| ObjectiveAcquired Immune Deficiency Syndrome(AIDS) is an important infectious disease which poses a serious threat to human health. In 2014, million people died of HIV-related illness. By the end of 2014, approximately 36.9 million people living with HIV/AIDS. According to the World Health Organization(WHO) report on global AIDS control, China is one of the highest burden countries in the world. Correctly understanding of AIDS spatial distribution characteristics is of great significance for epidemiologists to detect and monitor public health disease patterns. The main objective of this study is to examine the spatial distribution and hotspots of the HIV/AIDS epidemic by spatial autocorrelation analysis, to reveal the spatial distribution characteristics of HIV/AIDS and the epidemic regularity, to analyze the incidence of AIDS and its possible influencing factors, and to provide a rational basis for the development of a regional policy of making AIDS prevention and control. MethodsWe obtained data for AIDS incidence rate and the cumulatively number of reported cases of HIV/AIDS in mainland China for the period 1985 to 2013. Population size and fourteen original demographic and socio-economic indicators, including economic status, transportation and healthcare services, etc., were collected so as, to create the comprehensive information database in our country. Spatial autocorrelation analysis, local autocorrelation analysis, principal component analysis, and geographical weighted regression(GWR) were conducted using Excel 2003, SPSS 21.0 and Arc GIS 10.2. Results1 The thematic map of the HIV/AIDS epidemicIn 2013, HIV/AIDS epidemic in China exhibits the tendency of aggregation distribution. In general, the regions with the most severe HIV/AIDS epidemics were concentrated in south-western China, while regions with a low prevalence were located in north-eastern China, north-central regions, and the western plateaus including Qinghai and Tibet.2 General spatial autocorrelationThere was a statistically significant positive spatial autocorrelation between the incidence rate of AIDS and the cumulatively number of reported cases of HIV/AIDS(IAIDS=0.075, IHIV/AIDS=0.203, P <0.05).3 Local spatial autocorrelationBased on the incidence rate of AIDS, the high-high clustered regions included Guangxi, Yunnan and Sichuan, which not only demonstrated a high incidence rate of AIDS but also were surrounded by provinces with high incidence rates of AIDS. Based on the cumulatively number of reported cases of HIV/AIDS, Guangxi and Yunnan were located in high-high regions. Henan was located in a high-low clustered region.4 Hotspot AnalysisSix hotspots were identified based on the incidence of AIDS, including the provinces of Guangxi, Sichuan, Yunnan, Guizhou, Hainan and Hunan, which were the key regions to prevent and control of HIV/AIDS. Eight coldspots, including Beijing, Tianjin, Hebei, Shanxi, Shandong, Jiangsu, Inner Mongolia and Liaoning were identified. Based on the cumulatively number of reported cases of HIV/AIDS, Chongqing, Guangxi, Sichuan, Yunnan, Guizhou, Hunan and Hainan were hotspots, while the province of Inner Mongolia was a coldspot.5 GWR modelGWR model showed that economy, transportation and health had different response to AIDS incidence in China. Economic status had a negative effect on the AIDS incidence rate in most provinces, and ranged from-1.190 to 0.123. Health care services was the other negative macroscopic-factor, and ranged from-1.652 to-0.006. Transportation was positive factors for AIDS incidence and the value ranged from 0.098 to 2.385. The coefficient of determination ranged from 0.012 to 0.271.Conclusion1 In 2013, HIV/AIDS epidemic situation in China exhibits the tendency of spatial aggregation. Hot spots are mainly distributed in the south of the country, cold spots mainly distributed in the northeast.2 In terms of spatial autocorrelation and spatial heterogeneity, GWR model is powerful in analyzing the association between the AIDS incidence rate and macroscopic-factor. Economy, transportation and health have different influence on AIDS incidence rate in China. |
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