8 (62.5) 2.70 (0.56-13.05) 0.216 Others 60/129 (46.5) 0.89 (0.55-1.42) 0.614 24/50 (48.0) 0.94 (0.44-2.01) 0.880 36/79 (45.6) 1.01 (0.52-1.99) 0.966 Region Other province 10/20 (50.0) ref 5/12 (41.7) ref 5/8 (62.5) ref Yunnan 181/386 (46.9) 1.08 (0.43-2.73) 0.864 87/192 (45.3) 1.13 (0.31-4.21) 0.853 94/194 (48.4) 0.92 (0.21-4.09) 0.916 Current marital status Married 75/164 (45.7) ref 30/65 (46.2) ref 45/99 (45.4) ref Unmarried/single 116/242 (47.9) 1.31 (0.79-2.18) 0.304 62/139 (44.6) 1.06 (0.49-2.26) 0.884 54/103 (52.4) 1.52 (0.71-3.25) 0.278 Education Up to primary 113/234 (48.3) ref 58/120 (48.3) ref 55/114 (48.2) ref Above primary 78/172 (45.3) 1.13 (0.69-1.87) 0.622 34/84 (40.5) 1.03 (0.49-2.18) 0.932 44/88 (50.0) 1.32 (0.64-2.73) 0.461 Sexual orientation Heterosexual 125/260 (48.1) ref 61/125 (48.8) ref 64/135 (47.4) ref Homosexual/Bisexual 66/146 (45.2) 1.55 (0.88-2.72) 0.129 31/79 (39.2) 1.39 (0.62-3.15) 0.426 35/67 (52.2) 1.58 (0.67-3.76) 0.297 Ever injected drugs No 168/364 (46.1) ref 85/192 (44.3) ref 83/172 (48.3) ref Yes 23/42 (54.8) 1.40 (0.64-3.08) 0.396 7/12 (58.3) 1.19 (0.22-6.59) 0.839 16/30 (53.3) 1.71 (0.67-4.38) 0.265 No.of sexual partners Single 53/111 (47.7) ref 29/58 (50.0) ref 24/53 (45.3) ref Multiple 21/65 (32.3) 0.48 (0.23-1.00) 0.051 19/63 (30.2) 0.42 (0.18-0.98) 0.054 2/2 (100) Others 117/230 (50.9) 1.28 (0.66-2.46) 0.466 44/83 (53.0) 1.32 (0.51-3.41) 0.567 73/147 (49.7) 1.33 (0.48-3.72) 0.588 Condom use Consistent 55/118 (46.6) ref 18/39 (46.2) ref 37/79 (46.8) ref Casual/Never 47/108 (43.5) 1.27 (0.63-2.58) 0.508 47/108 (43.5) 0.90 (0.37-2.17) 0.815 0 Others 89/180 (49.4) 0.85 (0.45-1.60) 0.607 27/57 (47.4) 0.49 (0.16-1.44) 0.193 62/123 (50.4) 1.31(0.54-3.17) 0.545 CD4 count ≥550 112/230 (48.7) ref 13/28 (46.4) ref 99/202 (49.0) ref <550 79/176 (44.9) 0.90 (0.52-1.56) 0.714 79/176 (44.9) 0.93 (0.37-2.33) 0.872 0 (0.0) NA NA HBV Negative 174/374 (46.5) ref 77/182 (42.3) ref 97/192 (50.5) ref Positive 17/32 (53.1) 1.19 (0.55-2.57) 0.654 15/22 (68.2) 2.76 (1.00 - 7.67) 0.051 2/10 (20.0) 0.25 (0.05-1.18) 0.080 HCV Negative 177/381 (46.5) ref 82/188 (43.6) ref 95/193 (49.2) ref Positive 14/25 (56.0) 1.04 (0.40-2.74) 0.934 10/16 (62.5) 1.50 (0.33-6.80) 0.598 4/9 (44.4) 0.58 (0.12-2.89) 0.501 Created by the authors Cite Share Download PDF Status: Published Journal Publication published 13 Jan, 2022 Read the published version in European Journal of Medical Research → Version 1 posted Editorial decision: Major revision 06 Dec, 2021 Reviewer # 2 agreed at journal 03 Nov, 2021 Review # 1 received at journal 18 Oct, 2021 Reviews received at journal 16 Oct, 2021 Reviewers invited by journal 16 Oct, 2021 Reviewer # 1 agreed at journal 15 Oct, 2021 Editor assigned by journal 27 Sep, 2021 Submission checks completed at journal 27 Sep, 2021 Editor invited by journal 27 Sep, 2021 First submitted to journal 27 Sep, 2021 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-936581","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":54854687,"identity":"458e2c69-ea3b-4f9c-ae51-75091c63ead9","order_by":0,"name":"Wei Tu","email":"","orcid":"","institution":"Kunming Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wei","middleName":"","lastName":"Tu","suffix":""},{"id":54854688,"identity":"ee29e84b-0776-4cb7-a7eb-f7e006a67ba6","order_by":1,"name":"Yu-Ye Li","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAx0lEQVRIiWNgGAWjYHACxgMJFRI8bOyNjQ8+EKvnQMIZGzl+nsPNhjOI1sLYlmYsOSO9TZqDGOUGN5IPHHjAdjhxw82HDdIMDHZyug0EtaQlHEjgAWq5ndhgXMCQbGx2gKCWHIMDCRIQLckzGA4kbiOsJf/DgQQDkMMONhzmIU5LDjDEEkDeZ2xsJkqL5JlnQIcdAAVyYjPjDAMi/MJ3PPnhw5//QFF5/PmPDxV2cgS1KFxIQHEnAeUgIN9PyNBRMApGwSgYBQD2M1BSAXTEOwAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0003-0676-985X","institution":"Kunming Medical University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Yu-Ye","middleName":"","lastName":"Li","suffix":""},{"id":54854689,"identity":"5c946106-5a4c-464a-a2ed-3ba12f679e4e","order_by":2,"name":"Yi-Qun Kuang","email":"","orcid":"","institution":"Kunming Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yi-Qun","middleName":"","lastName":"Kuang","suffix":""},{"id":54854690,"identity":"f34f5524-525f-47d9-a07b-4d9208c89ada","order_by":3,"name":"Rong-Hui Xie","email":"","orcid":"","institution":"Hospital Provincial hospital of infectious diseases","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Rong-Hui","middleName":"","lastName":"Xie","suffix":""},{"id":54854691,"identity":"e16d7e7f-09f1-4734-a193-6c8a8095183e","order_by":4,"name":"Xing-Qi Dong","email":"","orcid":"","institution":"Yunnan Provincial Hospital of infectious diseases","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Xing-Qi","middleName":"","lastName":"Dong","suffix":""},{"id":54854692,"identity":"7b566b74-c9b5-4258-a290-f6fbeb457d87","order_by":5,"name":"Dan Zhang","email":"","orcid":"","institution":"Kunming Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Dan","middleName":"","lastName":"Zhang","suffix":""},{"id":54854693,"identity":"99cf1721-f189-44bc-b22b-eaa0b9edf9aa","order_by":6,"name":"Yan-Ling Ma","email":"","orcid":"","institution":"Centers for Disease Control and Prevention","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yan-Ling","middleName":"","lastName":"Ma","suffix":""},{"id":54854694,"identity":"f91f42a7-7cf7-4015-950c-89d0d824622a","order_by":7,"name":"Wan-Yue Zhang","email":"","orcid":"","institution":"Centers for Disease Control and Prevention","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wan-Yue","middleName":"","lastName":"Zhang","suffix":""},{"id":54854695,"identity":"6dac3f2f-43a7-4e64-8ead-4b12250f1ed4","order_by":8,"name":"Lin Lu","email":"","orcid":"","institution":"Kunming Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lin","middleName":"","lastName":"Lu","suffix":""}],"badges":[],"createdAt":"2021-09-25 10:16:41","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-936581/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-936581/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s40001-022-00635-w","type":"published","date":"2022-01-13T07:44:30+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":14523691,"identity":"e0085277-17da-49cd-b1e4-87d759fe1bcc","added_by":"auto","created_at":"2021-10-14 14:32:31","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":204676,"visible":true,"origin":"","legend":"Comparison of laboratory data between ART-naive participants and ART participants. (a) CD4+ T cell count (cells/µl). (b) Ratio of CD4+T cell count/CD8+ T cell count. (c) Lymphocyte count (109/L). (d) The percentage of lymphocytes (%). (e) Total T lymphocyte count (cells/µl). (f) Erythrocyte count (1012/L). (g) Hemameba count (109/L). (h) Platelet count (109/L). (i) Trioxypurine level (µmol/L). (j) Triglyceride level (mmol/L). (k) Number of sexual partners. Red bar shows the ART-naive group (n = 204) and green bar shows ART group (n = 202). Data are presented as mean ± SEM. The statistical significance was indicated as *p \u003c 0.05, and **p \u003c 0.001. \"Created by the authors\"","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-936581/v1/1e874d4b90779ac85ae8d402.png"},{"id":14523442,"identity":"74ce58a5-7f65-4df3-b85f-cdd3754a54d5","added_by":"auto","created_at":"2021-10-14 14:29:31","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":132077,"visible":true,"origin":"","legend":"Prevalence of STIs among HIV-infected patients. Different-colored squares represent different STI. HSV-2, TP, CT, NG and MG indicate herpes progenitalis, T. pallidum, C. trachomatis, N. gonorrhoeae and M. genitalium, respectively. \"Created by the authors\"","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-936581/v1/fc96634390862652bc2066a7.png"},{"id":14523444,"identity":"a2fe6db9-714a-4687-9f2b-15b642bb74bf","added_by":"auto","created_at":"2021-10-14 14:29:31","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":355196,"visible":true,"origin":"","legend":"Factors associated with STIs among HIV-positive participants. (a) Factors associated with HIV and active syphilis coinfection. (b) Factors associated with HIV and HSV-2 coinfection. (c) Factors associated with HIV and C. trachomatis coinfection. (d) Factors associated with HIV and N. gonorrhoeae coinfection. (e) Factors associated with HIV and M. genitalium coinfection. The red line shows risk factors associated with each coinfection, green line shows protective factors and the ref are the risk factors in each coinfection. *p \u003c 0.05 (Logistic regression). \"Created by the authors\"","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-936581/v1/5f7a1b6476696225dd6ea608.png"},{"id":17274394,"identity":"0c0e6cf3-551b-4461-9256-709e6ea4c431","added_by":"auto","created_at":"2022-01-13 07:44:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":932789,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-936581/v1/3c3c9350-6d5f-4fb9-ba02-c12c22c8f4e6.