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Trends in HIV prevalence among men who have sex with men in China 2003-09: a systematic review and meta-analysis.

BACKGROUND
The year-by-year trend of HIV prevalence among men who have sex with men (MSM) in China is not well documented.


METHODS
Published studies on HIV prevalence among MSM in China were reviewed and grouped by year, region and age group. Meta-analysis was used to summarise the estimates of national and regional HIV prevalence rates and trends among MSM from 2003 to 2009. HIV prevalence among MSM in different age groups (<25 years old v. ≥25 years old) was also calculated.


RESULTS
Eighty-three publications were included in the meta-analysis. The pooled HIV prevalence among MSM in China increased from 0.6% (95% confidence interval (CI): 0.0-2.1%) in 2003 to 7.4% (95% CI: 5.7-9.2%) in 2009. A yearly increase of 1.1% (95% CI: 0.5-1.5%, P<0.001) in HIV prevalence was detected. The pooled regional HIV prevalence among MSM ranged from 2.3% (95% CI: 1.7-2.9%) in east China to 11.4% (95% CI: 9.2-13.6%) in south-west China. No difference was detected (χ(2)=0.5160, P=0.4726) between HIV prevalence in the <25-year-old age group (3.1%, 95% CI: 1.6-4.6%) and that in the ≥25-year-old age group (4.0%, 95% CI: 1.8-6.3%).


CONCLUSION
The HIV prevalence among MSM in China is high and climbing. Effective strategies are required to prevent the epidemic from continuing to spread.