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

摘要

China’s public health surveillance system for HIV was established in late 1980s and has evolved significantlyduring the past three decades. With the gradually changing mode of HIV transmission from sharing of intravenousinjecting equipment to sexual exposure and the rapid spread of HIV infection among Chinese homosexual men in recentyears, an efficient and comprehensive population-level surveillance system for describing epidemics trends and riskbehaviours associated with HIV acquisition are essential for effective public health interventions for HIV. The currentreview describes the overall strength of the Chinese HIV surveillance system and its structural weaknesses from a politicaland social perspective. The HIV surveillance system in China has undergone substantial revamping leading to acomprehensive, timely and efficient reporting system. However, large data gaps and lack of quality control and sharing ofinformation obstruct the full performance of the system. This is largely due to fragmented authoritarianism brought aboutby the underlying political structure. Social stigma and discrimination in health institutes are also key barriers for furtherimprovements of HIV diagnosis and surveillance in China.