Secular trends in HIV/AIDS mortality in China from 1990 to 2016: Gender disparities

Gao, Disi; Zou, Zhiyong; Dong, Bin; Zhang, Wenjing; Chen, Tianqi; Cui, Wenxin; Ma, Yong

doi:10.1371/journal.pone.0219689

Cited by 29 publications

(36 citation statements)

References 35 publications

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“…The period effect showed that the incidence of HIV/AIDS in males was consistently higher than that in females during the study period, and the rate of increase in males was signi cantly higher than in females, which is consistent with the results of other studies [33][34]. The incidence among immigrant males was the highest, rising sharply from 2008 to 2010, then leveling off from 2010 to 2012 (7-8 per 100,000 population) and rising sharply again from 2012 to 2017 (16-17 per 100,000 population).…”

Section: Discussionsupporting

confidence: 91%

Analysis on the Trend of AIDS Incidence in Zhejiang, China Based on the Age-Period-Cohort Model from 2004 to 2018

Yin

et al. 2020

Preprint

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Background: To predict the trend of acquired immune deficiency syndrome(AIDS) in specific age groups and to determine the objective population for AIDS screening, we explored the three transmission routes (homosexual transmission, heterosexual transmission, drug injection and others) and characterized each patients group using the Age-Period-Cohort(APC) model based on the whole, local and immigrant populations in Zhejiang, China.Methods: The data recruited in this paper was obtained from the national "Comprehensive AIDS Prevention and Control Information System - Antiviral Therapy Management" database and the Chinese Disease Prevention and Control Information System and the Statistical Yearbook of Zhejiang, China. An APC model was used to estimate the impact of age, period and cohort on the incidence rate of AIDS, and to predict the AIDS incidence rate in specific age groups based on sexes and transmission routes.Results: The AIDS incidence rate peaked in males between 20 and 35 years old; the incidence rate of males was higher than that of females due to the impact of period; obvious cohort effect was observed among the immigrants. In the whole and local populations, the incidence rates of males in all age groups and females in both the 35-year-old group and the whole age group were predicted to increase sharply in five years. In the immigrant population, the AIDS incidence rates of males and females in all age groups were expected to increase significantly in five years; influenced by age, the incidence of AIDS through homosexual transmission peaked between 20 and 35 years old in the whole and local populations; under the influence of period, the incidence of AIDS via homosexual transmission in the whole and local populations increased and remained stable after 2015, and the incidence of AIDS transmitted by homosexual and heterosexual routes in the immigrants also showed an increasing trend. As a result of the cohort effect, the incidence of AIDS transmitted through homosexual route among the whole and local populations peaked in 1990; the incidence of AIDS in all age groups through different transmission routes would show an upward trend over the next five years.Conclusions: The results elucidate that there are sex differences in AIDS incidence rate, and the incidence of AIDS through various transmission routes in all groups is predicted to exhibit an upward trend in the five years to come. Effective intervention strategies should be developed and implemented by the public health departments in Zhejiang to control the epidemic of AIDS.

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Section: Discussionsupporting

confidence: 91%

Analysis on the Trend of AIDS Incidence in Zhejiang, China Based on the Age-Period-Cohort Model from 2004 to 2018

Yin

et al. 2020

Preprint

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“…Previous research in China has shown multiple factors contributing to this rise in HIV/AIDS related mortality. In particular, late diagnosis, education level, socioeconomic status, and older age were also associated with AIDS-related mortality (54). Thus, earlier diagnosis and immediate ART initiation are strategies that could be strengthened to reduce this burden of HIV-related deaths.…”