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eHigh Prevalence of Sexually Transmitted Infections and Risk Factors Among HIV-Positive Individuals in Yunnan, China\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSexually transmitted infections (STI) present an ongoing and persistent global public health challenge. The latest World Health Organization (WHO) estimates that among people aged between 15 and 49 years there are 374.3\u0026nbsp;million new curable cases of STI every year of either \u003cem\u003eChlamydia trachomatis\u003c/em\u003e (CT), \u003cem\u003eNeisseria gonorrhoeae\u003c/em\u003e (NG), \u003cem\u003eTrichomonas vaginalis\u003c/em\u003e (TV), or syphilis [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This means STIs are responsible for more than one million new infections per day [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Evidence shows that genital ulcers caused by STI are an important clinical manifestation, which can increase the risk of human immunodeficiency virus type 1 (HIV-1) acquisition and replication [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe synergistic effect between STI and HIV can destroy the health of HIV-infected individuals in various ways. Firstly, some STIs generally destroy mucosal barriers, induce genital inflammation and ulceration, increase viral shedding of HIV in the genital tract, increase the scale of susceptible immune cells (e.g, CD4\u003csup\u003e+\u003c/sup\u003e T cells, and dendritic cells (DCs)) in the genital tract, which may facilitate HIV transmission to the sex partners by the increase of HIV target cells [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Secondly, STIs also can restrain the immune responses of the skin-resident DCs and create a microenvironment conducive to HIV infection in the host; STI not only helps itself but creates a \"yellow brick road\" for HIV-1, which transmit mostly through the sexual route [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Thirdly, STI-HIV coinfection usually can reduce the CD4\u003csup\u003e+\u003c/sup\u003e T cell count and enhance HIV viral load in blood plasma and genital secretions, which might decrease the effectiveness of antiretroviral therapy (ART) [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Finally, STI-HIV coinfection is significantly associated with persistent immune activation and poorer CD4\u003csup\u003e+\u003c/sup\u003e T cell recovery [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. HIV can also accelerate the progression of other STIs. When the immune function is compromised, STI-HIV coinfection is more difficult to treat and may prolong the course of the disease [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eYunnan province is the earliest epidemic of AIDS in China and the most heavily affected area, there exists the largest number of HIV-Positive Individuals. Along with the rapid development of the economy, HIV has developed from high-risk groups to the general population, sexual transmission has now replaced unsafe intravenous drug use (IDU) as the dominant route of HIV transmission in China [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Epidemiological studies show that STIs are a public health problem in this area. Among miners in Yunnan province, the prevalence of CT, NG, syphilis and HSV-2 has been reported to be 4.8%, 0.8%, 1.8% and 9.6%, respectively [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Whereas among female sex workers involved in high-risk sexual behavior the prevalence of CT, NG, syphilis, HSV-2 and TV was 25.9%, 8.3%, 7.5%, 68.1% and 10.6%, respectively [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. STIs such as CT, MG, syphilis and TV cause asymptomatic disease [\u003cspan additionalcitationids=\"CR16 CR17\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Hence, it is difficult to screening and treats asymptomatic STIs, which also can induce genital inflammation and facilitate HIV transmission. Since HIV and STIs own almost the same routes of transmission and risk behaviors, we should make a strategy to control the spread of these infections combining with HIV. However, limited researches have been managed to determine the prevalence and risk factors of STI-HIV coinfection among HIV-positive participants in Yunnan, China. This study aimed to evaluate the prevalence of coinfection of STIs (syphilis, herpes progenitalis, \u003cem\u003echlamydia\u003c/em\u003e, \u003cem\u003egonorrhea\u003c/em\u003e and \u003cem\u003egenitalium\u003c/em\u003e) and the risk factors of coinfection among HIV-positive participants in Yunnan province. Our research results might be helpful to improve STIs screening and treatment services and reduce the risk of HIV acquisition and transmission.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe cross-sectional study was conducted from September 2020 to June 2021 and included ART-naive and ART HIV-Positive participants living in Yunnan, China. A total of 406 HIV-positive participants (204 cases of ART-naive group and 202 cases of ART group) were recruited. Demographic data including age, sex, nation, occupation, region, current marital status, education status, ever injected drugs, sexual orientation, number of sexual partners, condom use, HBV, HCV, blood routine, blood biochemistry, latest CD4\u003csup\u003e+\u003c/sup\u003e T cell count and ART were collected from the database of outpatient service system and questionnaire survey in Yunnan AIDS Care Center.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection and STI detection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTrained interviewers managed a face-to-face interview with each participant using a structured questionnaire. Measures included demographic characteristics, drugs use, sexual behaviors, and so on. Laboratory technicians collected approximately 5 ml of venous blood using an anticoagulant tube, which was centrifuged immediately for 15 minutes to separate the serum. Finally, participants provided a first-void urine specimen for the examination of \u003cem\u003eChlamydia trachomatis\u003c/em\u003e (CT), \u003cem\u003eNeisseria gonorrhoeae\u003c/em\u003e (NG), and \u003cem\u003eMycoplasma genitalium\u0026nbsp;\u003c/em\u003e(MG).\u003c/p\u003e\n\u003cp\u003eSerum samples were tested for\u0026nbsp;syphilis using the Treponema pallidum particle agglutination (TPPA, FUJIREBIO Inc, Japan) and the toluidine red unheated serum test (TRUST, Shanghai Rongsheng Biotech Co. Ltd, China). Active syphilis-positive individuals were defined as those who were positive for both TPPA and TRUST. Serum samples were tested for herpes simplex virus type 2 (HSV-2) immunoglobulin (IgG) antibodies using the HSV-2 IgG enzyme-linked immunoassay kit HerpesSelect 2 ELISA IgG (ACON Biotech Co. Ltd, China). First-void urine was collected from the participants for the detection of CT, NG and MG by polymerase chain reaction (PCR) using CT RNA PCR kit, NG RNA PCR kit, and MG RNA PCR kit (Shanghai Rendu Biotech Co. Ltd, China). If any test appeared positive, the participants would be notified and received treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe chi-squared test or Fisher\u0026rsquo;s exact test for categorical variables and \u003cem\u003et\u003c/em\u003e test for continuous variables were used to analyze differences of demographic characteristics and selected variables between the ART-naive group and ART group. Odds ratio (OR) and their 95% confidence intervals (CI) were calculated by using logistic regression analyses to evaluate the association between STI-HIV coinfection and its related factors with age, sex, nation, occupation, region, current marital status, education status, sexual orientation, ever injected drugs, number of sexual partners, condom use, HBV, HCV, CD4 latest and ART. All the statistics were performed by SPSS 19 software (IBM Company, New York, USA).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eCharacteristics of participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 406 HIV-infected participants agreed to participate in the study, among which, 204 cases (50.25%) were\u0026nbsp;ART-naive\u0026nbsp;participants\u0026nbsp;and 202 cases (49.75%) were ART\u0026nbsp;participants. The characteristics between\u0026nbsp;ART-naive\u0026nbsp;participants\u0026nbsp;and ART\u0026nbsp;participants were summarized in Table 1. Compared to\u0026nbsp;ART\u0026nbsp;participants,\u0026nbsp;ART-naive\u0026nbsp;participants\u0026nbsp;had a significantly higher unemployment rate (16.2% versus 4%) and were more likely to be unmarried or single (68.1% versus 51%).\u0026nbsp;A higher proportion of ever-injected drugs in ART\u0026nbsp;participants\u0026nbsp;(14.9%) than ART-naive\u0026nbsp;participants\u0026nbsp;(5.9%).\u0026nbsp;Regarding sexual behaviors, a total of 63 (30.9%) ART-naive\u0026nbsp;participants with multiple sexual partners compared to 2 (1%)\u0026nbsp;ART\u0026nbsp;participants\u0026nbsp;in the past year. The mean of sexual partners in the former were 3.2 (\u0026plusmn; 0.2) compared to the latter 1 (\u0026plusmn; 0.3).\u0026nbsp;A higher proportion of never-used condoms in ART\u0026nbsp;participants\u0026nbsp;(12.7%) than ART-naive\u0026nbsp;participants\u0026nbsp;(0%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe average count of CD4\u003csup\u003e+\u003c/sup\u003eT cells in ART-naive\u0026nbsp;participants\u0026nbsp;was\u0026nbsp;significantly lower than\u0026nbsp;ART\u0026nbsp;participants (mean: 321 cells/\u0026micro;l versus 807 cells/\u0026micro;l). Similarly, the average\u0026nbsp;count\u0026nbsp;of Total T lymphocytes was lower on\u0026nbsp;ART-naive\u0026nbsp;participants compared with\u0026nbsp;ART\u0026nbsp;participants (mean: 1464 cells/\u0026micro;l versus 1890 cells/\u0026micro;l). Therefore, CD4/CD8 also became lower on\u0026nbsp;ART-naive\u0026nbsp;participants (0.4 versus 0.9). Compared with\u0026nbsp;ART-naive\u0026nbsp;participants,\u0026nbsp;ART\u0026nbsp;participants had a higher average count of white cells, percentage of lymphocytes, lymphocyte count, platelet and triglyceride, but a lower average count of erythrocyte and trioxypurine (Fig 1). In addition, the age, sex, nation, region, education, sexual orientation and other data between ART-naive and ART groups had no statistical difference (\u003cem\u003ep\u003c/em\u003e \u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCoinfections and multiple infections in ART-naive and ART participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe prevalence of syphilis, herpes progenitalis,\u003cem\u003echlamydia\u003c/em\u003e,\u003cem\u003egonorrhea\u003c/em\u003e and \u003cem\u003egenitalium\u003c/em\u003e among the participants was 19.9% (ART-naive: 19.6% and ART: 20.3%), 33.2% (ART-naive: 29.4% and ART: 37.1%), 3.2% (ART-naive: 3.4% and ART: 3.0%), 2.0% (ART-naive: 3.4% and ART: 0.5%), 4.7% (ART-naive: 6.4% and ART: 3.0%) (Table 2). Percentage of coinfections and multiple infections in both groups was 10.8% (22/204) in ART-naive participants and 9.9% (20/202) in ART participants.