Estimating HIV Incidence among Key Affected Populations in China from Serial Cross-Sectional Surveys in 2010–2014

Introduction

HIV incidence is an important measure for monitoring the development of the epidemic, but it is difficult to ascertain. We combined serial HIV prevalence and mortality data to estimate HIV incidence among key affected populations (KAPs) in China.

Methods

Serial cross-sectional surveys were conducted among KAPs from 2010 to 2014. Trends in HIV prevalence were assessed by the Cochran-Armitage test, adjusted by risk group. HIV incidence was estimated from a mathematical model that describes the relationship between changes in HIV incidence with HIV prevalence and mortality.

Results

The crude HIV prevalence for the survey samples remained stable at 1.1 to 1.2% from 2010 to 2014. Among drug users (DUs), HIV prevalence declined from 4.48 to 3.29% (p<0.0001), and among men who have sex with men (MSM), HIV prevalence increased from 5.73 to 7.75% (p<0.0001). Changes in HIV prevalence among female sex workers (FSWs) and male patients of sexually transmitted disease clinics were more modest but remained statistically significant (all p<0.0001). The MSM population had the highest incidence estimates at 0.74% in 2011, 0.59% in 2012, 0.57% in 2013 and 0.53% in 2014. Estimates of the annual incidence for DUs and FSWs were very low and may not be reliable.

Conclusions

Serial cross-sectional prevalence data from representative samples may be another approach to construct approximate estimates of national HIV incidence among key populations. We observed that the MSM population had the highest incidence for HIV among high-risk groups in China, and we suggest that interventions targeting MSM are urgently needed to curb the growing HIV epidemic.

Below:  Study period from 2010 to 2014. DUs=drug users, FSW=female sex workers, MSM=men who have sex with men, STD=male patients of sexually transmitted disease clinics, PRG=pregnant women, DRV=long-distance truck drivers, YST=young (college-age) students, MOP=male mobile population (migrant workers).

Below:  Geographical distribution of HIV prevalence among drug users (DU), female sex workers (FSW), men who have sex with men (MSM) and male patients of sexually transmitted disease clinics (STD) in 2014.

Below:  HIV incidence among key populations from 2011 to 2014. DUs=drug users, FSW=female sex workers, MSM=men who have sex with men, STD=male patients of sexually transmitted disease clinics.

Full article at:   http://goo.gl/vdkLrN

By:  Yan Cui,1 Wei Guo,1 Dongmin Li,1 Liyan Wang,1 Cynthia X Shi,2 Ron Brookmeyer,3 Roger Detels,4 Lin Ge,1 Zhengwei Ding,1 and Zunyou Wu§,5

¹Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

²Division of Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

³Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA

⁴Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA

⁵National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

§Corresponding author: Zunyou Wu, National Centre for AIDS/STD Control and Prevention, Chinese Centre for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China. Tel: +8610 58900901. Fax: +8610 58900900. 

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