Epidemiological characteristics and socioeconomic factors of sexually transmitted infections in China during 2002–2021
Open accessAbstract
Sexually transmitted infections (STIs), including HIV, gonorrhea, and syphilis, pose significant public health challenges globally. In China, rising STI incidences are associated with rapid urbanization and changing sexual behaviors. This study aims to analyze the trends and socioeconomic factors of these three STIs in China. Incidence data for HIV, gonorrhea, and syphilis from 31 provinces (2002–2021) were obtained from the China Hygiene and Health Statistics Yearbook . JoinPoint regression was used to assess trends, hotspot analysis to identify spatial clusters, global principal component analysis (GPCA) to reduce data dimensionality, and a panel fixed-effects model (FEM) to identify influential factors. The annual average percentage changes (AAPCs) in incidence were 20.68% for HIV, - 2.37% for gonorrhea, and 11.55% for syphilis. Hotspot analysis revealed persistent HIV clusters in western provinces, gonorrhea clusters in the eastern coastal and parts of central provinces, and expanding syphilis clusters from western and central provinces to the entire country. GPCA extracted three components, explaining 83% of the overall variance. PA1 includes factors such as nighttime light data (NLD) and population density (PD). PA2 includes passenger volume (PAX), the working-age population aged 15–64 (P 15-64 ) and the number of healthcare institutions (HCIs). PA3 encompasses GDP per capita (pGDP) and the sex ratio (SR). FEM analysis showed that socioeconomic factors had varying impacts on the three STIs. HIV was negatively associated with PA1 (β = - 1.049, P < 0.05) and positively associated with PA2 (β = 0.614, P < 0.001), and negatively associated with PA3 (β = - 0.721, P < 0.001). Gonorrhea was positively associated with PA1 (β = 16.005, P < 0.001) and PA2 had strong positive correlations in most regions, while PA3 was not significant nationally. Syphilis had a negative association with PA3 at the national level (β = - 5.517, P < 0.001). This study demonstrates temporal and spatial variations in STI epidemiology in China from 2002 to 2021, reflecting socioeconomic development disparities. The findings highlight the need for geographically and socioeconomically tailored interventions to improve STI control strategies.
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The highest disease burden in the economically developed eastern region may be attributable to internal migrants.
“The highest disease burden in the economically developed eastern region may be attributable to several factors [41]. First, as the country’s primary economic hub, the eastern region attracts many internal migrants.”
From prevalence of syphilis among pregnant women in China: a systematic review and meta-analysis (2026) · cites this paper as [41]
The Results section on spatiotemporal distribution reports high gonorrhea incidence in eastern coastal provinces, and the Discussion suggests that population mobility could contribute to higher STI incidence. It does not identify internal migrants as the reason for an eastern-region burden, or establish that the east has the highest overall STI burden. Page numbers are unavailable in our copy. (LLM, conf=0.84)
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- Authors
- Shu, J.-T., Jiang, T., Li, C.-Y., Zou, M.-Y., Zhou, X.-Y., Zhuang, X., Zhang, B., Jiang, Y.-H., & Qin, G.
- Affiliations
- Nantong University (CN)
- Corresponding author
- Zhang, Bin
- Jiang, Yin-Hua
- Qin, Gang
- Venue
- BMC Public Health
- Published
- 2025-07-02
- Volume
- 25
- Issue
- 1
- Pages
- 2194-2194
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC12218023
- OpenAlex
- W4411868123
- Cited by
- 5
- References
- 45
- Citations by year
- 2026: 3 · 2025: 2
- FWCI
- 7.01
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- 2023 Preventive Medicine Research Project of Jiangsu Commission of Health (Ym2023079)
- Ministry of Science and Technology of China (2022YFC2304901)
- Jiangsu Provincial Research Hospital (YJXYY202204-YSB09, YJXYY202204-YSA03)
- Science and Technology Project of Nantong City (MS22022086)
- Topics
- Social Sciences › General Social Sciences › HIV, TB, and STIs Epidemiology
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- sexually transmitted infections, HIV, gonorrhea, syphilis, STI incidence trends, socioeconomic factors, nighttime lights, population density, passenger volume, medical institutions, GDP per capita, sex ratio, spatial clustering, China, urbanization, sexual behavior, public health policy, sexually transmitted disease control
- MeSH terms
- Adolescent, Adult, China, Female, Gonorrhea, Humans, Male, Middle Aged, Sexually Transmitted Diseases, Socioeconomic Factors, Syphilis, HIV Infections, Incidence, Young Adult
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