\u003c/p\u003e\n\u003cp\u003eFor the ART-naive participants, the coinfection rate by decreasing order of prevalence was 54.5% (12/22) for TP-HSV-2, 9.1% (2/22) for CT-HSV-2 and 9.1% (2/22) for TP-MG-HSV-2, and 4.5% (1/22) for MG-HSV-2, TP-NG, CT-NG, MG-NG, MG-TP, and for CT-NG-MG-HSV-2. The group of ART participants had a lower diversity of STIs. Coinfections by decreasing order of prevalence were 75.0% (15/20) for TP-HSV-2, 10.0% (2/20) for MG-HSV-2, 5% (1/20) for TP-NG, TP-NG-MG and TP-MG-HSV-2 (Fig 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors associated with STI-HIV coinfection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll of the items between STI-HIV coinfection groups were included in the logistic regression model (Table 3). For all participants, logistic regression analyses revealed that females were significantly associated with STI-HIV coinfection risk (OR = 3.46, 95%CI: 1.95-6.15, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001). In further stratification analysis of ART-naive and ART groups, Female also showed consistent significant associations with STI-HIV coinfection risk (OR = 3.89, 95% CI: 1.59-9.50, \u003cem\u003ep\u003c/em\u003e = 0.003 versus OR = 4.21, 95% CI: 1.84-9.61, \u003cem\u003ep\u003c/em\u003e = 0.001).\u003c/p\u003e\n\u003cp\u003eThe identification of risk factors for each STI was determined by logistic regression model. In the logistic regression analysis, all variables were adjusted, the following variables remained in the model as risk factors: age \u0026gt; 36 years (OR = 0.33, 95% CI: 0.13-0.87, \u003cem\u003ep\u003c/em\u003e = 0.024) reduced the risk of TP-HIV coinfection. Age \u0026gt; 36 years (OR = 2.24, 95%CI: 1.20-4.20, \u003cem\u003eP\u003c/em\u003e = 0.012) and female (OR = 3.47, 95% CI: 1.95-6.16, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001) significantly increased the risk of HIV-HSV-2 coinfection. Ever injected drugs (OR = 171.00, 95%CI: 13.80-2133.40, \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.001) and female (OR = 9.60, 95%CI: 1.46-63.06, \u003cem\u003eP\u003c/em\u003e = 0.019) were much associated with CT-HIV coinfection risk. Coinfection with HBV (OR = 100.50, 95% CI: 4.70-2168.70, \u003cem\u003ep\u003c/em\u003e = 0.003) increased the risk of NG-HIV coinfection, however, received antiretroviral therapy (OR = 0.03, 95% CI: 0.001 - 0.75, \u003cem\u003ep\u003c/em\u003e = 0.032) became a protective factor of NG-HIV coinfection. We also found Homosexual or Bisexual (OR = 5.12, 95% CI: 1.13-23.26, \u003cem\u003ep\u003c/em\u003e = 0.034) was significantly associated with an increase of MG-HIV coinfection. The logistic regression analysis showed the following variables as risk factors for each STI coinfection among participants with ART-naive status: homosexual or bisexual (OR = 3.99, 95%CI:1.02-15.61, \u003cem\u003ep\u003c/em\u003e = 0.047) for TP-HIV coinfection, female (OR = 3.03, 95% CI: 1.26-7.26, \u003cem\u003ep\u003c/em\u003e = 0.013) for HIV-HSV-2 coinfection, ever-injected drugs (OR = 68.60, 95% CI: 1.60-2880.00, \u003cem\u003ep\u003c/em\u003e = 0.027) and female (OR = 22.69, 95% CI: 1.10-448.20, \u003cem\u003ep\u003c/em\u003e = 0.040) for CT-HIV coinfection, age \u0026gt; 36 years (OR = 0.05, 95% CI: 0.003-0.77, \u003cem\u003ep\u003c/em\u003e = 0.032) and coinfection with HBV (OR = 81.84, 95% CI: 5.80-1159.50, \u003cem\u003ep\u003c/em\u003e = 0.001) for NG-HIV (Fig 3).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis is the first research of STI prevalence included large amounts of new HIV-infected people and detected by blood samples and first-voided urine samples in Yunnan, China. In the present study, a rather high STI prevalence among HIV-positive individuals was confirmed, namely, 47.0% (191/406) in total,45.1% (91/204) in ART-naive\u0026nbsp;individuals\u0026nbsp;and 49.0% (99/202) in ART individuals. This prevalence is much higher than the 5.3% observed in the HIV-positive\u0026nbsp;individuals in Nepal\u0026nbsp;[19], the 11.1% detected in the women living with HIV/AIDS (WLHA) in Uganda\u0026nbsp;[20]\u0026nbsp;and the 23.5% of HIV-infected MSM in China\u0026nbsp;[21], but the prevalence was less than the 60.6% of female sex workers in Peru\u0026nbsp;[22]\u0026nbsp;and the 60.5% of HIV-infected Women in Zimbabwe\u0026nbsp;[23]. The prevalence of genital tract discomfort was 0.5% (2/406),which was rather lower than the STI prevalence. It was interesting to find that HIV-positive individuals tend to neglect or maybe hide their genital tract discomfort. However, our health policy was that no symptom means no screening, those reason may contribute to the high prevalence of STIs. In this study, We found that the overall prevalence of STIs among ART individuals was slightly higher than among ART-naive individuals, although the difference was not statistically significant. This may be associated with the high prevalence of HSV-2/HIV coinfection, 29.4% (60/204) in the ART-naive group versus 37.1% (75/202) in the ART group. In HIV-positive individuals, genital herpes tends to recurrently attack, some individuals even show asymptomatic\u0026nbsp;[24], without intervention, HSV-2 infection will be persisted, accumulated, and transmitted in the people living with HIV/AIDS. However, the ART-naive group had a higher diversity of STIs, coinfections and more sexual partners, and the prevalence of CT, NG and MG was also higher in this study, we believe that ART-naive individuals may face greater threats of STIs and keep in a more dangerous situation.\u003c/p\u003e\n\u003cp\u003eHSV-2 was the most common STI detected, with an overall prevalence of 33.2% (135/406 ) for HIV-positive individuals in this study. The prevalence of HSV-2/HIV coinfection was much higher than the 6%-13% observed in non-injecting drug users\u0026nbsp;[25], but the prevalence was less than the 48.6% of HIV-positive men who have sex with men (MSM) in\u0026nbsp;Shenyang\u0026nbsp;[26]. Active syphilis was also the familiar STI observed, with the prevalence of 11.8% (24/204) for the ART-naive group and 11.4% (23/202) for the ART group. The result is similar to the 11.3% detected in\u0026nbsp;HIV-positive MSM in Zhejiang province\u0026nbsp;[27], however, the prevalence of\u0026nbsp;active syphilis detected\u0026nbsp;in our study was lesser than the 34.3% of HIV-Positive MSM in Shenyang and 82.9% of HIV-Positive MSM in the United States\u0026nbsp;[26, 28]. HSV-2 and TP can induce genital ulceration, which plays an important role in facilitating the acquisition and transmission of HIV and other STIs.Evidence shows that 60.7% of HSV-2, 3.9% of TP could be detected in ulcer specimens, and 68% of HSV-positive participants were coinfected with HIV in South Africa\u0026nbsp;[29]. Moreover,among genital ulcer disease people, the positivity rate of HSV,TP and HIV was\u0026nbsp;38.5%,16.0% and 52.2% in\u0026nbsp;Zimbabwe\u0026nbsp;[30].\u003c/p\u003e\n\u003cp\u003eThe prevalence of CT detected in the two groups of participants (3.4% vs 3.0%) was larger than the 0.9% identified in WLHA\u0026nbsp;[20], while it was smaller than the 11.1% of MSM in Port-au-Prince\u0026nbsp;[31]. The prevalence of NG identified in our study (3.4% vs 0.5%) was lower than the 5.4% observed in WLHA\u0026nbsp;[20]\u0026nbsp;and the 7.2% of HIV-positive MSM in Birmingham\u0026nbsp;[32].\u003c/p\u003e\n\u003cp\u003eVery few researches of\u0026nbsp;\u003cem\u003eM. genitalium\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eprevalence are assessed and generally associated with specific groups of women\u0026nbsp;[33]. Our study provides the first report of MG prevalence among ART-naive individuals in Yunnan. We identified a prevalence of 6.4% (13/204) of MG infection\u0026nbsp;in ART-naive participants. This prevalence was higher than the 2.4% detected in the HIV-infected women in Brazil\u0026nbsp;[34], but the prevalence was lower than the 10.5% of\u0026nbsp;HIV-Positive women in Zimbabwean\u0026nbsp;[35]. However, more and more\u0026nbsp;evidence shows an association\u0026nbsp;between MG and HIV infection. The report shows that the\u0026nbsp;prevalence of MG was comparable to that for CT, NG and HSV among HIV-positive men and\u0026nbsp;MG infection may associate with HIV shedding in the genital tract\u0026nbsp;[35]. MG\u0026nbsp;infection\u0026nbsp;was 21.4% among HIV-infected pregnant women and\u0026nbsp;was associated with higher plasma HIV levels\u0026nbsp;[36]. This finding was notable that the prevalence of MG infection in ART-naive participants was 6.4%, which was higher than CT or NG infection in the two groups. Therefore, we need further researches to understand MG infection in the HIV-positive population in Yunnan province.