Jiang J R, Zhou Y B, Li H T, Gao Y Q, Zhang Y L, Luo S S, Kang C Y, Liu J M
Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health/Office for National Maternal and Child Health Statistics of China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Zhonghua Yi Xue Za Zhi. 2018 Nov 6;98(41):3360-3364. doi: 10.3760/cma.j.issn.0376-2491.2018.41.014.
To describe the spatial distribution characteristics of the HIV prevalence among pregnant women in mainland China in 2016, providing scientific evidence for the prevention of mother-to-child transmission of HIV. Data on pregnant women and those living with HIV in 2016 for all counties in mainland China is from the National Maternal & Child Health Statistics dataset. To obtain robust estimates, 2 964 counties were merged into 344 cities. Spatial autocorrelation analysis and trend analysis were performed based on the city-level dataset to detailedly describe the characteristics of the spatial distribution. A total of 14 879 082 pregnant women were included in the analysis, among whom 5 051 were diagnosed to be infected with HIV, giving an overall prevalence of 34.0 per 100 000 pregnant women. The prevalence was higher in the south than in the north, and decreased from the west (93.5/100 000) to the east(8.6/100 000 ), more specifically, the prevalence in the West region was 11 times as high as that in the East region(χ(trend)(2)=68.61, <0.01). Stratified analysis by provinces showed that there were 6 provinces whose prevalence was >50.0 per 100 000, and they (Yunnan, Xinjiang, Sichuan, Guangxi, Guizhou and Chongqing) were all located in the West Region; pregnant women in these provinces accounted for 21% of all pregnant women, but the HIV cases accounted for 76% of all cases diagnosed in mainland China. Stratified analysis by cities showed that there were 30 cities whose prevalence was >100.0 per 100 000, and 28 of these cities were also located in the western provinces above. Furthermore, the global Moran's (0.5, <0.01) indeed indicated a strong clustered distribution across mainland China; 2 hot spots were observed in the Midwest of Xinjiang, and Yunnan and its bordering areas (Sichuan, Guizhou, Guangxi and Chongqing), while 1 cold spot in the central and east China. The HIV prevalence in the hot spots (183.6/100 000) was 23 times as much as that in the cold spot (8.1/100 000). The overall HIV prevalence for pregnant women who lived in mainland China in 2016 (34.0/100 000) ranked at low-level worldwide, but varied markedly across the whole country with 2 high-prevalence-clustered areas: the Midwest of Xinjiang Uygur Autonomous Region, and Yunnan province along with its bordering areas, indicating comprehensive intervention strategies especially targeted to the areas with high HIV prevalence should be developed.
描述2016年中国大陆孕妇中艾滋病毒感染率的空间分布特征，为预防艾滋病毒母婴传播提供科学依据。中国大陆所有县2016年孕妇及艾滋病毒感染者的数据来自国家妇幼卫生统计数据集。为获得可靠估计，将2964个县合并为344个市。基于市级数据集进行空间自相关分析和趋势分析，以详细描述空间分布特征。分析共纳入14879082名孕妇，其中5051人被诊断感染艾滋病毒，孕妇艾滋病毒总体感染率为每10万人34.0例。南方感染率高于北方，且从西部（每10万人93.5例）向东部（每10万人8.6例）递减，具体而言，西部地区感染率是东部地区的11倍（χ趋势(2)=68.61，<0.01）。按省份分层分析显示，有6个省份感染率>每10万人50.0例，这些省份（云南、新疆、四川、广西、贵州和重庆）均位于西部地区；这些省份的孕妇占所有孕妇的21%，但艾滋病毒病例占中国大陆所有确诊病例的76%。按城市分层分析显示，有30个城市感染率>每10万人100.0例，其中28个城市也位于上述西部省份。此外，全局莫兰指数（I=0.5，P<0.01）确实表明中国大陆存在强烈的聚集分布；在新疆中西部以及云南及其周边地区（四川、贵州、广西和重庆）观察到2个热点，而在中部和东部地区有1个冷点。热点地区的艾滋病毒感染率（每10万人183.6例）是冷点地区（每10万人8.1例）的23倍。2016年中国大陆孕妇艾滋病毒总体感染率（每10万人34.0例）在全球处于低水平，但全国范围内差异显著，存在2个高感染率聚集区：新疆维吾尔自治区中西部以及云南省及其周边地区，表明应制定特别针对艾滋病毒高感染率地区的综合干预策略。
