Lin Pang

Bio: Lin Pang is an academic researcher from Chinese Center for Disease Control and Prevention. The author has contributed to research in topics: Methadone maintenance & Population. The author has an hindex of 13, co-authored 28 publications receiving 710 citations. Previous affiliations of Lin Pang include Centers for Disease Control and Prevention.

HIV and syphilis prevalence among men who have sex with men: a cross-sectional survey of 61 cities in China

Abstract: Background. Human immunodeficiency virus (HIV) has rapidly spread among men who have sex with men (MSM) in China in recent years; the magnitude of the epidemic is unclear. We sought to test 3 hypotheses: (1) The prevalence of both HIV and syphilis among MSM in China is high, (2) the 2 epidemics each have unique geographical distributions, and (3) demographic and sexual behavior characteristics are different among segments of the MSM population in China. Methods. A total of 47 231 MSM from 61 cities in China participated in a cross-sectional survey conducted from February 2008 to September 2009. Demographic and behavioral data were collected and analyzed and blood samples tested for HIV and syphilis. Three subgroups among the broader MSM sample were described. Main outcome measures were HIV and syphilis prevalence. Results. An overall prevalence of 4.9% (2314/47 231; 95% confidence interval [CI], 4.7%–5.1%) for HIV and 11.8% (5552/47 231; 95% CI, 11.5%–12.0%) for syphilis was found. Syphilis-positive MSM had the highest HIV prevalence, 12.5% (693/5552; 95% CI, 11.6%–13.4%). However, correlations between HIV and syphilis prevalence were found in only 3 of 6 geographical regions (Northwest: r = 0.82, P = .0253; East: r = 0.78, P = .0004; and South-central: r = 0.63, P = .0276). Three subgroups—nonlocal MSM, Internet-using MSM, and female-partnering MSM—were found to have different profiles of characteristics and behaviors. Conclusions. HIV and syphilis prevalences among MSM in China are high and the 2 epidemics are largely separate geographically. Three segments of the Chinese MSM population each have different demographic and sexual risk “profiles” that suggest high potential for bridging infection across geographies, generations, and sexes.

Effectiveness of first eight methadone maintenance treatment clinics in China

Abstract: Objective: To evaluate the effectiveness of the first phase of eight methadone maintenance treatment (MMT) clinics in China. Design: Repeated cross-sectional surveys. Methods: Three surveys of clients attending the first phase of eight MMT clinics were carried out at entry, and 6 and 12 months after enrolment. Drug using behaviours, drugrelated criminal activity, and relationships with families were compared for the three periods. Blood specimen were collected and tested for HIV for each client at entry, and HIV-negative clients were re-tested after 12 months. Results: A total of 585, 609 and 468 clients participated in the first, second and third surveys,respectively. The proportion of clients who injecteddrugs reduced from 69.1to 8.9 and 8.8%, and the frequency of injection in the past month had reduced from 90 times per month to twice per month, employment increased from 22.9 to 43.2 and 40.6%, and self-reported criminal behaviours reduced from 20.7 to 3.6 and 3.8% in the three surveys. By the third survey, 65.8% of clients reported a harmonious relationship with families, an increase from 46.8% at entry, and 95.9% of clients were satisfied with MMT services. Eight HIV seroconversions were found among 1153 clients during 12 months. Conclusion: The study demonstrated that the first phase MMT contributed to a reduction in drug use, drug injecting behaviours, drug-related criminal behaviours, HIV infections, and improved relationships within families among heroin users who participated in the MMT programme. MMT needs to be scaled up nationwide rapidly with improved services. 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins

Factors associated with depression and anxiety among patients attending community-based methadone maintenance treatment in China

