Quantitatively monitoring AIDS policy implementation in China

BACKGROUND China has been scaling up its national AIDS programs since 2004. We tested a hypothesis that incrementally setting realistic quantitative targets for key indicators and monitoring performance would facilitate AIDS policy implementation in China. METHODS Core indicators monitoring the national AIDS program were developed, modified and used from 2007 through 2009. Targets of core indicators were set incrementally and monitored annually. Data were collected and reported from local counties in all 31 provinces of mainland China. Changes of core indicators from 2007 to 2009 were calculated and compared using Cochran-Armitage Trend tests. RESULTS The number of patients receiving free anti-retroviral treatment and methadone maintenance treatment increased from 41 777 to 81 739, from 97 554 to 241 975, respectively, between 2007 and 2009. The proportion of newly reported HIV/AIDS cases with a completed epidemiological investigation increased from 77.7% in 2007 to 91.1% in 2009 (P < 0.0001). The proportion of spouses of newly reported HIV/AIDS cases being tested for HIV increased from 24.7 to 63.4% (P < 0.001). Follow-up visits to people with HIV and AIDS increased from 32.8 and 34.0% in 2007 to 74.6 and 78.5% in 2009, respectively (both P < 0.0001). The proportion of CD4(+) cell count monitoring for people with HIV and AIDS increased from 45.3 and 10.1% in 2007 to 54.2 and 62.5% in 2009, respectively (both P < 0.001). Viral load monitoring for AIDS patients receiving anti-retroviral treatment increased from 9.1 to 48.5% (P < 0.001). CONCLUSIONS Setting targets for core indicators and monitoring performance has facilitated implementation of the national AIDS program in China.