Section: Hiv/aids Compared To Other Infectious Diseasesmentioning

confidence: 99%

History of the HIV Epidemic in China

Wu¹,

Jun-fang

Scott³

et al. 2019

Curr HIV/AIDS Rep

118

125

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Purpose of Review This study aims to review the history of the human immunodeficiency virus (HIV) infection epidemic in China. Recent Findings The HIV infection epidemic in China has evolved significantly over the past 35 years, from initially exclusively within people who inject drugs (PWID), to outbreaks due to plasma collection contamination in the mid-1990s, to now almost exclusive transmission via sexual contact. The number of newly-diagnosed cases and the number HIV-related deaths have increased each year since 2004, coinciding with a massive scale-up of both HIV testing and antiretroviral therapy initiation. The proportion of cases diagnosed later in their disease progression has remained constant.Summary The initial outbreaks of HIV across China were identified quickly and the overall trends have been monitored. While the HIV epidemic among PWID has been well managed, the growing HIV epidemic via sexual contact has grown more complex and even more difficult to control.

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“…Firstly, Changes of the demographic characters aggravated this issue. According to a Chinese census [23], the sex ratios of male to female at birth rose since 1990.The same concern existed in the U.S. as well. More HIV infections among males eventually lead a larger gender gap in HIV/AIDS incidence.…”

Section: Discussionmentioning

confidence: 96%

“…Nevertheless, advanced therapies on patients after HIV infection just restricted it spreading but can't eliminate the virus completely [43], uncontrollable high risk behaviors under its culture background [44] may cause HIV resurgence. At the same time, the advent of some aggressive treatment regimens accompanied with side-effects too [45]. Suffering sever side-effect pro les made potential patients hesitate to receive therapies or not and eventually resulted more new infections continued to occur.…”

Section: Discussionmentioning

confidence: 99%

Gender Disparities and Long-Term Changes of HIV/AIDS Incidence Rate in China and the U.S. From 1994-2019: Age-period-cohort Analysis

Ma¹,

Cui²,

Hu³

et al. 2020

Preprint

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Background: HIV/AIDS is a serious sexually transmitted disease with poor prognosis. So statistical data on burden of HIV/AIDS incidence and epidemic characteristics are valuable for policy making and reducing healthcare costs. This study aims to explore gender disparities of HIV/AIDS incidence and relative risks of HIV/AIDS incidence by gender and age groups in China and U.S. Methods: We extracted data from the 2019 Global Burden of Disease study and compared epidemic characteristic and gender disparities between China and U.S. Then we employed APC model to estimate age-period-cohort effect of HIV/AIDS incidence in both countries. Results: ASIR in China kept growing between 1994 and 2004 then fell to the level of mid-1990s but in U.S. ASIR increased in the past decade. There existed a huge and continuous expanding gender gap in U.S. while it came to widen in China before 2005 then shrunk during 2005-2019. APC analysis showed the age effect and period effect were consistent to the result of incidence comparison between male and female: gender disparities increased with progress of time in both countries and men had higher incidence of HIV/AIDS when they became old in China. Cohort effect indicated later birth groups bear relatively higher risks of incidence than earlier birth groups. Conclusions: large gender disparities could worsen the HIV epidemic situation. In the U.S., disparities continuously expanded meanwhile incidence of HIV/AIDS was increasing, while gap was under control in China and incidence curbed. Analyzing by APC model, besides younger age groups exposed to high risks of HIV/AIDS incidence in both countries, elder citizens in China faced higher risks which implies aging of population may lead another wave of HIV/AIDS epidemic. Therefore, both young and old age groups deserve to be noticed by police-makers and narrow gender disparities should put on agenda.

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Secular trends in HIV/AIDS mortality in China from 1990 to 2016: Gender disparities

Cited by 29 publications

References 35 publications

Analysis on the Trend of AIDS Incidence in Zhejiang, China Based on the Age-Period-Cohort Model from 2004 to 2018

Analysis on the Trend of AIDS Incidence in Zhejiang, China Based on the Age-Period-Cohort Model from 2004 to 2018

History of the HIV Epidemic in China

Gender Disparities and Long-Term Changes of HIV/AIDS Incidence Rate in China and the U.S. From 1994-2019: Age-period-cohort Analysis

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