Describing the Chinese HIV Surveillance System and the Influences of Political Structures and Social Stigma

Zhang, Lei; Fung Chow, Eric Pui; Zhang, Jun; Jing, Jun; Wilson, David P

The hospital-based surveillance relies on PLHIV to attend hospital to be diagnosed and cases subsequently reported. Complementing this passive reporting, active surveillance for HIV was adopted in 1995 and further expanded in 2003 to include second generation behavioral surveillance in China according to WHO recommendations [24, 25] . While the existing hospital-based diagnosis system provides HIV diagnosis and treatment data, sentinel surveillance collects information on HIV prevalence, incidence and the risk behaviours of at-risk populations. In China, HIV sentinel surveillance is collaboratively supervised by the Chinese MOH and WHO. In 2000, surveillance pilot sites targeting IDU, FSW, male clients and the general female population were established in Fujian, Xinjiang, Guangxi, Shanxi, Yunnan and Sichuan. The approach utilised 21 surveillance points in these provinces and from every surveillance point 400 people are sampled twice each year to estimate the prevalence, incidence rate and risk behaviours of the targeted population [26] . The sampling and reporting for each round is completed within 4 weeks. In 2002, China issued "Standards for HIV Surveillance and HIV/AIDS" and "STD Comprehensive Surveillance Guideline" to provide guidelines to standardise the practice of HIV surveillance. In 2009, the number of sentinel sites in China increased to 1318, covering 14 at-risk population groups [2, 14, 27] . Since the establishment of the web-based HIV reporting system in 2004, sentinel surveillance data is integrated with disease information reported from hospitals. This approach established a comprehensive database for data collection, analysis and sharing and enables high-level comparison and integration of epidemiological and behavioural surveillance data [14] . This further allows the conduct of evaluation and forecasting activities for guiding the formulation of public health intervention strategies.