{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T18:28:43Z","timestamp":1773340123817,"version":"3.50.1"},"reference-count":93,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2017,7,24]],"date-time":"2017-07-24T00:00:00Z","timestamp":1500854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Heterosexual transmission (HST) has become the current predominant transmission pathways of the HIV-1 epidemic in China. The aim of this study was to explore the geographic and dynamic change of HIV-1 subtypes through HST in China from published studies. Methods: Several electronic databases were searched to identify the studies, and the overall prevalence of HIV-1 subtypes was estimated by a meta-analysis method. Subgroup analysis was conducted by study region and time period. Publication bias was evaluated using Egger\u2019s test. The \u03c72 test was used to evaluate the proportion differences among subgroups. Sensitivity analysis was carried out to assess the stability of the overall prevalence estimates. Results: 42 studies were included in our final analysis. The overall prevalence of CRF01_AE was 46.34% (95% CI: 40.56\u201352.17%), CRF07_BC was 19.16% (95% CI: 15.02\u201323.66%), B\/B\u2019 was 13.25% (95% CI: 9.68\u201317.25%), CRF08_BC was 10.61% (95% CI: 7.08\u201314.70%), and C was 4.29% (95% CI: 1.85\u20137.48%). In subgroup analysis, the prevalence of CRF01_AE and CRF07_BC increased, while the prevalence of B\/B\u2019 decreased over time, whereby the prevalence of CRF07_BC and CRF08_BC have exceeded that of B\/B\u2019 since 2010. A significant higher prevalence of CRF01_AE was found in the South provinces, CRF07_BC in East provinces, CRF08_BC and C in Southwest provinces, and B\/B\u2019 in North provinces. Conclusions: The HIV-1 prevalent strains have evolved into complicated and diverse subtypes, and the proportion of HIV-1 subtypes through HST has changed constantly in different regions and periods in China. This highlights the urgent need to vigorously strengthen the prevention and control of the HIV-1 epidemic.<\/jats:p>","DOI":"10.3390\/ijerph14070830","type":"journal-article","created":{"date-parts":[[2017,7,24]],"date-time":"2017-07-24T10:04:13Z","timestamp":1500890653000},"page":"830","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Geographic Distribution and Temporal Trends of HIV-1 Subtypes through Heterosexual Transmission in China: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"14","author":[{"given":"Peipei","family":"Xiao","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianjun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of HIV\/STD Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gengfeng","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of HIV\/STD Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of HIV\/STD Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiping","family":"Huan","sequence":"additional","affiliation":[{"name":"Department of HIV\/STD Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haitao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China"},{"name":"Department of HIV\/STD Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China"},{"name":"Jiangsu Research Institute of Schistosomiasis Control, Wuxi 214064, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,7,24]]},"reference":[{"key":"ref_1","first-page":"S147","article-title":"Detection of antibody to LAV\/HTLV-III in sera from hemophiliacs in China","volume":"2","author":"Zeng","year":"1986","journal-title":"AIDS Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.socscimed.2006.09.019","article-title":"Expansion of HIV\/AIDS in China: Lessons from Yunnan province","volume":"64","author":"Xiao","year":"2007","journal-title":"Soc. Sci. Med."},{"key":"ref_3","first-page":"1041","article-title":"Sources of data for improved surveillance of HIV\/AIDS in China","volume":"38","author":"Jia","year":"2007","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"ii21","DOI":"10.1093\/ije\/dyq209","article-title":"Estimating the number of people living with HIV\/AIDS in China: 2003-09","volume":"39","author":"Wang","year":"2010","journal-title":"Int. J. Epidemiol."},{"key":"ref_5","unstructured":"National Center for AIDS\/STD Control and Prevention, China CDC (2017). Update on the AIDS\/STD epidemic in China and main response in control and prevention in December, 2016. Chin. J. AIDS STD, 23, 93. (In Chinese)."