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Epidemiology and Therapy of People Living with HIV in Various Provinces of China

Written By

Kefeng Qin

Submitted: 23 August 2025 Reviewed: 01 September 2025 Published: 09 February 2026

DOI: 10.5772/intechopen.1012758

Global Response to HIV/AIDS - From Epidemiology to Mental Health and Clinical Management IntechOpen
Global Response to HIV/AIDS - From Epidemiology to Mental Health ... Edited by Aldemir B. Oliveira-Filho

From the Edited Volume

Global Response to HIV/AIDS - From Epidemiology to Mental Health and Clinical Management [Working Title]

Aldemir B. Oliveira-Filho and Ricardo Roberto de Souza Fonseca

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Abstract

By December 2024, 1,355,017 human immunodeficiency virus/acquired immunodeficiency sysdrom (HIV/AIDS) cases had been reported in China, with 491,437 deaths; approximately 900,000 (~70%) of the 1.30 million persons living with HIV (PLWH) were on antiretroviral therapy (ART), achieving >90% viral suppression. Annual new diagnoses fell by 4% in 2024 to ~ 98,000; >96% of incident infections were sexually acquired (28% among men who have sex with men, 68% heterosexual). High-burden provinces (Sichuan, Guangxi, Yunnan, Chongqing) report largest absolute numbers, with incidence rates 10–17 per 100,000, but low-prevalence regions (Tianjin, Shanghai, Beijing) are pioneering long-acting injectables and pre-exposure prophylaxis (PrEP). City-wide cohort data from Huzhou (n = 1,812) show 94.7% survival after ≥1 year on ART, with early treatment (baseline CD4 ≥200 cells/µL) reducing mortality by 60%. Long-acting cabotegravir/rilpivirine is now reimbursed in five provinces (>12,000 patients switched), and a six-monthly lenacapavir PrEP pilot is underway for 2,000 high-risk women in Yunnan and Xinjiang. Therefore, China has built a unique multi-sector governance model with universal free first-line ART, tiered access to innovative regimens, and precision prevention, has transformed HIV into a low-level epidemic. In this chapter, the epidemiology and treatment effects in various provinces of China are analyzed and discussed.

Keywords

  • HIV
  • AIDS
  • PLWH
  • epidemic
  • therapy

1. Introduction

Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV) and was first identified in the United States in 1981. HIV targets the immune system, weakening defenses against infections and certain types of cancer. Transmission of HIV includes unprotected sexual behaviors through anal or vaginal intercourse, transfusions of contaminated blood, sharing contaminated needles, and transmission from mother to baby during pregnancy, childbirth, and breastfeeding. In May 2025, the World Health Organization (WHO) released the World Health Statistics 2025 report. Globally, in 2023, there were approximately 39.9 million people living with HIV (PLWH), and over 30 million PLWH were receiving antiretroviral therapy. In 2003, 630,000 people died from HIV-related causes [1]. There were an estimated 40.8 million PLWH worldwide, and 31.6 million (~70%) were receiving antiretroviral therapy (ART) at the end of 2024. New HIV infections totaled 1.3 million in 2024 [2].

In China, surveillance data released in April 2025 indicate that approximately 1.3 million PLWH reside in the 31 provincial-level administrative regions (excluding Hong Kong, Macao, and Taiwan). Around 900,000 (~70%) of these individuals are currently on ART, and more than 90% have achieved virological suppression (<50 copies/mL). This review synthesizes current epidemiological trends, provincial heterogeneity, treatment strategies, and the policy framework that has enabled China to transition HIV/AIDS from a rapidly emerging crisis to a manageable chronic disease epidemic.

2. Methods

2.1 Data sources

National surveillance data released by the Chinese Center for Disease Control and Prevention (China CDC) and provincial health commissions were used as the primary source. Annual case-notification files for the 31 provinces, municipalities, and autonomous regions (excluding Hong Kong, Macao, and Taiwan) up to December 31, 2024, were downloaded and de-identified. Supplementary information on ART coverage, drug-resistance surveillance, and prevention-program outputs was extracted from the National AIDS Information System and publicly available provincial surveillance bulletins.

2.2 Study design

A descriptive, cross-sectional analysis was conducted. Epidemiological indicators included: (1) cumulative and living HIV/AIDS cases; (2) annual new diagnoses and deaths; (3) transmission route distribution (heterosexual, men who have sex with men, injecting-drug use, mother-to-child, blood transfusion, unknown/other); (4) demographic characteristics (sex, age, ethnicity); and (5) provincial incidence rates per 100,000 population. Treatment indicators comprised ART initiation rates, viral-suppression rates (<50 copies/mL), regimen composition, and adverse-event frequencies reported in the national cohort.

2.3 Data processing

All case counts were validated against the mid-year population estimates provided by the National Bureau of Statistics to calculate province-specific incidence. Time-series trends from 2010 to 2024 were plotted to identify turning points in transmission patterns. To assess program performance, 2024 indicators were benchmarked against the targets specified in the 2024–2030 National Action Plan.

3. Epidemiology of PLWH in China

In April 2025, data released by the Chinese Center for Disease Control and Prevention showed that, as of December 31, 2024, a total of 1,355,017 cases of HIV infection/AIDS had been reported in the 31 provinces, including autonomous regions and municipalities directly under the Central Government of China, excluding Hong Kong and Macao, with 491,437 deaths. The number of HIV infection cases in China has surpassed that in the United States. The proportion of the total AIDS population in China is now close to 1‰, which is a cause for serious concern [3].

In 2024, a total of 101,626 cases of HIV/AIDS were newly reported, with 31,541 deaths. Currently, the number of people living with HIV infection is 749,839, and the number of AIDS cases is 605,178. Among the HIV/AIDS cases reported this year, the male-to-female ratio for HIV cases is 3.2:1, and the male-to-female ratio for AIDS cases is 3.8:1. There were 214 HIV infection cases and 62 AIDS cases among individuals under 15 years old. Transmission routes for the newly reported HIV/AIDS cases in 2024 include heterosexual transmission, accounting for 74,636 cases (73.4%), and homosexual transmission, accounting for 25,615 cases (25.2%). Transmission through injection drug use accounted for 160 cases (0.2%), while mother-to-child transmission accounted for 93 cases (0.1%). Transmission through both sexual contact and drug injection accounted for 44 cases (0.04%). The transmission route was unknown in 1,078 cases (1.1%) [4, 5]. 2025, monthly AIDS case reports ranged from 4,000 to 4,500 new diagnoses per month. In January, there were 2,832 reported AIDS cases and 1,375 deaths nationwide. In April, there were 4,534 cases and 1,642 deaths, while in May, there were 4,240 cases and 1,573 deaths [6]. The HIV/AIDS epidemic in each province is analyzed as follows (Figure 1).

Figure 1

Provincial-level HIV incidence rate in China, 2024 (per 100,000 population).

3.1 Sichuan

As of June 30, 2024, Sichuan Province reported the highest number of HIV infection and/or AIDS patients (HIV/AIDS) cases in China, with 174,700 living cases. This number represents a significant challenge for AIDS prevention and control efforts in the province. The infection rate is 17.47 per 100,000, and the large population base of Sichuan contributes to the high number of cases. Sexual transmission is the primary route of HIV infection, accounting for 98% of new cases, with heterosexual transmission making up over 70% of these cases. The prevalence of commercial sex work and frequent social activities in the region contributes to the spread of the virus. The epidemic is particularly severe in the southeastern part of Sichuan Province, where cities like Yibin and Luzhou have been identified as hot-spot areas. These regions have high population density and a large number of migrant workers, which increases the risk of HIV transmission. Modeling studies predict that without additional interventions, the adult HIV prevalence in Sichuan could increase to 0.306% by 2025, with an estimated 212,168 people living with HIV/AIDS [7–10].

3.2 Guangxi

Guangxi Zhuang Autonomous Region, located in southwestern China, is one of the provinces severely affected by the HIV epidemic. As of October 2020, Guangxi had reported over 97,000 living cases of HIV/AIDS. The infection rate is 12.32 per 100,000. The region has implemented several initiatives to control the epidemic, including the Guangxi AIDS Conquering Project (GACP). The primary mode of HIV transmission is through heterosexual contact, accounting for over 90% of new infections. However, there is also a significant proportion of infections transmitted through male-to-male sexual contact. The epidemic has shown a shift toward older age groups, with individuals aged 50 and above accounting for an increasing proportion of new cases. The proportion of individuals aged 50 and above increased from 42.72% in 2014 to 54.73% in 2020. The majority of new cases are male, with 74.69% of participants in a recent study being male. The overall education level among infected individuals is low, with only 2.25% having a college degree. While Guangxi has made progress in controlling the HIV/AIDS epidemic, ongoing efforts are needed to address the evolving transmission dynamics and demographic shifts in the region [11–14].

3.3 Chongqing

The Chongqing Municipal Health Commission and the Chongqing Center for Disease Control and Prevention released HIV/AIDS data for the period from January to October 2024. A total of 6,857 new cases of HIV/AIDS were reported, representing a 4.2% decrease compared to the same period last year. Among the newly reported cases, the male-to-female ratio was 2.6:1. Sexual transmission accounted for 98.2% of the newly reported cases, with 80% of the cases distributed in the central urban area and the main city new districts. Cases among individuals aged 50 and above accounted for 77.4%, with a male-to-female ratio of 2.3:1. As of October 2024, a total of 73,000 people living with HIV infection and AIDS were reported in the city. The infection rate is 11.60/100,000 [15–18].

