BMJ Public Health最新文献

{"title":"Assessing the health and economic burden of obesity-related complications in East-Asian populations: implementation of risk equations in the Core Obesity Model for Japan and model validation","authors":"Ichiro Tatsuno, L. Gerlier, Anamaria-Vera Olivieri, James Baker-Knight, Mark Lamotte","doi":"10.1136/bmjph-2023-000302","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000302","url":null,"abstract":"Obesity is associated with a significant clinical and economic burden and its prevalence has reached epidemic proportions worldwide. An ethnicity-specific impact of excess weight has been demonstrated, with Asian individuals exhibiting weight-related health problems at lower body mass indexes (BMIs) than Caucasians. We aimed to adapt the core obesity model (COM) to predict incidences of weight-associated diseases, including type 2 diabetes, acute coronary syndrome (ACS), stroke, cancers, sleep apnoea, hyperuricaemia/gout, total knee replacement (TKR) and non-alcoholic fatty liver disease (NAFLD) in a Japanese population.Literature was searched to identify studies reporting the association between risk factors and comorbidities in Japanese populations. Data were extracted to update the COM risk prediction equations. Internal and external validation were performed.Overall, good internal validity was achieved, with mild underestimation for diabetes, cardiovascular and all-cause death taken together (ordinary least squares linear regression [OLS-LRL] 0.8844), moderate overestimation of TKR and cancers (OLS-LRL 1.267) and a slight underestimation for NAFLD and hyperuricaemia (OLS-LRL 0.934). External validation results were aligned with known geographical patterns: complications occurred at lower BMI in Japanese individuals, with a threefold higher incidence of diabetes and twofold higher obstructive sleep apnoea, gout prevalence and colorectal cancer at equal BMI. Conversely, the 10-year cumulative ACS incidences predicted in a Japanese population were less than half of those in a Western population.The Japanese COM adaptation addresses ethnicity-specific patterns of overweight/obesity, with better sensitivity to lower BMIs for several associated complications. It may support regional public health policy and research.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating and mapping the evidence that screening for diabetic foot disease meets the criteria for population-wide screening: a scoping review","authors":"Jennifer A. Pallin, Lauren Connell, Caroline McIntosh, Paul M. Kavanagh, S. F. Dinneen, Patricia M. Kearney, C. Buckley","doi":"10.1136/bmjph-2023-000561","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000561","url":null,"abstract":"To evaluate and map the evidence around diabetes-related foot screening using the World Health Organisation screening principles, which set the gold standard for determining the appropriateness of introducing population-wide screening programmes internationally.A scoping review methodology in line with Arksey and O’Malley and the Joanna Briggs Institute.Medline (EBSCO), Scopus, ScienceDirect and EMBASE between 24 May 2022 and 12 July 2022. Reference lists of the selected studies, and ‘Google’ and ‘Google Scholar’ were also searched.Inclusion criteria were informed by the principles of screening. Articles, published in English since 2000, reporting on the impact of the diabetes-related foot ulcers, effectiveness of treatment available for those identified as being at risk, reliability of screening tests for screening for the at-risk foot and the effectiveness, cost-effectiveness, safety and ethics of diabetes-related foot screening programmes were included.Data were extracted by one reviewer, with data extraction headings relating to the principles of screening. A narrative synthesis approach was used to report the information from included studies.46 articles were deemed eligible for inclusion. Diabetes-related foot ulcers are an important health condition associated with increased risk of mortality and poorer quality of life. However, there is insufficient evidence on the effectiveness of treatments to prevent disease development. Moreover, while consensus exists on what screening tools should be used to screen for risk factors, there is no agreement on threshold values. Finally, there is no available information on the potential budgetary, organisational or societal implications of a whole-population diabetes-related foot screening programme.Existing evidence does not support the introduction of an organised population-wide screening programme in the context of World Health Organisation screening principles. Further research on treatment and management strategies for the at-risk foot and of whole-population screening programmes is required.