\u003c/p\u003e\n\u003cp\u003eWe found that ART-naive individuals had a higher\u0026nbsp;unemployment rate, unmarried rate, more sexual partners per year and less use of condoms compared to ART individuals. Unemployment and low income make marry become impractical in China and individuals are more likely to proceed with unprotected sexual behavior for economic gains. However, ART individuals had recognized their condition and more convenient to access STI preventative information.\u0026nbsp;Our result shows that the proportion of ever-injected drugs in the ART-naive\u0026nbsp;group was lower than in another group because the sexual transmission has become the dominant route of HIV transmission, with the government\u0026apos;s strict control of drugs, intravenous drug users will be rare.\u0026nbsp;The average count of CD4\u003csup\u003e+\u003c/sup\u003e T cells,\u0026nbsp;total T lymphocytes, CD4/CD8, lymphocyte count and percentage of lymphocytes in ART-naive\u0026nbsp;participants\u0026nbsp;were\u0026nbsp;significantly\u0026nbsp;lower than\u0026nbsp;ART\u0026nbsp;participants. In China, the enrolment criteria for ART changed that individuals should receive ART once diagnosed as HIV-positive from 2015. ART can restrain the replication of HIV-1 and gradual recovery of CD4\u003csup\u003e+\u003c/sup\u003e T-cell counts\u0026nbsp;[37]. We found the significant promotion of\u0026nbsp;CD4\u003csup\u003e+\u003c/sup\u003e T cells and\u0026nbsp;lymphocytes in the\u0026nbsp;ART group. ART\u0026nbsp;participants had a higher average count of white cell, platelet and triglyceride, but a lower average count of erythrocyte and trioxypurine. Lipid abnormalities and metabolic complications associated with ART maybe can explain it\u0026nbsp;[38, 39].\u003c/p\u003e\n\u003cp\u003eOur findings revealed that females were more likely to have one of the curable STIs (CT, NG, MG, HSV-2 or active syphilis), no matter in the ART-naive group or ART group. Two variables of female and ever-injected drugs showed a significant association with CT-HIV coinfection. Similarly, females and ages \u0026gt;36 years showed association with HSV-2/HIV coinfection. Homosexual or bisexual was associated with a significantly increased MG-HIV coinfection risk. However, age between 18 to 35 years becomes a risk factor in TP-HIV or NG-HIV coinfection. Other risk factors of TP-HIV coinfection were Homosexual or bisexual and NG-HIV coinfection was HIV/HBV coinfection. Participants receiving ART were less likely to have NG-HIV coinfection compared with those not receiving ART. In conclusion, risk factors associated with sexually transmitted infections among HIV-positive individuals were female, age between 18 to 35 years, ever-injected drugs, homosexual or bisexual, HIV/HBV coinfection, and not receiving ART.\u003c/p\u003e\n\u003cp\u003eOur results on STI-HIV coinfection have important implications for improving\u0026nbsp;STIs screening and treatment services\u0026nbsp;among HIV-positive individuals. Evidence shows that many STIs were asymptomatic.The prevalence of syphilis was 13.5%, among them, 91.3% were asymptomatic among women in China. Most of the anorectal (93.3%) and urethral (79.2%) MG infections were asymptomatic among MSM in western Sydney\u0026nbsp;[15]. A Nigerian study shows that over 95% of STI cases were asymptomatic among MSM\u0026nbsp;[40]. In Yunnan, we found that some hospitals and clinics may not screen other STIs when found a new HIV-positive case, especially in resource-poor settings and rural areas, unless having obvious symptoms. Therefore, strategies to screening all HIV-positive individuals for HSV-2, syphilis, and MG, and so on would be necessary. Untreated STIs may\u0026nbsp;facilitate HIV acquisition and transmission\u0026nbsp;and reduce the effectiveness of antiviral therapy.\u003c/p\u003e\n\u003cp\u003eThere are several limitations to the research. This was a cross-sectional study and the participants were not random. Our collected information might have been compromised by recall bias and social desirability bias as sexual behavior is private information to participants.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn conclusion, we identified a high prevalence of STIs among ART-naive and ART HIV-positive individuals in Yunnan.\u0026nbsp;HSV-2, syphilis and MG were the most common STIs in HIV-positive individuals.HSV-2 infection will be recurred, persisted and accumulated that cannot be stoped by ART. The prevalence of MG was high in ART-naive participant and the further researches are needed to understand this association. We suggest strengthening STIs joint\u0026nbsp;screening and treatment services\u0026nbsp;among every HIV-positive individual whether experienced ART or not, especially in resource-poor settings and rural areas.\u0026nbsp;Females, age between 18 to 35 years, ever-injected drugs, homosexual or bisexual, HIV/HBV coinfection and not receiving ART were identified as risk factors.\u0026nbsp;Younger patients, women, ever-injected drugs, homosexual or bisexual, coinfection with HBV and not receiving ART should be a focus for interventions to decrease STIs.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the review board of Yunnan Provincial Hospital of Infectious Diseases, and written informed consent was obtained from the study participants. All experiments were performed in accordance with the approved guidelines and regulations according to the principles expressed in the Declaration of Helsinki, and the experimental protocols were approved by the institutional review board.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN/A\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe majority of datasets used and/or analyzed during the current study are available from the indicated published resources. The remaining data, including model code, are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe work was supported by the Project of AIDS Bureau of Yunnan Province, the grant from National\u0026nbsp;Natural Science Foundation of China (81860553 and 32060177), the\u0026nbsp;\u0026quot;Ten-thousand Talents Program\u0026quot; of Yunnan Province (YNWR-MY-2018-039), the\u0026nbsp;Medical Leadership Foundation of Health and Family Planning Commission of Yunnan Province, China (L-201613), Yunnan Province\u0026nbsp;Clinical Research Center for Skin Immune Diseases (2019ZF012), and Yunnan Province\u0026nbsp;Clinical Center for Skin Immune Diseases (ZX2019-03-02).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eL.L., Y.Y.L. and Y.Q.K. conceived and designed the study. W.T., R.H.X., X.Q.D. and D.Z. contributed to experiment conduction and data acquisition. W.T., Y.L.M., W.Y.Z. and Y.Q.K. analyzed and interpreted the data. W.T. and Y.Q.K. drafted the manuscript. L.L., Y.Y.L. and Y.Q.K. contributed to the critical revision of the manuscript for important intellectual content. Y.Y.L. and L.L. obtained funding. All authors read and approved the final version of the manuscript for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank all the participants in this study, the staff of Biomedical Laboratory of Dermatology in the First affiliated Hospital of Kunming Medical University\u0026nbsp;and Yunnan Provincial Infectious Disease Hospital for their assistance in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProvenance and peer review\u003c/strong\u003e\u0026nbsp; Not commissioned; externally peer reviewed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eORCID iD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWei Tu https://orcid.org/0000-0003-1795-2262\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGlobal progress report on HIV, viral hepatitis and sexually transmitted infections, 2021 [Available from: https://www.who.int/publications/i/item/9789240027077. Accessed 10 September 2021.\u003c/li\u003e\n\u003cli\u003eTorrone EA, Morrison CS, Chen PL, Kwok C, Francis SC, Hayes RJ, et al. Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. PLoS Med. 2018;15(2):e1002511.\u003c/li\u003e\n\u003cli\u003eKalichman SC, Pellowski J, Turner C Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011;87(3):183-90.\u003c/li\u003e\n\u003cli\u003eStorim J, Verheyen J, Wolff E, Wohlschlaeger J, Heintschel von Heinegg E, Schadendorf D, et al. Antiretroviral therapy suppresses rectal HIV-RNA shedding despite inflammation in MSM with rectal C. trachomatis and N. gonorrhoeae infections-a cross-sectional, single-center study. Sex Transm Infect. 2019;95(2):95-8.\u003c/li\u003e\n\u003cli\u003eWard H, Ronn M Contribution of sexually transmitted infections to the sexual transmission of HIV. Curr Opin HIV AIDS. 2010;5(4):305-10.\u003c/li\u003e\n\u003cli\u003eCrisci E, Svanberg C, Ellegard R, Khalid M, Hellblom J, Okuyama K, et al. HSV-2 Cellular Programming Enables Productive HIV Infection in Dendritic Cells. Front Immunol. 2019;10:2889.\u003c/li\u003e\n\u003cli\u003eDesai DV, Kulkarni SS Herpes Simplex Virus: The Interplay Between HSV, Host, and HIV-1. Viral Immunol. 2015;28(10):546-55.\u003c/li\u003e\n\u003cli\u003eBuchacz K, Patel P, Taylor M, Kerndt PR, Byers RH, Holmberg SD, et al. Syphilis increases HIV viral load and decreases CD4 cell counts in HIV-infected patients with new syphilis infections. AIDS. 2004;18(15):2075-9.