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Expansion of HIV/AIDS in China: Lessons from Yunnan Province

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  • Xiao, Yan
  • Kristensen, Sibylle
  • Sun, Jiangping
  • Lu, Lin
  • Vermund, Sten H.

Abstract

In this article we systematically and critically review the Chinese and English language literature on human immunodeficiency virus (HIV)-related studies in Yunnan Province, Southwestern China. Yunnan Province had the first Chinese HIV outbreak and is still the worst affected area in the nation. Since 1989, HIV infection has extended from injecting drug users into the general population through sexual transmission. Since the economic reform of the 1980s, changed social norms and increased migration have spawned increases in HIV-related risk behaviors such as drug use and commercial sex work. A smaller size of "bridge" populations and lower sexual contact rates between persons in "bridge" and general populations may explain the slower expansion of the HIV epidemic in Yunnan compared to nearby Southeast Asian nations. In 2004, women in antenatal care had a 0.38% HIV prevalence province wide, although >1% infection rates are seen in those counties with high injection drug rates. Patterns of drug trafficking have spread the unusual recombinant HIV subtypes first seen in Yunnan to far-flung regions of China. Increased efforts of Yunnan's HIV control program are correlated with an improved general HIV awareness, but risk behaviors continue at worrisome rates. Future efforts should focus on changing risk behaviors, including harm reduction and condom promotion, especially among the "bridge" groups. The resurgence of commercial sex work in Yunnan, and the high frequency of workers migrating into provinces far from home and family are all sociocultural factors of considerable importance for future HIV and sexually transmitted disease control in China.

Suggested Citation

  • Xiao, Yan & Kristensen, Sibylle & Sun, Jiangping & Lu, Lin & Vermund, Sten H., 2007. "Expansion of HIV/AIDS in China: Lessons from Yunnan Province," Social Science & Medicine, Elsevier, vol. 64(3), pages 665-675, February.
  • Handle: RePEc:eee:socmed:v:64:y:2007:i:3:p:665-675
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    References listed on IDEAS

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    1. Wu, Z. & Detels, R. & Zhang, J. & Li, V. & Li, J., 2002. "Community-based trial to prevent drug use among youths in Yunnan, China," American Journal of Public Health, American Public Health Association, vol. 92(12), pages 1952-1957.
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    Cited by:

    1. Peipei Xiao & Jianjun Li & Gengfeng Fu & Ying Zhou & Xiping Huan & Haitao Yang, 2017. "Geographic Distribution and Temporal Trends of HIV-1 Subtypes through Heterosexual Transmission in China: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 14(7), pages 1-18, July.

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