},{"key":"ref_6","first-page":"1332","article-title":"Characteristics of HIV transmission through heterosexual contact in China, 2008\u20132014","volume":"36","author":"Wang","year":"2015","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1126\/science.2460925","article-title":"The accuracy of reverse transcriptase from HIV-1","volume":"242","author":"Roberts","year":"1988","journal-title":"Science"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"6588","DOI":"10.1073\/pnas.0936469100","article-title":"Tracing the origin and history of the HIV-2 epidemic","volume":"100","author":"Lemey","year":"2003","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"a006841","DOI":"10.1101\/cshperspect.a006841","article-title":"Origins of HIV and the AIDS pandemic","volume":"1","author":"Sharp","year":"2011","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"10498","DOI":"10.1128\/JVI.74.22.10498-10507.2000","article-title":"Unprecedented degree of human immunodeficiency virus type 1 (HIV-1) group M genetic diversity in the Democratic Republic of Congo suggests that the HIV-1 pandemic originated in Central Africa","volume":"74","author":"Vidal","year":"2000","journal-title":"J. Virol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2487","DOI":"10.1098\/rstb.2010.0031","article-title":"The evolution of HIV-1 and the origin of AIDS","volume":"365","author":"Sharp","year":"2010","journal-title":"Philos. Trans. R. Soc. Lond. Ser. B Biol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1097\/QAD.0b013e328342ff93","article-title":"Global trends in molecular epidemiology of HIV-1 during 2000\u20132007","volume":"25","author":"Hemelaar","year":"2011","journal-title":"AIDS"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.molmed.2011.12.001","article-title":"The origin and diversity of the HIV-1 pandemic","volume":"18","author":"Hemelaar","year":"2012","journal-title":"Trends. Mol. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"He, X., Xing, H., Ruan, Y., Hong, K., Cheng, C., Hu, Y., Xin, R., Wei, J., Feng, Y., and Hsi, J.H. (2012). A comprehensive mapping of HIV-1 genotypes in various risk groups and regions across China based on a nationwide molecular epidemiologic survey. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0047289"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/QAD.0000000000000125","article-title":"CRF01_AE subtype is associated with X4 tropism and fast HIV progression in Chinese patients infected through sexual transmission","volume":"28","author":"Li","year":"2014","journal-title":"AIDS"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/QAI.0000000000000473","article-title":"HIV-1 subtype B\/B\u2019 and baseline drug resistance mutation are associated with virologic failure: A multicenter cohort study in China","volume":"68","author":"Li","year":"2015","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Sui, H., Gui, T., Jia, L., Guo, W., Han, J., Liu, Y., Bao, Z., Li, H., Li, J., and Li, L. (2014). Different frequencies of drug resistance mutations among HIV-1 subtypes circulating in China: A comprehensive study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0091803"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jclinepi.2009.06.006","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration","volume":"62","author":"Liberati","year":"2009","journal-title":"J. Clin. Epidemiol."},{"key":"ref_19","first-page":"138","article-title":"The inverse of the Freeman-Tukey double arcsine transformation","volume":"32","author":"Miller","year":"1978","journal-title":"Am. Stat."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1179\/2047772412Z.00000000086","article-title":"Prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people: A systematic review and meta-analysis","volume":"106","author":"Cassone","year":"2012","journal-title":"Pathog. Glob. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1177\/0956462414543841","article-title":"Prevalence of HIV-1 subtypes among men who have sex with men in China: A systematic review","volume":"26","author":"Zhang","year":"2015","journal-title":"Int. J. STD AIDS"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."},{"key":"ref_24","first-page":"420","article-title":"Sequence and subtype analysis of gag gene of isolates confirmed by HIV-1 infections in Beijing in 2007","volume":"25","author":"Ye","year":"2009","journal-title":"Virology"},{"key":"ref_25","first-page":"3471","article-title":"Molecular epidemiology of HIV-1 in Guangdong province","volume":"33","author":"He","year":"2012","journal-title":"Guangdong Med."