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. 2008 Dec;37(6):1287-96.
doi: 10.1093/ije/dyn196. Epub 2008 Oct 14.

Estimates of HIV prevalence in a highly endemic area of China: Dehong Prefecture, Yunnan Province

Yujiang Jia  1 , Jiangping Sun, Lu Fan, Duan Song, Shuming Tian, Yuecheng Yang, Manhong Jia, Lin Lu, Xinhua Sun, Sanguo Zhang, Andrzej Kulczycki, Sten H Vermund
Affiliations

Estimates of HIV prevalence in a highly endemic area of China: Dehong Prefecture, Yunnan Province

Yujiang Jia et al. Int J Epidemiol. 2008 Dec.

Abstract

Background: Dehong Prefecture in Yunnan Province, China, borders Myanmar. Its proximity to the 'Golden Triangle', one of the world's largest illicit drug production and distribution centre, contributes to drug trafficking and ready availability of heroin. Dehong's 1.1 million people confront a serious HIV problem fuelled by injection drug use. The aim of this study is to improve the 2005 estimates of the true status of the HIV/AIDS epidemic in Dehong Prefecture.

Methods: We estimated the HIV prevalence by synthesizing the results from several data sources (HIV/AIDS case reports, surveys, surveillance activities and epidemiological studies). We applied three different statistical procedures for estimations: (i) The Workbook method, adapted to meet the estimation needs in Dehong Prefecture; (ii) An estimate based on antenatal clinical data; and (iii) a dynamic model based on the local epidemic pattern.

Results: We estimated that the population prevalence for HIV infections in Dehong Prefecture is 1.3% (likely range from low/high of three estimates: 0.9-1.7%) such that 13 500 people were living with HIV/AIDS in Dehong Prefecture (likely range: 8,200-18,300) in 2005. Infections remain concentrated among injection drug users, female sex workers and their clients with an uneven geographical distribution of estimated cases.

Conclusion: More reliable estimates of HIV prevalence can be made by synthesizing multiple data sources using several procedures. Current HIV prevention, care and treatment challenges are judged substantial in Dehong Prefecture, regardless of what modelling strategy is used.

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Figures

Figure 1
Figure 1
The geographic location of Dehong Prefecture and the distribution of the estimated number of people living with HIV/AIDS by county or city in Dehong Prefecture (B, one dot equals to two HIV/AIDS cases). Dehong Prefecture borders Myanmar on three sides with a ≈500 km border, is situated in the western part of Yunnan Province (A and C). The prefecture has two cities (Ruili City and Luxi City) and three counties (Longchuan County, Yingjiang County and Lianghe County) with 1.1 million persons living in an area of 11 526 km2 (4450 square miles, approximately the size of Jamaica, or the US state of CT). Dehong is an ethnically diverse region with five major distinct ethno-cultural groups
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