Evolution of HIV/AIDS Epidemics in China

China is vast, diverse, complex, and dynamic, and its HIV epidemic reflects these features. The surge of political, economic, and social change that came after the founding of the People's Republic of China in 1949 set the stage, and the departure from isolationist policies and movement toward participation in the global economy in the 1970s opened the door. HIV came to China in an outbreak among people who inject drugs in the southwest region in the late 1980s and again in a major outbreak among former commercial plasma donors in the mid-1990s. Over the past 30 years, China's HIV epidemic has expanded to other key populations (e.g., commercial sex workers, men who have sex with men) and all regions. The count of 146 people diagnosed in 1989 has grown to an estimated 1.25 million people as we enter 2019. The epidemic has steadily grown and expanded and has evolved into two parallel epidemics, one heterosexual and the other among men who have sex with men. This chapter documents the evolution of China's HIV epidemics-their general features, epidemiology, and impact.