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Area deprivation index predicts annual chronic kidney disease screening and chronic kidney disease development among patients with newly diagnosed hypertension and type 2 diabetes in a large midwestern health system: a retrospective cohort study","authors":"Marybeth Ingle, Rasha Khatib, Yuxian Du, Vesta Valuckaite, Rakesh Singh, Sheldon X Kong, Todd E. Williamson, Sarang Baman","doi":"10.1136/bmjph-2023-000679","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000679","url":null,"abstract":"We explore how area deprivation index (ADI), a national ranking of neighbourhood sociodemographic disadvantage is associated with chronic kidney disease (CKD) screening and development among patients with newly diagnosed hypertension (HTN) or type 2 diabetes (T2DM).Patients (n=235 208) with a new HTN or T2DM diagnosis between 2015 and 2018 in a large healthcare system were followed for 3 years to evaluate CKD screening (one estimated glomerular filtration rate and urinary albumin-to-creatine ratio) and CKD development. Multivariable logistic regression models evaluated associations between ADI quintiles with CKD screening and diagnosis.Most patients were white (57%) females (55%) with HTN (65%). Few were screened in the first year after diagnosis (17%) and 9% developed CKD within 3 years. The odds of patients being screened were 54% greater (OR 1.54; 95% CI 1.48 to 1.60) and 146% greater (OR 2.46; 95% CI 2.19 to 2.76) for developing CKD for most deprived compared with the least deprived.Patients with high ADI were more likely to be screened and almost twice as likely to develop CKD compared with the least deprived. Results highlight the importance of systematic health record data collection in large healthcare systems to evaluate social factors with health outcomes.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141276321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating COVID-19 vaccine effectiveness during pre-Delta, Delta and Omicron dominant periods among pregnant people in the U.S.: Retrospective cohort analysis from a nationally sampled cohort in National COVID Collaborative Cohort (N3C)","authors":"Qiuyuan Qin, Kenneth Wilkins, Sara E Jones, K. Bradwell, Lauren E. Chan, Jing Sun, Jerrod Anzalone, Qulu Zheng, Michael Liebman, Federico Mariona, Emily A. Groene Faherty, A. Challa, Elaine Hill, Rena C Patel","doi":"10.1136/bmjph-2023-000770","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000770","url":null,"abstract":"To evaluate the effectiveness of COVID-19 vaccinations (initial and booster) during pre-Delta, Delta and Omicron dominant periods among pregnant people via (1) COVID-19 incident and severe infections among pregnant people who were vaccinated versus unvaccinated and (2) post-COVID-19 vaccination breakthrough infections and severe infections among vaccinated females who were pregnant versus non-pregnant.Retrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative, 10 December 2020 –7 June 2022.Cohort 1 included pregnant people (15–55 years) and cohort 2 included vaccinated females of reproductive age (15–55 years).(1) COVID-19 vaccination and (2) pregnancy.Adjusted HRs (aHRs) for COVID-19 incident or breakthrough infections and severe infections (ie, COVID-19 infections with related hospitalisations).In cohort 1, 301 107 pregnant people were included. Compared with unvaccinated pregnant people, the aHRs for pregnant people with initial vaccinations during pregnancy of incident COVID-19 were 0.77 (95% CI 0.62 to 0.96) and 0.88 (95% CI 0.73 to 1.07) and aHRs of severe COVID-19 infections were 0.65 (95% CI 0.47 to 0.90) and 0.79 (95% CI 0.51 to 1.21) during the Delta and Omicron periods, respectively. Compared with pregnant people with full initial vaccinations, the aHR of incident COVID-19 for pregnant people with booster vaccinations was 0.64 (95% CI 0.58 to 0.71) during the Omicron period. In cohort 2, 934 337 vaccinated people were included. Compared with vaccinated non-pregnant females, the aHRs of severe COVID-19 infections for people with initial vaccinations during pregnancy was 2.71 (95% CI 1.31 to 5.60) during the Omicron periods.Pregnant people with initial and booster vaccinations during pregnancy had a lower risk of incident and severe COVID-19 infections compared with unvaccinated pregnant people across the pandemic stages. However, vaccinated pregnant people still had a higher risk of severe infections compared with non-pregnant females.