3.4 Yunnan

Yunnan Province, located in southwestern China, is one of the regions most severely affected by HIV/AIDS in the country. By the end of 2021, Yunnan had reported a cumulative total of 174,510 HIV/AIDS cases, with 124,372 people still alive. The infection rate is 11.52 per 100,000. Sexual transmission is now the primary mode of HIV infection, accounting for over 95% of new cases. This includes both heterosexual and male-to-male sexual transmission. In the early 2000s, the main transmission route was through intravenous drug use (IDU), but after 2006, it shifted to unprotected sexual contact. The ratio of males to females among newly infected individuals is approximately 1.43:1. The epidemic is increasingly affecting older individuals, with those aged 50 and above showing a higher risk of late detection. The majority of new cases are among the Han ethnicity, but minority groups such as Yi, Hani, Dai, Zhuang, Hui, Lisu, Bai, Wa, Jingpo, Lagu, Miao, Naxi, and Deang are also significantly affected. The epidemic is particularly severe in the southeastern part of Yunnan, with cities like Honghe, Kunming, Wenshan, and Qujing reporting higher numbers of cases. Yunnan shares borders with Myanmar, Laos, and Vietnam, and these border areas have seen significant HIV transmission due to cross-border activities and drug trafficking [19].

3.5 Guizhou

As of October 2021, Guizhou Province reported over 50,000 living cases of HIV/AIDS, with more than 20,000 reported deaths. Guizhou is classified as a first-category province in terms of the HIV/AIDS epidemic, indicating a relatively severe situation. The infection rate is 10.32 per 100,000. Sexual transmission is the primary mode of HIV infection in Guizhou, accounting for 92.5% of new cases. This includes both heterosexual and male-to-male sexual transmission. The epidemic is increasingly affecting older individuals, with those aged 50 and above showing a higher risk of late detection. The majority of new cases are male, with a male-to-female ratio of approximately 4:1 [20].

3.6 Xinjiang

Xinjiang is one of the high-incidence regions for HIV/AIDS in China. By September 2019, Xinjiang had 48,423 living cases, including 13,996 AIDS patients, ranking sixth in the country. The infection rate is 10.10 per 100,000. The epidemic has spread across the entire region, placing significant pressure on prevention and control efforts. Sexual transmission has been the dominant mode of HIV infection in Xinjiang since 2008. This includes both heterosexual and male-to-male sexual transmission. The majority of new cases are male, with a male-to-female ratio of approximately 4:1. The epidemic is increasingly affecting older individuals, with those aged 50 and above showing a higher risk of late detection [21, 22].

3.7 Hunan

Hunan Province, located in central China, faces a significant HIV burden. As of 2023, there were over 56,850 reported cases of people living with HIV (PLHIV) in the province. The infection rate is 4.52 per 100,000. From 2003 to 2005, intravenous drug use and blood transmission were the major transmission routes (over 50%) of HIV infections in Hunan. However, from 2006 to 2018, sexual transmission became the dominant route. In 2018, heterosexual transmission accounted for 71.8% of new cases, while homosexual transmission accounted for 18.8%. The epidemic is predominantly driven by sexual transmission and disproportionately affects individuals aged 50 and older [23–25].

3.8 Guangdong

According to statistics from the Guangdong Center for Disease Control and Prevention, as of October 2023, Guangdong Province reported a cumulative total of 88,432 living cases of HIV/AIDS, including 51,027 HIV-infected individuals and 37,405 AIDS patients. The infection rate is 4.03 per 100,000. From January to October 2023, 7,514 new cases of HIV infection and AIDS were reported. From January to October 2024, a total of 6,990 new cases of HIV infection and AIDS were reported, representing a 7.0% decrease compared to the same period in 2023. Sexual transmission remains the predominant route of HIV infection in Guangdong Province, accounting for over 95% of new infections. In 2024, sexual transmission accounted for 99.6% of new cases. Among these, male-to-male sexual transmission (MSM) accounted for 16.1% of new cases from January to October 2024. Heterosexual transmission accounted for 83.5% of new infections in 2024. The proportion of cases among individuals aged 50 and above continues to increase. As of October 2023, this age group accounted for 61.6% of all cases. From January to October 2024, this proportion remained high at 77.4%. The male-to-female ratio among new cases reported in 2024 was 2.6:1. Among individuals aged 50 and above, the male-to-female ratio was 2.3:1. The majority of HIV/AIDS cases are concentrated in urban areas. Guangzhou, Shenzhen, and Dongguan account for a significant proportion of the total cases [26, 27].

3.9 Specific findings in Shenzhen city

According to the Shenzhen Center for Disease Control and Prevention, from January to October 2023, Shenzhen reported 1,313 new cases of HIV infection and AIDS, which is almost the same as the same period last year (1,304 cases), including 827 HIV-infected individuals and 486 AIDS patients. The Shenzhen Center for Disease Control and Prevention stated that among the newly reported cases, those with Shenzhen household registration accounted for 16.8%, while non-Shenzhen household registration accounted for 83.2%. The average age at first detection was 36.0 years old, with the oldest being 87 years old. The cases were predominantly male, with males accounting for 91.9% and females 8.1%, resulting in a male-to-female ratio of 11.3:1. In terms of transmission routes, sexual transmission accounted for 99.6% (62.5% through male-to-male sexual contact and 37.1% through heterosexual contact), while other routes accounted for 0.4%. The cases were mainly detected through medical institutions (63.0%) and voluntary counseling and testing clinics (25.5%). Among the newly reported cases this year, young and middle-aged males aged 20–50 accounted for 81.4%, which is higher than the national and provincial average levels. The proportion of cases reported among individuals aged 50 and above continues to rise. From January to October 2023, a total of 198 cases among individuals aged 50 and above were reported in Shenzhen (75.8% of whom were male), accounting for 15.1% of the total number of newly reported cases. This proportion has been slowly and steadily increasing (before 2008, the proportion was below 8.0%). The Shenzhen Center for Disease Control and Prevention pointed out that this group has a generally low willingness to be tested, resulting in a low testing rate and a relatively common situation of late detection. With the intensification of population aging in the future, related issues need to be further valued and studied by the whole society [28].

3.10 Beijing

As of October 31, 2023, Beijing had reported a total of 40,840 cases of HIV/AIDS. The infection rate is 3.91 per 100,000. From January to October 2024, a total of 1,105 new cases were reported among residents currently living in Beijing, representing a 21% decrease compared to the same period last year. Currently, there are a total of 28,000 people living with HIV (PLWH) in the city. Sexual transmission remains the primary route of HIV spread in Beijing, with male-to-male sexual contact being the predominant mode. Transmission through injection drug use continues to be maintained at a low level [29, 30].

3.11 Jiangxi

As of October 2023, Jiangxi Province reported a cumulative total of 33,952 cases of HIV infection and AIDS, with 25,089 people currently living with the disease. By October 2024, Jiangxi Province had reported a total of approximately 35,500 living cases of HIV/AIDS. The infection rate was 3.55 per 100,000. From January to October 2024, 1,089 new cases of HIV infection and AIDS were reported, representing a 4.5% increase compared to the same period in 2023. Sexual transmission remains the primary route of HIV infection in Jiangxi Province, accounting for 99.6% of new cases in 2024. Specifically, male-to-male sexual transmission has seen a significant increase, rising from 0.9% in 2004 to 16.1% in 2024. Heterosexual transmission accounted for 83.68% of new cases in 2023. The proportion of cases among individuals aged 50 and above continues to rise. As of October 2023, this age group accounted for 61.6% of all new cases. In 2024, this proportion remained high at 61.57%. Males account for the majority of new cases, with a male-to-female ratio of 91.9:8.1. The epidemic is widespread across Jiangxi Province, with the highest number of cases reported in Shangrao, Nanchang, and Ganzhou, which together accounted for 48.42% of all cases. Since 2003, the number of student cases has been increasing, with male-to-male sexual transmission accounting for 96.7% of student cases. The increase in cases among individuals aged 50 and above is notable, highlighting the need for targeted prevention efforts in this demographic [31].

3.12 Zhejiang

Zhejiang Province, located in the southeast of China, has seen a significant increase in HIV/AIDS cases over the past two decades. By the end of October 2018, there were 26,575 living cases of HIV/AIDS in the province. As of 2022, a total of 56,699 HIV/AIDS patients had been reported in Zhejiang from 2005 to 2022. By the end of October 2023, there were 42,100 people living with HIV/AIDS, with 5,236 reported deaths. From January to October 2023, a total of 3,565 new cases were reported in the province, representing a 4.1% decrease compared to the same period last year. Among these new cases, 2,017 were infected through heterosexual contact and 1,418 through homosexual contact (a decrease of 2.6% and 6.8%, respectively, compared to 2022). The infection rate is 3.14 per 100,000. Sexual transmission accounted for 96.4% of all new cases. There were 1,289 new cases among individuals aged 50 and above, an increase of 2.4% compared to the same period last year, with males accounting for 72.9% of these cases and 44.3% infected through heterosexual commercial sex. There were 90 new cases reported among students, a 14.3% decrease compared to the same period last year, with 90% of these cases infected through male-to-male sexual contact. As of October 2024, the number of new HIV/AIDS cases reported in the province decreased by 8.2% compared to the same period last year. Sexual transmission accounted for 96.3% of all new cases, with infection rates through heterosexual and homosexual contact decreasing by 6.4% and 10.9%, respectively. The number of HIV/AIDS cases among individuals aged 50 and above also decreased [32, 33].

3.13 Henan

Henan Province has historically been one of the most severely affected regions by HIV/AIDS in China. By December 2006, a total of 35,232 HIV cases had been reported across 159 counties. As of October 31, 2024, there were 76,271 HIV/AIDS cases in Henan Province. From January to October 2024, 3,624 new cases of HIV/AIDS were reported, representing a 3.9% decrease compared to the same period last year. The infection rate is 3.03 per 100,000. Transmission of HIV through blood transfusion has been essentially blocked. Mother-to-child transmission and transmission through injection drug use have been reduced to their lowest historical levels. The overall epidemic growth rate in the province has slowed, and HIV/AIDS is maintained at a low prevalence level. Sexual transmission has become the primary route of HIV infection, accounting for over 99% of all cases [34].

