Objectives HIV/AIDS has become the leading cause of death by infectious disease in China since 2009. However, the trend of gender disparities in HIV/AIDS has not been reported in China since 1990. Our study aimed to explore the secular trend of HIV/AIDS mortality in China from 1990 to 2016 and to identify its gender disparities over the past 27 years. Method The mortality data of HIV/AIDS were obtained from the Global Burden of Disease Study 2016 (GBD 2016). Logistic regression was used to estimate the prevalence odds ratio (POR) of gender for HIV/AIDS mortality in different surveys. Results The standardized mortality of HIV/AIDS in China rose dramatically from 0.33 per 100,000 people in 1990 to 2.50 per 100,000 people in 2016. The rate of HIV/AIDS mortality increased more quickly in men than in women, and the sex gap of mortality of HIV/AIDS widened. By 2016, the HIV/AIDS mortality in men was 3 times that in women and was 5.74 times that in women within the 75- to 79-year-old age group. Conclusions The mortality of HIV/AIDS in China is increasing, with a widening gender disparity. It is critical for policymakers to develop policies to eliminate these disparities and to ensure that everyone can live a long life in full health.

The aim of this study was to investigate the long-term trends of human immunodeficiency virus (HIV) mortality in China and its associations with age, period and birth cohort. We used HIV mortality data obtained from the Global Burden of Disease Study (GBD) 2016 and analysed the data with an ageperiod-cohort framework. Age effects indicate different risks of different outcomes at specific periods in life; period effects reflect population-wide exposure at a circumscribed point in time; and cohort effects generally reflect differences in risk across birth cohorts.Our results showed that the overall annual percentage change (net drift) of HIV mortality was 11.3% (95% CI: 11.0% to 11.6%) for males and 7.2% (95% CI: 7.0% to 7.5%) for females, and the annual percentage changes in each age group (local drift) were greater than 5% (p < 0.01 for all) in both sexes. In the same birth cohort, the risk of death from HIV increased with age in both sexes after controlling for period effects, and the risk for each fiveyear period was 1.98 for males and 1.57 for females compared to their previous life stage. Compared to the period of 2002-2006, the relative risk (RR) of HIV mortality in 2012-2016 increased by 56.1% in males and 3.7% in females, and compared to the 1955-1959 birth cohort, the cohort RRs increased markedly, by 82.9 times in males and 34.8 times in females. Considering the rapidly increasing risk of HIV mortality, Chinese policymakers should take immediate measures to target the key age group of 15-44 years in both sexes. Human immunodeficiency virus (HIV) and the consequent acquired immune deficiency syndrome (AIDS) have caused one of the worst epidemics affecting humanity since the late 20th century, leading to a substantial number of deaths 1,2. In 2018, 770,000 people died from AIDS-related diseases; the Eastern and southern Africa regions had the highest numbers of AIDS-related deaths, accounting for a combined 40.3%, followed by Asia and the Pacific region, accounting for 25.0% 3. From 2010 to 2018, the number of global AIDS-related deaths decreased by 33%; however, the HIV mortality ratio increased from 1.54 per 100,000 to 1.71 per 100,000 individuals 3. HIV/ AIDS has also become the leading infectious cause of death in many countries 4. In South Africa, from 1992 to 2013, more than 60% of deaths were attributed to HIV 5. In Russia, HIV/AIDS has been the fastest increasing cause of premature death in the past decade, with an 86.5% increase 6. HIV became the leading infectious cause of death in China in 2009, and the number of deaths due to HIV/ AIDS increased from 5,544 in 2007 to 21,234 in 2011 7,8. In addition, HIV mortality in males is much higher than that in females in China 9. An existing study showed that the HIV prevalence in China increased exponentially over the past 16 years, and HIV mortality increased from 0.0002 per 100,000 individuals in 1992 to 0.9362 per 100,000 individuals in 2016 10. However, previous studies mainly focused on the age distribution of the incidence or mortality, and period ...

We aimed to analyze the recent trends of mortality and rankings of causes of death in Chinese children and adolescents from 1953 to 2016. Methods: Data on mortality and causes of death in Chinese children and adolescents aged 5 e19 years were extracted from the China Health Statistics Yearbook and the Global Burden of Disease Study from 1953 to 2016. Mortality variations were analyzed by year, age, sex, province, and causes of death.Results: The mortality of Chinese children and adolescents aged 5e19 years declined steadily from 1953 (366.03/100,000) to 2016 (27.21), with the largest reduction in adolescents aged 15e19 years and the smallest reduction in those aged 10e14 years. Large subnational disparities for all-cause mortality existed in national 31 provinces with higher mortality in western regions compared with eastern regions, but with narrowing disparities between 1981 and 2010. Injuries dominated the causes of death compared with noncommunicable diseases and communicable, maternal and neonatal, and nutritional diseases from 1990 (58.13/100,000 vs. 32.10 and 14.31) to 2016 (22.65 vs. 13.00 and 2.93). In 2016, the leading three causes of death were road injuries (8.30/100,000), drowning (7.25), and leukemia (2.60). Drowning was the leading cause of death for 5-to 14-yearolds, but road injuries have been the leading cause for 15-to 19-year-olds of both sexes since 2010.

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