Abstract
BACKGROUND: AIDS, gonorrhoea, and syphilis are the most common sexually transmitted infections, causing a heavy burden in China and worldwide. We analysed the long-term spatial and temporal trends of AIDS, gonorrhoea, and syphilis in the Chinese mainland between 2006-22. METHODS: We extracted the data on incidence and mortality of AIDS, gonorrhoea, and syphilis from the annual surveillance reports of China Information System for Disease Control and Prevention between 2006-22, which was developed by the Chinese Centre for Disease Control and Prevention and contains all notifiable diseases data. We used locally weighted regression to draw the trend curve and joinpoint regression analysis to calculate the average annual percentage change. We used the Bayesian structured time series model to evaluate the seasonal trends of sexually transmitted infections by province and the Moran I statistic to analyse the spatial clustering of sexually transmitted infections, detecting hot spots, cold spots, and spatial outliers. RESULTS: The incidence and mortality of sexually transmitted infections in the Chinese mainland were on the rise, especially in the group aged 15-24 years and the elderly aged ≥60. The incidence of AIDS and gonorrhoea in males was higher than in females. The mortality of the elderly aged ≥60 increased rapidly. The incidence of gonorrhoea and syphilis had a seasonal distribution. The high incidence of gonorrhoea was concentrated from May-November, and syphilis was concentrated from March-August. Between 2006-22, there was a trend of spatial clustering in sexually transmitted infections, forming high-high clusters and low-low clusters with clear boundaries. CONCLUSIONS: Schools could incorporate sexual health education into compulsory courses and the government may consider incorporating sexually transmitted infections rapid testing into routine chronic disease management. The interventions are needed to prevent the incidence among high-risk populations before summer, and focus on the Southwest, East China, and West China, where the incidence and case-fatality rates were high.