3.14 Liaoning

As of October 2024, Liaoning Province has reported a total of 20,774 living cases of HIV infection and AIDS, including 7,230 AIDS cases and a cumulative total of 3,219 HIV/AIDS-related deaths. The infection rate is 2.89 per 100,000. The epidemic remains at a low prevalence level. From 2017 to 2019, the number of newly reported HIV/AIDS cases in Liaoning Province decreased by 5.3%, 1.1%, and 3.1% year-on-year, respectively. Sexual transmission is the primary mode of HIV infection in Liaoning, accounting for 98.4% of new cases in 2024. This includes both heterosexual transmission (57.2%) and male-to-male sexual transmission (41.2%). From 1993 to 2015, the main transmission route was unsafe sexual behavior, accounting for 92.58% of all cases. Male-to-male sexual transmission (MSM) has shown a yearly increasing trend. In 2024, 35.7% of new cases were among individuals aged 50 and above. The majority of new cases are male, with a male-to-female ratio of approximately 4:1. The epidemic is particularly severe in certain regions of Liaoning, with Shenyang and Dalian reporting the highest number of cases [35, 36].

3.15 Fujian

Fujian Province has seen a significant increase in HIV/AIDS cases over the past few decades. From 1987 to the end of 2015, a total of 8,651 HIV/AIDS cases were reported across the province, with 1,557 deaths. The epidemic level is almost equivalent to the national level. However, the number of identified cases doubled from 528 in 2006–2007 to 1,129 in 2008–2009. As of October 31, 2022, a total of 25,157 cases of HIV/AIDS were reported, with 4,575 reported deaths and 20,582 PLW. From January to October 2022, 2,257 new cases of HIV infection and AIDS were reported, along with 356 new reported deaths. The infection rate is 2.68 per 100,000. In recent years, the number of new HIV/AIDS cases reported annually has remained around 2,000, with a slight upward trend. The epidemic situation remains serious. Currently, sexual transmission remains the primary route of infection. Approximately 95% of infections are attributed to unsafe sexual behaviors. Additionally, the number and proportion of cases in the age group of 60 and above have been increasing annually [37].

3.16 Shaanxi

Shaanxi Province has seen a significant increase in HIV/AIDS cases over the past few decades. The first HIV infection was reported in Shaanxi in 1994. By the end of 2010, there were 2,131 reported cases of HIV/AIDS in the province. From January to October 2022, a total of 1,922 new cases of HIV infection and AIDS were discovered and reported in the province, representing a 10.6% decrease compared to the same period last year. As of October 2024, Shaanxi reported a total of 21,474 living cases of HIV infection and AIDS. The infection rate is 2.66 per 100,000. The number of new HIV/AIDS cases continues to show a fluctuating downward trend. Sexual transmission remains the primary route of infection. The proportion of infections through sexual contact is 99.1%, with 62.3% attributed to heterosexual transmission and 36.8% to male-to-male sexual contact. The epidemic of HIV/AIDS has a wide impact and significant regional differences. The Guanzhong region reported the highest number of cases, accounting for 73.7%, followed by southern Shaanxi with 14.1% and northern Shaanxi with 12.2%. The age range of infected individuals is broad, with an increasing proportion of individuals aged 60 and above. The distribution is as follows: 0.2% under 15 years old; 60.2% aged 15–49; 21.4% aged 50–60; and 18.2% aged 60 and above, with a reported increase of 11.9% compared to the same period last year [38–40].

3.17 Qinghai

As of October 2023, Qinghai Province reported a total of 4,043 living cases of HIV infection and AIDS. From January to October 2024, a total of 1.118 million people were tested in Qinghai Province, with 376 new cases of HIV/AIDS reported. As of the end of October 2024, there were 4,043 living cases of HIV infection/AIDS in the province. The infection rate is 2.59 per 100,000. The epidemic of HIV/AIDS in Qinghai Province has the following characteristics: it continues to remain at a low prevalence level, but the HIV antibody positivity rate remains high among some high-risk groups. The majority of HIV-infected individuals and AIDS patients are distributed in Xining and Haidong, accounting for 77%. Males outnumber females, with a male-to-female ratio of 4.46:1. The epidemic mainly affects young and middle-aged individuals, with 66.36% of infections occurring among those aged 20–49. Sexual transmission is the main route of infection, accounting for 97.33%, with 43.02% through male-to-male sexual contact. [41]

3.18 Hubei

From 2010 to 2022, a total of 33,385 new cases of HIV/AIDS were reported in Hubei Province, with an increasing trend in the number of newly reported cases each year. From January to October 2023, Hubei Province reported 2,509 new cases of HIV infection, representing a 4.7% decrease compared to the same period last year. As of the end of October 2023, the province reported a total of 30,800 living cases of HIV/AIDS. The infection rate is 2.50 per 100,000. The overall epidemic of HIV/AIDS remains at a low prevalence level, but there has been a noticeable increase in the number of young (15–24 years) and elderly (≥50 years) cases. The epidemic is particularly severe in certain regions of Hubei, with Wuhan, Jingzhou, Huanggang, Huangshi, and Xiaogan reporting the highest number of cases. The epidemic is most severe in the central and eastern parts of Hubei Province, especially in Wuhan City and its surrounding counties [42–44].

3.19 Gansu

As of October 2024, Gansu Province reported 11,062 living cases of HIV/AIDS and 2,477 deaths. The infection rate is 2.35 per 100,000. From January to October 2024, a total of 1,089 new cases of HIV infection/AIDS were reported, representing a 4.5% increase compared to the same period in 2023. Among the living cases, 98.4% were infected through sexual contact, with 41.2% through male-to-male sexual contact and 57.2% through heterosexual contact. Transmission through injection drug use accounted for 0.7%, and other routes accounted for 0.9%. The living cases are distributed across all 86 counties (cities, districts) in the province. Lanzhou, Tianshui, and Linxia account for 52.9% of the total cases in the province. Sexual transmission remains the main route of infection [45].

3.20 Hainan

Hainan Province has seen a significant increase in HIV/AIDS cases over the past few decades. The first HIV/AIDS case was reported in 1987, and by the end of 2018, a total of 10,491 cases had been reported, with 4,267 deaths. As of October 2023, the number of living cases has reached 10,748, with 4,512 reported deaths. The infection rate is 2.24 per 100,000. Sexual transmission is the primary mode of HIV infection, accounting for 99.1% of new cases. This includes both heterosexual (57.2%) and male-to-male sexual transmission (41.9%). The initial imported cases originated from Guangdong Province around 2000, followed by repeated introductions from Guangdong and Hubei. The epidemic is increasingly affecting older individuals, with those aged 50 and above showing a higher risk of late detection. In 2023, 35.7% of new cases were among individuals aged 50 and above. The majority of new cases are male, with a male-to-female ratio of approximately 4:1. The epidemic is particularly severe in certain regions of Hainan, with Haikou and Sanya reporting the highest number of cases. Haikou serves as the epicenter of the epidemic, with significant transmission occurring to other cities such as Sanya, Danzhou, Chengmai, and Tunchang. Hainan has a high diversity of HIV-1 genotypes. The CRF65_cpx strain, which carries drug-resistant mutations, is the fourth most prevalent strain on the island [46, 47].

3.21 Jilin

As of the end of 2010, Jilin Province had reported a total of 1,477 HIV infections across all risk groups. By the end of 2009, there were 5,668 people living with HIV (PLWH). As of the end of November 2021, the number of people with HIV/AIDS exceeded 10,000 for the first time, with 98% of infections transmitted through sexual contact. The infection rate is 2.17 per 100,000. Sexual transmission is the primary mode of HIV infection in Jilin, accounting for 93.4% of new cases in 2010. This includes both heterosexual transmission (43.3%) and male-to-male sexual transmission (36.6%). A comprehensive molecular epidemiologic investigation conducted in 2010–2011 identified subtypes B, B’, and C; CRF01_AE (including lineages CRF01-1, CRF01-4, and CRF01-5); CRF02_AG; CRF07_BC (CRF07-1 and the newly identified lineage CRF07-2); and recombinant viruses. CRF01_AE was the predominant genotype in both heterosexual and MSM (men who have sex with men) sequences. A new statistically supported, monophyletic transmission cluster of CRF07_BC (designated CRF07-2) was identified among seven MSM from Changchun and one MSM from Songyuan. Additionally, a transmission cluster of CRF02_AG was found in local Jilin residents, particularly in the Korean ethnic group near the Jilin-North Korean border. The epidemic is increasingly affecting older individuals, with those aged 50 and above showing a higher risk of late detection. The majority of new cases are male, with a male-to-female ratio of approximately 4:1. The most heavily affected regions in Jilin Province are concentrated in several major cities, including Changchun, Jilin, and Yanbian Korean Autonomous Prefecture [48].

3.22 Shanghai

Since the first case of HIV infection was reported in Shanghai in 1987, as of November 20, 2024, a total of 32,349 cases of HIV infection, including 11,198 cases of AIDS, have been reported in the city, with 3,173 deaths. The infection rate is 2.13 per 100,000. From January 1 to November 20, 2024, a total of 1,282 cases of HIV infection and/or AIDS patients were reported in Shanghai, representing a 12.0% decrease compared to the same period last year (1,457 cases). Among these, 547 cases were AIDS patients, a decrease of 8.2% compared to the same period last year (596 cases). There were 181 reported deaths, a 36.0% decrease compared to the same period last year (283 cases). No mother-to-child transmission cases were reported. The HIV/AIDS epidemic in Shanghai in 2024 has the following characteristics: 1. Since 2019, the number of reported HIV infections in Shanghai has shown a sustained slight downward trend, with the epidemic maintained at a low prevalence level. 2. Sexual transmission remains the main route of HIV infection in Shanghai. Cases transmitted through sexual contact account for 96.3% of all reported cases, with male-to-male sexual transmission accounting for 52.1%, still a relatively high proportion. 3. Detection through medical institution visits and voluntary counseling and testing remains the primary method of identifying HIV infections in Shanghai. 4. Shanghai has had no reported cases of mother-to-child transmission of HIV for 15 consecutive years [49].