\u003c/li\u003e\n\u003cli\u003eDuffus WA, Mermin J, Bunnell R, Byers RH, Odongo G, Ekwaru P, et al. Chronic herpes simplex virus type-2 infection and HIV viral load. Int J STD AIDS. 2005;16(11):733-5.\u003c/li\u003e\n\u003cli\u003eYap SH, Abdullah NK, McStea M, Takayama K, Chong ML, Crisci E, et al. HIV/Human herpesvirus co-infections: Impact on tryptophan-kynurenine pathway and immune reconstitution. PLoS One. 2017;12(10):e0186000.\u003c/li\u003e\n\u003cli\u003eSchiffer JT, Swan DA, Magaret A, Schacker TW, Wald A, Corey L Mathematical Modeling Predicts that Increased HSV-2 Shedding in HIV-1 Infected Persons Is Due to Poor Immunologic Control in Ganglia and Genital Mucosa. PLoS One. 2016;11(6):e0155124.\u003c/li\u003e\n\u003cli\u003eLu L, Jia M, Ma Y, Yang L, Chen Z, Ho DD, et al. The changing face of HIV in China. Nature. 2008;455(7213):609-11.\u003c/li\u003e\n\u003cli\u003eZhang G, Wong M, Yi P, Xu J, Li B, Ding G, et al. HIV-1 and STIs prevalence and risk factors of miners in mining districts of Yunnan, China. J Acquir Immune Defic Syndr. 2010;53 Suppl 1:S54-60.\u003c/li\u003e\n\u003cli\u003eWang H, Wang N, Bi A, Wang G, Ding G, Jia M, et al. Application of cumulative odds logistic model on risk factors analysis for sexually transmitted infections among female sex workers in Kaiyuan city, Yunnan province, China. Sex Transm Infect. 2009;85(4):290-5.\u003c/li\u003e\n\u003cli\u003eCouldwell DL, Jalocon D, Power M, Jeoffreys NJ, Chen SC, Lewis DA Mycoplasma genitalium: high prevalence of resistance to macrolides and frequent anorectal infection in men who have sex with men in western Sydney. Sex Transm Infect. 2018;94(6):406-10.\u003c/li\u003e\n\u003cli\u003ede Waaij DJ, Dubbink JH, Ouburg S, Peters RPH, Morre SA Prevalence of Trichomonas vaginalis infection and protozoan load in South African women: a cross-sectional study. BMJ Open. 2017;7(10):e016959.\u003c/li\u003e\n\u003cli\u003eNishijima T, Teruya K, Shibata S, Yanagawa Y, Kobayashi T, Mizushima D, et al. Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008-2015. PLoS One. 2016;11(12):e0168642.\u003c/li\u003e\n\u003cli\u003eSilva G, Motta H, Souza EFA, Cardoso P, Pilotto JH, Eyer-Silva WA, et al. Chlamydia trachomatis asymptomatic urethritis recurrence among males living with HIV-1. Rev Inst Med Trop Sao Paulo. 2018;60:e65.\u003c/li\u003e\n\u003cli\u003ePoudel KC, Poudel-Tandukar K, Palmer PH, Mizoue T, Jimba M, Kobayashi J, et al. Coinfection of Sexually Transmitted Infections among HIV-Positive Individuals: Cross-Sectional Results of a Community-Based Positive Living with HIV (POLH) Study in Nepal. J Int Assoc Provid AIDS Care. 2017;16(4):338-46.\u003c/li\u003e\n\u003cli\u003eKakaire O, Byamugisha JK, Tumwesigye NM, Gamzell-Danielsson K Prevalence and factors associated with sexually transmitted infections among HIV positive women opting for intrauterine contraception. PLoS One. 2015;10(4):e0122400.\u003c/li\u003e\n\u003cli\u003eXian Y, Zhu B, Zhang X, Ma P, Wei Y, Xia H, et al. Risk factors associated with sexually transmitted infections among HIV infected men who have sex with men. PLoS One. 2017;12(2):e0170635.\u003c/li\u003e\n\u003cli\u003eCarcamo CP, Campos PE, Garcia PJ, Hughes JP, Garnett GP, Holmes KK, et al. Prevalences of sexually transmitted infections in young adults and female sex workers in Peru: a national population-based survey. Lancet Infect Dis. 2012;12(10):765-73.\u003c/li\u003e\n\u003cli\u003eLowe S, Mudzviti T, Mandiriri A, Shamu T, Mudhokwani P, Chimbetete C, et al. Sexually transmitted infections, the silent partner in HIV-infected women in Zimbabwe. South Afr J HIV Med. 2019;20(1):849.\u003c/li\u003e\n\u003cli\u003eGarland SM, Steben M Genital herpes. Best Pract Res Clin Obstet Gynaecol. 2014;28(7):1098-110.\u003c/li\u003e\n\u003cli\u003eDes Jarlais DC, Arasteh K, Feelemyer J, McKnight C, Tross S, Perlman DC, et al. Decline in Herpes Simplex Virus Type 2 Among Non-Injecting Heroin and Cocaine Users in New York City, 2005 to 2014: Prospects for Avoiding a Resurgence of Human Immunodeficiency Virus. Sex Transm Dis. 2017;44(2):85-90.\u003c/li\u003e\n\u003cli\u003eHu QH, Xu JJ, Chu ZX, Zhang J, Yu YQ, Yu H, et al. Prevalence and Determinants of Herpes Simplex Virus Type 2 (HSV-2)/Syphilis Co-Infection and HSV-2 Mono-Infection among Human Immunodeficiency Virus Positive Men Who Have Sex with Men: a Cross-Sectional Study in Northeast China. Jpn J Infect Dis. 2017;70(3):284-9.\u003c/li\u003e\n\u003cli\u003eChen L, Yang J, Ma Q, Pan X Prevalence of Active Syphilis Infection and Risk Factors among HIV-Positive MSM in Zhejiang, China in 2015: A Cross-Sectional Study. Int J Environ Res Public Health. 2019;16(9).\u003c/li\u003e\n\u003cli\u003eDean BB, Scott M, Hart R, Battalora L, Novak RM, Durham MD, et al. Sexually Transmitted Disease Testing of Human Immunodeficiency Virus-Infected Men Who Have Sex With Men: Room for Improvement. Sex Transm Dis. 2017;44(11):678-84.\u003c/li\u003e\n\u003cli\u003eKularatne RS, Muller EE, Maseko DV, Kufa-Chakezha T, Lewis DA Trends in the relative prevalence of genital ulcer disease pathogens and association with HIV infection in Johannesburg, South Africa, 2007-2015. PLoS One. 2018;13(4):e0194125.\u003c/li\u003e\n\u003cli\u003eMungati M, Machiha A, Mugurungi O, Tshimanga M, Kilmarx PH, Nyakura J, et al. The Etiology of Genital Ulcer Disease and Coinfections With Chlamydia trachomatis and Neisseria gonorrhoeae in Zimbabwe: Results From the Zimbabwe STI Etiology Study. Sex Transm Dis. 2018;45(1):61-8.\u003c/li\u003e\n\u003cli\u003eJean Louis F, Galbaud G, Leonard M, Pericles E, Journel I, Buteau J, et al. Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis in men having sex with men in Port-au-Prince, Haiti: a cross-sectional study. BMJ Open. 2020;10(3):e033976.\u003c/li\u003e\n\u003cli\u003eFootman A, Dionne-Odom J, Aaron KJ, Raper JL, Van Der Pol B Performance of 4 Molecular Assays for Detection of Chlamydia and Gonorrhea in a Sample of Human Immunodeficiency Virus-Positive Men Who Have Sex With Men. Sex Transm Dis. 2020;47(3):158-61.\u003c/li\u003e\n\u003cli\u003eDaley GM, Russell DB, Tabrizi SN, McBride J Mycoplasma genitalium: a review. Int J STD AIDS. 2014;25(7):475-87.\u003c/li\u003e\n\u003cli\u003eRodrigues LLS, Hardick J, Nicol AF, Morgado MG, Martinelli KG, de Paula VS, et al. Sexually transmitted infections among HIV-infected and HIV-uninfected women in the Tapajos region, Amazon, Brazil: Self-collected vs. clinician-collected samples. PLoS One. 2019;14(4):e0215001.\u003c/li\u003e\n\u003cli\u003eNapierala Mavedzenge S, Muller EE, Lewis DA, Chipato T, Morrison CS, Weiss HA Mycoplasma genitalium is associated with increased genital HIV type 1 RNA in Zimbabwean women. J Infect Dis. 2015;211(9):1388-98.\u003c/li\u003e\n\u003cli\u003eRoxby AC, Yuhas K, Farquhar C, Bosire R, Mbori-Ngacha D, Richardson BA, et al. Mycoplasma genitalium infection among HIV-infected pregnant African women and implications for mother-to-child transmission of HIV. AIDS. 2019;33(14):2211-7.\u003c/li\u003e\n\u003cli\u003eYang X, Su B, Zhang X, Liu Y, Wu H, Zhang T Incomplete immune reconstitution in HIV/AIDS patients on antiretroviral therapy: Challenges of immunological non-responders. J Leukoc Biol. 2020;107(4):597-612.\u003c/li\u003e\n\u003cli\u003eLagathu C, Bereziat V, Gorwood J, Fellahi S, Bastard JP, Vigouroux C, et al. Metabolic complications affecting adipose tissue, lipid and glucose metabolism associated with HIV antiretroviral treatment. Expert Opin Drug Saf. 2019;18(9):829-40.\u003c/li\u003e\n\u003cli\u003eWaters DD, Hsue PY Lipid Abnormalities in Persons Living With HIV Infection. Can J Cardiol. 2019;35(3):249-59.\u003c/li\u003e\n\u003cli\u003eKeshinro B, Crowell TA, Nowak RG, Adebajo S, Peel S, Gaydos CA, et al. High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria. J Int AIDS Soc. 2016;19(1):21270.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003eCharacteristics of ART-naive and ART HIV\u003csup\u003e+\u003c/sup\u003e participants\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.362038664323375%\"\u003e\n \u003cp\u003e\u003cstrong\u003eART-naive (n = 204)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.010544815465728%\"\u003e\n \u003cp\u003e\u003cstrong\u003eART (n = 202)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;v\u003c/strong\u003e\u003cstrong\u003ealue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.33557046979866%\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"49.66442953020134%\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" width=\"100%\"\u003e\n \u003cp\u003eGeneral\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eAge, years, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e37 (18-86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e39.5 (23-69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003e18-35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e93 (45.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e74 (36.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003e\u0026ge;36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e111 (54.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e128 (63.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e167 (81.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e158 (78.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e37 (18.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e44 (21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.358\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eNation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eEthnic Han\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e171 (83.