Acquired Immunodeficiency Syndrome ; transmission ; China ; HIV Infections ; transmission ; Humans ; Models, Theoretical

OBJECTIVETo explore dynamic characteristics of the HIV mother to child transmission (MTCT) epidemic in China.

METHODSA deterministic dynamic transmission model was used to determine the effect of key parameters on the likely long-term trends of the HIV MTCT epidemic in China. Matlab 7.0 was used to develop the model.

RESULTSThe number of the susceptibles (S), the transmission rate (β), and the screening proportion (α) of HIV positive pregnant women have the greatest impact on the HIV MTCT epidemic in China. The growth of the MTCT epidemic in China could not be controlled only by decreasing the MTCT transmission rate. The prevalence of HIV positive women should be reduced and more pregnant women should be tested for HIV.

CONCLUSIONPrevention of MTCT (PMTCT) should focus not only on the reduction of HIV transmission rates and incidences of HIV among women but also on the increase of HIV testing for pregnant women. The most cost-effective PMTCT means for China should be investigated in future studies.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Female ; HIV Infections ; mortality ; transmission ; Humans ; Infant ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; statistics & numerical data ; Models, Statistical ; Pregnancy ; Pregnancy Complications, Infectious ; epidemiology ; virology ; Prevalence

BACKGROUNDHeterosexual sex has become the dominant transmission route in China. Recently studies reported high heterogeneity in heterosexual transmission risk in resource-limited countries. The aim of this study was to summarize the risk of HIV transmission among Chinese serodiscordant couples.

METHODSA systematic review and meta-analysis of observational studies of heterosexual HIV transmission among serodiscordant couples in China was conducted. Two reviewers conducted a literature search using the China National Knowledge Infrastructure (CNKI), Chinese Medical Current Contents (CMCC), and Medline databases. Pooled transmission estimates per 100 person-years (PY) were calculated using a random-effects model. Meta-regression analysis and subgroup analysis stratified by study design, transmission direction and period of antiretroviral therapy (ART) availability were conducted to assess the factors associated with transmission.

RESULTSEleven eligible studies were identified reporting on 11 984 couples and 405 HIV transmission events. HIV transmission risk from HIV-positive individuals to heterosexual partners was 1.68 (95%CI 0.74 - 2.62) per 100 PY. Study design did not reach statistical significance in meta-regression analysis. The pooled female-to-male transmission estimate was 1.11 (95%CI 0.09 - 2.14) per 100 PY and male-to-female transmission estimate was 1.43 (95%CI 0.19 - 2.68) per 100 PY. The pooled estimate for those before the availability of the Chinese National Free Antiretroviral Therapy Program (2.13 (95%CI 0.00 - 4.63) per 100 PY) was higher than that for those after the implementation of this program (1.44 (95%CI 0.62 - 2.26) per 100 PY).

CONCLUSIONSTransmission estimates in China were lower than other developing countries, but higher than developed countries. Research that better defines HIV secondary transmission rates and the associated behavioral, treatment adherence, and health-related risk factors among heterosexual serodiscordant couples in China is needed.

China ; Female ; HIV Infections ; etiology ; transmission ; Heterosexuality ; Humans ; Male ; Risk

OBJECTIVEThe migrant population is a vulnerable group for HIV infection in China. Understanding potential epidemic trends among migrants is critical for developing HIV preventative measures in this population.

METHODSThe Estimation and Projection Package (EPP) model was used to process prefecture and county-level surveillance data to generate HIV prevalence and epidemic trends for migrant populations in China.

RESULTSThe prevalence of HIV among migrants in 2009 was estimated at 0.075% (95% CI: 0.042%, 0.108%) in China. The HIV epidemic among migrants is likely to increase over the next 5 years, with the prevalence expected to reach 0.110% (95% CI: 0.070%, 0.150%) by 2015.

CONCLUSIONAlthough the 2009 estimates for the HIV/AIDS epidemic in China indicate a slower rate of increase compared with the national HIV/AIDS epidemic, it is estimated to persistently increase among migrants over the next 5 years. Migrants will have a strong impact on the overall future of the HIV epidemic trend in China and evidence-based prevention and monitoring efforts should be expanded for this vulnerable population.

China ; epidemiology ; Condoms ; Epidemics ; statistics & numerical data ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Models, Theoretical ; Prevalence ; Risk Factors ; Safe Sex ; Sexual Behavior ; Transients and Migrants