3.23 Anhui

Anhui Province is facing a severe HIV epidemic, with an increasing number of newly diagnosed cases. As of October 31, 2018, the total number of HIV-positive individuals in the province had reached 17,183. In 2023, a total of over 13 million people were tested for HIV, with 28,484 living cases of HIV infection reported. The infection rate is 2.06 per 100,000. Originally, the dominant transmission route of HIV in Anhui Province was paid blood donation. Currently, sexual transmission is the primary mode of HIV infection in Anhui, accounting for 98.32% of new cases. This includes both heterosexual and male-to-male sexual transmission. The study identified multiple HIV-1 subtypes, including CRF07_BC, CRF01_AE, and CRF55_01B. The most prevalent subtypes were CRF07_BC (41.4%), CRF01_AE (38.1%), and CRF55_01B (6.3%). A high number of unique recombinant forms (URFs) were also found, indicating that many individuals were repeatedly infected by different HIV strains [50, 51].

3.24 Jiangsu

As of the end of October 2024, there were 45,177 people living with HIV/AIDS in Jiangsu Province, including 28,481 infected individuals and 16,696 AIDS patients. A total of 44,994 cases were under follow-up management in the province, with 6,503 cumulative reported deaths. The overall infection rate in the population was 5.3 per 10,000. From January to October 2024, a total of 3,371 new cases of HIV/AIDS were reported in the province, including 2,477 infected individuals and 894 AIDS patients, representing a 5.9% decrease compared to the same period last year. There were 443 deaths reported, a 5.1% decrease compared to the same period last year. The epidemic in Jiangsu Province remains at a low prevalence level overall. The current epidemic of HIV/AIDS in Jiangsu Province is characterized by the following features: (1) Widespread Epidemic: Indigenous HIV/AIDS cases have been reported in all prefecture-level cities, counties (cities, districts). (2) Predominance of Sexual Transmission: Sexual transmission continues to be the main route of infection. Among the new cases reported in 2024, 99.7% were transmitted through sexual contact, with 56.4% attributed to male-to-male sexual contact. Surveillance results from sentinel sites show that the HIV antibody positivity rate among men who have sex with men (MSM) remained between 6% and 8% from 2018 to 2023. (3) Rising Infections Among the Elderly and Young Students: The proportion of new HIV/AIDS cases among individuals aged 60 and above increased from 6.4% in 2011 to 20.3% in 2023. The proportion of new cases among young students aged 15–24 increased from 2.9% in 2011 to 4.8% in 2023, and their proportion within the same age group rose from 17.2% in 2011 to 35.5% in 2023 [52, 53].

3.25 Tianjin

Tianjin has maintained a low prevalence of HIV/AIDS within its population. From 2011 to 2022, a total of 2,965 infections were reported, with 658 deaths. From January to October 2024, a total of 435 new cases of HIV/AIDS were reported and managed in Tianjin, representing a 19.29% decrease compared to the same period last year (539 cases). As of the end of October 2024, a total of 7,583 cases of HIV infection and/or AIDS patients were under management in Tianjin. The infection rate is 1.84 per 100,000. The primary mode of transmission for the newly reported cases was sexual contact, with 78.85% attributed to male-to-male sexual transmission, 20.23% to heterosexual transmission, and 0.92% to other or unknown routes. The majority of these cases were among young and middle-aged males, with sexual contact being the predominant mode of transmission. The number of people living with HIV (PLWH) in Tianjin ranks 27th in the country [54, 55].

3.26 Heilongjiang

As of October 31, 2023, there were 16,026 people living with HIV/AIDS in Heilongjiang Province, with 3,029 reported deaths. The infection rate is 1.84 per 100,000. Among all infections and cases, 97.9% were transmitted through sexual contact, including 73.8% through male-to-male sexual contact and 24.1% through heterosexual contact. Transmission through injection drug use accounted for 0.4%, and other transmission routes accounted for 1.7%. The overall epidemic level of HIV/AIDS in Heilongjiang Province remains low. Since 2017, the number of reported HIV/AIDS cases has shown a slow downward trend. From January to October 2023, 1,098 new cases of HIV infection and AIDS were reported, representing a 1.5% decrease compared to the same period in 2022. Sexual transmission remains the primary mode of transmission in Heilongjiang Province. Among the new cases reported from January to October 2023, 97.1% were transmitted through sexual contact, including 69.6% through male-to-male sexual contact and 27.5% through heterosexual contact. Other transmission routes accounted for 2.9%. Except for Songling District and Xinlin District in the Greater Khingan Region, all other counties (cities, districts) in Heilongjiang Province have reported living cases. Harbin City has the highest number of living cases, accounting for 50.1% of all cases in the province, followed by Qiqihar City (9.7%) and Suihua City (7.4%) [56, 57].

3.27 Ningxia

Ningxia Hui Autonomous Region (NHAR) is considered a low HIV prevalence region in China. As of October 2024, a total of 1,008 HIV infections had been detected. The infection rate is 1.69 per 100,000. However, recent years have seen an increase in the detection rate of drug resistance following antiretroviral therapy (ART). Heterosexual transmission is the primary mode of HIV transmission in NHAR (75.78%). The majority of elderly HIV-1/AIDS patients are male (78.37%), with low educational attainment (46.63% having completed primary school or below) and predominantly engaged in farming (52.40%). Among men who have sex with men (MSM), the age range is 15–63 years, with a mean age of 37.21 years, while for individuals infected through heterosexual transmission (HSTs), the age range is 19–81 years, with a mean age of 46.19 years. Most patients reside in Yinchuan City, the capital of NHAR. Spatial analysis shows that cases are primarily concentrated in districts and counties under Yinchuan’s jurisdiction. Between 2020 and 2021, 332 individuals out of 3,524 who received antiviral treatment had a viral load greater than 400 copies/mL, mainly consisting of those treated with lamivudine + efavirenz + tenofovir disoproxil fumarate (3TC + EFV + TDF) [58].

3.28 Tibet

As of the latest available data, the Tibet Autonomous Region (TAR) maintains a relatively low prevalence of HIV/AIDS. However, specific numbers for 2024 are not readily available. Between 2004 and 2013, a total of 253 HIV infection cases were reported in Tibet. In 2017, the number of reported HIV carriers and AIDS patients in Tibet rose to 41, up from 30 the previous year. The infection rate is 1.54 per 100,000 [59].

3.29 Shanxi

As of October 2024, the epidemic of HIV/AIDS in Shanxi Province continues to show an increasing trend. By the end of 2011, there were 3,055 PLWH, with 1,180 deaths. As of October 2022, there were a total of 12,768 PLWH, with 3,523 deaths. From January to October 2023, 1,115 new HIV/AIDS cases were reported. In July 2024, six new cases of HIV/AIDS were reported. The infection rate is 1.49 per 100,000. The number of individuals with HIV/AIDS in Taiyuan is 2,287 and 1,461, the highest in the province; in Datong, 1,365 and 800; and in Changzhi, 1,057 and 670, respectively. Heterosexual transmission Accounts for 54.6%. Male-to-male sexual transmission Accounts for 41.2%. Mother-to-child transmission Accounts for 0.2%. Injection drug use transmission Accounts for 0.1% [60].

3.30 Inner Mongolia

As of October 31, 2022, the Inner Mongolia Autonomous Region had

Cumulatively, 5,266 individuals have been reported as living with HIV infection and AIDS, including 3,639 people with HIV infection and 1,627 with AIDS. There have been 513 reported deaths, leaving 4,753 individuals currently living with the condition. From January to October 2023, the Inner Mongolia Autonomous Region reported 774 new cases of HIV/AIDS. In March 2024, the region reported 4 new cases of HIV/AIDS. The infection rate is 1.36 per 100,000. Heterosexual transmission accounts for 39.2% of cases, while homosexual transmission accounts for 57.2%, making up 96.4% of all cases. Drug use injection accounts for 1.7%, and transmission through blood plasma and blood products accounts for 0.9%, together comprising 2.6% of cases. Mother-to-child transmission Accounts for 0.2% of cases. The epidemic is predominantly concentrated among young and middle-aged individuals aged 20–49, who account for 83.3% of cases. Individuals under 20 years old account for 1.5% of cases. Males represent 91.7% of cases, while females account for 8.3%. The number of HIV/AIDS cases among the youth population is decreasing annually, but the proportion of cases in the 15–19 age group is increasing year by year. A recent study reported that a total of 249,919 individuals attended HIV voluntary counseling and testing (VCT) clinics in the Inner Mongolia Autonomous Region from 2019 to 2023, including 128,069 males (51.24%) and 121,850 females (48.76%). However, only 785 cases (0.31%) were confirmed as HIV positive. High-risk factors include being male, aged 45- < 65 years of age, unmarried, having a junior high school education or below, a history of high-risk behaviors or exposure risks, engaging in commercial heterosexual behaviors or non-commercial non-fixed heterosexual behaviors, homosexual behaviors, having an HIV-positive spouse/fixed partner/mother, drug injection, and seeking care at general hospitals or traditional Chinese medicine hospitals [61]. The HIV/AIDS epidemic in the Inner Mongolia Autonomous Region is generally at a low prevalence level, but the situation is more severe in certain regions and populations.

