title: High HIV prevalence and risk of infection among rural-to-urban migrants in various migration stages in China: a systematic review and meta-analysis.
abstract: BACKGROUND
  Rural-to-urban migrants represent 17% of the total Chinese population and are considered a potential high-risk bridging population of HIV infection between urban and rural China.
  
  
  METHODS
  Based on a systematic review and meta-analysis, this study determined HIV prevalence among rural-to-urban migrants in different stages of migration. This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
  
  
  RESULTS
  We identified 54 studies reporting 59 HIV prevalence levels among rural-to-urban migrants in China. Overall, 53.4% (95% confidence interval, 33.5%-72.4%) of urban patients with HIV have migratory background. The floating-out population showed a higher HIV prevalence (0.15% [0.06%-0.34%]) than did the Chinese population (0.057%; odds ratio, 2.63 [1.35-5.14]). The floating-in population showed a higher HIV prevalence (0.38% [0.29%-0.50%]), corresponding to 6.70 (6.05-7.41) times greater odds of HIV infection. Higher prevalence levels were observed among female migrants (0.69% [0.51%-0.93%]), reflecting a much higher odds of HIV infection (12.18 [11.11-13.35]). Infection risk among returning migrants (0.18% [0.12%-0.29%]) was 3.16 (2.06-4.84) times higher than the overall Chinese population. Chinese internal migrants contribute to a substantial amount of the overall HIV epidemic in China.
  
  
  CONCLUSIONS
  Migrants are at greater risk for HIV infection than the general Chinese population and likely to facilitate the geographical spread of HIV in China. Targeted strategies for health promotion and HIV prevention for migrants in China should be developed.
authors: Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia. lzhang@kirby.unsw.edu.au
authors: Lei
authors: L
authors: Zhang
authors: Eric P F
authors: EP
authors: Chow
authors: Heiko J
authors: HJ
authors: Jahn
authors: Alexander
authors: A
authors: Kraemer
authors: David P
authors: DP
authors: Wilson
mesh_terms: D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data