title: Effects of HIV status notification on reducing the risk of sexual transmission of HIV in China.
abstract: BACKGROUND
  The risk of HIV sexual transmission is much higher among people unaware of their HIV status than among those aware. Only a few studies have indicated that the incidence of unsafe sex can be reduced when people know their HIV status. This study was to investigate this effect in China.
  
  
  METHODS
  A cohort study consisting of two surveys was conducted at two different times among a group of people living with HIV/AIDS, whose status was newly diagnosed with HIV via sexual contact, in Shanghai, Chongqing, and Kunming. The first survey was conducted among 823 people tested positive for HIV before notifying them of the HIV status. The second survey was conducted among 650 HIV-positive people at six months following the first survey (after notification of HIV status). The scope of survey covered unsafe sex practices, number of unsafe sexual partners, and frequency of unsafe sexual behaviors over the prior six months. Unsafe sex is defined as unprotected anal or vaginal sex with partners who are HIV positive or whose HIV status is unknown.
  
  
  RESULTS
  The proportion of unsafe sex was reduced by about 85% after HIV status notification. The risk of HIV sexual transmission was 15 times higher among persons unaware of their HIV status than among those aware. Approximately 95% of new sexually transmitted HIV infections stemmed from 56% of the infected persons unaware of their HIV status in China.
  
  
  CONCLUSIONS
  Timely HIV status notification has the potential to significantly reduce unsafe sex among HIV-infected persons and reduce the risk for HIV transmission via unsafe sex.
authors.affiliation: School of Public Health, Central South University, Changsha, Hunan 410008, China; AIDS Healthcare Foundation (AHF), Beijing 100009, China.
authors.forename: Yugang
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Department of Sociology, Tsinghua University, Beijing 100084, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Jing
authors.affiliation: Hunan Provincial Health Information, Education and Communication Center, Changsha, Hunan 410008, China.
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Kunming Health Bureau, Kunming, Yunnan 650011, China.
authors.forename: Huasheng
authors.initials: H
authors.lastname: Li
authors.affiliation: Chongqing Centers for Disease Prevention and Control, Chongqing 400042, China.
authors.forename: Liangui
authors.initials: L
authors.lastname: Feng
authors.affiliation: Shanghai Centers for Disease Prevention and Control, Shanghai 200336, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Ning
authors.affiliation: School of Public Health, Central South University, Changsha, Hunan 410008, China. Email: tanhz99@qq.com.
authors.forename: Hongzhuan
authors.initials: H
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012749:Sexually Transmitted Diseases / Q000150:complications; D047568:Unsafe Sex; D055815:Young Adult