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141280648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic disparities in risk perceptions and precautionary actions against COVID-19 among the working age population aged 18–59 in Japan: a cross-sectional study","authors":"Kyoko Shimamoto, Y. Ibuka","doi":"10.1136/bmjph-2023-000181","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000181","url":null,"abstract":"Risk perceptions and precautionary actions against COVID-19 have been reported to be generally insufficient globally, and differences by subpopulation group have been concerning, as a key driver to widening health gaps. Although a body of literature examined these key constructs, critical comparative examinations of various risk perceptions and precautionary actions by socioeconomic group are still limited in Japan and Asia.This study examines subjective and objective risk perceptions and precautionary actions against COVID-19 infection among the general working age population aged 18–59 in Japan, focusing on the differences by socioeconomic group and health status. A cross-sectional survey was conducted in March 2021, using an online self-reporting questionnaire, in selected prefectures in Japan where COVID-19 infection cases ranked the highest. Participants were randomly recruited, and quota sampling methods were employed with the weighting of the sample distribution by geographic location (n=2764).Subjective and objective risk perceptions and precautionary actions were significantly related to several of the socioeconomic variables, including gender, income, employment and household composition, as well as self-reported health status. These disparities were substantial even with the key basic preventive behaviour including mask wearing, avoidance of large gatherings and hand washing. Further, these risk perceptions and precautionary actions showed unexpected relationships with socioeconomic position and health status, contrary to existing evidence or theory, particularly among younger generations and worse health populations.This evidence suggests that risk perceptions and precautionary actions do not always seem to align, and their disparities by socioeconomic group and health status have been underscored in Japan, which may suggest complex and distinct pathways by subpopulation group. Further evidence and strategies for COVID-19 and other infectious disease prevention would be critical in transitions of the infectious disease prevention and control strategy, targeting both the high-risk population group and higher risk-taking group.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141275866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does electronic data collection perform better than paper-based data collection in health research fieldwork? A participatory action research in Zanzibar","authors":"Omar Juma Othman, E. Mashayo, Jamison Jones, Kajal Shah, Christine Graham, A. Yong, Ronnie Graham, F. Omar, V. Chan","doi":"10.1136/bmjph-2023-000749","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000749","url":null,"abstract":"Technological advancement in low-resource settings is opening the gateway to implementation of electronic data collection methods that improve data quality. We examined the concerns to use electronic data collection tool in Zanzibar, codeveloped a tool that addressed the concerns and evaluated the process and limitations of incorporating an electronic data collection tool aside from paper-based during a community-based study in Zanzibar.The science of improvement Plan-Do-Study-Act model guided this mixed-method participatory action research (PAR). From November 2022 to October 2023, 14 data collection team members participated in (1) a consultative workshop with a fishbone analysis to understand their hesitance to use electronic data collection tools for fieldwork (Plan); (2) developing implementation and evaluation plan for the paper-based method (Do); (3) assessing the proportion of errors and challenges faced using paper-based method (Study); and (4) codeveloping, implementing and assessing an electronic data collection tool (Act).Stakeholders were hesitant to use electronic data collection tools because of fear of lost data due to poor internet, insufficient competency with technology due to lack of training, unfamiliarity with technology in general and fear of lost wages. The study revealed that using a paper-based data collection tool during baseline was time-consuming, with 12.8% of responses being errors (2611 errors out of 20 398 responses). However, once implemented, the electronic data collection application was fast and simple, with minimal errors (0.02%). Overall, there is a need to improve devices’ storage capacity devices and provide more training.Using the PAR approach, we understood the concerns with electronic data collection tools, allowed the team to experience the challenges faced with the paper-based collection method, codeveloped an appropriate solution and changed their attitude towards using technology that could increase accuracy and efficiency of their fieldwork.