Abstract
BackgroundMen who have sex with men (MSM) are disproportionately affected by HIV in China. Globally, younger MSM are at higher risk for incident HIV infections, but there has been substantial variation in the estimates of age-stratified HIV incidence among MSM in mainland China, potentially due to regional differences in the nature of the epidemic. Given the need for quality epidemiological data to meet the global goal of ending new HIV infections by 2030, this systematic review and meta-analysis aims to determine age-stratified HIV incidence in mainland China, including consideration by geographic region and time.MethodsThis review will include longitudinal studies, cross-sectional surveys, and surveillance reports among MSM in mainland China that have reported HIV incidence. We will search studies and reports published from January 1, 2003, to April 30, 2020, in both English and Chinese language literature databases. For each study considered, two reviewers will independently screen, determine eligibility, and extract relevant data, with discrepancies resolved by consensus of a third reviewer. The methodological quality of included studies will be assessed by the Quality Assessment Tool for Systematic Reviews of Observational Studies Score (QATSO). We will develop age-stratified estimates of HIV incidence with geographic variations and temporal trends. Heterogeneity will be examined using statistical techniques appropriate to the dataset. For subgroup analyses, we will conduct mixed-effects meta-analysis models.DiscussionThis review will contribute to a better understanding of the HIV epidemic among MSM in mainland China by providing age-stratified estimates of HIV incidence with a portrayal of geographic and temporal variations. Findings will reflect epidemic dynamics, informing local and national intervention programs and policies for HIV prevention, and providing estimation data to inform future research among MSM in China.Systematic review registrationPROSPERO ID 154834
Highlights
Despite the low Human immunodeficiency virus (HIV) prevalence among the general population in China, men who have sex with men (MSM) are disproportionately affected by HIV [1]
Our study aims to provide comprehensive and updated information on HIV incidence among Chinese Men who have sex with men (MSM), with estimates stratification by age and temporal trends at national and regional levels
3) What factors are associated with temporal changes in HIV incidence in MSM residing in mainland China?
Summary
Despite the low HIV prevalence among the general population in China, men who have sex with men (MSM) are disproportionately affected by HIV [1]. A recent systematic analysis of 355 cross-sectional studies in China indicated that MSM aged 50 years and older had the highest HIV prevalence of 19.3%, compared with the overall national prevalence of 5.7% [16], indicating that HIV incidence may not plateau but instead continue at high levels throughout adulthood. Together, these empirical findings suggest that age is a critical component in understanding the epidemic of HIV among MSM that merits further exploration. Given the need for quality epidemiological data to meet the global goal of ending new HIV infections by 2030, this systematic review and meta-analysis aims to determine age-stratified HIV incidence in mainland China, including consideration by geographic region and time
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