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e179 (88.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e33 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e23 (11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eEmployee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e121 (59.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e115 (56.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e33 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e8 (4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e50 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e79 (39.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eRegion\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eYunnan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e192 (94.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e194 (96.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eOther province\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e12 (5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e8 (4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.371\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eCurrent marital status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e65 (31.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e99 (49.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eUnmarried or single\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e139 (68.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e103 (51.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eUp to primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e120 (58.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e114 (56.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eAbove primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e84 (41.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e88 (43.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.626\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eSexual orientation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e125 (61.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e135 (66.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eHomosexual/Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e79 (38.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e67 (33.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.243\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eEver injected drugs\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e12 (5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e30 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e192 (94.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e172 (85.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eNo.of sexual partners\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e58 (28.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e53 (26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eMultiple\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e63 (30.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e2 (1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e83 (40.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e147 (72.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eCondom use\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eConsistent/Casual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e121 (59.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e79 (39.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e26 (12.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e57 (28.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e123 (60.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eGenital tract discomfort\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e2 (1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003e\u0026nbsp; No or unanswered\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e202 (99.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e202 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e0.483\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eCD4, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e273 (1-1148)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e731 (551-2200)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e28 (13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e202 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eDown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e176 (86.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eCD4/CD8, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e0.25 (0.02-3.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e0.88 (0.30-6.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e16 (7.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e135 (66.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eDown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e160 (78.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e65 (32.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003etotal T lymphocytes, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e1314 (112-5416)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e1815 (923-3840)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e111 (54.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e180 (89.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"34.27065026362039%\"\u003e\n \u003cp\u003eDown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.362038664323375%\"\u003e\n \u003cp\u003e39 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"26.010544815465728%\"\u003e\n \u003cp\u003e1 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.35676625659051%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u003cem\u003evalues were based on the chi-square test (or Fisher exact test) for categorical variables.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe statistical significance was indicated as\u0026nbsp;*p\u0026nbsp;\u0026lt;\u0026nbsp;0.05, and **p\u0026nbsp;\u0026lt;\u0026nbsp;0.001.\u003c/p\u003e\n\u003cp\u003eCreated by the authors\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003ePrevalence of Sexually Transmitted Infections among HIV\u003csup\u003e+\u0026nbsp;\u003c/sup\u003eParticipants.\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"35.265700483091784%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal (n = 406)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e\u003cstrong\u003eART-na\u0026iuml;ve (n = 204)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e\u003cstrong\u003eART (n = 202)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCase number (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCase number (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCase number (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"35.265700483091784%\"\u003e\n \u003cp\u003eSyphilis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"35.265700483091784%\"\u003e\n \u003cp\u003eTPPA +\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e81 (19.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e40 (19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e41 (20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"35.265700483091784%\"\u003e\n \u003cp\u003eTPPA + TRUST +\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e47 (11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e24 (11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e23 (11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"35.265700483091784%\"\u003e\n \u003cp\u003eHSV-2 IgG +\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e135 (33.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e60 (29.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e75 (37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"35.265700483091784%\"\u003e\n \u003cp\u003e\u003cem\u003eNeisseria gonorrhoeae\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e8 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e7 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e1 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"35.265700483091784%\"\u003e\n \u003cp\u003e\u003cem\u003eChlamydia trachomatis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e13 (3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e7 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e6 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"35.265700483091784%\"\u003e\n \u003cp\u003e\u003cem\u003eMycoplasma genitalium\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e19 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e13 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.578099838969404%\"\u003e\n \u003cp\u003e6 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.265700483091784%\"\u003e\n \u003cp\u003eSTI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.578099838969404%\"\u003e\n \u003cp\u003e191 (47.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.578099838969404%\"\u003e\n \u003cp\u003e92 (45.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.578099838969404%\"\u003e\n \u003cp\u003e99 (49.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCreated by the authors\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eLogistic regression analyses of related factors Associated with Curable STI-HIV coinfection among HIV\u003csup\u003e+\u003c/sup\u003e participants.