The HIV epidemic in China: history, response, and challenge

He, Na; Detels, Roger

doi:10.1038/sj.cr.7290354

Cited by 115 publications

(67 citation statements)

References 17 publications

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“…While large numbers of HCPs have received appropriate training, there are still gaps between their knowledge and its application (Zhang et al, 2005). He and Detels warn that the limited availability of well-trained HCPs is China's most severe barrier to implementing successful HIV/ AIDS prevention and control programmes (He & Detels, 2005).…”

Section: Recommendations For Future Researchmentioning

confidence: 99%

Chinese health care providers’ attitudes about HIV: a review

2007

AIDS Care

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China has one of the fastest growing HIV epidemics in the world with an increase in reported cases of about 30% yearly (UNAIDS, 2004). As the epidemic has grown, there have been several studies of health care provider attitudes towards HIV in China over the last 15 years. While attitudes have evolved, misconceptions about transmission of HIV, low levels of support for people living with HIV/AIDS and stigmatized groups, and a poor understanding of the importance of condoms in HIV prevention, remain. The studies are limited by a weakness of survey instruments and an absence of focus on the gendered nature of the HIV epidemic. Recommendations for future research in this area include development of a theoretical base, consideration of gender and stigma, and incorporation of these issues into the survey instruments.

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Section: Recommendations For Future Researchmentioning

confidence: 99%

Chinese health care providers’ attitudes about HIV: a review

2007

AIDS Care

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“…The HIV/AIDS epidemic among MSM in China is only beginning to be understood and MSM were not added to China's HIV/AIDS national sentinel surveillance system until 2003 (He & Detels, 2005). To-date, only anecdotal evidence about stigma and discrimination against MSM has been reported.…”

Section: Introductionmentioning

confidence: 98%

Experiences of Social Discrimination Among Men Who Have Sex with Men in Shanghai, China

2006

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In China, men who have sex with men (MSM) are at increasingly high risk for HIV. However, prevention efforts targeting this population may be hindered because of the stigma associated with homosexuality in traditional Chinese culture. We conducted qualitative interviews with 30 MSM in Shanghai to better understand the types and sources of stigma and discrimination and how MSM respond to them. The stigma associated with homosexuality can be traced back to four culturally based factors: social status and relationships, the value of family, perceptions of immorality and abnormality, and gender stereotypes of masculinity. In particular, the centrality of the family and the importance of maintaining key relationships caused stress and anxiety, contributing to more frequent encounters with felt stigma. In response, MSM often evaded the scrutiny of family members through various tactics, even prompting some to leave their rural homes. Implications of these findings on HIV/AIDS prevention are discussed.

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“…Since the late 20th century, China has made vigorous responses to the HIV/AIDS epidemic, including implementing the “Four Frees and One Care” policy and 5-year action plans, as well as issuing a series of regulations for the prevention and control of HIV/AIDS [25–28]. Through a series of intervention efforts such as needle exchange, condom distribution and knowledge education, the prevalence of HIV-1 among IDUs in Yunnan dropped from 79.7% in 1991 to 18.3% in 2012 [13,29].…”

Section: Discussionmentioning

confidence: 99%

Burmese injecting drug users in Yunnan play a pivotal role in the cross-border transmission of HIV-1 in the China-Myanmar border region

Chen

Wang

et al. 2018

Virulence

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Injecting drug users (IDUs) are the major risk group for HIV-1 infection in the China-Myanmar border area. There are a large number of Burmese IDUs living in Yunnan (Yunnan-mIDUs) who might be associated with the cross-border transmission of HIV-1. From 2010 to 2013, 617 Yunnan-mIDUs were recruited from three counties of Yunnan, 19.0% of whom were detected to be HIV-1 positive by serological testing. Partial HIV-1 p17, pol, vif-env, and env genes were amplified from the positive samples and were sequenced. Phylogenetic and HIV-1 subtyping analyses revealed that HIV-1 recombinant forms (RFs), including RF_BC (36.4%), RF_01BC (26.1%), RF_01C (9.1%) and RF_01B (1.1%), were predominant among this cohort. Of the identified HIV-1 strains, 14.8%, 9.1% and 3.4% belonged to subtype C, CRF01_AE and subtype B, respectively. Transmission cluster analysis showed that sequences from the Yunnan-mIDUs formed transmission clusters not only with those from Burmese IDUs but also with those from Chinese IDUs, indicating that Yunnan-mIDUs might acquire HIV-1 infection from or spread HIV-1 to both Burmese and Chinese IDUs. Phylogeographic analyses revealed three cross-border transmission patterns associated with Yunnan-mIDUs, in which Yunnan-mIDUs served as the crucial nodes linking the Burmese and Chinese IDUs. These results suggest that Yunnan-mIDUs are a potential viral reservoir for the diffusion of HIV-1 in Yunnan and play a pivotal role in the bidirectional cross-border transmission of HIV-1 in the China-Myanmar border region. More intervention efforts that focus on Yunnan-mIDUs are recommended in Yunnan’s campaign against HIV/AIDS.

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The HIV epidemic in China: history, response, and challenge

Cited by 115 publications

References 17 publications

Chinese health care providers’ attitudes about HIV: a review

Chinese health care providers’ attitudes about HIV: a review

Experiences of Social Discrimination Among Men Who Have Sex with Men in Shanghai, China

Burmese injecting drug users in Yunnan play a pivotal role in the cross-border transmission of HIV-1 in the China-Myanmar border region

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