title: Spatial Analysis of the Human Immunodeficiency Virus Epidemic among Men Who Have Sex with Men in China, 2006-2015.
abstract: BACKGROUND
  Studies have shown a recent upsurge in human immunodeficiency virus (HIV) burden among men who have sex with men (MSM) in China, especially in urban areas. For intervention planning and resource allocation, spatial analyses of HIV/AIDS case-clusters were required to identify epidemic foci and trends among MSM in China.
  
  
  METHODS
  Information regarding MSM recorded as HIV/AIDS cases during 2006-2015 were extracted from the National Case Reporting System. Demographic trends were determined through Cochran-Armitage trend tests. Distribution of case-clusters was examined using spatial autocorrelation. Spatial-temporal scan was used to detect disease clustering. Spatial correlations between cases and socioenvironmental factors were determined by spatial regression.
  
  
  RESULTS
  Between 2006 and 2015, in China, 120 371 HIV/AIDS cases were identified among MSM. Newly identified HIV/AIDS cases among self-reported MSM increased from 487 cases in 2006 to >30 000 cases in 2015. Among those HIV/AIDS cases recorded during 2006-2015, 47.0% were 20-29 years old and 24.9% were aged 30-39 years. Based on clusters of HIV/AIDS cases identified through spatial analysis, the epidemic was concentrated among MSM in large cities. Spatial-temporal clusters contained municipalities, provincial capitals, and main cities such as Beijing, Shanghai, Chongqing, Chengdu, and Guangzhou. Spatial regression analysis showed that sociodemographic indicators such as population density, per capita gross domestic product, and number of county-level medical institutions had statistically significant positive correlations with HIV/AIDS among MSM.
  
  
  CONCLUSIONS
  Assorted spatial analyses revealed an increasingly concentrated HIV epidemic among young MSM in Chinese cities, calling for targeted health education and intensive interventions at an early age.
authors.affiliation: National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Qin
authors.affiliation: National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.affiliation: University of North Carolina Project-China, Guangzhou.|School of Medicine, University of North Carolina at Chapel Hill; and.
authors.forename: Weiming
authors.initials: W
authors.lastname: Tang
authors.affiliation: Mission Arogya Health and Information Technology Research Foundation, Kolkata, India.
authors.forename: Tanmay
authors.initials: T
authors.lastname: Mahapatra
authors.affiliation: National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
authors.forename: Liyan
authors.initials: L
authors.lastname: Wang
authors.affiliation: National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
authors.forename: Nanci
authors.initials: N
authors.lastname: Zhang
authors.affiliation: National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
authors.forename: Zhengwei
authors.initials: Z
authors.lastname: Ding
authors.affiliation: National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
authors.forename: Chang
authors.initials: C
authors.lastname: Cai
authors.affiliation: National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
authors.forename: Yan
authors.initials: Y
authors.lastname: Cui
authors.affiliation: National Center for AIDS/Sexually Transmitted Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, and.
authors.forename: Jiangping
authors.initials: J
authors.lastname: Sun
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000266:history / Q000635:transmission*; D049674:History, 21st Century; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D011159:Population Surveillance; D062206:Spatial Analysis; D062211:Spatio-Temporal Analysis; D055815:Young Adult
keywords: China.; HIV/AIDS; men who have sex with men; spatial analysis; trend