IJE Advance Access originally published online on October 14, 2008
International Journal of Epidemiology 2008 37(6):1287-1296; doi:10.1093/ije/dyn196
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Estimates of HIV prevalence in a highly endemic area of China: Dehong Prefecture, Yunnan Province
1 Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
2 Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
3 National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing 100050, PR China.
4 Dehong Prefecture Center for Disease Control and Prevention, Mang City 678400, Yunnan Province, PR China.
5 Dehong Prefecture Health Bureau, Mang City, Yunnan Province, PR China.
6 Yunnan Center for Disease Control and Prevention, Kunming 650022, Yunnan Province, PR China.
7 Division of AIDS, Bureau of Disease Control, Ministry of Health, Beijing 100044, PR China.
8 School of Mathematical Sciences, Graduate University of Chinese Academy of Sciences, Beijing 100049, PR China.
9 School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35025, USA.
* Corresponding author. National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, 27 Nanwei Road, Xuanwu District, Beijing 100050, China. E-mail: jpsun{at}chinaids.org.cn
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Abstract |
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Background Dehong Prefecture in Yunnan Province, China, borders Myanmar. Its proximity to the ‘Golden Triangle’, one of the world's largest illicit drug production and distribution centre, contributes to drug trafficking and ready availability of heroin. Dehong's 1.1 million people confront a serious HIV problem fuelled by injection drug use. The aim of this study is to improve the 2005 estimates of the true status of the HIV/AIDS epidemic in Dehong Prefecture.
Methods We estimated the HIV prevalence by synthesizing the results from several data sources (HIV/AIDS case reports, surveys, surveillance activities and epidemiological studies). We applied three different statistical procedures for estimations: (i) The Workbook method, adapted to meet the estimation needs in Dehong Prefecture; (ii) An estimate based on antenatal clinical data; and (iii) a dynamic model based on the local epidemic pattern.
Results We estimated that the population prevalence for HIV infections in Dehong Prefecture is 1.3% (likely range from low/high of three estimates: 0.9–1.7%) such that 13 500 people were living with HIV/AIDS in Dehong Prefecture (likely range: 8200–18 300) in 2005. Infections remain concentrated among injection drug users, female sex workers and their clients with an uneven geographical distribution of estimated cases.
Conclusion More reliable estimates of HIV prevalence can be made by synthesizing multiple data sources using several procedures. Current HIV prevention, care and treatment challenges are judged substantial in Dehong Prefecture, regardless of what modelling strategy is used.
Keywords HIV, AIDS, estimation, model, China, substance abuse
Accepted 22 August 2008
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