Characterizing the HIV/AIDS Epidemic in the United States and China

Huang, Ming-Bo; Li, Ye; Liang, Bingyu; Ning, Chuanyi; Roth, William; Jiang, Junjun; Huang, Jiegang; Zhou, Bo; Zang, Ning; Powell, Michael D.; Liang, Hao; Bond, Vincent C.

doi:10.3390/ijerph13010030

Cited by 79 publications

(68 citation statements)

References 3 publications

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“…Our figure of 14.8% (95% CI 10.4 to 19.8) is statistically consistent with the pooled estimate of 17.7% for HIV prevalence among transgender women in low-to middleincome countries [1]. The prevalence is notably higher than that of most other key populations at risk for HIV in China [10][11][12][13][14], with rare exceptions in the southwest region of the country [13]. Moreover only three-fourths of transgender women testing positive in our study knew their HIV statusa level that falls well below the UNAIDS target of 90% awareness [19].…”

Section: Discussionsupporting

confidence: 88%

High HIV prevalence and associated risk factors among transgender women in China: a cross‐sectional survey

et al. 2019

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Introduction Transgender women may face the highest prevalence of HIV of any population, experiencing a disproportionate burden of disease frequently confirmed in surveys throughout the developing and developed world. However, few studies have been conducted specifically for transgender women in China. This study aimed to measure HIV prevalence and explore risk factors for infection in a diverse sample of Chinese transgender women to help advocate for prevention and care interventions for this population. Methods From July 2018 to May 2019, we adapted a respondent‐driven sampling (RDS) approach to recruit a diverse sample of 250 transgender women through chains of peer referrals in two cities of eastern China, Nanjing and Suzhou. Eligible participants (i.e. 18 years of age or older, living in Jiangsu province and assigned male sex at birth but currently self‐identified as a gender different from male) completed a self‐administered questionnaire on a mobile phone to collect demographic characteristics and risk behaviours and underwent HIV testing. Results and discussion The survey sample was young (82% under age 35 years), with 28.8% having a university degree, 39.2% reporting work at entertainment venues, 47.6% ever having taken hormones and 6.4% being diagnosed with an STI in the last year. One in five (20.8%) reported having engaged in sex work. HIV prevalence was 14.8% (95% CI 10.6 to 19.8), with 75.6% of those testing HIV positive reporting they were already aware of their serostatus. In multivariate analysis, HIV prevalence was significantly higher among transgender women above the age of 24 years, those who work at entertainment venues, who never have taken hormones, and who had been diagnosed with an STI in the last year. Conclusions The prevalence of HIV among transgender women in our study, at 14.8%, is among the highest detected in any population in eastern China. Chinese transgender women may therefore follow the disparity in the burden of HIV noted worldwide. Data support policies to prioritize transgender women for HIV testing outreach, for in‐depth research to better understand the specific drivers of infection in this population, and for trans‐friendly HIV care and prevention programmes to address their specific needs.

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Section: Discussionsupporting

confidence: 88%

High HIV prevalence and associated risk factors among transgender women in China: a cross‐sectional survey

et al. 2019

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“…The Guangxi Zhuang Autonomous Region, located on the southern coast of China, has high prevalence of HIV type 1 in China Consistent with changes in pattern in China , sexual transmission has now become the dominant route of new HIV infections in Guangxi; in particular, the number of HIV‐1‐infected MSM has been increasing rapidly . The risk of sexual transmission of HIV is correlated with the amount of virus in blood and semen .…”

mentioning

confidence: 98%

After 18 months of antiretroviral therapy, total HIV DNA decreases more pronouncedly in patients infected by CRF01_AE than in those infected by subtype B and CRF07_BC

