Young MSM Population Is Changing HIV Epidemic Pattern in Northeast China: a Seven-year Cross-sectional Study

Background: Human immunodeficiency virus type 1 (HIV-1) epidemic in China is featured by geographical diversity of epidemic patterns. Understanding the characteristics of regional HIV epidemic allows carrying out targeted prevention and control measures. However, in some regions of Northeast China, current HIV-1 epidemic feature is largely unknown.Methods: Information of 1006 newly diagnosed HIV-1 infected participants were collected before antiretroviral therapy during 2010-2016 in Harbin city of Northeast China. HIV-1 genotype was identified based on the viral gag and env genes. Comparison analyses were made among different participant groups and sampling time periods to understand HIV-1 epidemic trend. Multivariable logistic regression was used to evaluate the factors associated with immune status of participants.Results: Homosexual contact among men who have sex with men (MSM) was the main transmission route and CRF01_AE was the most dominant HIV-1 genotype. Newly diagnosed cases were getting younger, which was mainly due to the continuous increase in the proportion of young cases (aged < 30 years) among CRF01_AE-infected individuals, especially the CRF01_AE-infected MSM. The proportion of cases with good immune status (CD4 count > 500 cells/μl) continued to increase, and younger in age, HIV-1 infection via homosexual contact among MSM and infection by non-CRF01_AE genotype were positive factors for the good immune outcome.Conclusions: Young MSM have become a new vulnerable group for HIV-1 transmission in Northeast China. This group is changing local HIV-1 epidemic pattern. Measures for preventing and controlling HIV-1 infection among this population are urgently needed in the future.