Abstract
ObjectiveMen who have sex with men (MSM) and heterosexuals are the populations with the fastest growing HIV infection rates in China. We characterize the epidemic growth and age patterns between these two routes from 2004 to 2015 in Chongqing and Shenzhen, China.Design and methodsData were downloaded from the National HIV/ AIDS Comprehensive Response Information Management System. For the new HIV diagnoses of heterosexuals and MSM in both cities, we estimated the growth rates by fitting different sub-exponential models. Heat maps are used to show their age patterns. We used histograms to compare these patterns by birth cohort.ResultsThe MSM epidemics grew significantly in both cities. Chongqing experienced quadratic growth in HIV reported cases with an estimated growth rate of 0.086 per week and a “deceleration rate” of 0.673. HIV reported cases of MSM in Shenzhen grew even more drastically with a growth rate of 0.033 per week and “deceleration rate” of 0.794. The new infections are mainly affecting the ages of 18 to 30 in Chongqing and ages of 20 to 35 in Shenzhen. They peaked in early 1990’s and mid-1990’s birth cohorts in Chongqing and Shenzhen respectively. The HIV epidemic among heterosexuals grew rapidly in both cities. The growth rates were estimated as 0.02 and 0.028 in Chongqing and Shenzhen respectively whereas the “deceleration rates” were 0.878 and 0.790 in these two places. It affected mostly aged 18 to 75 in males and 18 to 65 in females in Chongqing and aged 18 to 45 in males and 18 to 50 in females in Shenzhen in 2015. In Chongqing, the heterosexual female epidemics display two peaks in HIV diagnoses in the birth cohorts of early 1950’s and early 1980’s, with heterosexual male epidemics peaked in early 1940’s and early 1960’s. The heterosexual male and female epidemics display higher rates in the birth cohort 1940-1960, than the birth cohort 1960-1990. It peaked in birth cohorts of 1950’s and 1980’s in Shenzhen.ConclusionsWe revealed striking differences in epidemic growth and age patterns of the HIV epidemics in these two cities. Our results may be used to inform age-targeted public health policies to curb their epidemic growth.
Highlights
The Human Immunodeficiency Virus (HIV) epidemic has become the greatest global public health challenge with some 2.1 million new infections in 2015 [1]
We revealed striking differences in epidemic growth and age patterns of the HIV epidemics in these two cities
In China, while the national HIV epidemic demonstrated a low prevalence trend, 12 of 31 provinces had reported over 10,000 cases of People living with HIV (PLHIV) or AIDS individually in 2014
Summary
The Human Immunodeficiency Virus (HIV) epidemic has become the greatest global public health challenge with some 2.1 million new infections in 2015 [1]. Previous studies demonstrated significant variations in HIV prevalence trends geographically and among different routes of transmission in China. HIV prevalence amongst injection drug users (IDU) decreased outside Southwest China but remained at relatively low levels in all Chinese regions except southwest. Chongqing belongs to the same cluster as Guizhou and Sichuan Their epidemic has shifted from IDU to sexual transmission in recent years. Shenzhen belongs to another cluster that consists of Beijing, Tianjin, Jiangsu, Zhejiang, Shanghai and Guangdong. Their epidemic has expanded from heterosexual transmission to both heterosexual and MSM transmission in the past few years [4]. Zhang et al used spatial temporal analysis to analyse the epidemic among young people in China and found a marked increase in sexual transmission with a wide geographical variation [6]
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