},{"key":"ref_26","first-page":"538","article-title":"Gene subtype analysis of HIV-1 strains isolated from different population groups in Huzhou","volume":"25","author":"Wu","year":"2015","journal-title":"Chin. J. Health Lab. Technol."},{"key":"ref_27","first-page":"22","article-title":"Study of spreading mode and molecular epidemiological characteristcs of heterosexual transmitted HIV in Huaian","volume":"26","author":"Fan","year":"2015","journal-title":"Jiangsu J. Prev. Med."},{"key":"ref_28","first-page":"55","article-title":"Epidemiological features and molecualr evolution of HIV-1 through heterosexual contact in Huaian","volume":"11","author":"Yan","year":"2016","journal-title":"Pathog. Biol."},{"key":"ref_29","first-page":"976","article-title":"Molecular epidemiology of the human immunodeficiency virus-1 isolated from patients confirmed lately in Jiangsu province","volume":"29","author":"Yang","year":"2009","journal-title":"ACTA Univ. Med. Nanjing"},{"key":"ref_30","first-page":"294","article-title":"Molecular epidemiology of HIV-1 transmission among heterosexuals in Kunming","volume":"23","author":"Li","year":"2009","journal-title":"Chin. J. Derm. Vener."},{"key":"ref_31","first-page":"5","article-title":"Molecular epidemiological characteristics of HIV-1 in Shanghai, 2007\u20132013","volume":"22","author":"Wu","year":"2016","journal-title":"Chin. J. AIDS STD"},{"key":"ref_32","first-page":"180","article-title":"Molecular epidemiological survey on HIV-1 subtypes in people with heterosexual transmission in Shanghai","volume":"15","author":"Tao","year":"2016","journal-title":"J. Diagn. Concepts Pract."},{"key":"ref_33","first-page":"217","article-title":"Molecular epidemiological study of HIV-1 in Minghang District of Shanghai","volume":"16","author":"Zhang","year":"2015","journal-title":"Chin. Prev. Med."},{"key":"ref_34","first-page":"82","article-title":"Study on the molecular-epidemiological characteristics of HIV-1 in Shenzhen, 1992\u20132008","volume":"33","author":"Zhao","year":"2012","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_35","first-page":"562","article-title":"Molecular epidemiological characteristics of 528 HIV-1 infected cases in Shenzhen","volume":"15","author":"Kong","year":"2015","journal-title":"Chin. Trop. Med."},{"key":"ref_36","first-page":"192","article-title":"Molecular epidemiology of HIV-1 subtypes in Shenzhen of 2010","volume":"12","author":"Shi","year":"2012","journal-title":"Chin. Trop. Med."},{"key":"ref_37","first-page":"509","article-title":"The genetic subtype of HIV-1 in different groups of HIV-1 infected person in Tianjin","volume":"16","author":"Wang","year":"2012","journal-title":"Chin. J. Dis. Control Prev."},{"key":"ref_38","first-page":"1035","article-title":"Study on subtypes distribution and characteristics for HIV-1 infection among MSM and heterosexuals","volume":"15","author":"Zhao","year":"2011","journal-title":"Chin. J. Dis. Control Prev."},{"key":"ref_39","first-page":"145","article-title":"Characteristics and distribution of HIV-1 subtypes in Yunnan province","volume":"22","author":"Li","year":"2016","journal-title":"Chin. J. AIDS STD"},{"key":"ref_40","first-page":"883","article-title":"Distribution of HIV-1 subtypes among different populations in Dehong prefecture, Yunnan province in 2011","volume":"33","author":"Chen","year":"2012","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_41","first-page":"79","article-title":"Distribution of subtypes of pol gene in HIV-1 epidemic strains in Guangxi Zhuang Autonomous Region, 2010\u20132012","volume":"50","author":"Wang","year":"2016","journal-title":"Chin. J. Prev. Med."},{"key":"ref_42","first-page":"758","article-title":"Molecular epidemiology of HIV-1 in Shanghai in 2013","volume":"33","author":"Zheng","year":"2015","journal-title":"Chin. J. Infect. Dis."},{"key":"ref_43","first-page":"278","article-title":"Molecular epidemiology and drug resistance: Survey on HIV-1 in Luwan District of Shanghai","volume":"11","author":"Wu","year":"2012","journal-title":"J. Diag. Concepts Pract."},{"key":"ref_44","first-page":"1055","article-title":"Analysis on HIV-1 in homosexual and heterosexual transmission in molecular epidemiology in Shenzhen","volume":"44","author":"Bao","year":"2010","journal-title":"Chin. J. Prev. Med."