HIV/AIDS in China

HIV/AIDS in China can be traced to an initial outbreak of the human immunodeficiency virus (HIV) first recognized in 1989 among injecting drug users along China's southern border.^[1]^[2] Figures from the Chinese Center for Disease Control and Prevention, World Health Organization, and UNAIDS estimate that there were 1.25 million people living with HIV/AIDS in China at the end of 2018, with 135,000 new infections from 2017. The reported incidence of HIV/AIDS in China is relatively low,^[3] but the Chinese government anticipates that the number of individuals infected annually will continue to increase.^[4]

While HIV is a type of sexually transmitted infection,^[5] the first years of the epidemic in China were dominated by non-sexual transmission routes, particularly among users of intravenous drugs through practices such as needle sharing.^[6] By 2005, 50% of new HIV cases were due to sexual transmission,^[7] with heterosexual sex gradually becoming the most common means of new infections in the 2000s.^[8] New infections among men who have sex with men (MSMs) grew rapidly thereafter, representing 26% of all new cases in 2014, up from 2.5% in 2006.^[9] Another major, non-sexual channel of infection was the Plasma Economy of the 1990s, wherein large numbers of blood donors, primarily in poor, rural areas in Henan Province, were infected with HIV as a result of systematically dangerous practices by state and private blood collection clinics.^[10]

^ Xiao et al. 2007, p. 667.
^ He & Detels 2005, pp. 825–826.
^ National Health and Family Planning Commission of the PRC 2015, p. 8.
^ "Still a tough battle to win fight against HIV: China Daily editorial". China Daily. November 29, 2018. Retrieved 19 February 2020.
^ Sharp & Hahn 2011, p. 1.
^ Kaufman, Kleinman & Saich 2006, p. 3-5.
^ Wu et al. 2007, p. 682.
^ Zhang et al. 2006, p. 2075: "However, our finding of a large number of sexually transmitted CRF01_AE viruses in Yunnan among non-IDUs is new. In particular, the rapid increase of HIV-1 prevalence among non-IDU populations has emerged as an alarming trend. IDU dominance in the late 1980s and throughout the 1990s has now been gradually replaced by those infected through heterosexual contact or other routes.”
^ National Health and Family Planning Commission of the PRC 2015, p. 9-10.
^ He & Detels 2005, p. 827: "At some local government-run blood banks and in many private underground blood banks operated in the early and middle 1990s in central China, blood was often collected from several villagers at the same time, and mixed together in a container or a centrifuge from which the plasma was collected. ... Such procedures, as well as recycling of used needles and inadequately sterilized equipment, allowed HIV to be rapidly transmitted among these donors, generating a large number of HIV-infected farmers and peasants.”

[FOOTNOTEXiao_et_al.2007667-1] Xiao et al. 2007, p. 667.

[FOOTNOTEHeDetels2005825–826-2] He & Detels 2005, pp. 825–826.

[FOOTNOTENational_Health_and_Family_Planning_Commission_of_the_PRC20158-3] National Health and Family Planning Commission of the PRC 2015, p. 8.

[CD18Editorial-4] "Still a tough battle to win fight against HIV: China Daily editorial". China Daily. November 29, 2018. Retrieved 19 February 2020.

[FOOTNOTESharpHahn20111-5] Sharp & Hahn 2011, p. 1.

[FOOTNOTEKaufmanKleinmanSaich20063-5-6] Kaufman, Kleinman & Saich 2006, p. 3-5.

[FOOTNOTEWu_et_al.2007682-7] Wu et al. 2007, p. 682.

[FOOTNOTEZhang_et_al.20062075-8] Zhang et al. 2006, p. 2075: "However, our finding of a large number of sexually transmitted CRF01_AE viruses in Yunnan among non-IDUs is new. In particular, the rapid increase of HIV-1 prevalence among non-IDU populations has emerged as an alarming trend. IDU dominance in the late 1980s and throughout the 1990s has now been gradually replaced by those infected through heterosexual contact or other routes.”

[FOOTNOTENational_Health_and_Family_Planning_Commission_of_the_PRC20159-10-9] National Health and Family Planning Commission of the PRC 2015, p. 9-10.

[FOOTNOTEHeDetels2005827-10] He & Detels 2005, p. 827: "At some local government-run blood banks and in many private underground blood banks operated in the early and middle 1990s in central China, blood was often collected from several villagers at the same time, and mixed together in a container or a centrifuge from which the plasma was collected. ... Such procedures, as well as recycling of used needles and inadequately sterilized equipment, allowed HIV to be rapidly transmitted among these donors, generating a large number of HIV-infected farmers and peasants.”

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