3.31 Hebei

Since the first case of HIV infection was reported in Hebei Province in 1989, as of the end of October 2024, a total of 26,518 cases of HIV/AIDS have been reported in the province, with 4,154 deaths. From January to October 2024, 1,746 new cases of HIV infection and AIDS were reported, along with 263 deaths. The infection rate is 1.16 per 100,000. The epidemic of HIV/AIDS in Hebei Province has the following characteristics: (1) Low Prevalence Level: The epidemic remains at a low prevalence level, with the number of living cases ranking 20th in the country. (2) Effective Control of Mother-to-Child Transmission: There were no reported cases of mother-to-child transmission in 2024. Sexual transmission is the main route of infection, accounting for 97.8% of new cases, with 67.0% attributed to male-to-male sexual contact. (3) Risk of Spread to the General Population: There is a risk of transmission from high-risk groups to the general population. Among newly reported cases of male-to-male transmission, 42.0% were individuals who are married or have a spouse. (4) Increasing Proportion of Individuals Aged 50 and Above: This age group accounted for 35.7% of new cases reported in 2024, with 55.3% of these cases being transmitted through male-to-male sexual contact [62].

3.32 Shandong

Since the first case of HIV infection was identified among returning laborers in 1992, as of October 31, 2022, Shandong Province has reported 24,079 living cases of HIV/AIDS, based on the current address of residence. Among these living cases, 97.7% were infected through sexual contact (70.6% through male-to-male sexual contact and 27.1% through heterosexual contact). From January to October 2022, based on the current address of residence, a total of 2,291 new cases of HIV infection and AIDS were reported in the province. Among these newly reported cases, 99.0% were infected through sexual contact (71.9% through male-to-male sexual contact and 27.1% through heterosexual contact). The HIV/AIDS epidemic in Shandong Province is characterized by the following main features: 1. The epidemic is at a low prevalence level overall, with a decrease in the number of newly reported cases compared to the same period of the previous year. From January to October 2022, the number of newly reported cases decreased by 15.5% compared to the same period of the previous year. 2. Sexual transmission is the main route of HIV infection, with a significant increase in male-to-male transmission. Over the past five years, more than 95% of newly identified HIV infections and AIDS cases in the province were transmitted through sexual contact. The proportion of male-to-male transmission cases in the total number of reported cases each year has risen from 43.8% in 2011 to 75.6% in 2021 [63].

4. Therapy for PLWH in China

China has successfully transformed HIV/AIDS from an invariably fatal illness into a manageable chronic condition, comparable to hypertension, by ensuring nationwide access to antiretroviral therapy (ART). This achievement has stabilized the lives of AIDS patients, reduced onward transmission, and contributed to social harmony. In 2003, the Chinese government began providing free antiviral drugs to rural residents and economically disadvantaged people in urban areas who were not covered by basic medical insurance or other medical security systems and who were living with HIV/AIDS.

4.1 Classification and policies of HIV treatment drugs

As of 2024, there are four types of anti-HIV/AIDS drugs in China.

4.1.1 Free drugs

The free antiviral drugs provided to people living with HIV (PLWH) in China mainly include the following:

  1. Zidovudine (AZT): May cause side effects such as anemia.

  2. Lamivudine (3TC): Relatively few side effects.

  3. Stavudine (d4T): May cause peripheral neuropathy.

  4. Tenofovir (TFV): May cause bone density loss.

  5. Abacavir (ABC): May cause allergic reactions.

  6. Efavirenz (EFV): May cause central nervous system side effects, such as insomnia, vivid dreams, and rashes.

  7. Nevirapine (NVP): May cause rashes and liver function abnormalities.

  8. Lopinavir + Ritonavir (LPV/r): Used for antiviral treatment.

  9. In addition, the domestic antiviral drug Efavirenz/Emtricitabine/Tenofovir Disoproxil Fumarate (EFV/FTC/TDF) Tablets (brand name “Norlay”) has also been included in the national free drug catalog. Patients only need to take one tablet per day to achieve stable treatment effects.

4.1.2 Self-paid drugs

The following are some common self-paid drugs and their prices:

  1. Taidou (Lamivudine + Tenofovir) (3TC + TDF): 780 Yuan.

  2. Truvada (Emtricitabine + Tenofovir) (FTC/TDF): 1,980 yuan.

  3. Rilpivirine (RPV): 1,200 yuan, covered by medical insurance in some cities.

  4. Isentress (Raltegravir): 1,980 yuan.

  5. Tivicay (Dolutegravir) (DTG): 1,980 yuan.

  6. Triumeq (Abacavir/Lamivudine/Dolutegravir) (ABC/3TC/DTG): 2,880 yuan.

  7. Stribild (Elvitegravir/Cobicistat/Emtricitabine/Tenofovir): 1,290 yuan, covered by medical insurance in some cities.

  8. Biktarvy (Bictegravir/Emtricitabine/Tenofovir Alafenamide) (BIC/FTC/TAF): 3,680 yuan.

  9. Doravirine (DOR): 2,280 yuan.

4.1.3 Drugs in medical insurance of China

There are nine HIV drugs in China’s medical insurance catalog, specifically:

  1. Efavirenz (EFV)/Cobicistat/Tenofovir Alafenamide (TAF) Tablets (Brand Name: Jiefukang): Included in the medical insurance catalog in 2019, it is a single-tablet regimen for HIV treatment.

  2. Lamivudine/Dolutegravir (3TC/DTG) Tablets (Brand Name: Dovato): China’s first complete single-tablet regimen for HIV treatment consisting of two drugs.

  3. Ainovir (ANV) Tablets (Brand Name: Aibangde): A new generation of non-nucleoside reverse transcriptase inhibitors.

  4. Bictegravir/Emtricitabine/Tenofovir Alafenamide (BIC/FTC/TAF) Tablets (Brand Name: Biktarvy): Included in the medical insurance catalog starting January 1, 2022.

  5. Albuvirtide for Injection (Brand Name: Aikening): Included in medical insurance in 2021, with a payment standard of 532 yuan per vial.

  6. Aino Metite Tablets (Brand Name: Fubangde): The first domestically developed triple-combination single-tablet regimen for HIV treatment with independent intellectual property rights.

  7. Doravirine/Lamivudine/Tenofovir Disoproxil (DOR/3TC/TDF) Tablets (Brand Name: Deszhuo): A triple-combination single-tablet regimen containing a non-nucleoside reverse transcriptase inhibitor.

  8. Azvudine (FNC) Tablets: Used for the treatment of HIV, they were included in the medical insurance catalog on January 18, 2023, with a price of 11.58 yuan per tablet (3 mg).

  9. Nevirapine/Zidovudine/Lamivudine Tablets: Used for the treatment of HIV.

4.1.4 Advances in HIV/AIDS treatment

  1. Long-Acting Injectable Drugs

    1. Lenacapavir (LNE) (Sunlenca): In 2022, Lenacapavir was approved by the U.S. Food and Drug Administration (FDA), becoming the first HIV treatment drug in the world that only requires two injections per year. Lenacapavir is a new type of HIV-1 capsid inhibitor that stops viral replication by disrupting the virus’s outer shell. In the PURPOSE 1 study, Lenacapavir demonstrated 100% efficacy in HIV prevention among women. Additionally, at 52 weeks, 92.8% of subjects still received injections on time, highlighting the role of long-acting injections in improving adherence.

    2. Cabotegravir and Rilpivirine (CAB/RPV): In 2021, the FDA approved Cabenuva, a long-acting injectable drug containing cabotegravir and rilpivirine, administered once a month or every two months. This drug is suitable for patients who have achieved undetectable viral loads in their current treatment regimens.

  2. Oral Medications

    1. Islatravir (ISL): Islatravir is a new type of nucleoside reverse transcriptase translocation inhibitor (NRTTI), taken orally once a week. In a Phase II study, Islatravir, in combination with Lenacapavir, showed a viral suppression rate comparable to daily oral B/F/TAF.

    2. New PrEP Drugs: In addition to long-acting injectable drugs, new oral PrEP drugs are also in development. These drugs aim to provide more effective preventive measures to reduce the risk of HIV transmission.

  3. Therapeutic Vaccines

    1. HTI Vaccine: Researchers are developing a therapeutic HIV vaccine to help people already infected with HIV enhance their immune system’s response to the virus. In a small study, 40% of subjects were able to discontinue antiretroviral therapy (ART) for up to 22 weeks after vaccination.

    2. VRC01LS Antibody: The NIAID is studying a broadly neutralizing antibody, VRC01LS, which is administered once a month to maintain viral loads in HIV-infected individuals.

  4. Other New Drugs and Therapies

    1. Gene Editing Technology: Researchers are exploring the use of gene-editing technologies (such as CRISPR) in combination with antibodies to eradicate HIV infection.

    2. Bispecific Antibodies: Bispecific antibodies can promote the clearance of HIV-1 reservoir cells by natural killer cells, offering a new strategy for HIV treatment.

4.2 HIV/AIDS prevention policies in China

China has developed a comprehensive, multi-sector HIV/AIDS policy system that has transitioned from an emergency response to sustained, low-level epidemic control. Below is a concise summary of the key elements.

4.2.1 Strategic plans and goals

2024–2030 National Plan: Reduce new infections and AIDS-related deaths, and keep the epidemic at low levels. By 2025, ≥90% of the general public and ≥95% of key populations will have accurate HIV knowledge; mother-to-child transmission will be reduced to < 2%; spousal transmission in sero-discordant couples to < 0.3%. Four consecutive “Five-Year Action Plans” since 2000 have established measurable targets and allocated central and provincial budgets for prevention, treatment, and social support.