},{"key":"ref_45","first-page":"532","article-title":"The relationship between distribution of different subtypes of HIV-1 and the transmission routes in Shenzhen","volume":"30","author":"Bao","year":"2012","journal-title":"Chin. J. Infect. Dis."},{"key":"ref_46","first-page":"308","article-title":"Molecular epidemiology of HIV infection cases in 2003\u20132005 in Zhejiang province","volume":"13","author":"Pan","year":"2007","journal-title":"Chin. J. AIDS STD"},{"key":"ref_47","first-page":"984","article-title":"Molecular epidemiology among newly-diagonsed HIV-1 infections in Taizhou, Zhejiang province, 2011","volume":"28","author":"Qiu","year":"2013","journal-title":"Dis. Surveil."},{"key":"ref_48","first-page":"49","article-title":"Molecular epidemiological characteristics of HIV-1 strains isolated from newly diagnosed MSM subjects (2006\u20132010) in Beijing, China","volume":"34","author":"Ye","year":"2013","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_49","unstructured":"Jin, M.H., Wu, X.F., and Yang, Z.R. (2014). Analysis of subtypes of HIV-1 gag gene through sexually transmission in Huzhou. Chin. J. AIDS STD, 20, (In Chinese)."},{"key":"ref_50","first-page":"2889","article-title":"Molecualr epidemiology on HIV in Ningbo in 2009","volume":"20","author":"Zhang","year":"2010","journal-title":"Chin. J. HLT"},{"key":"ref_51","first-page":"1174","article-title":"Modecular epidemiological study of HIV-1 in Qinann district of Qinzhou","volume":"35","author":"Shen","year":"2015","journal-title":"Chin. J. RHSA"},{"key":"ref_52","first-page":"1195","article-title":"A molecular epidemiological study on the human immunodeficiency virus infection in Wuxi city","volume":"19","author":"Cheng","year":"2015","journal-title":"Chin. J. Dis. Control Prev."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1097\/QAI.0b013e3181c7d5bf","article-title":"Genetic and epidemiologic characterization of HIV-1 infection in Liaoning province, China","volume":"53","author":"Han","year":"2010","journal-title":"J. Acquir. Immune Defic. Synd."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Chen, S., Cai, W., He, J., Vidal, N., Lai, C., Guo, W., He, H., Chen, X., Fu, L., and Peeters, M. (2012). Molecular epidemiology of human immunodeficiency virus type 1 in Guangdong province of Southern China. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0048747"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1089\/aid.2007.0269","article-title":"Molecular tracing of sexual HIV type 1 transmission in the Southwest border of China","volume":"24","author":"Bao","year":"2008","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1002\/jmv.23360","article-title":"Subtype CRF01_AE dominate the sexually transmitted human immunodeficiency virus type 1 epidemic in Guangxi, China","volume":"85","author":"Li","year":"2013","journal-title":"J. Med. Virol."},{"key":"ref_57","first-page":"714","article-title":"Genetic subtype and epidemiological feature of HIV-1 circulating strains among recently infected patients in Fujian province","volume":"35","author":"Deng","year":"2014","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_58","first-page":"836","article-title":"HIV-1 subtype and the distribution in Yunnan province","volume":"33","author":"Yang","year":"2012","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_59","first-page":"44","article-title":"Molecular epidemiological study on HIV\/AIDS under the follow-up program in Zhejiang province in 2009","volume":"34","author":"Zhang","year":"2013","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_60","first-page":"638","article-title":"Subtype and transmission of HIV strain in both HIV infected spouses in Zhejiang province","volume":"31","author":"Pan","year":"2010","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Chen, Y., Chen, S., Kang, J., Fang, H., Dao, H., Guo, W., Lai, C., Lai, M., Fan, J., and Fu, L. (2014). Evolving molecular epidemiological profile of human immunodeficiency virus 1 in the Southwest border of China. