Research Progress in the Epidemiology of HIV/AIDS in China

Abstract

After thirty-two years since the first domestic outbreak of human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) among injection drug users (IDUs) and almost two decades of comprehensive response efforts by the Chinese government, HIV/AIDS remains a major public health problem. The increasing burden of HIV/AIDS and comorbidities, the emergence of new HIV subtypes and/or circulating recombinant forms and drug mutations, the changing transmission networks, and the urgency of immediate antiretroviral therapy initiation upon an HIV diagnosis are increasingly challenging and altogether likely to have significant impact on the HIV epidemic in China. Upon the call for the global AIDS response to end AIDS by 2030, China needs to develop an innovative and pragmatic roadmap to address these challenges. This review is intended to provide a succinct overview of what China has done in efforts to achieve the global goal of ending AIDS by 2030 and the recently proposed "95-95-95-95" target (95% combination prevention, 95% detection, 95% treatment, 95% viral suppression), and to summarize the most recent progresses in the epidemiological research of HIV/AIDS in China with the aim of providing insights on the next generation of HIV control and prevention approaches and to shed light on upgrading the national strategy to end AIDS in this country.

The impact of COVID-19 non-pharmaceutical interventions on HIV care continuum in China: An interrupted time series analysis

“…The median number of PEP prescriptions recorded per day was 8 (4-15) during the 1,117 days before NPIs (23 January, 2020), compared with 4 (2-7) during the 76 days of NPIs (23 January, 2020 to 7 April, 2020, the NPIs period), and 14 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) during the 268 days post-NPIs (8 April, 2020 to 31 December, 2020, post-NPIs period). Poisson segmented regression analysis showed that the number of PEP prescriptions decreased by 71¢ 5% in the first week of the NPIs period (20-26 January, 2020) (incidence rate ratio [IRR] 0¢285; 95% confidence interval [CI] 0¢192-0¢423; Table 2 and Figure 2A; compared with counterfactual), then 71¢2% (0¢288, 0¢197-0¢ 423) and 70¢8% (0¢292, 0¢201-0¢424) in the second (27 January-2 February, 2020) and third week (3-9 February, 2020), respectively; the number of prescriptions showed an increasing trend of 2¢4% per week in the post-NPIs period (1¢024,1¢012-1¢037), and by the end of 2020 (28-31 December, 2020) the number of prescriptions still had not reached expected level (0¢523,0¢394-0¢696).…”

“…Data for all indicators except median time intervals and ART initiation showed a long-term increasing trend until 2020, which may be related to the rigorous efforts in massive HIV screening and testing strategies such as rapid expansion of voluntary counseling and testing clinics scale in the past decade. 17 The decrease in median time intervals may be due to the implementation of the “treat-all” in China starting in June 2016, while the steady trend in ART initiation may be due to a lack of momentum in the effects of this revision.…”

“…By the end of 2020, a total of 1·05 million PLHIV had been reported, with a population prevalence of 0·075%. 17 PLHIV in China access HIV care services, including CD4 and viral load monitoring, ART collection, etc., at designated hospitals that are specialized in infectious disease treatment. HIV treatment and CD4 and viral load monitoring are publicly covered.…”

Does HIV-Related Stigma Depress Social Well-Being of Youths Affected by Parental HIV/AIDS?

“…In 2020, around 37.7 million people were living with HIV/AIDS globally, of which China had about 1.053 million people, and 351,000 cumulative reported deaths (1,2). Despite China has carried out a series of interventions (2), the HIV/AIDS epidemic has had a detrimental effect on people living with HIV/AIDS and their family members, including children and youths. Youths (aged [20][21][22][23][24][25][26][27][28][29][30] affected by parental HIV/AIDS, including youths who lost one or both of their parents to HIV/AIDS ("AIDS orphans") and youths who are living with HIV-infected parents ("Vulnerable children") (3,4).…”

“…HIV/AIDS has been identified as a serious global public health concern. In 2020, around 37.7 million people were living with HIV/AIDS globally, of which China had about 1.053 million people, and 351,000 cumulative reported deaths ( 1 , 2 ). Despite China has carried out a series of interventions ( 2 ), the HIV/AIDS epidemic has had a detrimental effect on people living with HIV/AIDS and their family members, including children and youths.…”