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. 2017 Apr 1;64(7):956-963.
doi: 10.1093/cid/cix031.

Spatial Analysis of the Human Immunodeficiency Virus Epidemic among Men Who Have Sex with Men in China, 2006-2015

Qianqian Qin  1 , Wei Guo  1 , Weiming Tang  2   3 , Tanmay Mahapatra  4 , Liyan Wang  1 , Nanci Zhang  1 , Zhengwei Ding  1 , Chang Cai  1 , Yan Cui  1 , Jiangping Sun  1
Affiliations

Spatial Analysis of the Human Immunodeficiency Virus Epidemic among Men Who Have Sex with Men in China, 2006-2015

Qianqian Qin et al. Clin Infect Dis. .

Abstract

Background: Studies have shown a recent upsurge in human immunodeficiency virus (HIV) burden among men who have sex with men (MSM) in China, especially in urban areas. For intervention planning and resource allocation, spatial analyses of HIV/AIDS case-clusters were required to identify epidemic foci and trends among MSM in China.

Methods: Information regarding MSM recorded as HIV/AIDS cases during 2006-2015 were extracted from the National Case Reporting System. Demographic trends were determined through Cochran-Armitage trend tests. Distribution of case-clusters was examined using spatial autocorrelation. Spatial-temporal scan was used to detect disease clustering. Spatial correlations between cases and socioenvironmental factors were determined by spatial regression.

Results: Between 2006 and 2015, in China, 120 371 HIV/AIDS cases were identified among MSM. Newly identified HIV/AIDS cases among self-reported MSM increased from 487 cases in 2006 to >30 000 cases in 2015. Among those HIV/AIDS cases recorded during 2006-2015, 47.0% were 20-29 years old and 24.9% were aged 30-39 years. Based on clusters of HIV/AIDS cases identified through spatial analysis, the epidemic was concentrated among MSM in large cities. Spatial-temporal clusters contained municipalities, provincial capitals, and main cities such as Beijing, Shanghai, Chongqing, Chengdu, and Guangzhou. Spatial regression analysis showed that sociodemographic indicators such as population density, per capita gross domestic product, and number of county-level medical institutions had statistically significant positive correlations with HIV/AIDS among MSM.

Conclusions: Assorted spatial analyses revealed an increasingly concentrated HIV epidemic among young MSM in Chinese cities, calling for targeted health education and intensive interventions at an early age.

Keywords: China.; HIV/AIDS; men who have sex with men; spatial analysis; trend.

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Figures

Figure 1.
Figure 1.
Geographical distribution of the human immunodeficiency virus/AIDS cases reported among men who have sex with men at the county level in the years 2006, 2009, 2012, and 2015 in China.
Figure 2.
Figure 2.
A, Proportional distribution of transmission route of identified human immunodeficiency virus (HIV)/AIDS cases among men who have sex with men (MSM) by year. B, Number of identified HIV/AIDS cases among MSM by age. C, Number of identified HIV/AIDS cases among MSM by education. D, Number of identified HIV/AIDS cases among MSM by marriage.
Figure 3.
Figure 3.
Local clusters of the population-level annual human immunodeficiency virus/AIDS diagnosis rate of men who have sex with men at county level by year, China, 2006–2015.
See this image and copyright information in PMC

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