title: Emerging disparity in HIV/AIDS disease progression and mortality for men who have sex with men, Jiangsu Province, China.
abstract: Few data exist on HIV disease progression and antiretroviral treatment (ART) impact among men who have sex with men (MSM) in China. Using data from the national case reporting system from 2004 to 2010, we describe changes in CD4 cell count before and after ART initiation, disease progression, and mortality among MSM in Jiangsu province compared with other persons living with HIV/AIDS. Median CD4 cell count among MSM at HIV diagnosis was 432 and decreased rapidly in 12 months to below the level of heterosexuals (slope: MSM -38.0, heterosexuals -15.5, injection drug users [IDU] -8.0, blood donors -10.5). Among those initiating ART, median CD4 cell count among MSM was 157, yet the increase in count was slower than for other groups (slope: MSM 26.9, heterosexuals 31.9, IDU 29.0, blood donors 35.0). Progression to AIDS was faster among MSM than heterosexuals and IDU. For the present, the mortality rate was lower for MSM compared with heterosexuals and blood donors; however, against a backdrop of more recent infection (ie, MSM had younger age, and 93.8 % were diagnosed after 2008), findings suggest a survival rate for MSM that will fall behind other groups. Improved medical and psychosocial supportive care is needed for this stigmatized population lest disparities become greater.
authors.affiliation: Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, China.
authors.forename: Hongjing
authors.initials: H
authors.lastname: Yan
authors.forename: Haitao
authors.initials: H
authors.lastname: Yang
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
authors.forename: Chongyi
authors.initials: C
authors.lastname: Wei
authors.forename: Jinshui
authors.initials: J
authors.lastname: Xu
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Liu
authors.forename: Xiaoqin
authors.initials: X
authors.lastname: Xu
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
mesh_terms: D000704:Analysis of Variance; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002681:China / Q000453:epidemiology; D018450:Disease Progression; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D054624:Health Status Disparities; D054625:Healthcare Disparities; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents