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Background In the past, many data collection systems were in operation for different HIV/AIDS projects in China. We describe the creation of a unified, web-based national HIV/AIDS information system designed to streamline data collection and facilitate data use.Methods Integration of separate HIV/AIDS data systems was carried out in three phases. Phase 1, from January 2006 to December 2007, involved creating a set of unified data collection forms that took into account existing program needs and the reporting requirements of various international organizations. Phase 2, from January to October 2007, involved creating a web-based platform to host the integrated HIV/AIDS data collection system. Phase 3, from November to December 2007, involved pilot testing the new, integrated system prior to nationwide application.Results Eight web-based data collection subsystems based on one platform began operation on 1 January 2008. These eight subsystems cover: (i) HIV/AIDS case reporting; (ii) HIV testing and counselling; (iii) antiretroviral treatment (ART) for adults; (iv) ART for children; (v) behavioural interventions for high-risk groups; (vi) methadone maintenance treatment; (vii) sentinel and behavioural surveillance; and (viii) local county background information. The system provides real-time data to monitor HIV testing, prevention and treatment programs across the country.Conclusion China’s new unified, web-based HIV/AIDS information system has improved the efficiency of data collection, reporting, analysis and use, as well as data quality and security. It is a powerful tool to support policy making, program evaluation and implementation of the national HIV/AIDS program and, thus, may serve a model for other countries.

Disease-free survival time was extended with the use of HAART, but these gains were not equally distributed by sex and IDU in our cohort.

Background As China continues to commit to universal access to HIV/AIDS prevention, treatment and care services, its HIV/AIDS policies have become increasingly information driven. We review China’s key national-level HIV/AIDS policies and discuss policy gaps and challenges ahead.Methods We conducted a desk review of key national-level policies that have had a major impact on China’s HIV/AIDS epidemic, and examined recent epidemiological data relevant to China’s HIV response.Results National-level policies that have had a major impact on China’s HIV/AIDS response include: ‘Four Frees and One Care’; 5-year action plans; and HIV/AIDS regulation. These landmark policies have facilitated massive scaling up of services over the past decade. For example, the number of drug users provided with methadone maintenance treatment significantly increased from 8116 in 2005 to 241 975 in 2009; almost a 30-fold increase. The ‘Four Frees and One Care’ policy has increased the number of people living with AIDS on anti-retroviral treatment from some 100 patients in 2003 to over 80 000 in 2009. However, stigma and discrimination remains major obstacles for people living with HIV/AIDS trying to access services.Conclusions China’s current national policies are increasingly information driven and responsive to changes in the epidemic. However, gaps remain in policy implementation, and new policies are needed to meet emerging challenges.

The strategy for monitoring HIV/AIDS in China has evolved with the epidemic. The national HIV/AIDS surveillance system was established in 1985 and sentinel surveillance started in 1995. Initially, 42 sentinel sites were established to monitor the epidemic among certain high-risk groups, including drug users, female sex workers, STD clinic attendees and long-distance truck drivers in epidemic areas. In the last decade the programme has been considerably expanded. Target groups now also include pregnant women, men who have sex with men (MSM), clients of female sex workers and tuberculosis (TB) patients. By the end of 2006, 393 national and 370 provincial sites report to the National Centre for AIDS/Sexually transmitted disease Control and Prevention. In 2004, a nationwide HIV testing campaign was launched among certain high risk groups, including former plasma donors and injecting drug users. Routine testing in health care settings and detention centres was introduced in 2005. Behavioural surveillance began in 2004 and there were already 159 sites in 27 provinces by the end of 2006. In addition a number of epidemiological surveys have been undertaken among various groups to augment surveillance data. The combination of these comprehensive strategies is used to monitor the HIV/AIDS epidemic and guide policy decision-making. The Chinese experience illustrates how surveillance systems need to be dynamic in order to monitor trends in HIV over time.