(P186-LB) Lessons Learnt from Trend Changes in Chinese Drug Users and their HIV/HCV Prevalence , 1999- 2021

Background: China has suffered from the re-emergence of illicit drugs since the 1990s, resulting in the high prevalence of HIV/ HCV infection. and therefore, implemented multiple interventions as the response, including the methadone maintenance treatment (MMT) program in 2006. This study aims to investigate the trend changes in the numbers of Chinese drug users and the HIV/HCV prevalence among them from 1999 to 2021.



Methods: This retrospective study used data released by China National Narcotics Control Commission and Chinese Center for Disease Prevention and Control. The joinpoint regression was used to analyze the trend in the number of drug users, measured by the annual percent change (APC), identifying the turning points between 1999 and 2021. The interrupted time-series analysis was applied to compare the changes in HIV/HCV-related indicators before and after the turning point.



Results: The population of Chinese drug users and heroin users both witnessed a fluctuant increase before 2007 and reached peaks around 2013 (drug users: APC = 16.18; heroin users: APC = 11.50, P < 0.05). Both populations, together with those on MMT, have since been constantly declining. The number of MMT participants dropped from over 2 million in 2013 to 73,000 in 2021. Setting 2013 as the mark for the decline after implementing MMT, significant changes were observed in the positive rate of HIV (0.34%, 95%CI: 0.15% to 0.53%, P < 0.05) and HCV (2.57%, 95%CI: 0.28% to 4.86%, P < 0.05) antibody among drugs users. The subgroup analysis showed an obvious change in the HIV-positive conversion of Chinses MMT participants before and after the decline (0.09%, 95%CI:0.06% to 0.12%, P < 0.05). No significant level changes were detected for all three indicators in the year 2013.



Conclusion: The year 2007 and 2013 marked the watersheds of China’s drug situation in the past two decades, when comprehensive interventions, including MMT, were officially launched and the overall decline of drug populations occurred, respectively. The decrease in HIV/HCV positive rates proved the effectiveness of interventions, especially before 2013. However, sustainable efforts are still needed for HIV/HCV control, considering the impact of the decline of this community and issues that arise from it.