Study on the identification of HIV/AIDS and its surveillance system in rural areas of central China

OBJECTIVE: To explore the effective strategies for human immunodeficiency virus (HIV) surveillance and identification in rural areas of central China. METHODS: In a selected rural prefecture area of central China an epidemiological investigation was conducted for all reported HIV/AIDS cases. A historical and analytic review was performed with particular interests in examining the HIV epidemic reporting and identification system. RESULTS: Among all 626 reported HIV-infected individuals in the selected prefecture 86.1% (539/626) of them were infected through commercial plasma donation or clinically operated blood transfusion. With respect to disease surveillance and identification in the area 52.2% (327/626) of all the cases were reported by hospitals or clinics. The number and proportion of HIV/AIDS cases identified or reported at county prefecture and provincial levels were 207 (33.1%) 303 (48.4%) and 116 (18.5%) respectively. The number and proportion of HIV/AIDS identified through specific epidemiological investigations and/or voluntary testing had been increased in recent years. In addition among HIV/AIDS cases that were clinically identified the proportion of those who were identified as outpatients had steadily increasedwith the highest proportion (59.3%) observed in 2004. CONCLUSIONS: In rural areas of central China where the major mode of HIV transmission was through commercial plasma donation or clinically operated blood transfusion hospitals and clinics seemed to have played and would continue to play important roles regarding HIV identification and surveillance. The role of institutions or settings at the prefecture level regarding HIV identification and surveillance should not be ignored.