Background Despite a recent upsurge of HIV/AIDS epidemic among young people in China, youth-specific HIV data were limited. Methods Altogether 56621 HIV/AIDS cases, aged 15–24, registered in the Case Reporting System of China between 2005 and 2012 and having complete spatial information were included in the present analysis. Spatial autocorrelation (general and local) and space-time scanning were performed using ArcGIS10.2 and SaTScan 9.3 software, respectively. Results During 2005–2012, the number of reported HIV/AIDS cases and proportion of HIV cases increased while proportion of AIDS cases decreased. Sexual contact evolved as the pre-dominant route of transmission in later years. Spatial analysis showed marked geographic variations of HIV infection among young people throughout China during 2005–2012. The number of new hotspots increased over years. They were mainly localized in southeast coastal areas and southwest bordering provinces or autonomous regions of Guangxi, Yunnan and Sichuan and Beijing municipality. Later these hotspots shifted towards northeastern part. Significant clusters of HIV positive cases were identified in three different time-periods, which indicated high HIV transmission among young Chinese in the recent past. The risk of HIV was highest in the first cluster (2009–2012, largest in size) covering Guizhou and Yunnan province, Chongqing municipality, Guangxi and Sichuan province. The second cluster (2010–2012) was mostly located in Shanghai, South Jiangsu, Zhejiang and South Anhui area while the third cluster (2010–2012) was in Beijing and Tianjin. Conclusions Target-specific comprehensive behavioral interventions were urgently needed to contain further spread of HIV epidemic among young people.

To assess the patterns and predictors of AIDS-related mortality and identify its correlates among adult people living with HIV/AIDS (PLWHA) in China, a retrospective record-based cohort study was conducted among 18 years or older PLWHA, who had at least one follow up reported to the national database between January-1989 and June-2012. Cumulative Incidence Function was used to calculate AIDS-related mortality rate. Gray’s test was used to determine the variation in cumulative incidence across strata. The Fine and Gray model was used to measure the burden of cumulative incidence of AIDS-related mortality and strength of its association with potential correlates. Among 375,629 patients, 107,634 died during study period, of which 54,759 (50.87%) deaths were AIDS-related. Cumulative mortality rates of AIDS-related death at one, two, five, 10 and 15 years post-diagnosis were 5.7%, 8.2%, 14.3%, 22.9% and 30.9%, respectively. Among PLWHA, male gender, ethnic minority and having AIDS were associated with significantly higher mortality. Further, homosexual transmission, being on ART and increasing CD4-testing frequency were associated with lower mortality. To reduce mortality among PLWHA, efficient interventions targeting males, ethnic minority, heterosexually infected and AIDS patients should be combined with immunologic monitoring, enhancement of coverage of HIV-testing and ART.

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