Skip to main content
Top
Published in: BMC Infectious Diseases 1/2018

Open Access 01-12-2018 | Research article

A spatiotemporal meta-analysis of HIV/syphilis epidemic among men who have sex with men living in mainland China

Authors: Rong Fu, Jinkou Zhao, Dan Wu, Xiayan Zhang, Joseph D. Tucker, Meiwen Zhang, Weiming Tang

Published in: BMC Infectious Diseases | Issue 1/2018

Login to get access

Abstract

Background

Geographic differences in HIV, syphilis and condomless sex among men who have sex with men in China remained unknown. We aimed to elucidate these spatiotemporal changing patterns in China.

Methods

We conducted a spatiotemporal meta-analysis. We searched four databases for studies conducted between 2001 and 2015. We included studies that reported original data of HIV/syphilis prevalence in China, the study’s area/province, and period of data collection. We grouped studies into six regions and four time periods. We examined the changing patterns of national and regional prevalence of HIV, syphilis and condomless sex.

Results

Search results yielded 2119 papers, and 272 were included in the meta-analysis. The sample sizes of the studies ranged from 19 to 47,231. National HIV prevalence increased from 3.8% (95% CI 3.0–4.8) in 2001–07 to 6.6% (5.6–7.7) in 2013–15. In most regions, the rise occurred before 2010 and the HIV prevalence remained relatively stable afterwards, except for the Northwest which showed a considerable increase since 2008. National syphilis prevalence decreased from 12.3% (10.2–14.9) in 2001–07 to 7.1% (5.6–8.9) in 2013–15.

