HIV in China
We all know that China is changing – fast. With the largest population in the world and the speed of urbanization, the potential for the spread of human immunodeficiency virus (HIV) is worrying. By some estimates, over a million people in China could be infected with HIV, but reliable figure on the prevalence of HIV/AIDS in China have always been hard to come by. The most recent data from CDC estimates that in 2007, an estimated 700,000 people in China were living with HIV. An estimated 50,000 new HIV infections and 20,000 deaths related to acquired immunodeficiency syndrome (AIDS) occurred in 2007, and an estimated 71% of persons with HIV infection were unaware of their HIV status. In 2007, 40% of those living with HIV had been infected through heterosexual transmission and 38% through injection-drug use (HIV Infection – Guangdong Province, China, 1997-2007. MMWR 58(15) 396-400 April 24, 2009).
Guangdong Province in southeastern China is the country’s most heavily populated region, with an estimated 76 million permanent residents and 17 million migrants. Guangdong has undergone rapid economic development in recent years. The number of HIV infections in Guangdong increased from 102 recorded in 1997 to 4,593 in 2007, although this increase is partly due to increased testing and surveillance. Among males classified by HIV transmission category, 82% of newly diagnosed infections were attributed to injection-drug use, and among females, 53% engaged in high-risk heterosexual conduct.
During the ten years from 1997-2007, an aggregated total of 22,571 newly diagnosed HIV cases were reported in Guangdong, 82% in males and 18% in females. Every year, injection-drug use was the most commonly reported HIV transmission category.
The recent increase in reported HIV cases attributed to high-risk heterosexual contact and the decline in cases attributed to injection-drug use might suggest a shift in Guangdong’s HIV epidemic similar to the national trend, in which heterosexual transmission is the main transmission category in China. In the central region of Guangdong Province, where approximately 80% of the province’s HIV cases were reported in 2007, rapid economic growth has led to an influx of migrant workers. Migrant women who lack appropriate job skills might seek to supplement their income by becoming sex workers, and migrant men living apart from their spouses might become clients of sex workers.
The findings in this report are subject to at least three limitations. First, large percentages of the data were missing key elements. For example, in approximately 22% of cases, the patient’s age group was unknown, and approximately 38% of patients were not classified by transmission category. Second, because definitions for sex worker and injection-drug user were institution based, verification was not possible. Finally, because HIV-positive people in China are required by law to report their names and national identification numbers, those consenting to HIV testing likely represent a sample that is biased in unpredictable ways.
More community-based sampling of populations at high risk are being planned to provide a more complete picture of the HIV epidemic in Guangdong. Surveillance methods should be redefined so that they rely less extensively on institutions and more accurately represent those populations at greatest risk. Finally, because an estimated 71% of people with HIV infection in China are unaware of their status, more HIV counseling and testing should be urgently provided.
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Related:
- The changing face of HIV in China. 2008 Nature 455: 609-11
- HIV treatment reduces death rates in Africa
- Why is HIV a pathogen?
- How does HIV cause AIDS?
Tags: Biology, China, disease, Emerging disease, Guangdong, Health, HIV/AIDS, Medicine, Microbiology, Podcast, Science, Virology
