Sexual Mixing in Shanghai: Are Heterosexual Contact Patterns Compatible With an HIV/AIDS Epidemic?


Journal Article

China's HIV prevalence is low, mainly concentrated among female sex workers (FSWs), their clients, men who have sex with men, and the stable partners of members of these high-risk groups. We evaluate the contribution to the spread of HIV of China's regime of heterosexual relations, of the structure of heterosexual networks, and of the attributes of key population groups with simulations driven by data from a cross-sectional survey of egocentric sexual networks of the general population of Shanghai and from a concurrent respondent-driven sample of FSWs. We find that the heterosexual network generated by our empirically calibrated simulations has low levels of partner change, strong constraints on partner selection by age and education, and a very small connected core, mainly comprising FSWs and their clients and characterized by a fragile transmission structure. This network has a small HIV epidemic potential but is compatible with the transmission of bacterial sexually transmitted infections (STIs), such as syphilis, which are less susceptible to structural breaks in transmission of infection. Our results suggest that policies that force commercial sex underground could have an adverse effect on the spread of HIV and other STIs.

Full Text

Duke Authors

Cited Authors

  • Merli, MG; Moody, J; Mendelsohn, J; Gauthier, R

Published Date

  • June 2015

Published In

Volume / Issue

  • 52 / 3

Start / End Page

  • 919 - 942

PubMed ID

  • 25904346

Pubmed Central ID

  • 25904346

Electronic International Standard Serial Number (EISSN)

  • 1533-7790

International Standard Serial Number (ISSN)

  • 0070-3370

Digital Object Identifier (DOI)

  • 10.1007/s13524-015-0383-4


  • eng