The Role of Sexual Networks in the Chinese HIV Epidemic

Giovanna Merli, Duke University
James Moody, Duke University
S Joshua Mendelsohn, Duke University

China’s HIV prevalence is very low (740,000 estimated HIV infections corresponding to 0.05% of the adult population). We evaluate the contribution of China’s regime of sexual relations, the structure of sexual networks, and the attributes of key population groups to the spread of HIV, including the possibility that China’s present regime of sexual relations is such that an HIV epidemic cannot be sustained. We use data from the first survey of egocentric sexual networks ever conducted in China (Shanghai Sexual Networks Survey) to identify key attributes of the social organization of sexual partnering, in particular the sexual mixing of population groups identified by their age and education; and simulate networks which take into account observed mixing patterns by age, education and degree. We assess whether the structure of sexual networks (e.g. network connectivity) is compatible with an HIV epidemic. We find that network connectivity in Shanghai is highly constrained by patterns of mixing by age and education.