Our finding that 94% of children engaged in this program are still alive and of improved health after 3 years of treatment demonstrates that China's national pediatric ART program is effective. This program needs to be expanded to better meet treatment demands, and efforts to identify HIV-positive children earlier must be prioritized.

The HIV-1 incidence in IDU in city C was stable and relatively low. In contrast, there is a high HIV-1 incidence among IDU in cities D and E. The adjusted BED-CEIA estimated incidence rates indicate clearly that interventions must be strengthened continuously in IDU, especially in two Chinese cities.

Objective: To assess the predictors and prevalence of HIV infection among injection drug users in highly endemic regions along major drug trafficking routes in three Chinese provinces. Methods:We enrolled participants using community outreach and peer referrals. uestionnaire-based interviews provided demographic, drug use, and sexual behavior information. HIV was tested via ELISA and syphilis by RPR. Results:Of the 689 participants, 51.8% were HIV-infected, with persons living in Guangxi having significantly lower prevalence (16.4%) than those from Xinjiang and Yunnan (66.8% and 67.1%, respectively). Syphilis seropositivity was noted in 5.4%. Longer duration of IDU, greater awareness of HIV transmission routes, and living in Xinjiang or Yunnan were associated with HIV seropositivity on multivariable analysis. Independent risk factors differed between sites. In Guangxi, being male and having a longer duration of IDU were independent risk factors for HIV infection; in Xinjiang, older age and sharing needles and/or syringes were independent factors; in Yunnan, more frequent drug injection, greater awareness of HIV transmission routes, and higher income were independent predictors of HIV seropositivity. Conclusion:Prevalence rates of HIV among IDUs in China are more than two out of three in some venues. Risk factors include longer duration of IDU and needle sharing. Also associated with HIV were factors that may indicate some success in education in higher risk persons, such as higher knowledge. A systemic community-level intervention with respect to evidenced-based, population-level interventions to stem the spread of HIV from IDU in China should include needle exchange, opiate agonist-based drug treatment, condom distribution along with promotion, and advocacy for community-based VCT with bridges to HIV preventive services and care.

To explore the temporal genetic variation of human immunodeficiency virus type 1 CRF07_BC and reconstruct its epidemic in Xinjiang, China, we studied 216 C2-V4 fragments of env genes sampled from 1996 to 2008. Phylogenetic analysis indicates that the viruses prevailing in Xinjiang form a large monophyletic cluster and may have originated from a common ancestor. The epidemic in Xinjiang was probably established around 1995 (95 % confidence interval, 1994-1996). We noted an increased diversity of CRF07_BC over time, with a rapid evolutionary rate we estimated to be 8.3¾10"3 substitutions per site per year in the env gene. After 5-6 years of the epidemic (1997)(1998)(1999)(2000)(2001)(2002), the transmission rate of CRF07_BC in Xinjiang slowed down, although CRF07_BC infection remained at a high prevalence.In China, the local epidemic of HIV-1 subtype B9 (Thai B) in 1989 and C in 1992 among intravenous drug users (IDUs) in Yunnan triggered the severe HIV-1 epidemic in China (Luo et al., 1995;Ma et al., 1990;Shao et al., 1994;Wu et al., 2007;Zhang et al., 2006;Zheng et al., 1994). CRF07_BC, a recombinant derived from subtypes B9 and C, was first identified among IDUs in Sichuan and Xinjiang in 1996 ( Fig. 1) (Shao et al., 1999; Su et al., 2000). HIV-1 CRF07_BC has predominated in Xinjiang for over twelve years (Shao et al., 1999; Su et al., 2000), mainly transmitted in IDUs (over 80 % The GenBank/EMBL/DDBJ accession numbers of the sequences reported in this study are FJ875724-FJ875939.Supplementary material is available with the online version of this paper. unanimously subtyped as CRF07_BC, with the assistance of corresponding gag or tat genes. The sequences from any group (sampling year) were intermingled with high genetic homology, regardless of geographical region or sampling year biases. Therefore, CRF07_BC strains may spread through ongoing local transmissions and account for the HIV-1 epidemic in Xinjiang during 1996-2008, probably as a consequence of a founder effect. The CRF07_BC strains in Xinjiang were postulated to originate from a common lineage, forming the large monophyletic cluster (Fig. 2a). Journal of General Virology(2009), 90, 1757-1761 DOI 10.1099/vir.0.009290-Bayesian methods were utilized for the inference, which allowed for the estimation of phylogeny and divergence times of CRF07_BC in Xinjiang under an uncorrelated exponential relaxed molecular clock model, using BEAST v1. 4.8 (Drummond & Rambaut, 2007). All analyses were

BackgroundTo quantify the contribution of locally implemented prevention programmes in contributing to reductions in treatment and care costs by averting HIV infections among those who inject drugs this study calculates net financial benefit of providing harm reduction programmes using information from services being implemented in Urumqi, Xinjiang Uighur Autonomous Region of China ( between 2005 and 2010).MethodsInformation was collected to assess cost of providing methadone treatment (MMT) and needle and syringe programmes (NSP). HIV incidence was estimated among people who inject drugs (PWID). HIV infections averted were calculated. Net benefit was assessed by estimating costs of providing prevention programmes and comparing these to the costs of providing care.ResultsAn estimated 5678 (range 3982–7599) HIV infections were averted between 2005 and 2010 and the net financial benefit of providing harm reduction programmes compared to treatment and care costs for HIV infections averted was USD 4.383 million during the same time period.ConclusionThese results demonstrate the net and accumulating benefit of investing in harm reduction programmes for PWID in Urumqi. The return on investment progressively increased during the time period studied and it is clear that these cost savings will continue to accrue with the continued implementation of HIV prevention interventions in the community that include harm reduction programmes targeted at PWID.