title: The proportion and trend of human immunodeficiency virus infections associated with men who have sex with men from Chinese voluntary blood donors: a systematic review and meta-analysis.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV)-positive cases associated with men who have sex with men (MSM) have rapidly increased over the past years. The objective of this study is to comprehensively evaluate the proportions, changing trends, and geographical distribution of MSM-associated HIV cases from Chinese voluntary blood donors by systematically reviewing the available literature.
  
  
  METHODS
  Major English and Chinese research databases were searched for studies reporting study locations, study years, the number of HIV infections among blood donors, and the number of HIV-positive donations associated with MSM in China. The proportion estimates were calculated; subgroup analyses and test for time trend were performed using software of comprehensive meta-analysis.
  
  
  RESULTS
  Thirty-four studies met eligibility criteria. The pooled proportion of HIV-positive donations associated with MSM from 2001 to 2012 was 36.5% (95% confidence interval, 29.6%-44.1%). The epidemic was found to be more severe in northeast and north China compared to south China (59.6%; 55.0% vs. 3.8%, respectively). The proportion showed a significantly increasing trend over the study period (10.3% in 2001-2005; 38.6% in 2006-2009; and 47.6% in 2010-2012; trend test chi-square = 16.42, p < 0.001).
  
  
  CONCLUSIONS
  The relatively high proportion of MSM- associated HIV-positive donors is of concern. Efficient and effective measures focused on public education and improving knowledge of blood safety are needed to prevent this at-risk population from seeking HIV testing through blood donation. It is also imperative to expand the scope of postdonation nucleic acid testing to shorten the window period to improve blood supply safety in China.
authors.affiliation: Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P.R. China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Jinxin
authors.initials: J
authors.lastname: Lu
authors.forename: Junjie
authors.initials: J
authors.lastname: Xu
authors.forename: Kathleen Heather
authors.initials: KH
authors.lastname: Reilly
authors.forename: Yongze
authors.initials: Y
authors.lastname: Li
authors.forename: Christiana Meng
authors.initials: CM
authors.lastname: Zhang
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Jiang
authors.forename: Wenqing
authors.initials: W
authors.lastname: Geng
authors.forename: Lunan
authors.initials: L
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Shang
mesh_terms: D000293:Adolescent; D000328:Adult; D001782:Blood Donors / Q000706:statistics & numerical data*; D058731:Blood Safety; D002681:China / Q000453:epidemiology; D003625:Data Collection; D016208:Databases, Factual; D058872:Epidemics; D062305:Geographic Mapping; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology* / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D012959:Socioeconomic Factors; D065227:Transfusion Reaction; D055815:Young Adult