{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:45:52Z","timestamp":1791373552091,"version":"4.3.1"},"reference-count":43,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>A thorough and precise comprehension understanding of the HIV epidemic is crucial for effective HIV prevention and control. This study aimed to update the estimates of the overall HIV burden in China in 2018 and to assess the trends of HIV prevalence, incidence, and mortality from 1985 to 2018. The Estimation and Projection Package (EPP)\/Spectrum software was utilized for estimation, a method highly recommended by UNAIDS. Data were collected from more than 1800 HIV sentinel surveillance sites, population\u2010based seroprevalence surveys, and HIV screening of antenatal clinics and pre\u2010marital medical check\u2010ups across the country. Assumptions about age and sex were used to adapt the parameters of disease progression, including CD4 progression rates and mortality rates for individuals on and off antiretroviral therapy (ART). Joinpoint (version 4.7.0.0) was used to analyze the trends of prevalence, incidence, mortality, and fatality rates from 1985 to 2018. In 2018, the total number of people living with HIV (PLWH) adults in China was estimated to be 1.23 million, corresponding to approximately 106.5\/100\u2009000 in the country. A total of 71.8% of adult PLWH were men. Over half of PLWH (58.6%) were infected through heterosexual contact, about one\u2010third (30.2%) through male\u2010to\u2010male transmission, 9.0% through IDU, and 2.3% due to former plasma donation. HIV incidence in adults reached its first small peak in 1992 with 52\u2009400 new infections (95% confidence interval: 2700\u2013920\u2009000). After a brief period of rapid decline between 1992 and 1994, the annual number of new infections among adults increased again and remained relatively stable at 81\u2009000 (95% uncertainty interval [UI]: 60\u2009000\u2013105\u2009000) in 2018. In recent years, the number of new infections through blood donation has been eliminated, and the number of infections through injecting drug use has been kept low. Sexual contact became the predominant transmission route, while casual sexual contact became increasingly common. Overall, HIV mortality has been steadily increasing and has recently begun to decline during the period of 2012\u20132018. The number of deaths from HIV\/AIDS in 2018 was approximately 35\u2009000 (95% UI: 30\u2009000\u201341\u2009000). The number of estimated PLWH in China has exceeded one million, due to the ongoing occurrence of new infections and longer survival rates. HIV transmission through blood products has been eradicated. Casual sex has become a significant mode of transmission. It is recommended to enhance the implementation of strategies and measures for sexual communication in the general population and to bolster multidisciplinary research.<\/jats:p>","DOI":"10.1002\/jmv.70048","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T11:09:42Z","timestamp":1734952182000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Estimates of HIV Incidence, Prevalence, and Mortality in China 2018"],"prefix":"10.1002","volume":"96","author":[{"given":"Fangfang","family":"Chen","sequence":"first","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongmin","family":"Li","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houlin","family":"Tang","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Ge","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Cui","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peilong","family":"Li","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Cai","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Qin","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichen","family":"Jin","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuquan","family":"Qu","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongfu","family":"Liu","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiming","family":"Shao","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zunyou","family":"Wu","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjie","family":"Han","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Lv","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,23]]},"reference":[{"issue":"3","key":"e_1_2_9_2_1","first-page":"iii87","article-title":"Estimating the Number of People at Risk for and Living With HIV in China in 2005: Methods and Results","volume":"82","author":"Lu F.","year":"2006","journal-title":"Sexually Transmitted Infections"},{"key":"e_1_2_9_3_1","unstructured":"\u201cMinistry of Health People's Republic of China Joint United Nations Programme on HIV\/AIDS World Health Organization. 2011 Estimates for the HIV\/AIDS Epidemic in China \u201dBeijing China 2011."