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0107578"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1089\/aid.2010.0344","article-title":"High prevalence of HIV type 1 subtype B\u2019 among heterosexuals in Western Hubei, Central China: Bridging the epidemic into the general population","volume":"27","author":"Li","year":"2011","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1186\/s40064-016-2378-z","article-title":"HIV-1 diversity in infected individuals in Suzhou and Suqian, China","volume":"5","author":"Qin","year":"2016","journal-title":"SpringerPlus"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"148","DOI":"10.2174\/1570162X13666150929094555","article-title":"HIV-1 is spreading out of former high-risk population through heterosexual transmission in Hebei, China","volume":"14","author":"Gui","year":"2016","journal-title":"Curr. HIV Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1097\/00126334-200309010-00014","article-title":"Identification and distribution of HIV type 1 genetic diversity and protease inhibitor resistance-associated mutations in Shanghai, P. R. China","volume":"34","author":"Zhong","year":"2003","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/QAI.0b013e31824f19f5","article-title":"Rising epidemic of HIV-1 infections among general populations in Fujian, China","volume":"60","author":"Yao","year":"2012","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_67","first-page":"1164","article-title":"Distribution of HIV-1 genotypes in China: A systematic review","volume":"35","author":"Su","year":"2014","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1089\/aid.2016.0029","article-title":"Nationwide trends in molecular epidemiology of HIV-1 in China","volume":"32","author":"Li","year":"2016","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Lin, H., Ding, Y., Liu, X., Wu, Q., Shen, W., and He, N. (2015). High prevalence of HIV infection and bisexual networks among a sample of men who have sex with men in Eastern China. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0129300"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1136\/sextrans-2011-050079","article-title":"Prevalence of bisexual behaviour among bridge population of men who have sex with men in China: A meta-analysis of observational studies","volume":"87","author":"Yun","year":"2011","journal-title":"Sex. Transm. Infect."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"11323","DOI":"10.1038\/srep11323","article-title":"The sexually driven epidemic in youths in China\u2019s Southwestern border region was caused by dynamic emerging multiple recombinant HIV-1 strains","volume":"5","author":"Wei","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Lim, R.B., Wong, M.L., Tan, P.H., and Govender, M. (2015). Heterosexual men who patronise entertainment establishments versus brothels in an asian urban setting\u2014which group practises riskier sexual behaviours?. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-2132-4"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1037\/adb0000162","article-title":"Meta-analysis of the association between methamphetamine use and high-risk sexual behavior among heterosexuals","volume":"30","author":"Hittner","year":"2016","journal-title":"Psychol. Addict. Behav. J. Soc. Psychol. Addict. Behav."},{"key":"ref_74","first-page":"1073","article-title":"A systematic review of temporal and geographical distributions of HIV genotypes in China during 2000\u20132012","volume":"17","author":"Tao","year":"2013","journal-title":"Chin. J. Dis. Control Prev."},{"key":"ref_75","first-page":"1487","article-title":"High genetic diversity of HIV-1 was found in men who have sex with men in Shijiazhuang, China","volume":"11","author":"Li","year":"2011","journal-title":"Infect. Genet. Evol. J. Mol. Epidemiol. Evol. Genet. Infect. Dis."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Lu, L., Ba, L., Liu, L., Yang, L., Jia, M., Wang, H., Fang, Q., Shi, Y., and Yan, W. (2006). Dominance of HIV-1 subtype CRF01_AE in sexually acquired cases leads to a new epidemic in Yunnan province of China. PLoS Med., 3.","DOI":"10.1371\/journal.pmed.0030443"},{"key":"ref_77","first-page":"541","article-title":"Molecular epidemiology of HIV in China: 1985\u20132015","volume":"36","author":"Wang","year":"2015","journal-title":"Zhonghua Liuxingbingxue Zazhi"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1016\/S0140-6736(05)79316-8","article-title":"Two subtypes of HIV-1 among injection-drug users in Southern China","volume":"351","author":"Yu","year":"1998","journal-title":"Lancet"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"19279","DOI":"10.1038\/srep19279","article-title":"Geographic origin and evolutionary history of China's two predominant HIV-1 circulating recombinant forms, CRF07_BC and CRF08_BC","volume":"6","author":"Feng","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"19993","DOI":"10.7448\/IAS.18.1.19993","article-title":"The temporal increase in HIV-1 non-R5 tropism frequency among newly diagnosed patients from northern poland is associated with clustered transmissions","volume":"18","author":"Parczewski","year":"2015","journal-title":"J. Int. AIDS Soc."