Shifting Patterns of the HIV Epidemic in Southwest China: A Case Study Based on Sentinel Surveillance, 1995-2012.
The HIV epidemic is experiencing a rapid shift in transmission profile in China. This study aims to examine the changes in magnitude, transmission pattern, and trend of the HIV epidemic in a typical Southwest Chinese prefecture over the period of 1995-2012. HIV surveillance data from the web-based reporting system were analyzed during this period. We investigated the temporal trends in the changing characteristics of HIV transmission, the HIV disease burden in key affected populations, and assessed the impacts on HIV disease progression due to scale-up of antiretroviral treatment. A total of 3556 HIV/AIDS cases were reported in Yuxi prefecture, Yunnan, over the study period. The number of HIV tests conducted has dramatically increased from 1041 in 1995 to 247,859 in 2012, resulting in a substantial increase in HIV diagnoses from 11 cases to 327 cases over the same period. Since 2005, cumulatively 1250 eligible people living with HIV (PLHIV) have received combination antiretroviral therapy which reduced AIDS disease progression from 9.0% (95% CI: 6.7-11.4%) in 1995 to 0.1% (0-0.3%) in 2012 (ptrend=0.0002). The primary mode of HIV transmission has been shifted from injection sharing (71.9% diagnoses in 1995-2004) to unsafe sexual contacts (82.6% diagnoses in 2012). Yuxi prefecture is experiencing a concentrated but shifting HIV epidemic. Scale-up of HIV testing is essential to effective sentinel surveillance and enhancing early diagnosis and treatment in PLHIV.
1Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.|2Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.|3Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|4The Kirby Institute, University of New South Wales Australia, Sydney, New South Wales, Australia.
Eric P F
EP
Chow
1Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.|5Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China.
Liangmin
L
Gao
5Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China.
Liang
L
Chen
1Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
Jun
J
Jing
1Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.|3Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|4The Kirby Institute, University of New South Wales Australia, Sydney, New South Wales, Australia.
Lei
L
Zhang
D000293:Adolescent; D017677:Age Distribution; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D058872:Epidemics; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D012111:Residence Characteristics; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D012698:Serologic Tests; D017678:Sex Distribution; D012959:Socioeconomic Factors
D019380:Anti-HIV Agents