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyq209"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2004.010207"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa835"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2004.010157"},{"issue":"3","key":"e_1_2_9_8_1","first-page":"iii45","article-title":"Projecting the Demographic Impact of AIDS and the Number of People in Need of Treatment: Updates to the Spectrum Projection Package","volume":"82","author":"Stover J.","year":"2006","journal-title":"Sexually Transmitted Infections"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.029868"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2010.044222"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050640"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000483"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001322"},{"key":"e_1_2_9_14_1","unstructured":"National Center for AIDS\/STD Control and Prevention China CDC. Work Plan on HIV Epidemic Estimation in China (2018). Beijing: National Center for AIDS\/STD Control and Prevention China CDC;2018."},{"key":"e_1_2_9_15_1","unstructured":"National Center for AIDS\/STD Control and Prevention China CDC. Quick Start User Manual of Spectrum\/EPP Software 2018 (Simplified Chinese). Beijing: National Center for AIDS\/STD Control and Prevention China CDC;2018."},{"key":"e_1_2_9_16_1","unstructured":"National Center for AIDS\/STD Control and Prevention China CDC. Guideline on Data Collection and Utilization for HIV Epidemic Estimation in China (2018). Beijing: National Center for AIDS\/STD Control and Prevention China CDC;2018."},{"key":"e_1_2_9_17_1","unstructured":"National Center for AIDS\/STD Control and Prevention China CDC. Guidelines for HIV Sentinel Surveillance Survey in China. Beijing: National Center for AIDS\/STD Control and Prevention China CDC;2017."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70245-7"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.5365\/wpsar.2012.3.3.004"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60753-X"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep28005"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70097-4"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000304694.54884.06"},{"issue":"2","key":"e_1_2_9_24_1","first-page":"ii79","article-title":"Development of a Unified Web\u2010Based National HIV\/AIDS Information System in China","volume":"39","author":"Mao Y.","year":"2010","journal-title":"International Journal of Epidemiology"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181958530"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyq209"},{"issue":"1","key":"e_1_2_9_28_1","first-page":"1","article-title":"2011 Estimates for the HIV\/AIDS Epidemic in China. Beijing, China: Ministry of Health, People's Republic of China, Joint United Nations Programme on HIV\/AIDS, World Health Organization","volume":"18","author":"Ministry of Health PsRoC, HIV\/AIDS; JUNPo, Organization. WH","year":"2012","journal-title":"Chinese Journal of AIDS & STD"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2017.1291169"},{"key":"e_1_2_9_30_1","unstructured":"UNAIDS. UNAIDS data.2019. (accessed 2022\/10\/13) https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2019-UNAIDS-data_en.pdf."},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000323"},{"key":"e_1_2_9_32_1","unstructured":"Centers for Disease Control and Prevention.Estimated HIV Incidence and Prevalence in the United States 2014\u20132018 HIV Surveillance Supplemental Report 25 no. 1 (2020) http:\/\/www.cdc.gov\/hiv\/library\/reports\/hiv-surveillance.html."},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05757-2"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/1079063216672168"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.4.443"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1468-0"},{"issue":"11","key":"e_1_2_9_37_1","first-page":"977","article-title":"Characteristics of Non\u2010Marital and Non\u2010Commercial Heterosexual Transmission of HIV Infection in Miao\u2010Dong Autonomous Prefecture of Qiandongnan","volume":"51","author":"Yu Q. Y.","year":"2017","journal-title":"Zhonghua yu fang yi xue za zhi [Chinese Journal of Preventive Medicine]"},{"issue":"12","key":"e_1_2_9_38_1","first-page":"1269","article-title":"Epidemiological Characteristics and Latent Class Analysis of Non\u2010Marital Heterosexual Behaviors Among Human Immunodeficiency Virus\/Acquired Immunodeficiency Syndrome Individuals in Jiangmen, Guangdong Province Between 2015 and 2017","volume":"52","author":"Yu Q. Y.","year":"2018","journal-title":"Zhonghua yu fang yi xue za zhi [Chinese Journal of Preventive Medicine]"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep31081"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/607261"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92698-4"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61898-4"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70946-6"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3158-x"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.70048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T13:17:08Z","timestamp":1740230228000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.70048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":43,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/jmv.70048"],"URL":"https:\/\/doi.org\/10.1002\/jmv.70048","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"2024-04-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70048"}}