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With the widespread implementation of antiretroviral therapy in many countries, the HIV/AIDS epidemic has declined. However, little is known about the prevalence of adherence rate to Highly Active Antiretroviral Therapy (HAART) in patients with HIV infection in China. This is the first meta-analysis of cross-sectional studies of treatment adherence (≥ 95%) to HAART in Chinese patients. Both English (PubMed, PsycINFO, EMBASE, and Web of Science) and Chinese (WanFang, CNKI, and SinoMed) databases were systematically and independently searched by three investigators. Studies with adherence rate estimates of HAART were included. Adherence rate estimates of each eligible study were extracted and pooled using the random-effects model. A total of 40 studies conducted in China were eligible and analyzed. The mean rate of ≥ 95% adherence to HAART was 81.1% (95%CI: 75.1%–88.0%, I2 = 97.3%) at one week, 80.9% (95%CI: 74.7%–85.9%, I2 = 96.6%) at one month, and 68.3% (95%CI: 46.1%–84.4%, I2 = 97.1%) at 3 months or longer. Subgroup analyses revealed that samples with no gender predominance, low education level, middle economic region, rural area, older age (42.3 years), and recent publication (2013 or later) were correlated to higher HAART adherence. The average rate of HAART adherence was relatively high in China, which indicates effective HIV/AIDS policy, prevention and control measures. However, the HAART adherence rate decreased over the study time period. [ABSTRACT FROM AUTHOR]

A rapid increase in heterosexual transmission of HIV and a high prevalence of sexually transmitted infections (STIs) in China signals potential outbreaks of generalized epidemics. A large proportion of heterosexual transmission has been through commercial sex; thus, millions of female sex workers (FSWs) and their clients play a critical role in the country's HIV/STI epidemics. A number of prevention interventions targeting FSWs have been implemented in response to changes in policy toward HIV as well as growing epidemics. This study reviews existing HIV/STI prevention interventions studies targeting FSWs in China. A total of 25 studies (28 articles) were identified from English and Chinese journal databases. Most studies recruited FSWs from entertainment establishments and had small sample sizes of less than 400. A majority employed a simple pre-post design with an open cohort, none applied a randomized controlled trial, and only two studies had a quasi-experimental design. Venue-based knowledge education and condom promotion represented the typical intervention approach. Some adapted internationally validated programs such as Voluntary Counseling and Testing and 100% Condom Use Programs (CUP), but no scale-up data were reported. Significant intervention effects were reported in most studies, especially increases in HIV/STI-related knowledge and condom use rates. Of the nine studies reporting STI rates, the results were mixed; some even reported increased STIs despite higher condom use. We call for more HIV/STI interventions targeting FSWs in China, particularly, interventions with rigorous design and externally validated measures, and more diversity in intervention programs including biomedical and structural interventions as well as innovative intervention delivery. We also advocate that effective intervention programs be translated into sustainable policies and programs that could have an impact on China's HIV and STI epidemics. [ABSTRACT FROM AUTHOR]