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141274475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of patient–family physician language concordance on healthcare utilisation and mortality: a retrospective cohort study of home care recipients in Ontario, Canada","authors":"Michael Reaume, Ricardo Batista, Ewa Sucha, Michael Pugliese, Rhiannon Roberts, E. Rhodes, Emily Seale, Claire E. Kendall, Lise M. Bjerre, Louise Bouchard, Sharon Johnston, Manish Sood, Denis Prud’homme, Douglas G. Manuel, P. Tanuseputro","doi":"10.1136/bmjph-2023-000762","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000762","url":null,"abstract":"As the world’s linguistic diversity continues to increase at an unprecedented rate, a growing proportion of patients will be at risk of experiencing language barriers in primary care settings. We sought to examine whether patient–family physician language concordance in a primary care setting is associated with lower rates of hospital-based healthcare utilisation and mortality.We conducted a population-based retrospective cohort study of 497 227 home care recipients living in Ontario, Canada. Patient language was obtained from home care assessments while physician language was obtained from the College of Physicians and Surgeons of Ontario. We defined primary care as language concordant when patients and their rostered family physicians shared a mutually intelligible language, and we defined all other primary care as language discordant. The primary outcomes were Emergency Department (ED) visits, hospitalisations and death within 1 year of index home care assessment.Compared with non-English, non-French speakers who received language-discordant primary care, those who received language-concordant primary care experienced fewer ED visits (53.1% vs 57.5%; p<0.01), fewer hospitalisations (35.0% vs 37.6%; p<0.01) and less mortality (14.4% vs 16.6%; p<0.01) during the study period. In multivariable regression analyses, non-English, non-French speakers had lower risks of ED visits (adjusted hazard ratio [aHR] 0.91, 95% CI 0.88 to 0.94), hospitalisations (aHR 0.94, 95% CI 0.90 to 0.98) and death (aHR 0.87, 95% CI 0.82 to 0.93) when they received language-concordant primary care. For francophones, the risk of experiencing an ED visit, a hospitalisation or death was not impacted by the language of their family physician.Patient–family physician language concordance is associated with a lower risk of adverse outcomes in non-English and non-French speakers. Optimising the delivery of language-concordant care could potentially result in significant decreases in the use of acute healthcare services and mortality at the population level.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141275750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to needlestick injury among healthcare support staff in Greater Accra, Ghana: a cross-sectional study","authors":"Philip Apraku Tawiah, Emmanuel Appiah-Brempong, Paul Okyere, Mary Eyram Ashinyo","doi":"10.1136/bmjph-2023-000681","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000681","url":null,"abstract":"This study aims to determine the prevalence and predisposing factors of a needlestick injury (NSI) among healthcare support staff in the Greater Accra region, Ghana.An analytical cross-sectional survey was carried out from 30 January 2023 to 31 May 2023, involving 10 major health facilities. A multistage sampling method was adopted. The data analyses were performed using STATA V.15 software. χ2, Fisher’s exact and Mann-Whitney U tests were used to identify the preliminary association between the outcome variables and predisposing factors. Log-binomial regression analyses were used to confirm factors associated with NSI at a significance level of p<0.05.The study was conducted among 149 healthcare support staff. The 1-year exposure to NSI was 68 (45.6%) (95% CI (37.5% to 54.0%)). Being a healthcare assistant (APR=2.81 (95% CI 1.85 to 4.25)), being married (APR=0.39 (95% CI 0.25 to 0.63)), being a supervisor (APR=0.34 (95% CI 0.20 to 0.57)), had training on standard precaution (APR=0.27 (95% CI 0.14 to 0.57)) and non-existence of needlestick reporting system (APR=0.46 (95% CI 0.29 to 0.74)) were significantly associated with NSI.The prevalence of NSI was high compared with other regional studies, and the risk factors were related to sociodemographic, behavioural and organisational factors. The study recommends guidelines that are geared towards NSI exposure among healthcare support staff.