Estimating the number of people at risk for and living with HIV in China in 2005: methods and results

BACKGROUND: No new estimates of HIV infection have been available for China since 2003. However, since then, data availability has increased dramatically. OBJECTIVES: To use internationally recommended methods to make new estimates of the number of people exposed to HIV in China, the number living with HIV, and the number of new HIV infections and deaths in 2005. METHODS: The UNAIDS Workbook method was adapted to meet the needs of China. Local data were used to estimate the size of each risk population and HIV prevalence by risk group for every prefecture. These estimates were combined into provincial and national estimates. The UNAIDS Estimates and Projections Package and Spectrum were used to derive estimates of incidence and mortality from prevalence data, taking into account treatment. RESULTS: It was estimated that 650,000 people are living with HIV/AIDS in China (range 540,000-760,000), of whom 70,000 were newly infected in 2005 (range 60,000-80,000). Between 20,000 and 30,000 people are estimated to have died of HIV in 2005. The new estimate compares with an estimate of 840,000 people living with HIV/AIDS in 2003 (range 650,000-1,020,000). The estimated number of infected former plasma donors fell from 199,000 to 55,000. Infections remain concentrated among drug injectors, those buying and selling sex, and men who have sex with men. CONCLUSION: The new estimates are based on a much wider range of surveillance data as well as mass screening of former plasma donors, and are made at the prefecture level. More limited data from high prevalence provincial surveillance sites led to past estimates that now seem too high. New infections outpace death, and the HIV epidemic in China is still growing.