Conclusions

The trends of HIV and syphilis infections have been effectively curbed in MSM in most regions of China. Continuous efforts, particularly promotion of condom use, are needed to further reduce these infections.
Appendix
Available only for authorised users
Literature
1.
go back to reference van Griensven F, de Lind van Wijngaarden JW, Baral S, Grulich A. The global epidemic of HIV infection among men who have sex with men. Curr Opin HIV AIDS. 2009;4(4):300–7.CrossRef van Griensven F, de Lind van Wijngaarden JW, Baral S, Grulich A. The global epidemic of HIV infection among men who have sex with men. Curr Opin HIV AIDS. 2009;4(4):300–7.CrossRef
2.
go back to reference Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.CrossRef Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.CrossRef
3.
go back to reference Li Y, Xu J, Reilly KH, Zhang J, Wei H, Jiang Y, et al. Prevalence of HIV and syphilis infection among high school and college student MSM in China: a systematic review and meta-analysis. PLoS One. 2013;8(7):e69137.CrossRef Li Y, Xu J, Reilly KH, Zhang J, Wei H, Jiang Y, et al. Prevalence of HIV and syphilis infection among high school and college student MSM in China: a systematic review and meta-analysis. PLoS One. 2013;8(7):e69137.CrossRef
4.
go back to reference Zhang L, Chow EPF, Jing J, Zhuang X, Li X, He M, et al. HIV prevalence in China: integration of surveillance data and a systematic review. Lancet Infect Dis. 2013;13(11):955–63.CrossRef Zhang L, Chow EPF, Jing J, Zhuang X, Li X, He M, et al. HIV prevalence in China: integration of surveillance data and a systematic review. Lancet Infect Dis. 2013;13(11):955–63.CrossRef
5.
go back to reference Chow EP, Wilson DP, Zhang J, Jing J, Zhang L. Human immunodeficiency virus prevalence is increasing among men who have sex with men in China: findings from a review and meta-analysis. Sex Transm Dis. 2011;38(9):845–57.CrossRef Chow EP, Wilson DP, Zhang J, Jing J, Zhang L. Human immunodeficiency virus prevalence is increasing among men who have sex with men in China: findings from a review and meta-analysis. Sex Transm Dis. 2011;38(9):845–57.CrossRef
6.
go back to reference Zhou Y, Li D, Lu D, Ruan Y, Qi X, Gao G. Prevalence of HIV and syphilis infection among men who have sex with men in China: a meta-analysis. Biomed Res Int. 2014;2014:620431.PubMedPubMedCentral Zhou Y, Li D, Lu D, Ruan Y, Qi X, Gao G. Prevalence of HIV and syphilis infection among men who have sex with men in China: a meta-analysis. Biomed Res Int. 2014;2014:620431.PubMedPubMedCentral
7.
go back to reference Tang S, Tang W, Meyers K, Chan P, Chen Z, Tucker JD. HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review. BMC Infect Dis. 2016;16(1):588.CrossRef Tang S, Tang W, Meyers K, Chan P, Chen Z, Tucker JD. HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review. BMC Infect Dis. 2016;16(1):588.CrossRef
8.
go back to reference Liu G, Lu H, Wang J, Xia D, Sun Y, Mi G, et al. Incidence of HIV and syphilis among men who have sex with men (MSM) in Beijing: an open cohort study. PLoS One. 2015;10(10):e0138232.CrossRef Liu G, Lu H, Wang J, Xia D, Sun Y, Mi G, et al. Incidence of HIV and syphilis among men who have sex with men (MSM) in Beijing: an open cohort study. PLoS One. 2015;10(10):e0138232.CrossRef
9.
go back to reference Chen Z-Q, Zhang G-C, Gong X-D, Lin C, Gao X, Liang G-J, et al. Syphilis in China: results of a national surveillance programme. Lancet. 2007;369(9556):132–8.CrossRef Chen Z-Q, Zhang G-C, Gong X-D, Lin C, Gao X, Liang G-J, et al. Syphilis in China: results of a national surveillance programme. Lancet. 2007;369(9556):132–8.CrossRef
10.
go back to reference Tucker JD, Chen X-S, Peeling RW. Syphilis and social upheaval in China. N Engl J Med. 2010;362(18):1658–61.CrossRef Tucker JD, Chen X-S, Peeling RW. Syphilis and social upheaval in China. N Engl J Med. 2010;362(18):1658–61.CrossRef
11.
go back to reference Chen X-S, Gong X-D, Liang G-J, Zhang G-C. Epidemiologic trends of sexually transmitted diseases in China. Sex Transm Dis. 2000;27(3):138–42.CrossRef Chen X-S, Gong X-D, Liang G-J, Zhang G-C. Epidemiologic trends of sexually transmitted diseases in China. Sex Transm Dis. 2000;27(3):138–42.CrossRef
12.
go back to reference Gao L, Zhang L, Jin Q. Meta-analysis: prevalence of HIV infection and syphilis among MSM in China. Sex Transm Infect. 2009;85(5):354–8.CrossRef Gao L, Zhang L, Jin Q. Meta-analysis: prevalence of HIV infection and syphilis among MSM in China. Sex Transm Infect. 2009;85(5):354–8.CrossRef
13.
