Notifiable sexually transmitted infections in China: Epidemiologic trends and spatial changing patterns

Sexually transmitted infections (STIs) have become one of the major public health threats to the sustainable development of human beings. Among all of the STIs in China, three are listed as the notifiable infectious diseases, i.e., gonorrhea, syphilis, and HIV/AIDS, which demand more attention. This study aims to detect, describe, and compare the spatial-temporal clustering of these notifiable STIs in China and to relate spatial analysis results to epidemiologic trends during the past decade. A descriptive epidemiology analysis and a spatial autocorrelation analysis (global and local) are adopted to study the epidemiologic trends and spatial changing patterns of STIs respectively. The results indicated that there were regional disparities and spatial clusters in the spatial distribution of notifiable STIs in China. However, the incidence rates of the three notifiable STIs displayed relatively different characteristics in epidemiologic trends and the agglomeration level. Overall, the Yangtze River Delta region, the southwestern border area, and some other border regions are the places demanding more attention. In the end, we propose a three-dimensional prevention and control strategy, which focuses on not only the most-at-risk populations, but also the most-at-risk areas and most-at-risk timings. Besides, some measures targeting more than one STI should also be formulated.