4.2.2 Core prevention strategies

  1. Sexual transmission: “High-risk behavior intervention teams” in every CDC conduct outreach, condom promotion, and HIV testing for sex workers and MSM. Coverage rose from 31% (2008) to 81% (2014) among FSWs and from 9% to 79% among MSM; condom use and testing rates improved in parallel. PrEP (Truvada) and national PEP guidelines were approved in 2020.

  2. drug use: Methadone maintenance therapy (MMT) and needle-syringe programs have been scaled up under the 2006 AIDS regulations and the 2008 Anti-Drug Law. HIV incidence among MMT clients fell from 0.95 to 0.03 per 100 person-years (2006–2017).

  3. Blood safety: Commercial plasma collection was banned in the 1990s; voluntary, unpaid donation, and nucleic-acid testing at all blood banks since 2015 have nearly eliminated transfusion-related infections.

4.2.3 Treatment and Care

  1. “Four Frees, One Care” policy (2003–): free antiretroviral therapy (ART), free testing, free PMTCT prophylaxis, free schooling for AIDS orphans, and living subsidies for impoverished patients.

  2. China CARES Program: launched in 2003, it now covers over 170 million people in 309 counties and provides integrated prevention, treatment, legal support, and annual national supervision visits.

  3. Treatment coverage in high-burden Liangshan (Sichuan) increased from 41% in 2017 to 95% in 2020, with mother-to-child transmission decreasing from 9% to 3.7%.

4.2.4 Governance and funding

  1. The State Council leads an inter-ministerial coordination mechanism (public security, justice, finance, education, women’s federation, etc.). Central and local governments jointly finance programs; e.g., 640 million yuan (≈ 90 million USD) was invested in Liangshan (2017–2020).

  2. More than 100 national and 3,600 county-level policy documents have been issued under China CARES to institutionalize local implementation.

4.2.5 Human rights and social support

  1. Police and health departments cooperate to reduce stigma: officers conduct home visits in plain clothes, help former drug users find employment, and integrate HIV services with poverty-alleviation efforts.

  2. Legal protections ensure the confidentiality of testing and treatment; discrimination in employment, education, and healthcare is prohibited.

HIV/AIDS policy framework in China combines evidence-based biomedical interventions (ART, MMT, PrEP/PEP), structural measures (blood safety, anti-drug laws), and social protection programs, coordinated from the State Council down to village clinics, steadily driving new infections and mortality rates downward.

4.3 HIV/AIDS treatment in Huzhou, China

Huzhou is a city in northern Zhejiang. A fully government-funded, city-wide Highly Active Antiretroviral Therapy (HAART) program has been running there since 2005 [64]. The key points are summarized below.

4.3.1 Treatment regimens

  1. Free first-line combinations (e.g., 3TC/EFV/TDF) are supplied to all registered PLWH.

  2. Self-paid alternatives (e.g., BIC/FTC/TAF) are available for those who prefer newer drugs or experience side-effects.

  3. Immunological and virological outcomes are similar between free and paid regimens: median CD4 gain ≈ 185 cells/µL and average viral-load drop ≈ 13,000 copies/mL after ≥1 year of therapy.

4.3.2 Clinical effectiveness

  1. City-wide cohort data (1,812 patients, 2005–2021) show a 94.7% survival rate after starting HAART.

  2. Early treatment is strongly protective: a baseline CD4 ≥200 cells/µL reduces the risk of death by approximately 60% (Jin, 2022).

  3. Conversely, older age, WHO stage III/IV disease, and heterosexual transmission route are associated with higher mortality.

4.3.3 Monitoring and follow-up

  1. CD4 counts and viral-load testing are performed at baseline and every 6–12 months through the Huzhou Center for Disease Control and Prevention (CDC) network.

  2. Drug-resistance surveillance and adherence counseling are integrated into routine follow-up visits.

4.3.4 Access and equity

  1. Treatment is free of charge to all residents and documented temporary residents; written, informed consent is required.

  2. The program covers the entire prefecture (population: 3.4 million) and is embedded in the national AIDS information system of China for seamless record-keeping.

4.3.5 Recent research insights

A 2018–2020 sub-study in Huzhou showed that standard ART is effective across all major HIV subtypes circulating in the region (CRF01_AE, CRF07_BC, etc.), with no need for subtype-specific regimens.

Huzhou provides comprehensive, free HAART with robust monitoring and good clinical outcomes; early diagnosis and treatment initiation remain priorities for further improving survival and quality of life among people living with HIV/AIDS [65, 66].

4.4 People living with HIV (PLWH) in China, mid-year 2025

By June 2025, the estimated number of people living with HIV (PLWH) was approximately 1.30 million (~0.09% of the population), including 2,024 new diagnoses (~ 98,000, a −4% decrease compared to 2023). The primary transmission route in 2024 was sexual, accounting for over 96% of cases (men who have sex with men [MSM] ~ 28%, heterosexual transmission ≈ 68%) [67, 68]. The National Action Plan for 2024–2030, issued in December 2024, includes the following goals: (1) Risk-behavior reduction: a ≥10% decrease in high-risk MSM behaviors compared to the previous five-year baseline; (2) Mother-to-child transmission: ≤ 2% (2024: 1.9%); (3) Spousal transmission: ≤ 0.3% in sero-discordant couples; (4) Public awareness: ≥90% among the general population and ≥95% among key populations. Therapeutics and prevention roll-outs for 2025 include: (1) Long-acting injectables (cabotegravir + rilpivirine), now reimbursed in Beijing, Shanghai, Guangdong, Sichuan, and Yunnan (~12,000 patients switched); (2) A six-monthly lenacapavir prevention pilot for 2,000 high-risk women in Yunnan and Xinjiang; (3) PrEP scale-up, with over 60,000 cumulative users (double the 2023 figure) [69].

5. Conclusion

China has achieved a historic transition: HIV/AIDS has evolved from a rapidly emerging crisis into a manageable, low-level chronic disease epidemic. By December 2024, more than 1.35 million HIV infections had been recorded nationwide. The mortality-to-case ratio has fallen sharply, and approximately 70% of all people living with HIV (PLWH) now receive antiretroviral therapy with >90% virological suppression. These gains are the result of a uniquely Chinese, multi-sector governance model founded on three pillars: (1) universal access – through the “Four Frees, One Care” policy and successive National Action Plans; (2) tiered drug security: free first-line regimens for all, reimbursed innovative single-tablet or long-acting injectable options in richer provinces, and targeted introduction of next-generation agents for highly treatment-experienced patients; and (3) precision prevention: sexual-health outreach for key populations, scaled-up PrEP/PEP, near elimination of mother-to-child and blood-borne transmission, and integration of HIV services with poverty-alleviation programs.

Geographically, the epidemic remains heterogeneous. High-burden south-western provinces (Sichuan, Guangxi, Yunnan, Chongqing) still report the largest absolute numbers, but sustained political commitment, community engagement, and cross-border cooperation have begun to flatten incidence curves. Meanwhile, low-prevalence regions such as Tianjin, Shanghai, and Hebei have pioneered early adoption of long-acting injectables and PrEP, demonstrating that even resource-rich municipalities can act as policy incubators for the rest of the country.

Looking forward, three challenges dominate the 2024–2030 agenda. First, demographic aging is shifting the epidemic toward adults aged ≥50 years who are diagnosed late and have higher competing-mortality risks; routine provider-initiated testing must expand beyond antenatal clinics to all medical encounters for older patients. Second, emerging drug resistance, especially to NNRTIs and NRTIs in settings with long-standing generic use, calls for strengthened routine viral-load monitoring and wider access to integrase- or capsid-inhibitor-based regimens. Third, social and structural determinants (stigma, rural-to-urban migration, and uneven health-insurance portability) still impede consistent linkage and retention across the treatment cascade.

Innovation continues to outpace these challenges. Long-acting cabotegravir/rilpivirine is already reimbursed in four major provinces; the six-monthly lenacapavir PrEP pilot in Yunnan and Xinjiang will clarify population-level impact; and domestic research pipelines now include weekly oral NRTTIs, therapeutic vaccines, and CRISPR-based reservoir-editing strategies. If current funding trajectories and political commitments are sustained, China is on track to meet the 2025 intermediate targets of the National Action Plan: ≤ 2% mother-to-child transmission, ≤ 0.3% spousal transmission, and ≥90% public awareness, while laying the groundwork for the eventual elimination of HIV as a public-health threat by 2035.