go back to reference Das A, Li J, Zhong F, Ouyang L, Mahapatra T, Tang W, et al. Factors associated with HIV and syphilis co-infection among men who have sex with men in seven Chinese cities. Int J STD AIDS. 2015;26(3):145–55.CrossRef Das A, Li J, Zhong F, Ouyang L, Mahapatra T, Tang W, et al. Factors associated with HIV and syphilis co-infection among men who have sex with men in seven Chinese cities. Int J STD AIDS. 2015;26(3):145–55.CrossRef
14.
go back to reference Wu Z, Xu J, Liu E, Mao Y, Xiao Y, Sun X, et al. HIV and syphilis prevalence among men who have sex with men: a cross-sectional survey of 61 cities in China. Clin Infect Dis. 2013;57(2):298–309.CrossRef Wu Z, Xu J, Liu E, Mao Y, Xiao Y, Sun X, et al. HIV and syphilis prevalence among men who have sex with men: a cross-sectional survey of 61 cities in China. Clin Infect Dis. 2013;57(2):298–309.CrossRef
15.
go back to reference Zhong F, Liang B, Xu H, Cheng W, Fan L, Han Z, et al. Increasing HIV and decreasing syphilis prevalence in a context of persistently high unprotected anal intercourse, six consecutive annual surveys among men who have sex with men in Guangzhou, China, 2008 to 2013. PLoS One. 2014;9(7):e103136.CrossRef Zhong F, Liang B, Xu H, Cheng W, Fan L, Han Z, et al. Increasing HIV and decreasing syphilis prevalence in a context of persistently high unprotected anal intercourse, six consecutive annual surveys among men who have sex with men in Guangzhou, China, 2008 to 2013. PLoS One. 2014;9(7):e103136.CrossRef
16.
go back to reference Liang J, Liu L, Cheung M, Lee MP, Wang H, Li CH, et al. Community-based HIV-1 early diagnosis and risk behavior analysis of men having sex with men in Hong Kong. PLoS One. 2015;10(4):e0125715.CrossRef Liang J, Liu L, Cheung M, Lee MP, Wang H, Li CH, et al. Community-based HIV-1 early diagnosis and risk behavior analysis of men having sex with men in Hong Kong. PLoS One. 2015;10(4):e0125715.CrossRef
17.
go back to reference Yang Z, Huang Z, Dong Z, Zhang S, Han J, Jin M. Prevalence of high-risky behaviors in transmission of HIV among high school and college student MSM in China: a meta-analysis. BMC Public Health. 2015;15:1272.CrossRef Yang Z, Huang Z, Dong Z, Zhang S, Han J, Jin M. Prevalence of high-risky behaviors in transmission of HIV among high school and college student MSM in China: a meta-analysis. BMC Public Health. 2015;15:1272.CrossRef
18.
go back to reference Song L, Mei J, Lu J, Fu L, Li X, Niu J, et al. Change trend of HIV/AIDS related risk factors and influencing factors among men who have sex with men in Yunnan, 2010-2013. Zhonghua Liu Xing Bing Xue Za Zhi. 2015;36(2):153–7.PubMed Song L, Mei J, Lu J, Fu L, Li X, Niu J, et al. Change trend of HIV/AIDS related risk factors and influencing factors among men who have sex with men in Yunnan, 2010-2013. Zhonghua Liu Xing Bing Xue Za Zhi. 2015;36(2):153–7.PubMed
19.
go back to reference Qin Q, Tang W, Ge L, Li D, Mahapatra T, Wang L, et al. Changing trend of HIV, syphilis and hepatitis C among men who have sex with men in China. Sci Rep. 2016;6:31081.CrossRef Qin Q, Tang W, Ge L, Li D, Mahapatra T, Wang L, et al. Changing trend of HIV, syphilis and hepatitis C among men who have sex with men in China. Sci Rep. 2016;6:31081.CrossRef
20.
go back to reference Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382(9903):1525–33.CrossRef Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382(9903):1525–33.CrossRef
21.
go back to reference Wang A, Wang F, Wang Q, Wang J, Feng T, Lu H, et al. AIDS diagnosis and treatment guideline. Chinese J Infect Dis. 2006;24(2):133–44. Wang A, Wang F, Wang Q, Wang J, Feng T, Lu H, et al. AIDS diagnosis and treatment guideline. Chinese J Infect Dis. 2006;24(2):133–44.
22.
go back to reference AIDS Group CSoID. Chinese Medical Association. In: AIDS diagnosis and treatment guideline (2011 version); 2011. AIDS Group CSoID. Chinese Medical Association. In: AIDS diagnosis and treatment guideline (2011 version); 2011.
23.
go back to reference Wang QQ, Zhang G. Guidelines for Diagnosis and Treatment of Sexually Transmitted Diseases. Shanghai Science and Technology Press. Wang QQ, Zhang G. Guidelines for Diagnosis and Treatment of Sexually Transmitted Diseases. ​Shanghai Science and Technology Press.
24.
go back to reference Council OotS. China's 12th Five-Year Plan for Containment and Prevention of AIDS Beijing; 2012. Council OotS. China's 12th Five-Year Plan for Containment and Prevention of AIDS Beijing; 2012.
26.
go back to reference Liu M. Two gay men seeking two lesbians: an analysis of Xinghun (formality marriage) ads on China’s Tianya. Cn. Sexuality & Culture. 2013;17(3):494–511.CrossRef Liu M. Two gay men seeking two lesbians: an analysis of Xinghun (formality marriage) ads on China’s Tianya. Cn. Sexuality & Culture. 2013;17(3):494–511.CrossRef