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141036399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compliance status of tobacco control laws in the university setting of Bangladesh: an analytical study followed a mixed-method approach","authors":"N. Akter, B. Banu, S. Chowdhury, T. T. Tabassum, S. Hossain","doi":"10.1136/bmjph-2023-000496","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000496","url":null,"abstract":"Implementation of National Tobacco Control Laws (NTCLs) in university settings was found to be worse in Bangladesh.This study aimed to depict the compliance status of tobacco control laws (TCLs) and the associated factors following the university setting approach in Bangladesh.This cross-sectional study was conducted with a mixed-method approach among the 385 students (quantitative method), 10 teachers and 10 administrative staff (qualitative method) of Northern University Bangladesh. Data were collected through mobile phone calling (quantitative) and in-depth interviews method (qualitative). Appropriate ethical issues were addressed. Logistic regression analysis was performed to find out the determinants. The study revealed non-satisfactory compliance with TCLs among 56.4% of study subjects which was strongly supported by the outcome of the qualitative approach. Predominant non-satisfactory compliance was found through the explorations of the conditions of buying and selling tobacco (78.4%), pasting no-smoking signage (3.2%), antitobacco advertisement within the university (34.8%) and specific university policy to implement NTCL. Non-satisfactory compliance was found significant among the younger aged (≤21 years: COR/p=2.74/0.01; 95% CI 1.27 to 5.92) from the first-year group (adjusted odds ratio (AOR)/p=2.28/0.02; 95% CI 1.15 to 4.49) who had moderate nicotine dependency (AOR/p=4.04/0.01; 95% CI 1.28 to 12.74), poor knowledge on TCLs (AOR/p=3.57/0.02; 95% CI 1.28 to 9.95) and the respondents who suggested family guidance (AOR/p=1.77/0.06; 95% CI 0.97 to 3.22) might be a sustainable way to minimise tobacco consumption in the university setting.The study revealed some crucial factors for the non-satisfactory compliance status towards TCLs in the university setting. This empirical outcome and evaluation strategy can guide to plan of future large-scale studies, which may lead to implementing effective intervention programmes focusing on the development of a tobacco-free environment in the university setting.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141044640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homosexual identity and network overlap predictors of HIV infection among older men from rural China: a case–control study","authors":"Yi Yang, Yuan Li, Shuangfeng Fan, Jia He, Jing Xi, S. He","doi":"10.1136/bmjph-2023-000781","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000781","url":null,"abstract":"The number of newly reported older (≥50 years old) people living with HIV/AIDS in China has been steadily increasing, and heterosexual transmission has been identified as the major route.In this study, based on biopsychosocial model, a case–control study (74 cases vs 296 controls) was applied to find out predictors (21 potential ones) of HIV infection among older men from rural China. Binary logistic regression with backward selection was applied.Out of 21 potential predictors of HIV infection, 4 were confirmed: receiving HIV-related health education (HRHE) (OR 0.449, 95% CI 0.238 to 0.848), self-reported homosexual identity (16.517 (95% CI 1.073 to 254.182)), visiting female sex workers (FSW) (58.427 (95% CI 7.895 to 432.403)), complete non-overlap of intimate social network and sexual network (2.912 (95% CI 1.372 to 6.177)), partial overlap (3.334 (95% CI 1.536 to 7.236)).Findings from this study suggest current comprehensive prevention and control services need to be strengthened to provide effective HRHE including condom use to older men and help them to improve condom use, especially during visiting FSW and among self-reported homosexual older men. Moreover, increasing intimacy in their sexual relationships is necessary.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}