Comprehensive HIV/AIDS Programs in Sichuan

Abstract

By the end of 2017, a total of 110,872 people living with HIV (PLWH) had been diagnosed in Sichuan, including 42,496 AIDS patients, making Sichuan one of the provinces heavily affected by the HIV/AIDS epidemic. The male/female ratio was 2.8:1; the 20–49 age group accounted for 68.5% of infections; and the Han ethnic majority accounted for 68.1% and the Yi ethnic minority accounted for 30.3% of the total cases. PLWH have a wide range of occupations, with farmers, unemployed, and rural migrant workers taking up the majority. Transmission by injection drug use accounted for the majority of cases until 2010, with sexual transmission rapidly expanding in the last decade. By the end of 2017, nearly 79,000 PLWH were receiving antiretroviral treatment in Sichuan province. Mortality greatly declined in recent years among those who received treatment. The number of HIV-related deaths surpassed 5000 in 2017. A comprehensive surveillance network has been set up composed of routine screening, case reporting, sentinel surveillance, specific epidemiological investigation, estimation of the HIV epidemic, and analysis of the incidence rate in different risk groups. Education activities targeting different groups have been carried out from provincial level to prefecture level and communities. Free antiretroviral treatment during the past decade has reduced the mortality rate among PLWH and has improved the quality of their life. Tailored behavioral interventions were implemented to effectively change high-risk behaviors among key populations. Prevention of mother-to-child transmission (PMTCT) has covered all 21 prefectures and 181 counties. A comprehensive prevention and treatment system that takes the community as its basis, health departments its mainstay, and professional institutes its backbone, with the coordination of security, civil administration and education, and the general public have been established. Remarkable progress has been made, but a great challenge lies ahead to control HIV sexual transmission, particularly in minorities.