References

  1. 1. Pei J, Wu Z, Si B, Ma C, Liu Y, Ma X, Kuai W, Zhang Y, Li Y. HIV-1 drug resistance and genetic transmission networks among patients with sexually transmitted HIV in Ningxia, China. Frontiers in Public Health. 2025;12:1485516
  2. 2. Zhang F, Zhu S, Tang H, Zhao D, Zhang X, Zhao G, Zhang X, Li T, Ruan L, Zhu W. Ambient particulate matter, a novel factor hindering life spans of HIV/AIDS patients: Evidence from a ten-year cohort study in Hubei, China. Science of the Total Environment. 2023;875:162589
  3. 3. Cao X, Cao J, Qi H, Yu W, Zeng Z, Peng Y, Wang M.Prevalence of primary drug resistance among newly diagnosed HIV-1-infected individuals in Hunan Province, China. AIDS Research and Human Retroviruses. 2023;39(8):422–428
  4. 4. Zhou J, Ni Y, Chen X, Ma Y, Ni M.Incidence and influencing factors of HIV infection among injection drug users in Xinjiang. Chinese Journal of Public Health. 2018;34(12):1587–1591
  5. 5. Kuang J, Dong S, Ma BL, Li J.Late detection of new HIV/AIDS cases in Qinghai Province from 2017-2022 and its influencing factors. Chinese Journal of Disease Control & Prevention. 2024;28(12):1414–1419
  6. 6. Diao J, Huang Q, Fang B, Zhou C, Ou Y, Chen L, Jiang H.Analysis of people newly diagnosed with HIV and intervention measures in Chongqing. Scientific Reports. 2025;15(1):10823
  7. 7. Sun X, Yang W, Tang S, Shen M, Wang T, Zhu Q, Shen Z, Tang S, Chen H, Ruan Y, Xiao Y.Declining trend in HIV new infections in Guangxi, China: Insights from linking reported HIV/AIDS cases with CD4-at-diagnosis data. BMC Public Health. 2020;20(1):919
  8. 8. Zhang M, Ma Y, Wang Z, Wang G, Wang Q, Li X, Lin F, Zhang C.Prevalence and transmission of pretreatment drug resistance in people living with HIV-1 in Shanghai, China, 2017-2021. Virulence. 2024;15(1):2373105
  9. 9. Chen Y, Cheng W, Yang J, Jiang J, Chen L, Pan X, Chai C, Jiang J. Characteristics and factors associated with initial antiretroviral medicine use among newly treated HIV/AIDS patients in Zhejiang Province, Eastern China: A cross-sectional study. Preventive Medicine Reports. 2025;55:103114
  10. 10. Yu D, Zhu K, Li M, Zhang F, Yang Y, Lu C, Zhong S, Qin C, Lan Y, Yu J, Petersen JD, Jiang J, Liang H, Ye L, Liang B. The origin, dissemination, and molecular networks of HIV-1 CRF65_cpx strain in Hainan Island, China. BMC Infectious Diseases. 2024;24(1):269
  11. 11. Yang S, Chiu APY, Lin Q, Zeng Z, Li Y, Zhang Y, Yang Z, Yang L, He D. HIV epidemics in Shenzhen and Chongqing, China. PLoS One. 2018;13(2)
  12. 12. Zhou Y, Chen Y, Lu J, Zhang Z, Sun Q, Liu X, Xu X, Ya X, Hu H. Sustained high HIV incidence among men who have sex with men in Jiangsu Province, China: Based on the limiting-antigen avidity EIA method and six consecutive surveys, 2016-2021. Frontiers in Public Health. 2023;11:1277570
  13. 13. Ma G, Chen H, Chen J, Jiang Z, Ma T. HIV transmission between spouses living in Lu’an City, Anhui Province, China: A longitudinal study. Epidemiology and Infection. 2019;147:e205
  14. 14. Lin MW, Pei YX, Chen QF, Liu R, Sun C, Dou ZH.A retrospective cohort study of case fatality rate of HIV/AIDS cases and influencing factors in Jingzhou, Hubei Province, 1996-2021. Chinese Journal of Epidemiology. 2023;44(9):1369–1375
  15. 15. Zhang YQ, Li QH, Li EL, Wang YR, Tang ZY, Gao X, Lu RR, Liu SY, Chen XH, Wang FX, Wang JY.Identification of a novel HIV-1 second-generation circulating recombinant form (CRF136_0107) among MSM in China. AIDS. 2023;37(8):F19–23
  16. 16. Liang Y, Xu YK, Fan PY, Nie YG, Geng J, Shi JC, Zhang GL, Zhao DY.Spatial-temporal distribution of newly reported HIV/AIDS cases in Henan Province, 1995-2020. Chinese Journal of Epidemiology. 2024;45(12):1685–1692
  17. 17. Liu Y, Ma X, Pei J, Yang D, Li Y, Zhu X, Wu Z. Epidemiological and spatial analysis of newly diagnosed HIV-1/AIDS patients before antiretroviral therapy in Ningxia from 2020 to 2021. PLoS One. 2025;20(4)
  18. 18. Zhang Z, Song L, Xiao M, Wang X, Chen H, Jin X, Li X, Fu L, Niu J, Luo H.Surveillance for human immunodeficiency virus infection in population at high risk for acquired immune deficiency syndrome in Yunnan, 2017-2022. Dis Surveill. 2023;38(11):1330
  19. 19. Wang Z, Wang D, Lin L, Qiu Y, Zhang C, Xie M, Lu X, Lian Q, Yan P, Chen L, Feng Y, Xing H, Wang W, Wu S. Epidemiological characteristics of HIV transmission in southeastern China from 2015 to 2020 based on HIV molecular network. Frontiers in Public Health. 2023;11:1225883
  20. 20. Jin M, Yang Z, Li J, Liu X, Wu Z. Factors influencing survival status of HIV/AIDS after HAART in Huzhou City, Eastern China. Canadian Journal of Infectious Diseases and Medical Microbiology. 2022;2022:2787731
  21. 21. Yang H, Li Y, Xu M, Hu Y, Yuan F, Liu L, Li L, Yuan D, Ye L, Zhou C, Zhang Y, Su L, Liang S. The update of HIV-1 prevalence and incidence and spatio-temporal analyses of HIV recent infection among four sub-groups in Sichuan, China during surveillance period between 2016 and 2022. Infection and Drug Resistance. 2023;16:6535–6548
  22. 22. Hou Z, Jiang Y, Zhang L, Tu A, Liu T, Du X, Dai C, Xu Y, Qiao R, Tan J.Characterization and recombinant genotypes of HIV-1 in Gansu Province, China. AIDS Research and Human Retroviruses. 2021;37(12):946–953
  23. 23. Peng Q, Liu X, Tang X, Zhang Q, Zhao J, Zheng C, Zhao F, Zhou Y, Zhang L, Sun L, Zhang H, Jia X, Song Y, Cao T, Wang S, Rao M, Chen Z, Wang H, He Y.Low rate of pre-exposure prophylaxis and post-exposure prophylaxis uptake and high prevalence of transmitted drug resistance among newly diagnosed primary HIV infections in Shenzhen, China: A real-world retrospective study. Chinese Medical Journal. 2022;135(22):2730–2737
  24. 24. Li X, Zhao YB, Ren Q, Jia H, Chen T, Wu Q, Chang WH.Awareness, willingness, and status of using HIV pre-exposure prophylaxis among men who have sex with men in Shaanxi Province. Chinese Journal of Epidemiology. 2024;45(12):1679–1684
  25. 25. WHO. HIV and AIDS [fact sheet]. Geneva: World Health Organization; 2025 July 15. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids
  26. 26. Liu G, Zhang H, Zhu WB, Peng YQ, Ding R, Fan ML, Fan LQ, Li WN.HIV prevalence among 338,432 infertile individuals in Hunan, China, 2012-2018: A cross-sectional study. PLoS One. 2020;15(9):e0238564
  27. 27. He Y, Wu G, Tan T, Lu R, Zhang W, Zhou C.Recent and local HIV infections among newly diagnosed cases in two districts of Chongqing, China (2019-2021). AIDS and Behavior. 2025;29(1):228–234
  28. 28. WHO. HIV statistics, globally and by WHO region, 2024. Geneva: World Health Organization; 2025. Available from: https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/hiv-epi-fact-sheet-march-2025.pdf [Accessed 2025 Jun 30]
  29. 29. National HIV/AIDS and STD epidemic report for December 2024. Chinese Journal of AIDS & STD. 2025, 3 (31), 225
  30. 30. Qin K. Treating people living with HIV using highly active antiretroviral therapy. Journal of Infectious Diseases and Therapy. 2024;12:8
  31. 31. Hou YS, Jin YC, Cai C, Tang HL, Qin Q, Lyu F.Characteristics of the HIV/AIDS epidemic among people aged ≥ 50 years in China during 2018–2021. Biomedical and Environmental Sciences. 2024;37(4):399–405
  32. 32. Lv H, Wang J, Zhang Q, Chen W, Hou Z, Li D, Jing Y, Xing X, Zhang X, Qin J, Liu T, Yan X, Yuwen P, Li Y, Wu Z, Zhao K, Zhang N, Shao Y, Yang S, Ma L, Ren Y, Hu J, Zhang X, Wang Y, Li W, Zhang Y.National preoperative HIV prevalence in China: A retrospective analysis of 4,753,874 surgical patients. Scientific Reports. 2025;15(1):19712
  33. 33. Yang H, Li Y, He F, Yuan F, Liu L, Li L, Yuan D, Ye L, Zhou C, Zhang Y, Su L, Liang S. Demographic characteristics and hot-spot areas of recent infections among new HIV diagnoses in Sichuan, China, between 2018 and 2020. Infection and Drug Resistance. 2023;16:779–789
  34. 34. Liu Y, Ji W, Yin Y, Yang S, Yang S, Zhou C, Cai Y, Wang K, Peng Z, He D.An analysis on the trend of AIDS/HIV incidence in Chongqing and Shenzhen, China from 2005-2015 based on age-period-cohort model. Mathematical Biosciences and Engineering. 2021;18(5):6961–6977
  35. 35. Zheng Q, Wang J, Dong Y, Du X, Cao Y, Wang J, Shen Q, Liu B, Tang X, Li Y, Deng Y. Analysis of monitoring data of AIDS in Xinjiang from 2004 to 2015. Bull Dis Control Prev (China). 2017;1:34–38
  36. 36. Zhang D, Wu J, Zhang Y, Shen Y, Dai S, Wang X, Xing H, Lin J, Han J, Li J, Qin Y, Liu Y, Miao L, Su B, Li H, Li L.Genetic characterization of HIV-1 epidemic in Anhui Province, China. Virology Journal. 2020;17(1):17
