Emerging Disparity in HIV/AIDS Disease Progression and Mortality for Men Who Have Sex with Men, Jiangsu Province, China
- 365 Downloads
Few data exist on HIV disease progression and antiretroviral treatment (ART) impact among men who have sex with men (MSM) in China. Using data from the national case reporting system from 2004 to 2010, we describe changes in CD4 cell count before and after ART initiation, disease progression, and mortality among MSM in Jiangsu province compared with other persons living with HIV/AIDS. Median CD4 cell count among MSM at HIV diagnosis was 432 and decreased rapidly in 12 months to below the level of heterosexuals (slope: MSM −38.0, heterosexuals −15.5, injection drug users [IDU] −8.0, blood donors −10.5). Among those initiating ART, median CD4 cell count among MSM was 157, yet the increase in count was slower than for other groups (slope: MSM 26.9, heterosexuals 31.9, IDU 29.0, blood donors 35.0). Progression to AIDS was faster among MSM than heterosexuals and IDU. For the present, the mortality rate was lower for MSM compared with heterosexuals and blood donors; however, against a backdrop of more recent infection (ie, MSM had younger age, and 93.8 % were diagnosed after 2008), findings suggest a survival rate for MSM that will fall behind other groups. Improved medical and psychosocial supportive care is needed for this stigmatized population lest disparities become greater.
KeywordsChina Gay men Surveillance Disease progression Mortality HIV
The study was supported by the Jiangsu provincial government through the Jiangsu Province’s Outstanding Medical Academic Leader Program (RC2011087) and by the Jiangsu Provincial Center for Disease Control and Prevention (JKRC2011003). Additional support was made available through the University of California San Francisco (UCSF) Center for AIDS Prevention Studies (US National Institute of Mental Health P30 MH06224), the International Traineeships in AIDS Prevention Studies (R25MH064712), and the University of California Berkeley-UCSF AIDS International Training and Research Program (Fogarty International Center, D43TW000003). The authors thank the working group members from HIV/AIDS/STD prevention and control institute in JSCDC, for program implementation and assistance.
Conflict of interest
There are no conflicts of interest.
- 1.Ministry of Health of the People’s Republic of China. 2012 China AIDS Response Progress Report. http://www.unaids.org.cn/pics/20120614140133.pdf/. Accessed 22 April 2012.
- 3.China Ministry of Health. 2011 Estimates for the HIV/AIDS Epidemic in China. http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s3586/201201/53957.htm/. Accessed 26 April 2012.
- 6.Yan H, Zhang M, Li J, et al. Prevalence of sexually transmitted infections and the behavior characteristics of men who have sex with men in Jiangsu province. Chin Prev Med. 2010;11(12):1249–52.Google Scholar
- 7.Yang H, Hao C, Huan X, et al. HIV incidence and associated factors in a cohort of men who have sex with men in Nanjing. China Sex Transm Dis. 2010;37(4):208–13.Google Scholar
- 8.Liu H, Yang H, Li X, et al. Men who have sex with men and human immunodeficiency virus/sexually transmitted disease control in China. Sex Transm Infect. 2006;33(2):68–76.Google Scholar
- 10.Ministry of Health of the People’s Republic of China. China 2010 UNGASS Country Progress Report (2008–2009). http://www.unaids.org/en/Regionscountries/Countries/China/. Accessed 30 April 2012.
- 12.BBC News. Aids takes deathly toll in China. February 18, 2009. http://news.bbc.co.uk/2/hi/asia-pacific/7896133.stm/. Accessed 2 May 2012.
- 17.Zhang F, Wang Y, Wang J, et al. National Free Antiretroviral Treatment Handbook (version 2). People’s Medical Publishing House; 2007.Google Scholar
- 18.Hao Y, Sun X, Wu Z, et al. AIDS comprehensive control and prevention manual. Peking University Medical Press; 2010.Google Scholar
- 19.National Center for AIDS/STD Control and Prevention of the Chinese Center for Disease Control and Prevention. Guideline for database HIV/AIDS case reporting and management. July 2008. http://www.chinaids.org.cn/n16/n1193/n4073/n106347.files/n106346.pdf/. Accessed 20 April 2012.
- 27.Yang H, Xiao Z, Huan X, et al. Threshold survey of transmitted HIV-1 drug resistance in Jiangsu province. J Nanjing Univ. 2012;32(1):1–4.Google Scholar