Merli, M. Giovanna, Sara Hertog, Bo Wang, Jing Li
Working paper no. 2004-14
The Chinese population is believed to be in the early stages of an HIV/AIDS epidemic, and concerns are great that the epidemic may soon spread to the general population via heterosexual transmission. Using a bio-behavioral macrosimulation model driven by realistic input parameters from the Chinese Health and Family Life Survey (CHFLS), we evaluate the implications of China’s regime of sexual relations for the future course of HIV/AIDS in the world’s largest population. Our results illustrate the importance of accounting for prevailing patterns of sexual behavior in the Chinese population. They show that, under the prevailing regime of sexual relations, as measured by the CHFLS, the simulated adult HIV prevalence rate for 50-year projection horizons remains below one or two percent, depending on which sexual mixing scenarios we ascribe to. Alternative scenarios based on assumptions about changes in sexual norms and behaviors, consistent with the strong relationship between average income and risky sexual behavior observed in the CHFLS, produce much larger epidemics. In particular, a simulated rise in the demand for commercial sex in combination with bi-monthly contacts with prostitutes will produce an explosive epidemic, but could be prevented by means of an effective policy intervention promoting 100% condom use with prostitutes.