\u003c/p\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" width=\"20.056497175141242%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" width=\"26.412429378531073%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSTI-HIV co-infection rate, (N = 406),n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" width=\"25.706214689265536%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSTI-HIV co-infection rate on ART-naive, (N = 204),n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" width=\"27.824858757062145%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSTI-HIV co-infection rate on ART,(N = 202),n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.32394366197183%\"\u003e\n \u003cp\u003e\u003cstrong\u003en/N (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.267605633802816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.507042253521126%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.443661971830986%\"\u003e\n \u003cp\u003e\u003cstrong\u003en/N (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.795774647887324%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.97887323943662%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.267605633802816%\"\u003e\n \u003cp\u003e\u003cstrong\u003en/N (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.612676056338028%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR (95%CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.80281690140845%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eAge,years\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e18-35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e72/167 (43.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e37/93 (39.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e35/74 (47.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u0026ge;36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e119/239 (49.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.24 (0.70-2.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.461\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e55/111 (49.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.12 (0.48-2.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.791\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e64/128 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e1.08 (0.45-2.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.858\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e136/325 (41.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e66/167 (39.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e70/158 (44.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e55/81 (67.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e3.46 (1.95-6.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e26/37 (70.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e3.89 (1.59-9.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e29/44 (65.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e4.21 (1.84-9.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eNation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eEthnic Han\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e168/350 (48.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e79/171 (46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e89/179 (49.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e23/56 (41.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e0.66 (0.36-1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e13/33 (39.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e0.60 (0.25-1.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e10/23 (43.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e0.61 (0.23-1.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.324\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eEmployee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e110/236 (46.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e52/121 (42.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e58/115 (50.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e21/41 (51.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.26 (0.61-2.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e16/33 (48.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.06 (0.44-2.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.896\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e5/8 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e2.70 (0.56-13.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.216\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e60/129 (46.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e0.89 (0.55-1.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.614\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e24/50 (48.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e0.94 (0.44-2.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.880\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e36/79 (45.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e1.01 (0.52-1.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.966\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eRegion\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eOther province\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e10/20 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e5/12 (41.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e5/8 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eYunnan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e181/386 (46.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.08 (0.43-2.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.864\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e87/192 (45.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.13 (0.31-4.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.853\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e94/194 (48.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e0.92 (0.21-4.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.916\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eCurrent marital status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e75/164 (45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e30/65 (46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e45/99 (45.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eUnmarried/single\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e116/242 (47.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.31 (0.79-2.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.304\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e62/139 (44.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.06 (0.49-2.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.884\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e54/103 (52.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e1.52 (0.71-3.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.278\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eUp to primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e113/234 (48.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e58/120 (48.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e55/114 (48.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eAbove primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e78/172 (45.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.13 (0.69-1.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.622\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e34/84 (40.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.03 (0.49-2.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.932\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e44/88 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e1.32 (0.64-2.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.461\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eSexual orientation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e125/260 (48.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e61/125 (48.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e64/135 (47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eHomosexual/Bisexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e66/146 (45.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.55 (0.88-2.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e31/79 (39.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.39 (0.62-3.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e35/67 (52.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e1.58 (0.67-3.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.297\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eEver injected drugs\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e168/364 (46.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e85/192 (44.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e83/172 (48.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e23/42 (54.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.40 (0.64-3.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e7/12 (58.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.19 (0.22-6.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.839\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e16/30 (53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e1.71 (0.67-4.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.265\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eNo.of sexual partners\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e53/111 (47.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e29/58 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e24/53 (45.