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1089\/aid.2013.0067","article-title":"Determination of the high prevalence of dual\/mixed- or X4-tropism among HIV type 1 CRF01_AE in Hong Kong by genotyping and phenotyping methods","volume":"29","author":"To","year":"2013","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1093\/infdis\/jir719","article-title":"Transmission of the X4 phenotype of HIV-1: Is there evidence against the \u201crandom transmission\u201d hypothesis?","volume":"205","author":"Hedskog","year":"2012","journal-title":"J. Infect. Dis."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Li, X., Xue, Y., Cheng, H., Lin, Y., Zhou, L., Ning, Z., Wang, X., Yu, X., Zhang, W., and Shen, F. (2015). HIV-1 genetic diversity and its impact on baseline CD4+T cells and viral loads among recently infected men who have sex with men in Shanghai, China. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0129559"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Li, X., Xue, Y., Zhou, L., Lin, Y., Yu, X., Wang, X., Zhen, X., Zhang, W., Ning, Z., and Yue, Q. (2014). Evidence that HIV-1 CRF01_AE is associated with low CD4+T cell count and CXCR4 co-receptor usage in recently infected young men who have sex with men (MSM) in Shanghai, China. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0089462"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Huang, S.W., Wang, S.F., Lin, Y.T., Yen, C.H., Lee, C.H., Wong, W.W., Tsai, H.C., Yang, C.J., Hu, B.S., and Lin, Y.H. (2014). Patients infected with CRF07_BC have significantly lower viral loads than patients with HIV-1 subtype B: Mechanism and impact on disease progression. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0114441"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1089\/aid.2014.0187","article-title":"The identification of a novel HIV-1 CRF01_AE\/B recombinant using the near full length genome in Jiangsu province, China","volume":"30","author":"Guo","year":"2014","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1089\/aid.2016.0027","article-title":"Near full-length genome sequences of two novel HIV-1 recombinant forms detected in Henan province, China","volume":"32","author":"Li","year":"2016","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"285288","DOI":"10.1089\/aid.1998.14.285","article-title":"Cloning and characterization of a virtually full-length HIV type 1 genome from a subtype B\u2019-Thai strain representing the most prevalent B-clade isolate in China","volume":"14","author":"Graf","year":"1998","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1097\/QAD.0b013e328351430d","article-title":"Tracing the origin and history of HIV-1 subtype B' epidemic by near full-length genome analyses","volume":"26","author":"Li","year":"2012","journal-title":"AIDS"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1089\/aid.2011.0177","article-title":"Identification of new CRF51_01B in singapore using full genome analysis of three HIV type 1 isolates","volume":"28","author":"Ng","year":"2012","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1089\/aid.2013.0228","article-title":"Genome sequence of a novel HIV-1 circulating recombinant form (CRF57_BC) identified from Yunnan, China","volume":"30","author":"Wei","year":"2014","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1089\/aid.2013.0233","article-title":"Identification of a novel HIV type 1 circulating recombinant form (CRF65_cpx) composed of CRF01_AE and subtypes B and C in Western Yunnan, China","volume":"30","author":"Feng","year":"2014","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.urolonc.2006.12.001","article-title":"Meta-analysis in medical research: Potentials and limitations","volume":"26","author":"Zwahlen","year":"2008","journal-title":"Urol. Oncol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/14\/7\/830\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:43:49Z","timestamp":1760208229000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/14\/7\/830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,24]]},"references-count":93,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2017,7]]}},"alternative-id":["ijerph14070830"],"URL":"https:\/\/doi.org\/10.3390\/ijerph14070830","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,24]]}}}