27.
go back to reference Beyrer C, Sullivan P, Sanchez J, Baral SD, Collins C, Wirtz AL, et al. The increase in global HIV epidemics in MSM. AIDS. 2013;27(17):2665–78.CrossRef Beyrer C, Sullivan P, Sanchez J, Baral SD, Collins C, Wirtz AL, et al. The increase in global HIV epidemics in MSM. AIDS. 2013;27(17):2665–78.CrossRef
28.
go back to reference Rou K, Sullivan SG, Liu P, Wu Z. Scaling up prevention programmes to reduce the sexual transmission of HIV in China. Int J Epidemiol. 2010;39(suppl_2):ii38–46.PubMedPubMedCentral Rou K, Sullivan SG, Liu P, Wu Z. Scaling up prevention programmes to reduce the sexual transmission of HIV in China. Int J Epidemiol. 2010;39(suppl_2):ii38–46.PubMedPubMedCentral
29.
go back to reference Luo S, Han L, Lu H, Dou Z, Tao Q, Khoshnood K, et al. Evaluating the impact of test-and-treat on the HIV epidemic among MSM in China using a mathematical model. PLoS One. 2015;10(6):e0126893.CrossRef Luo S, Han L, Lu H, Dou Z, Tao Q, Khoshnood K, et al. Evaluating the impact of test-and-treat on the HIV epidemic among MSM in China using a mathematical model. PLoS One. 2015;10(6):e0126893.CrossRef
30.
go back to reference Yang H-T, Tang W, Xiao Z-P, Jiang N, Mahapatra T, Huan X-P, et al. Worsening epidemic of HIV and syphilis among men who have sex with men in Jiangsu Province, China. Clin Infect Dis. 2014;58(12):1753–9.CrossRef Yang H-T, Tang W, Xiao Z-P, Jiang N, Mahapatra T, Huan X-P, et al. Worsening epidemic of HIV and syphilis among men who have sex with men in Jiangsu Province, China. Clin Infect Dis. 2014;58(12):1753–9.CrossRef
31.
go back to reference Bien CH, Best JM, Muessig KE, Wei C, Han L, Tucker JD. Gay apps for seeking sex partners in China: implications for MSM sexual health. AIDS Behav. 2015;19(6):941–6.CrossRef Bien CH, Best JM, Muessig KE, Wei C, Han L, Tucker JD. Gay apps for seeking sex partners in China: implications for MSM sexual health. AIDS Behav. 2015;19(6):941–6.CrossRef
32.
go back to reference Li X, Fang X, Lin D, Mao R, Wang J, Cottrell L, et al. HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China. AIDS Educ Prev. 2004;16(6):538–56.CrossRef Li X, Fang X, Lin D, Mao R, Wang J, Cottrell L, et al. HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China. AIDS Educ Prev. 2004;16(6):538–56.CrossRef
33.
go back to reference Tucker JD, Yin Y-P, Wang B, Chen X-S, Cohen MS. An expanding syphilis epidemic in China: epidemiology, behavioural risk and control strategies with a focus on low-tier female sex workers and men who have sex with men. Sex Transm Infect. 2011;87(Suppl 2):ii16–i8.CrossRef Tucker JD, Yin Y-P, Wang B, Chen X-S, Cohen MS. An expanding syphilis epidemic in China: epidemiology, behavioural risk and control strategies with a focus on low-tier female sex workers and men who have sex with men. Sex Transm Infect. 2011;87(Suppl 2):ii16–i8.CrossRef
34.
go back to reference Tucker JD, Cohen MS. China's syphilis epidemic: epidemiology, proximate determinants of spread, and control responses. Curr Opin Infect Dis. 2011;24(1):50.CrossRef Tucker JD, Cohen MS. China's syphilis epidemic: epidemiology, proximate determinants of spread, and control responses. Curr Opin Infect Dis. 2011;24(1):50.CrossRef
35.
go back to reference Control CD. Prevention. HIV testing and risk behaviors among gay, bisexual, and other men who have sex with men-United States. MMWR Morb Mortal Wkly Rep. 2013;62(47):958. Control CD. Prevention. HIV testing and risk behaviors among gay, bisexual, and other men who have sex with men-United States. MMWR Morb Mortal Wkly Rep. 2013;62(47):958.
36.
go back to reference Phillips AN, Cambiano V, Nakagawa F, Brown AE, Lampe F, Rodger A, et al. Increased HIV incidence in men who have sex with men despite high levels of ART-induced viral suppression: analysis of an extensively documented epidemic. PLoS One. 2013;8(2):e55312.CrossRef Phillips AN, Cambiano V, Nakagawa F, Brown AE, Lampe F, Rodger A, et al. Increased HIV incidence in men who have sex with men despite high levels of ART-induced viral suppression: analysis of an extensively documented epidemic. PLoS One. 2013;8(2):e55312.CrossRef
Metadata
Title
A spatiotemporal meta-analysis of HIV/syphilis epidemic among men who have sex with men living in mainland China
Authors
Rong Fu
Jinkou Zhao
Dan Wu
Xiayan Zhang
Joseph D. Tucker
Meiwen Zhang
Weiming Tang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2018
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-018-3532-8

Other articles of this Issue 1/2018

BMC Infectious Diseases 1/2018 Go to the issue