  37. 37. Fan PF, Yang Q, Mao YR, Hu Q, Tang HL, Li J, Luo YL, Wang F, Zhan HQ, Zang SM.Follow-up of people living with HIV/AIDS by primary health care institutions in rural area of Jiangxi Province. Chinese Journal of Epidemiology. 2019;40(3):346–349
  38. 38. Wei Q, Zhao Y, Lv Y, Kang X, Pan S, Yao S, Wang L.High rate of HIV-1 drug resistance in antiretroviral therapy-failure patients in Liaoning Province, China. AIDS Research and Human Retroviruses. 2022;38(6):502–509
  39. 39. Ma N, Chen XH, Zhao Y, Kang X, Pan S, Yao WQ. HIV-1 molecular transmission network among sexually transmitted populations in Liaoning Province, China. Medicine (Baltimore). 2021;100(28)
  40. 40. Li Y, Liu QX, Luan RS, Yang Y, Wu T, Yang BH.Projecting the dynamic trends of human immunodeficiency virus/acquired immunodeficiency syndrome: Modeling the epidemic in Sichuan Province, China. Biomedical and Environmental Sciences. 2024;37(9):1003–1014
  41. 41. Li X, Tong Z, Zeng Q, Xu M, Shen B, Zhang W, Zhang Y, Wang W, Qin K.HAART treatment with free provided medications for people living with HIV in Huzhou, China: HAART treatment for PWLH in Huzhou. Journal of Clinical Virology Plus. 2024;4(4):10019
  42. 42. Li J, Zhang R, Lan G, Lin M, Tan S, Zhu Q, Chen H, Huang J, Ding D, Li C, Ruan Y, Wang N. The distribution and associated factors of HIV/AIDS among youths in Guangxi, China, from 2014 to 2021: Bayesian spatiotemporal analysis. JMIR Public Health and Surveillance. 2024;10:e53361
  43. 43. Shi HJ, Wang SN, Li X, Wu SS, Wu R, Yuan X, Wang JW, Sheng XY, Xu YY, Zhu ZP.Regional molecular transmission characteristics of newly reported HIV-infected students aged ≥18 years in Nanjing City from 2016 to 2022. Chinese Journal of Preventive Medicine. 2025;59(1):82–89
  44. 44. Chinese Association of STD & AIDS Prevention and Control; National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital. Expert consensus on the diagnosis and treatment of acute HIV infection. Chinese Journal of AIDS & STD. 2025;31(3):226–235
  45. 45. Shi C, Li X, Dai Y, Chen M, Mao L, Zhou X, Lei Y, Yuan W. Experiences, challenges, and needs of people living with HIV in Hunan Province, China: A qualitative study. Journal of Multidisciplinary Healthcare. 2025;18:1405–1421
  46. 46. Li Y, Yang J, Yang H, Li X, Kong R, Liu Bai B, Zhang Y, Li I. Characteristics of individuals attending HIV voluntary counseling and testing clinics in Inner Mongolia Autonomous Region. Preventive Medicine. 2025;37(4):356–360
  47. 47. Wang D, Zhou M, Wang P, Zhang J, Mi Y, Cheng F, Liu J. Treatment-naïve people living with HIV aged 50 years or older in Beijing, China, 2010-2020: Joinpoint regression model analysis of surveillance data. Journal of the International AIDS Society. 2023;26(12)
  48. 48. Zhang C, Lan Y, Li L, He R, Meng Y, Li J, Chen W. HIV-1 tropism in low-level viral load HIV-1 infections during HAART in Guangdong, China. Frontiers in Microbiology. 2023;14:1159763
  49. 49. Pang X, Ma J, He Q, Tang K, Huang J, Fang N, Xie H, Lan G, Liang S.Analysis of HIV transmission characteristics and intervention effects in Guangxi based on molecular networks. AIDS. 2025;39(6):719–727
  50. 50. Ma S, Chen Y, Lai X, Lan G, Ruan Y, Shen Z, Zhu Q, Tang S. Predicting the HIV/AIDS epidemic and measuring the effect of AIDS conquering project in Guangxi Zhuang Autonomous Region. PLoS One. 2022;17(7)
  51. 51. Jin X, Xiao D, Xu JJ, Smith MK, Xiu XF, Ding ZW, Cao NX, Bao YG.Factors affected HIV testing and HIV infection among internet-based self-testing MSM who never tested for HIV in Beijing, China. Biomedical and Environmental Sciences. 2020;33(10):775–779
  52. 52. Lu C, Zhu K, Zhang N, Li M, Zhong S, Qin C, Luo T, Zhang R, Zhang J, Ning Y, Liang H, Ye L, Liang B, Yu D.The origin and dissemination of HIV-1 subtype B on Hainan Island, South China, 2007-2024. BMC Infectious Diseases. 2025;25(1):310
  53. 53. China CDC Weekly. Vol. 7 No. 2. Beijing: Chinese Center for Disease Control and Prevention; 2025 Jan 10. Available from: https://weekly.chinacdc.cn/fileCCDCW/journal/img/cover/d9df0f22-0f49-4756-860c-ab236dcc66d6.pdf [Accessed 2025 June 30]
  54. 54. Li QH, Wang JY, Liu SY, Zhang YQ, Li EL, Wang YR, Zhang SL, Zhao WB, Liu SL, Chen XH, Wang FX. Young MSM changed temporal HIV-1 epidemic pattern in Heilongjiang Province, China. Frontiers in Microbiology. 2022;13:1028383
  55. 55. Wang JY, Zhang KG, Ruan JX, Chen W, Wang L.Shift in HIV/AIDS epidemic and factors associated with false positives for HIV testing: A retrospective study from 2013 to 2018 in Xi’an, China. Current HIV Research. 2020;18(3):219–226
  56. 56. Cao W, Yao Y, Wei W, Lin F, Lu J, Yuan Z.Survival time and related factors on HIV/AIDS patients in Guizhou Province from 1995 to 2018. Chinese Journal of Epidemiology. 2020;41(4):557
  57. 57. Lu X, Wang Y, Ma L, Liu M, Li Y, An N, Zhang X, Tang X, Li Q. Epidemic trend, genetic characteristics, and transmission networks of HIV-1 among treatment-naive men who have sex with men in Hebei Province, China. Frontiers in Microbiology. 2024;15:1405565
  58. 58. Guo Z, Xia Y, Chai C, Jiang J.Insights into the molecular network characteristics of major HIV-1 subtypes in developed Eastern China: A study based on comprehensive molecular surveillance data. Infection. 2025;53(3):905–920
  59. 59. State Council of China. National Plan for HIV/AIDS Prevention & Control (2024-2030). Beijing: State Council; 2024 December 12. Available from: https://www.gov.cn/zhengce/content/202412/content_6992032.htm [Accessed 2025–June–30]
  60. 60. Yu M, Wang J, Zhao J, Guo Y, Bai J, Liu Z, Gong H, Ning T, Zheng M, Hou J, Cui Z.Economic evaluation of the Comprehensive AIDS prevention and control program - Tianjin Municipality, China, 2011-2022. China CDC Wkly. 2023;5(48):1067–1072
  61. 61. Liu Y, Zhang Y, Xu X, Deng Z, Wang X, Yuan D, Xue Z, Zhang X.Preventing HIV epidemic in China: Policy evolution and coordination mechanisms in the past four decades. China CDC Wkly. 2023;5(48):1084–1091
  62. 62. Zhang C, Yan Y, Zhu X, Li L, Li Y, Wang G, He F, Song Y, Liu Y, Zhang N.Evaluating the spatial accessibility and spatial layout optimization of HIV/AIDS healthcare services in Shandong Province, China. Scientific Reports. 2024;14(1):11258
  63. 63. Zhong H, Wei F, Song Y, Chen H, Ni Z. Health-related quality of life and associated factors among people living with HIV/AIDS in Sichuan, China: A cross-sectional study. Frontiers in Public Health. 2023;11:1133657
  64. 64. Gao R, Li W, Xu J, Guo J, Wang R, Zhang S, Zheng X, Wang J.Characteristics of subtype and molecular transmission networks among newly diagnosed HIV-1 infections in patients residing in Taiyuan City, Shanxi Province, China, from 2021 to 2023. Viruses. 2024;16(7):1174
  65. 65. Zhao Q, Wang Y, Yang M, Li M, Zhao Z, Lu X, Shen B, Luan B, Zhao Y, Cao B, Yao L, Zhao B, Su Y, Chen T.Evaluating the effectiveness of measures to control the novel coronavirus disease 2019 in Jilin Province, China. BMC Infectious Diseases. 2021;21(1):245
  66. 66. Xie Y, Liu J, Lin K, Fu X, Yan Y, Xie Y, Tan Z, Liu Q, Li J, Wang L, Zhou Y, Ye C, Cen M, Xu L, Yan Y, Yang F, Yang Y, Li Y, Jiang H. The longitudinal change of depressive symptoms among people living with HIV in Guangdong Province, China: A network analysis. Journal of Affective Disorders. 2025;383:69–77
  67. 67. Wangmo D, Gan MZ, Dong AB, Yangjin B, Bazong T, Liu L, Liao LJ, Ruan YH, Shao YM, Feng Y, Xing H.Molecular characterization of HIV-1-circulating strains among pre-treatment patients in Tibet. Biomedical and Environmental Sciences. 2020;33(12):953–958
  68. 68. Zhang F, Wan Y, Tang H, Zhao D, Zhu S, Ruan L, Zhu W. Submicronic particulate matter (PM1), a “neglected killer” for HIV/AIDS patients in Hubei, China: Results from a cohort study from 2001 to 2020. Science of the Total Environment. 2023;905:167093
  69. 69. Zhen M, Zhao H, Ning T, Zhao F, Gong H, Lyu F, Yu M.Divergent transmission dynamics and drug resistance evolution of HIV-1 CRF01_AE and CRF07_BC in Tianjin, China (2013-2022). Virology Journal. 2025;22(1):137

Written By

Kefeng Qin

Submitted: 23 August 2025 Reviewed: 01 September 2025 Published: 09 February 2026

© 2026 The Author(s). Licensee IntechOpen. This content is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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