Abstract: Aim To estimate the prevalence of, and identify factors associated with, depression and anxiety among community-based methadone maintenance treatment (MMT) clients in China. Design A cross-sectional survey. Setting Nine MMT clinics, three each from three Chinese provinces (Yunnan, Anhui and Jiangsu) between October 2008 and February 2009. Participants A total of 1301 MMT clients. Measurements A questionnaire, including the Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS), and on-site urine drug testing. Findings The prevalence of depression (SDS score ≥ 53) and anxiety (SAS score ≥ 50) in our sample was 38.3% [95% confidence interval (CI) = 35.7, 40.9] and 18.4% (95% CI = 16.3, 20.5), respectively, with 14.2% (95% CI = 12.3, 16.1) displaying symptoms of both. Sample prevalence rates for depression [mean = 49.69, standard deviation (SD) = 10.34] and anxiety (mean = 40.98, SD = 10.66) were higher than the national average for each (t(0.05/2, 1300) = 19.2, P < 0.001 and t(0.05/2, 1300) = 8.0, P < 0.001, respectively). Employing multi-level modelling techniques, gender (P = 0.03) and employment status (P < 0.001) were found to be associated significantly with depression in a single-level model; however, in a multi-level mixed model, only employment status (P < 0.001) was associated with depression. Gender (P = 0.03), education level (P = 0.02), marital status (P = 0.04), employment status (P < 0.001), positive urine drug test results (P = 0.02) and daily methadone dose (P < 0.001) were found to be associated significantly with anxiety in a single-level model, while only employment status (P < 0.01) and positive results for the urine drug test (P = 0.04) were associated with anxiety in a multi-level mixed model. Conclusions A considerable proportion of methadone maintenance treatment clients in China have experienced depression and anxiety during treatment. There is a need to provide tailored mental health interventions for this high-risk population.

The increase in global HIV epidemics in MSM.

Abstract: Epidemics of HIV in MSM continue to expand in most low, middle, and upper income countries in 2013 and rates of new infection have been consistently high among young MSM. Current prevention and treatment strategies are insufficient for this next wave of HIV spread. We conducted a series of comprehensive reviews of HIV prevalence and incidence, risks for HIV, prevention and care, stigma and discrimination, and policy and advocacy options. The high per act transmission probability of receptive anal intercourse, sex role versatility among MSM, network level effects, and social and structural determinants play central roles in disproportionate disease burdens. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiologic data show marked clustering of HIV in MSM networks, and high proportions of infections due to transmission from recent infections. Prevention strategies that lower biological risks, including those using antiretrovirals, offer promise for epidemic control, but are limited by structural factors including, discrimination, criminalization, and barriers to healthcare. Subepidemics, including among racial and ethnic minority MSM in the United States and UK, are particularly severe and will require culturally tailored efforts. For the promise of new and combined bio-behavioral interventions to be realized, clinically competent healthcare is necessary and community leadership, engagement, and empowerment are likely to be key. Addressing the expanding epidemics of HIV in MSM will require continued research, increased resources, political will, policy change, structural reform, community engagement, and strategic planning and programming, but it can and must be done.

The global epidemic of HIV infection among men who have sex with men

Abstract: Purpose of review In the last few years, there have been reports of new, newly identified and resurging epidemics of HIV infection among men who have sex with men (MSM). This article reviews and summarizes the global epidemic of HIV infection among MSM. Recent findings In the Western world, the increase in notifications of new HIV infections among MSM is continuing. Steep increases in reports of new HIV diagnoses among MSM were also seen in the developed economies of East Asia. In the developing world, epidemiologic studies have now established the presence of MSM populations in Africa, China and Russia and a high HIV prevalence among them. High and increasing HIV prevalence was also reported from South and Southeast Asia, and Latin America and the Caribbean. Summary

Oral substitution treatment of injecting opioid users for prevention of HIV infection

Abstract: Injecting drug users are vulnerable to infection with HIV and other blood borne viruses as a result of collective use of injecting equipment as well as sexual behaviour. This review looks at original studies that reported the frequency or prevalence of risk behaviours, or information on HIV infection related to substitution treatment of opioid dependence to assess the extent to which oral substitution treatment prevents the transmission of HIV infection. It was not possible to accurately estimate the extent of reduction, but it is clear that oral substitution treatment reduces risk behaviours and also the probability of HIV infection amongst injecting drug users in substitution treatment. [Click on link above for Cochrane review]