HIV prevalence in China: integration of surveillance data and a systematic review

Zhang, Lei; Chow, Eric P F; Jing, Jun; Zhuang, Xun; Li, Xiaoshan; He, Meiqi; Sun, Huamin; Li, Xiaoyan; Görgens, Marelize; Wilson, David; Wang, Lan; Guo, Wei; Li, Dongming; Cui, Yan; Wang, Lu; Wang, Ning; Wu, Zunyou

doi:10.1016/s1473-3099(13)70245-7

Cited by 245 publications

(222 citation statements)

References 39 publications

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“…79 Several HIV epidemic clusters have been described, illustrating the diversity of the epidemic. 80 Zhang et al 81 used the public health data system of the Chinese Center for Disease Control and Prevention (China CDC) to characterize trends and prevalence for HIV from all 31 provinces. At the end of 2011, 780,000 people were living with HIV/AIDS in China, with 48,000 new infections.…”

Section: Myanmarmentioning

confidence: 99%

“…In 2010, the national HIV prevalence was 9.08% in PWID and 0.36% in FSW, with low incidence in both populations (0.57% and 0.02%, respectively). 81 In contrast, HIV prevalence among Chinese MSM increased rapidly in all Chinese regions in the past decade and disproportionally affected southwest China where overlapping bisexual, commercial, and drug use behaviors are commonly observed. 82 HIV prevalence in MSM increased from 1.77% in 2000 to 5.98% in 2010, with a national incidence of 0.98% in 2010.…”

Section: Myanmarmentioning

confidence: 99%

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HIV Epidemic in Asia: Implications for HIV Vaccine and Other Prevention Trials

Phanuphak

Shao³

et al. 2015

AIDS Research and Human Retroviruses

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An overall decrease of HIV prevalence is now observed in several key Asian countries due to effective prevention programs. The decrease in HIV prevalence and incidence may further improve with the scale-up of combination prevention interventions. The implementation of future prevention trials then faces important challenges. The opportunity to identify heterosexual populations at high risk such as female sex workers may rapidly wane. With unabating HIV epidemics among men who have sex with men (MSM) and transgender (TG) populations, an effective vaccine would likely be the only option to turn the epidemic. It is more likely that efficacy trials will occur among MSM and TG because their higher HIV incidence permits smaller and less costly trials. The constantly evolving patterns of HIV-1 diversity in the region suggest close monitoring of the molecular HIV epidemic in potential target populations for HIV vaccine efficacy trials. CRF01_AE remains predominant in southeast Asian countries and MSM populations in China. This relatively steady pattern is conducive to regional efficacy trials, and as efficacy warrants, to regional licensure. While vaccines inducing nonneutralizing antibodies have promise against HIV acquisition, vaccines designed to induce broadly neutralizing antibodies and cell-mediated immune responses of greater breadth and depth in the mucosal compartments should be considered for testing in MSM and TG. The rationale and design of efficacy trials of combination prevention modalities such as HIV vaccine and preexposure prophylaxis (PrEP) remain hypothetical, require high adherence to PrEP, are more costly, and present new regulatory challenges. The prioritization of prevention interventions should be driven by the HIV epidemic and decided by the country-specific health and regulatory authorities. Modeling the impact and cost-benefit may help this decision process.

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Section: Myanmarmentioning

confidence: 99%

Section: Myanmarmentioning

confidence: 99%

HIV Epidemic in Asia: Implications for HIV Vaccine and Other Prevention Trials

Phanuphak

Shao³

et al. 2015

AIDS Research and Human Retroviruses

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“…22,30,31 The results suggest that the ability of programs to identify people with HIV will determine the impact on reducing new HIV infections. Similarly, in Vietnam, it was found that an intervention consisting of an annual offer of voluntary HTC among IDUs and immediate ART, adding to combination prevention, could potentially reduce HIV incidence from 61 per 100 000 person-years in 2010 to 6.2 per 100 000 person-years (a 90% reduction) in 10 years.…”

Section: Prevention Benefit Of Art Testing and Treatingmentioning

confidence: 99%

“…It has been estimated through mathematical modelling that quadrupling HIV testing and treatment rates could potentially avert 120 000 new HIV infections and 160 000 AIDS-related deaths in the next half decade. 30 The biggest challenge for China in the cascade is how to get people diagnosed for HIV (Table 2; Fig. 1b).…”

Section: The Chinese Approach To Art-based Preventionmentioning

confidence: 99%

Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region

Kato²,

Phanuphak

et al. 2014

Sex. Health

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Abstract. Evidence has emerged over the past few years on the effectiveness of antiretroviral-based prevention technologies to prevent (i) HIV transmission while decreasing morbidity and mortality in HIV-infected persons, and (ii) HIV acquisition in HIV-uninfected individuals through pre-exposure prophylaxis (PrEP). Only few of the planned studies on treatment as prevention (TasP) are conducted in Asia. TasP might be more feasible and effective in concentrated rather than in generalised epidemics, as resources for HIV testing and antiretroviral treatment could focus on confined and much smaller populations than in the generalised epidemics observed in sub-Saharan Africa. Several countries such as Cambodia, China, Thailand and Vietnam, are now paving the way to success. Similar challenges arise for both TasP and PrEP. However, the operational issues for PrEP are amplified by the need for frequent retesting and ensuring adherence. This paper describes challenges for the implementation of antiretroviral-based prevention and makes the case that TasP and PrEP implementation research in Asia is much needed to provide insights into the feasibility of these interventions in populations where firm evidence of 'real world' effectiveness is still lacking.

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“…It is estimated that 35.3 million people throughout the world live with HIV (1). This infection is more prevalent among certain subpopulations, such as men who have sex with men (2), sex workers (3), injection drug users (IDU), and non-injection drug users (NIDU) (4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%