[Estimation and projection on HIV/AIDS through application of Estimation and Projection Package and Spectrum models, in Taizhou prefecture, Zhejiang province].

OBJECTIVE: To apply Estimation and Projection Package (EPP) and Spectrum models for the estimation and projection on HIV/AIDS epidemics in areas with relatively low HIV/AIDS prevalence in China, and to explore the influences of antiretroviral therapy (ART) on the outputs of the models. METHODS: Taizhou prefecture in Zhejiang province was selected as the study site. Social and demographic data as well as all the information on HIV/AIDS epidemics in Taizhou prefecture were collected, managed, input to EPP and Spectrum models to estimate and project the HIV/AIDS epidemic in Taizhou prefecture. Impact of ART on the HIV/AIDS epidemic was also assessed. RESULTS: According to the estimates from both EPP and Spectrum model, the HIV/AIDS epidemic in Taizhou prefecture was at a relatively low level. HIV prevalence rates among men having sex with men (MSM) and injection drug users (IDU) were relatively high and rapidly increasing. It was estimated that 1773 (1384 - 2449) people were living with HIV in 2010 in Taizhou prefecture, with an overall HIV prevalence of 0.03% (0.02% - 0.04%). ART had reduced and would continue to reduce new HIV infections and AIDS deaths, but had no significant impact on the overall HIV prevalence and the numbers of people living with HIV and adults who were in need of ART. CONCLUSION: EPP and Spectrum models seemed to be suitable and useful tools for estimation and projection on HIV/AIDS in Taizhou prefecture, and the results could provide reference for the further studies in other areas with a relatively low epidemic level of HIV/AIDS. ART appeared effective for HIV/AIDS prevention and control.

[Risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province].

OBJECTIVE: To understand the risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province. METHODS: Newly reported HIV infections from May 2008 through March 2010 in Taizhou prefecture were invited to participate in a cross-sectional survey which requested numbers and contact information of individuals with whom they had had high risk contacts as well as risk behavioral acts with them. Persons having had risky contacts with HIV-infected cases were thereof approached to participate in this survey and to receive HIV testing. Those who tested positive for HIV were subject to further round of the surveys. RESULTS: A total of 267 HIV cases were newly reported during this study period. Among them, 191 participated in the survey and served as 'index cases', including 158 cases identified from routine HIV surveillance programs and 33 cases identified from the present survey. Heterosexual transmission was the primary transmission route (74.9%, or 143/191), followed by homosexual transmission (19.4%, or 37/191) and injection drug use (5.8%, or 11/191). These 191 HIV cases reported a total of 1152 individuals with whom they had had risky contacts. They were able to provide contact information of 461 risk contacts. Of them, 129 received HIV testing and 61 (47.3%) tested positive for HIV. HIV prevalence was the highest among spouses or long-term sex partners of HIV cases (45.6%, or 47/103) and male sex partners of HIV-infected men having sex with men (MSM) (60.0%, or 12/20). Condom use was very low among them, with only 33.9% consistently using condoms for sex. CONCLUSION: Newly reported HIV infections in Taizhou prefecture reported a large and complicated risk behavioral networks and low condom use, suggesting a potential risk of HIV among these connected people, especially among MSM. Much efforts are needed to intervene these high risk subgroups and high risk behavioral networks.