Shift in HIV/AIDS Epidemic in Southeastern China: A Longitudinal Study from 1987 to 2015

Abstract

Objective: The aim of this study was to investigate the shift in the epidemiological features of HIV/AIDS during the last three decades in Fujian Province, southeastern China, so as to provide evidence for the development of novel HIV/AIDS control strategies. Methods: Data pertaining to the conventional surveillance, sentinel surveillance and epidemiological survey in Fujian Province during the period from 1987 to 2015 were collected. The epidemiological trends were described, and the subtypes of HIV strain were genotyped. In addition, the response to antiretroviral therapy was evaluated, and HIV genotypic resistance was assayed. Results: There was an increasing trend observed in the reported cases of HIV/AIDS in Fujian Province. From 1987 to the end of 2015, a total of 8651 HIV/AIDS cases were reported across the province, with totally 1557 deaths found. Among the total cases, the ratio of male/female cases was 3.7:1, which appeared to be an increasing trend; 77.1% cases were detected in young and middle-aged populations aged 19 to 50 years, however, the new HIV infections recently tended to occur in young people aged 15 to 18 years and in populations aged 50 years and older. Among all infected individuals, 49.3% were married, however, the percentage of unmarried cases increased from 6.67% before 1994 to 40.1% in 2015; 64.8% had junior high school education or lower, however, the proportion of HIV/AIDS cases with junior college education or above gradually increased from 6.5% in 2009 to 21.4% in 2015. The reported HIV/AIDS cases were predominantly found in coastal regions; however, a rapidly increasing trend was seen in the number of HIV/AIDS cases in inland regions, and the geographical variation of the cases gradually reduced. There were multiple routes of HIV transmission found in Fujian Province, and 94.2% infections were sexually transmitted, with a large increase in the percentage of male homosexual transmission. A variety of HIV-1 subtypes were genotyped in the province during the study period, and CRF01-AE and CRF07-BC intersubtype recombinant forms were predominant; however, a declining trend in the proportion of HIV-1 CRF01-AE recombinant virus and a significant rise in the proportion of HIV-1 CRF07-BC recombinant virus were observed. Over 90% HIV inhibition was found in all cases receiving antiretroviral therapy during the period from 2011 to 2015, indicating a low prevalence of HIV drug resistance. Conclusions: An increasing trend is still observed in the HIV/AIDS epidemics in Fujian Province, southeastern China. However, the epidemiological pattern of HIV/AIDS has recently changed in the province, and effective control interventions targeting the shift in the epidemiological features of HIV/AIDS should therefore be implemented to control the spread of the epidemic.

Sample‐to‐cutoff ratios using Architect HIV Ag/Ab Combo: The influence with the results of supplemental tests and optimal cutoff value to predict HIV infection

“…Data from World Health Organization (WHO) have shown that people living with HIV (PLWH) were more than 35 million and 940 000 people died from HIV‐related causes globally in 2017 . Since the HIV/AIDS was first reported in Beijing and Zhejiang Province in 1985, the spread rate of HIV in China is alarming. Quite a few prevention policies and tremendous efforts, such as ban on imported blood products since 1985, blood donors must be tested for HIV since 1995, methadone maintenance treatment program and four free one care, have been made and performed for HIV/AIDS transmission in China.…”

Surging HIV‐1 CRF07_BC epidemic among recently infected men who have sex with men in Fujian, China

“…Moreover, CRF01_AE was the major circulating subtype (70.9%) whereas non‐CRF01_AE strains included C/CRF07_BC/CRF08_BC (5.8%), B/B′ (15.1%) and unique recombinant forms (8.1%) . By the end of 2015, there were a total of 8651 infected people reported in Fujian, indicating a 3.4‐fold increase compared to 2514 cases in 2009 . To date, however, the phylodynamics of MSM infections remains largely elusive there.…”

Shift in New HIV/AIDS Epidemic and Factors Associated with False Positives for HIV Testing: A Retrospective Study from 2013 to 2018 in Xi’an, China

“…26 In the study, the sexual contact was the most prominent route of HIV transmission in Xi'an, accounting for 88.6% of the cases, which was similar to other studies in China. [3][4][5] Recently, it is notable that the HIV/AIDS epidemic in adolescents/students and older adults is significant increase in China. 3,5,27 However, they are not usually considered as the high-risk population and are less likely to be tested for HIV.…”

“…[3][4][5] Recently, it is notable that the HIV/AIDS epidemic in adolescents/students and older adults is significant increase in China. 3,5,27 However, they are not usually considered as the high-risk population and are less likely to be tested for HIV. During the study period, the proportion of students among HIV cases increased yearly.…”

“…Since the first AIDS case was identified in 1985 in Beijing, the HIV/AIDS epidemic had reached all 31 provinces/autonomous regions/municipalities in China in 1998. [1][2][3] In China, the national prevalence is still low (less than 0.1%), 4,5 however, the epidemic varies geographically, and the newly HIV infections and AIDS cases increase annually. [6][7][8] By the end of september 2018, there were 849,602 people living with HIV (PLWH) in mainland China.…”