Jiao

et al. 2018

Microbiology and Immunology

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Whether the amount of HIV DNA is associated with the subtype of HIV-1 after antiretroviral therapy (ART) has not been reported. In the present study, the amount of HIV DNA and RNA and CD4+T counts in blood and semen prior to and after 18 months of ART were compared in 48 patients infected by CRF01_AE, subtype B or CRF07_BC of HIV-1. Viral RNA was suppressed and CD4 cell count recovery achieved in all patients. The level of HIV DNA were similar before ART; however, patients with CRF01_AE had less HIV DNA after ART than those with subtype B and CRF07_BC infection. According to prediction of co-receptor usage by Geno2Pheno and PSSM in combination, more than 35.6% of clones for CRF01_AE were predicted as CXCR4-using before ART, whereas less than 6% of those for subtype B and CRF07_BC were predicted as CXCR4-using. After 18 months of ART, no CXCR4-using clones were predicted in any of the subtypes. Despite more HIV RNA and fewer CD4 + T cells in patients with CRF01_AE before therapy, no significant differences (P > 0.05) in viral RNA or CD4 cell counts were observed between the subtypes after 18 months of ART. Thus, 18 months of antiretroviral therapy was more efficient in patients with CRF01_AE. Considering that successful ART dramatically reduces the viral load in both blood and semen, risks of sexual transmission of HIV were reduced, contributing to prevention of rapid spread of HIV among men who have sex with men in the region.

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“…Although great efforts have been made by Chinese government over the last three decades, HIV and AIDS remains an important public health concern in China [1, 2]. In 2014, more than half a million people living with HIV and 0.2 million AIDS cases were reported, and there were more than 0.1 million new HIV infections [3]. Since the first AIDS case was reported in early 1980's, China had initiated a set of measures to combat this emerging health problem.…”

Section: Introductionmentioning

confidence: 99%

Changing epidemiological patterns of HIV and AIDS in China in the post-SARS era identified by the nationwide surveillance system

et al. 2018

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BackgroundChina has made substantial progress in tackling its HIV and AIDS epidemic. But the changing patterns of HIV and AIDS incidence based on the longitudinal observation data were rarely studied.MethodsThe reporting incidence (RI) and mortality data on HIV and AIDS in China covering 31 provinces from 2004 to 2014 were collected from the Chinese Public Health Science Data Center. To decompose the time-series data, Empirical Mode Decomposition (EMD) was applied to properly describe the trends of HIV and AIDS incidence. A mathematical model was used to estimate the relative change of incidence among provinces and age groups.ResultsA total of 483,010 newly HIV infections and 214,205 AIDS cases were reported between 2004 and 2014 nationwide. HIV infection increased from 13,258 in 2004 (RI 1.02 per 100,000 person years) to 74,048 in 2014 (RI 5.46 per 100,000). The number of AIDS cases increased from 3054 in 2004 (RI 0.23 per 100,000) to 45,145 in 2014 (RI 3.33 per 100,000). The overall relative changes for HIV infection and AIDS incidence were 1.11 (95% confidence interval [CI] 1.10–1.13) and 1.28 (95% CI 1.23–1.33), respectively. The relative increase for HIV and AIDS RI was higher in northwest provinces while lower in Henan, Xinjiang, Guangxi and Yunnan. The overall relative changes for HIV infection were 1.12 (95% CI 1.11–1.14) in males and 1.10 (95% CI 1.06–1.13) in females. For AIDS RI, the relative increases were 1.31 (95% CI 1.26–1.36) in males and 1.22 (95% CI 1.17–1.28) in females. The lowest relative increase was detected among young adults, while the largest relative increase (odds ratio [OR] > 1.30) was detected in people aged 55 years or above.ConclusionsHIV and AIDS showed an increasing trend in China from 2004 to 2014, respectively, but the epidemic tended to be under control among provinces and young people that used to have a high HIV and AIDS incidence. Northwest China and older people could be new “hop-spots” for HIV and AIDS risk.

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Characterizing the HIV/AIDS Epidemic in the United States and China

Cited by 79 publications

References 3 publications

High HIV prevalence and associated risk factors among transgender women in China: a cross‐sectional survey

High HIV prevalence and associated risk factors among transgender women in China: a cross‐sectional survey

After 18 months of antiretroviral therapy, total HIV DNA decreases more pronouncedly in patients infected by CRF01_AE than in those infected by subtype B and CRF07_BC

Changing epidemiological patterns of HIV and AIDS in China in the post-SARS era identified by the nationwide surveillance system

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