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eMultiple\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e21/65 (32.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e0.48 (0.23-1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e19/63 (30.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e0.42 (0.18-0.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e2/2 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e117/230 (50.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.28 (0.66-2.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e44/83 (53.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.32 (0.51-3.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.567\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e73/147 (49.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e1.33 (0.48-3.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.588\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eCondom use\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eConsistent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e55/118 (46.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e18/39 (46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e37/79 (46.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eCasual/Never\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e47/108 (43.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.27 (0.63-2.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.508\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e47/108 (43.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e0.90 (0.37-2.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.815\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e89/180 (49.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e0.85 (0.45-1.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e27/57 (47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e0.49 (0.16-1.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e62/123 (50.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e1.31(0.54-3.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.545\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eCD4 count \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u0026ge;550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e112/230 (48.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e13/28 (46.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e99/202 (49.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u0026lt;550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e79/176 (44.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e0.90 (0.52-1.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.714\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e79/176 (44.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e0.93 (0.37-2.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.872\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eHBV\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e174/374 (46.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e77/182 (42.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e97/192 (50.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e17/32 (53.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.19 (0.55-2.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.654\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e15/22 (68.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e2.76 (1.00 - 7.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e2/10 (20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e0.25 (0.05-1.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.080\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\" width=\"100%\"\u003e\n \u003cp\u003eHCV\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e177/381 (46.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e82/188 (43.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e95/193 (49.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003eref\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.859154929577464%\"\u003e\n \u003cp\u003e14/25 (56.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e1.04 (0.40-2.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.605633802816901%\"\u003e\n \u003cp\u003e0.934\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.154929577464788%\"\u003e\n \u003cp\u003e10/16 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.43661971830986%\"\u003e\n \u003cp\u003e1.50 (0.33-6.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.183098591549296%\"\u003e\n \u003cp\u003e0.598\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.014084507042254%\"\u003e\n \u003cp\u003e4/9 (44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.690140845070422%\"\u003e\n \u003cp\u003e0.58 (0.12-2.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.042253521126761%\"\u003e\n \u003cp\u003e0.501\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003cp\u003eCreated by the authors\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"HIV, syphilis, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, HSV-2, risk factor","lastPublishedDoi":"10.21203/rs.3.rs-936581/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-936581/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eYunnan has the highest rates of HIV in the country. Other treatable sexually transmitted infections (STIs) are associated with accelerated HIV transmission and poor ART outcomes, but are only diagnosed by syndromic algorithms.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe recruited 406 HIV-positive participants for a cross-sectional study (204 ART-naive and 202 ART). Blood samples and first-voided urine samples were collected. Real-time polymerase chain reaction methods were used for \u003cem\u003eChlamydia trachomatis\u003c/em\u003e (CT), \u003cem\u003eNeisseria gonorrhoeae\u003c/em\u003e (NG) and \u003cem\u003eMycoplasma genitalium\u003c/em\u003e (MG). Syphilis and HSV-2 tests were also performed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong 406 participants, the overall prevalence of STI was 47.0% and 45.1% in ART-naive individuals and 49.0% in ART individuals, respectively. Testing frequency was 11.6% (11.8% vs 11.4%), 33.2% (29.4% vs 37.1%), 3.2% (3.4% vs 3.0%), 2.0% (3.4% vs 0.5%) and 4.7% (6.4% vs 3.0%) for active syphilis, HSV-2, \u003cem\u003echlamydia\u003c/em\u003e, \u003cem\u003egonorrhoeae\u003c/em\u003e and \u003cem\u003egenitalium\u003c/em\u003e. Percentage of multiple infections in both groups was 10.8% (22/204) in ART-naive participants and 9.9% (20/202) in ART participants. Females, age between 18 to 35 years, ever injected drugs, homosexual or bisexual, HIV/HBV coinfection, and not receiving ART were identified as risk factors. Self-reported asymptom was not eliminating of having a laboratory-diagnosed STI.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eSTI prevalence was 47.0% (45.1% vs 49.0%), HSV-2, syphilis and MG were the most common STIs in HIV-infected individuals. We found high prevalence (6.4%) of Mycoplasma genitalium in ART-naive individuals. ART can reduce the diversity of STI-HIV coinfection but not the prevalence. HIV-positive individuals tend to neglect or maybe hide their genital tract discomfort, thus we suggest strengthening STI joint screening and treatment services among HIV-infected individuals whether they describe genital tract discomfort or not.\u003c/p\u003e","manuscriptTitle":"High Prevalence of Sexually Transmitted Infections and Risk Factors Among HIV-Positive Individuals in Yunnan, China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-10-14 14:29:29","doi":"10.21203/rs.3.rs-936581/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2021-12-06T10:52:09+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2021-11-04T00:00:00+00:00","index":2,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2021-10-19T00:00:00+00:00","index":1,"fulltext":"Recommendation: Reviewer's comments unavailable due to the journal's policy.\n"},{"type":"editorInvitedReview","content":"","date":"2021-10-16T21:05:07+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2021-10-16T20:51:28+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2021-10-16T00:00:00+00:00","index":1,"fulltext":""},{"type":"editorAssigned","content":"","date":"2021-09-28T00:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2021-09-27T23:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2021-09-27T23:00:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Medical Research","date":"2021-09-27T20:54:59+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"53a87649-2a6d-4871-91eb-909a70b8e33c","owner":[],"postedDate":"October 14th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":7848322,"name":"Internal Medicine"}],"tags":[],"updatedAt":"2022-01-13T07:44:30+00:00","versionOfRecord":{"articleIdentity":"rs-936581","link":"https://doi.org/10.1186/s40001-022-00635-w","journal":{"identity":"european-journal-of-medical-research","isVorOnly":false,"title":"European Journal of Medical Research"},"publishedOn":"2022-01-13 07:44:30","publishedOnDateReadable":"January 13th, 2022"},"versionCreatedAt":"2021-10-14 14:29:29","video":"","vorDoi":"10.1186/s40001-022-00635-w","vorDoiUrl":"https://doi.org/10.1186/s40001-022-00635-w","workflowStages":[]},"version":"v1","identity":"rs-936581","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-936581","identity":"rs-936581","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}